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Efficacy of Chinese Medicine Acupoint Application Combined with Montelukast on Children with Perennial Allergic Rhinitis: A Randomized Controlled Trial

  • Acupuncture Research
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

To evaluate the efficacy of Chinese medicine acupoint application (CMAA) combined with Western medicine for perennial allergic rhinitis (PAR) in children.

Methods

In this prospective, parallel, randomized, placebo-controlled and single-blind trial from August to September, 2017, 180 children with PAR were randomly assigned to an integrative group (CMAA and Montelukast), CMAA group (CMAA and placebo tablet), or Montelukast group (placebo CMAA and Montelukast). Participants were applied with CMAA for 6 sessions over 2 weeks, and/or Montelukast Chewable Tablet orally once daily for 12 weeks. The changes in severity of symptoms were measured by Visual Analog Scale (VAS) and rhinitis control assessment test (RCAT) at 0, 2, 4 and 12 weeks of treatment. Blood samples were collected for serum interleukin-4, interferon gamma γ and T helper type 1 (Th1)/Th2 flow cytometric analysis at the time points of 0, 4 and 12 weeks.

Results

Eight cases dropped out from the trial, 3 in the integrative group, 2 in the CMAA group and 3 in the Montelukast group. The VAS scores decreased significantly while the RCAT scores increased significantly in all three groups at 4 and 12 weeks compared with baseline (P<0.01 or P<0.05). The VAS scores were significantly lower while the RCAT scores were significantly higher in the integrative and CMAA groups than the Montelukast group at 2 and 4 weeks (P<0.01 or P<0.05). At 2, 4 and 12 weeks, the scores of nasal congestion, sneezing, sleep problem, and rhinitis symptom control in the integrative and CMAA groups increased significantly compared with baseline (P<0.01 or P<0.05). The least percentages of Th2 and the most alleviated Th2 shift (highest Th1/Th2) were observed in the integrative group at 12 weeks compared with the other two groups (P<0.05).

Conclusion

The combination of CMAA with Montelukast might be more effective and appropriate than either option alone for children with PAR. (Registered at Chinese Clinical Trial Register, registration No. ChiCTR-IOR-17012434)

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References

  1. Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 2017;140:950–958.

    Article  Google Scholar 

  2. Wang XD, Zheng M, Lou H, Wang C, Zhang Y, Bo M, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011. Allergy 2016;71:1170–1180.

    Article  CAS  Google Scholar 

  3. Montoro J, Del Cuvillo A, Mullol J, Molina X, Bartra J, Davila I, et al. Validation of the modified allergic rhinitis and its impact on asthma (ARIA) severity classification in allergic rhinitis children: the PEDRIAL study. Allergy 2012;67:1437–1442.

    Article  CAS  Google Scholar 

  4. Magnan AO, Mely LG, Camilla CA, Badier MM, Montero-Julian FA, Guillot CM, et al. Assessment of the Th1/Th2 paradigm in whole blood in atopy and asthma: increased IFN-γ-producing CD8+ T cells in asthma. Am J Respir Crit Care Med 2000;161:1790–1796.

    Article  CAS  Google Scholar 

  5. Okubo K, Inoue Y, Numaguchi H, Tanaka K, Saito I, Oshima N, et al. Montelukast in the treatment of perennial allergic rhinitis in paediatric Japanese patients: an open-label clinical trial. J Drug Assess 2016;5:6–14.

    Article  Google Scholar 

  6. Yang SH, Yu CL. Antiinflammatory effects of Bu-zhong-yi-qitang in patients with perennial allergic rhinitis. J Ethnopharmacol 2008;115:104–109.

    Article  Google Scholar 

  7. Wu XQ, Peng J, Li GQ, Su HP, Liu GX, Liu BY. Association between skin reactions and efficacy of summer acupoint application treatment on chronic pulmonary disease: a prospective study. Chin J Integr Med 2016;22:284–292.

    Article  Google Scholar 

  8. Tai CJ, Chien LY. The treatment of allergies using Sanfujiu: a method of applying Chinese herbal medicine paste to acupoints on three peak summer days. Am J Chin Med 2004;32:967–976.

    Article  Google Scholar 

  9. Wang J, Xiong X. Current situation and perspectives of clinical study in integrative medicine in China. Evid Based Complement Alternat Med 2012;2012:268542.

    PubMed  PubMed Central  Google Scholar 

  10. Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet 2005;366:136–143.

    Article  CAS  Google Scholar 

  11. Kun W, Zhong LL, Dai L, Cheng CW, Lu AP, Bian ZX. Tian Jiu therapy for allergic rhinitis: study protocol for a randomized controlled trial. Trials 2016;17:248.

    Article  Google Scholar 

  12. Zhou F, Yan LJ, Yang GY, Liu JP. Acupoint herbal patching for allergic rhinitis: a systematic review and meta-analysis of randomised controlled trials. Clin Otolaryngol 2015;40:551–568.

