Treatment of Allergic Rhinitis with Acupuncture Based on Pathophysiological

Allergic rhinitis is one of the most common allergic diseases in the world, affecting between 10% and 25% of the global population, which represents more than 500 million people. This inflammatory condition of the upper airways causes symptoms such as paroxysmal sneezing, rhinorrhea, nasal itching, and nasal obstruction, significantly impacting patients' quality of life. In addition to nasal symptoms, allergic rhinitis is frequently associated with sleep disturbances, emotional difficulties, reduced work capacity, and other complications such as asthma, sinusitis, and conjunctivitis. The economic impact is also considerable, with annual costs estimated at approximately 20 billion dollars worldwide.

This study aimed to analyze current knowledge on acupuncture and allergic rhinitis, evaluating the available scientific evidence regarding the efficacy and safety of acupuncture in the treatment of this condition. The researchers conducted a comprehensive narrative review, examining randomized clinical trials and meta-analyses published between 2013 and 2023. The methodology involved the analysis of multiple studies that compared acupuncture with sham acupuncture, conventional medications, or no treatment. The studies evaluated used different measurement scales, including total nasal symptom scores, quality of life questionnaires related to rhinoconjunctivitis, and visual analog scales to measure symptom intensity.

The results consistently demonstrated that acupuncture provides significant benefits in the treatment of allergic rhinitis. Compared with sham acupuncture, true acupuncture showed a statistically significant reduction in nasal symptom scores and improvement in patients' quality of life. Specific studies revealed that acupuncture can reduce levels of mite-specific immunoglobulin E, decrease the release of substance P (a proinflammatory neuropeptide), and modulate several inflammatory markers such as interleukins and cytokines. In addition, acupuncture demonstrated the ability to regulate the balance between type 1 and type 2 helper T cells, which is fundamental in the allergic immune response.

The benefits extended beyond nasal symptoms, including improvement in ocular symptoms, sleep disturbances, and a reduction in the need for rescue medications.

For patients and healthcare professionals, these findings represent an important therapeutic alternative. Acupuncture offers significant advantages in terms of safety, with rare adverse effects reported, in contrast to the potential side effects of conventional medications such as intranasal corticosteroids and antihistamines. The studies indicated that acupuncture can be used as a single treatment or in combination with conventional therapies, providing long-lasting symptomatic relief. Particularly interesting was the finding that preventive acupuncture, applied weeks before the pollen season, can significantly reduce the incidence and severity of seasonal allergic rhinitis episodes.

For healthcare professionals, acupuncture represents a valuable complementary tool, especially for patients who do not respond adequately to conventional treatments or who experience significant adverse effects with medications.

However, the study also identified important limitations that should be considered. Many of the clinical trials analyzed presented relatively small sample sizes, which may limit the generalizability of the results. Heterogeneity in acupuncture protocols, including different points used, frequency, and duration of treatments, makes it difficult to establish ideal standardized protocols. In addition, some studies had short follow-up periods, not allowing adequate evaluation of the long-term effects of acupuncture.

The methodological quality of some trials was considered moderate, highlighting the need for more rigorous studies with improved experimental designs.

In conclusion, current scientific evidence supports the use of acupuncture as an effective and safe therapeutic option for the treatment of allergic rhinitis. The mechanisms of action involve modulation of the immune response, reduction of local inflammation, and regulation of neurochemical mediators. Although additional larger-scale studies of superior methodological quality are needed to consolidate these findings, acupuncture has already demonstrated sufficient potential to be considered a valuable alternative in the management of allergic rhinitis. For patients seeking treatment options with a lower risk of adverse effects and for those who have not been successful with conventional therapies, acupuncture represents a promising therapeutic possibility that deserves consideration from both patients and healthcare professionals specialized in the treatment of allergic diseases.