Complementary and Alternative Therapy (CAM) in the Treatment of Allergic Rhinitis

Part of the following topical collections:
  1. Topical Collection on Rhinitis


CAM is any therapeutic intervention that exists outside traditional allopathic medicine. The utilization in the US population is increasing up to 4 out of 10 patients in some surveys [1]. Given this increasing prevalence, it is essential that clinicians have the resources to advise their patients in the utilizations, benefits, and potential harms of these alternative therapies. Recent literature was reviewed in regard to traditional Chinese medicine [TCM], acupuncture, homeopathy, and herbal therapy in the treatment of allergic rhinitis limited to randomized controlled trials. Several complementary treatment studies demonstrated statistically significant benefits to patients’ quality of life and symptom scoring without providing duration of effect. Alternative therapy studies have revealed mixed results in regard to efficacy. Although the adverse effect profile is low, additional studies will be required to further promote integration into the standard of care for the routine treatment of allergic rhinitis.


Allergic rhinitis Complementary treatment Herbal treatment Traditional Chinese medicine Acupuncture Homeopathy 


Compliance with Ethics Guidelines

Conflict of Interest

John Kern and Leonard Bielroy declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Barnes PM, et al. "Complementary and alternative medicine use among adults and children: United States, 2007." Natl Health Stat Report. 2008;(12): 1–23.Google Scholar
  2. 2.
    Chang C, Gershwin ME. Integrative medicine in allergy and immunology. Clin Rev Allergy Immunol. 2013;44(3):208–28.PubMedCrossRefGoogle Scholar
  3. 3.
    Wang S et al. Meta-analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis. Allergy. 2012;67(5):583–92.PubMedCrossRefGoogle Scholar
  4. 4.
    Yang SH et al. Traditional Chinese medicine, Xin-yi-san, reduces nasal symptoms of patients with perennial allergic rhinitis by its diverse immunomodulatory effects. Int Immunopharmacol. 2010;10(8):951–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Chui SH et al. A panel study to evaluate quality of life assessments in patients suffering from allergic rhinitis after treatment with a Chinese herbal nasal drop. Phytother Res. 2010;24(4):609–13.PubMedGoogle Scholar
  6. 6.
    Lenon GB et al. Lack of efficacy of a herbal preparation (RCM-102) for seasonal allergic rhinitis: a double blind, randomised, placebo-controlled trial. Asia Pac Allergy. 2012;2(3):187–94.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Cao WZ et al. Allergic rhinitis treated with acupuncture and the triple-strong stimulation therapy at dazhui (GV 14): a randomized controlled trial. Zhongguo Zhen Jiu. 2014;34(2):110–4.PubMedGoogle Scholar
  8. 8.
    Wang H et al. Effect of penetrating needling at head acupoints on perennial allergic rhinitis. Zhongguo Zhen Jiu. 2013;33(9):789–92.PubMedGoogle Scholar
  9. 9.••
    Brinkhaus B et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med. 2013;158(4):225–34. Large trial with well organized evaluation of efficacy. PubMedCrossRefGoogle Scholar
  10. 10.•
    Choi SM et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365–74. Multicenter trial demonstrating patient reported improvement with both sham and true acupuncture. PubMedCrossRefGoogle Scholar
  11. 11.
    Xue CC et al. Semi-self-administered ear acupressure for persistent allergic rhinitis: a randomised sham-controlled trial. Ann Allergy Asthma Immunol. 2011;106(2):168–70.PubMedCrossRefGoogle Scholar
  12. 12.
    Fleckenstein J et al. Impact of acupuncture on vasomotor rhinitis: a randomized placebo-controlled pilot study. J Altern Complement Med. 2009;15(4):391–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Magnusson AL et al. The effect of acupuncture on allergic rhinitis: a randomized controlled clinical trial. Am J Chin Med. 2004;32(1):105–15.PubMedCrossRefGoogle Scholar
  14. 14.••
    Brinkhaus B et al. Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Ann Allergy Asthma Immunol. 2008;101(5):535–43. Demonstrated evaluation of acupuncture in the setting of continued medical therapy and show a reduction in medication use. PubMedCrossRefGoogle Scholar
