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Yu ping feng san for pediatric allergic rhinitis: A systematic review and meta-analysis of randomized controlled
Yong Liao1,2, Juan Zhong3,4, Shuqin Liu3
1Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu.
Insights
Yu ping feng san (YPFS) does not show significant benefits for pediatric allergic rhinitis (PAR) based on current evidence. While YPFS appears safer with lower recurrence rates than Western medicine, study limitations necessitate further rigorous research.
Area of Science:
- Integrative Medicine
- Pediatric Allergy
- Evidence-Based Medicine
Background:
- Systematic evaluation of Yu ping feng san (YPFS) for pediatric allergic rhinitis (PAR) is lacking.
- Understanding the treatment effects and safety profile of YPFS in pediatric populations is crucial.
Purpose of the Study:
- To systematically assess the efficacy and safety of Yu ping feng san (YPFS) in treating pediatric allergic rhinitis (PAR).
Main Methods:
- A comprehensive literature search was conducted across multiple databases up to November 1, 2019.
- Included randomized controlled trials (RCTs) were assessed for risk of bias, and meta-analysis was performed using RevMan 5.3.
- The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate evidence quality.
Main Results:
- Ten RCTs with 1069 participants (aged 3-15 years) were identified; 8 were included in the efficacy analysis.
- No significant overall efficacy benefit was found for YPFS compared to control groups (RR 0.32, P=0.98).
- YPFS demonstrated relatively better safety (RR 0.29, P=0.0005) and lower recurrence rates than Western medical therapy.
Conclusions:
- Current evidence is insufficient to support the routine use of YPFS for PAR due to poor study design and methodological limitations.
- While YPFS appears safer, further large-scale, rigorously designed studies are required to confirm its utility in treating pediatric allergic rhinitis.
Background:
The potential treatment effects and safety of Yu ping feng san (YPFS) for pediatric allergic rhinitis (PAR) patients have yet to be studied systematically.
Objectives:
To assess the effects and safety of YPFS for treat pediatric patients, allergic rhinitis.
Methods:
We systematically searched PubMed, EMBASE (Excerpta Medical Database), Cochrane library, Chinese Cochrane Centre's Controlled Trials Register platform, Wanfang Chinese Digital Periodical and Conference Database, China National Knowledge Infrastructure Database, and VIP Chinese Science, from inception dates to November 1, 2019. Randomized controlled trials (RCTs) were included. The risk of bias in the trials was assessed in accordance with the Cochrane Handbook, version 5.1.0. RevMan 5.3 software was used to perform a meta-analysis. Grading of Recommendations Assessment, Development and Evaluation methodology was applied to evaluate the evidence quality for each outcome. The quality of evidence for each outcome measurement was low for 4 outcomes and very low for 5 outcomes.
Results:
A total of 10 RCTs involving 1069 participants (3-15 years old) fulfilled the inclusion criteria. After exclusion, 8 RCTs were pooled for efficacy assessment. The overall efficacy evaluation result did not show benefit for the experimental group (relative risk 0.32, CI 95% 0.24-0.45; P = .98;) Investigation of variation of serum IgA, immunoglobulin E, IgG in three studies in 2 groups returned no statistical significance. YPFS gave relatively better safety (relative risk 0.29, CI 95% 0.14-0.58; P = .0005; Fig. S8, http://links.lww.com/MD/F751) and lower recurrence rates than did Western medical therapy.
Conclusions:
Current evidence cannot support the routine use of YPFS for treatment of PAR. This may be due to poor-quality study-design limitations of the included YPFS studies. Our data showed that the use of YPFS for PAR is relatively safe compared to Western medical therapy, but a conclusion could not be drawn because only 5 studies were analyzed. Every study suffered from some methodological limitation. Therefore, further large, rigorously-designed studies are necessary to determine conclusively the utility of YPFS in PAR.
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