    Article  CAS  Google Scholar 

  13. Shou Y, Hu L, Zhang C, Xu S, Jin Q, Huang L, et al. Efficacy of acupuncture at three nasal acupoints plus acupoint application for perennial allergic rhinitis: a multicenter, randomized controlled trial protocol. Trials 2020;21:110.

    Article  CAS  Google Scholar 

  14. Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Mechin H, Daures JP, et al. Visual Analog Scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy 2007;62:367–372.

    Article  CAS  Google Scholar 

  15. Meltzer EO, Schatz M, Nathan R, Garris C, Stanford RH, Kosinski M. Reliability, validity, and responsiveness of the Rhinitis Control Assessment Test in patients with rhinitis. J Allergy Clin Immunol 2013;131:379–386.

    Article  Google Scholar 

  16. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008;12:1–23.

    Google Scholar 

  17. Liu Q, Liu J, Liu D. Clinical research into Ke Min Yin for treatment of persistent allergic rhinitis in patients with qi deficiency and blood stasis. J Tradit Chin Med 2003;23:106–108.

    PubMed  Google Scholar 

  18. Ortiz M, Witt CM, Binting S, Helmreich C, Hummelsberger J, Pfab F, et al. A randomised multicentre trial of acupuncture in patients with seasonal allergic rhinitis-trial intervention including physician and treatment characteristics. BMC Complement Altern Med 2014;14:128.

    Article  Google Scholar 

  19. Peng J, Wu X, Hu J, Fang Y, Zi M, Liu B. Influencing factors on efficacy of summer acupoint application treatment for allergic rhinitis: a retrospective study. J Tradit Chin Med 2012;32:377–381.

    Article  CAS  Google Scholar 

  20. Yang J, Xu H. External application of herbal medicine to acupoints. J Tradit Chin Med 2008;28:21–24.

    Article  CAS  Google Scholar 

  21. Chen S, Guo SN, Marmori F, Wang J, Bai P, Zhang JJ, et al. Clinical practice guideline for allergic rhinitis treatment with acupuncture [published online ahead of print]. Chin J Integr Med 2020. doi:https://doi.org/10.1007/s11655-020-3161-0.

    Google Scholar 

  22. Lagos JA, Marshall GD. Montelukast in the management of allergic rhinitis. Ther Clin Risk Manag 2007;3:327–332.

    Article  CAS  Google Scholar 

  23. Yilmaz O, Altintas D, Rondon C, Cingi C, Oghan F. Effectiveness of montelukast in pediatric patients with allergic rhinitis. Int J Pediatr Otorhinolaryngol 2013;77:1922–1924.

    Article  Google Scholar 

  24. Storms W. Update on montelukast and its role in the treatment of asthma, allergic rhinitis and exercise-induced bronchoconstriction. Expert Opin Pharmacother 2007;8:2173–2187.

    Article  CAS  Google Scholar 

  25. Chowdhury M, Uddin M, Das S, Hoque M. Montelukast in allergic rhinitis: a review. Med Today 2012;24:75–78.

    Article  Google Scholar 

  26. Smart J, Tang M, Kemp A. Polyclonal and allergen-induced cytokine responses in children with elevated immunoglobulin E but no atopic disease. Clin Exp Allergy 2002;32:1552–1557.

    Article  CAS  Google Scholar 

  27. Jayasekera NP, Toma TP, Williams A, Rajakulasingam K. Mechanisms of immunotherapy in allergic rhinitis. Biomed Pharmacother 2007;61:29–33.

    Article  CAS  Google Scholar 

  28. Eifan A, Durham S. Pathogenesis of rhinitis. Clin Exp Allergy 2016;46:1139–1151.

    Article  CAS  Google Scholar 

  29. Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF, Nicklas RA, et al. Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 2006;118:S17–S61.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China

    You-jin Li & Xiao-qing Rui

  2. Department of Clinical Laboratory, Shanghai East Hospital, School of Medicine, Tong Ji University, Shanghai, 200120, China

    Ming Zong

  3. Department of Chinese Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China

    Li-feng Ding

  4. Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China

    Bei-yin Ma

  5. Department of Chinese Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200090, China

    Li-ping Qin

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  1. You-jin Li
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  2. Ming Zong
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  3. Li-feng Ding
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Corresponding author

Correspondence to Li-ping Qin.

Additional information

Supported by the Medicine Leading Science and Technology Project of Shanghai Municipal Science and Technology Commission (No. 15401933800)

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Li, Yj., Zong, M., Ding, Lf. et al. Efficacy of Chinese Medicine Acupoint Application Combined with Montelukast on Children with Perennial Allergic Rhinitis: A Randomized Controlled Trial. Chin. J. Integr. Med. 26, 845–852 (2020). https://doi.org/10.1007/s11655-020-3099-2

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  • DOI: https://doi.org/10.1007/s11655-020-3099-2

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