  15. 15.
    Lee MS et al. Acupuncture for allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol. 2009;102(4):269–79. quiz 279–281, 307.PubMedCrossRefGoogle Scholar
  16. 16.
    Reinhold T et al. Cost-effectiveness for acupuncture in seasonal allergic rhinitis: economic results of the ACUSAR trial. Ann Allergy Asthma Immunol. 2013;111(1):56–63.PubMedCrossRefGoogle Scholar
  17. 17.
    White A et al. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ. 2001;323(7311):485–6.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Wheway J et al. Patient safety incidents from acupuncture treatments: a review of reports to the National Patient Safety Agency. Int J Risk Saf Med. 2012;24(3):163–9.PubMedGoogle Scholar
  19. 19.
    Xia Z, Xu L. Acupuncture at agger nasi for treatment of allergic rhinitis. J Tradit Chin Med. 1997;17(4):278–9.PubMedGoogle Scholar
  20. 20.
    Taylor MA et al. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. BMJ. 2000;321(7259):471–6.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Aabel S et al. Is homeopathic 'immunotherapy' effective? A double-blind, placebo-controlled trial with the isopathic remedy Betula 30c for patients with birch pollen allergy. Br Homeopath J. 2000;89(4):161–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Goossens M et al. Evaluation of the quality of life after individualized homeopathic treatment for seasonal allergic rhinitis. A prospective, open, non-comparative study. Homeopathy. 2009;98(1):11–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Friese KH, Zabalotnyi DI. Homeopathy in acute rhinosinusitis: a double-blind, placebo controlled study shows the efficiency and tolerability of a homeopathic combination remedy. HNO. 2007;55(4):271–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Kim LS et al. Treatment of seasonal allergic rhinitis using homeopathic preparation of common allergens in the southwest region of the US: a randomized, controlled clinical trial. Ann Pharmacother. 2005;39(4):617–24.PubMedCrossRefGoogle Scholar
  25. 25.
    Weiser M et al. A randomized equivalence trial comparing the efficacy and safety of Luffa comp.-Heel nasal spray with cromolyn sodium spray in the treatment of seasonal allergic rhinitis. Forsch Komplementarmed. 1999;6(3):142–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Passalacqua G et al. ARIA update: I—systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol. 2006;117(5):1054–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Schapowal, A. and G. Petasites Study. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324(7330):144–6.CrossRefGoogle Scholar
  28. 28.
    Schapowal, A. and G. Petasites Study. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Arch Otolaryngol Head Neck Surg. 2004;130(12):1381–6.CrossRefGoogle Scholar
  29. 29.
    Schapowal, A. and G. Study. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze339. Phytother Res. 2005;19(6):530–7.CrossRefGoogle Scholar
  30. 30.
    Lee DK et al. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Clin Exp Allergy. 2003;33(7):882–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Gray RD et al. Effects of butterbur treatment in intermittent allergic rhinitis: a placebo-controlled evaluation. Ann Allergy Asthma Immunol. 2004;93(1):56–60.PubMedCrossRefGoogle Scholar
  32. 32.
    Saxena VS et al. Multicenter clinical trials on a novel polyherbal formulation in allergic rhinitis. Int J Clin Pharmacol Res. 2004;24(2–3):79–94.PubMedGoogle Scholar
  33. 33.
    Vyjayanthi G, Shetty S, Saxena VS, et al. Randomized, double-blind, placebo-controlled trial of Aller-7 in patients with allergic rhinitis. Res Commun Pharmacol Toxicol. 2003;8:15–24.Google Scholar
  34. 34.••
    Guo R et al. Herbal medicines for the treatment of allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol. 2007;99(6):483–95. Large review of common herbal therapy for allergic rhinitis. PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Rutgers University–New Jersey Medical SchoolNewarkUSA
  2. 2.Robert Wood Johnson University HospitalRutgers UniversityNew BrunswickUSA

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