ND Center for Nursing



Evidence Based PracticeCritical Appraisal Topic (CAT)Acupuncture for Allergic RhinitisDate: May 24, 2015Appraised by: Jennifer Vandal, BSN, RN, FNP-SClinical Scenario: Active acupuncture has shown to be an effective treatment for patients with allergic rhinitis. Ms. A is a 20 year old female that has come to clinic with sneezing, itchy eyes, runny nose, wheezing, shortness of breath, and "allergies." She states she was diagnosed with allergic rhinitis in the past and has used over the counter medications to help decrease her symptoms. This has now stopped working and she is looking into other treatment for allergic rhinitis. She has heard about acupuncture therapy as a treatment and is willing to try to see if it helps decrease her symptoms of allergic rhinitis. PICO Question: Do patients with allergic rhinitis who receive active acupuncture therapy have a lower total nasal symptom score compared to patients who do not receive active acupuncture therapy?Summary and Appraisal of Key Evidence:1. In the study by Choi, Park, Li, Jung, Zi, Kim, . . ., & Baoyan (2012), 238 participants were split up into three different groups: 97 received active acupuncture treatment, 94 received sham acupuncture and 47 did not received any treatment. The study was completed over a 4 week period and the participants received active acupuncture treatments three times a week. After the study was completed the participants who received active acupuncture had a significantly reduced total nasal symptom score compared to those who did not receive active acupuncture treatment.Strengths and opportunities of this study were that there was a high number of participants and results showed that those who have received active acupuncture treatment had a significantly reduced total nasal symptom score compared to those who did not receive this treatment. Weaknesses of this study were that it did not state if all participants received the treatment at the same time each day and that could skew the overall results. Threats to this study included those who were picked to not receive treatment may have increased symptoms from allergic rhinitis and could not receive treatment until the study was completed. 2. In the article by Witt & Brinkhaus (2010), 30 participants were randomly split up into two groups and treated with active acupuncture or sham acupuncture. This study was over a 4 week period and participants received acupuncture three times a week. By the end of the study only 26 participants completed it. The results showed that the total nasal symptom score was significantly reduced when using active acupuncture compared to those who did not. Strengths and opportunities of this study were that the study had a relative number of participants that were separated evenly and showed that those who received the treatment had a significantly reduced total nasal symptom score compared to those that did not receive treatment. Weaknesses of this study were that not everyone finished the study and that could skew the results of the overall study. Threats to this study included those trained to do the acupuncture on the participants may not all insert the needles at the same length on each participants. This could skew the results and may harm the participants of the study. Clinical Bottom Line: Based on these two research studies presented, patients who received active acupuncture therapy for allergic rhinitis showed a lower total nasal symptom score compared to patients that did not receive it. The strengths of these studies included that both studies showed a high level of evidence based research with utilizing diagnostic tools, randomization, limited bias, and statistical analysis. The weakness of these studies is that there was not many current studies to support the evidence. In conclusion, active acupuncture can be recommended in primary care as a complementary and an alternative therapy for allergic rhinitis. ReferencesChoi, S., Park, J., Li, S., Jung, H., Zi, M., Kim, T., . . . Baoyan, L. (2012). A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy, 68(3), 365-374. doi:10.1111/all.12053Witt, C., & Brinkhaus, B. (2010). Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis — An overview about previous and ongoing studies. Autonomic Neuroscience, 157(1), 42-45. Retrieved May 24, 2015, from ................
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