Acupuncture Combined With Sphenopalatine Ganglion Needling for Allergic Rhinitis: A Randomized Controlled Trial

Although the therapeutic effects of acupuncture and sphenopalatine ganglion (SPG) needling for allergic rhinitis (AR) are well established, evidence for the efficacy of their combination remains limited.

In this multicenter, randomized, parallel-controlled trial, 260 patients with persistent moderate-to-severe AR were assigned to 8 weeks of pharmacotherapy (MED; loratadine 10 mg/day), acupuncture (ACU; 3 sessions/week), sphenopalatine ganglion needling (SPG-N; 1 session/week), or combination therapy (COM, which received both acupuncture and SPG needling). The primary outcome was the response rate (≥30% reduction in total nasal symptom score [TNSS]) at Week 8. Secondary outcomes included changes in TNSS, total non-nasal symptom score (TNNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ), and visual analogue scale (VAS) scores from baseline to Weeks 2, 4, 8, and the 4-week follow-up.

At Week 8, response rates differed significantly among groups (COM: 82.54%; ACU: 71.43%; SPG-N: 55.74%; MED: 45.31%; p < 0.001) and were sustained at the 4-week follow-up. The COM showed the earliest significant improvement at Week 2 (63.49%, p < 0.001). Compared to MED, both COM (relative risk [RR] = 1.90, 95% confidence interval [CI], 1.40-2.58; p < 0.001) and ACU (RR = 1.61, 95% CI, 1.18-2.21; p = 0.003) were associated with significantly higher response rates at Week 8, whereas SPG-N was not (RR = 1.27, 95% CI, 0.90-1.79; p = 0.17).

This study demonstrated that acupuncture combined with SPG needling provides more rapid, robust, and sustained symptomatic improvement in AR, offering an evidence-based non-pharmacologic alternative for AR management.