Intranasal acupuncture therapy for allergic rhinitis: A systematic review and meta-analysis of randomized controlled trials.

Background: Allergic rhinitis (AR) is a prevalent allergic condition affecting the nasal mucosa. Intranasal acupuncture therapy (IAT), an innovative therapy that involves the precise insertion of acupuncture needles into specific nasal acupoints, has demonstrated potential effects in managing AR. The aim of this study was to evaluate the effectiveness and safety of IAT in the management of AR. Methods: Nine databases were systematically searched for randomized controlled trials (RCTs) from their inception to September 2024. We included participants who were diagnosed with AR and who received IAT alone or as add-on treatment to conventional treatment. The Cochrane risk of bias 2.0 tool and the GRADE approach were used to assess the quality of the studies. A meta-analysis was performed via RevMan 5.4.1 software. Results: Twenty-one RCTs with 1889 participants were included. The certainty of evidence was generally low or moderate. Compared with sham acupuncture, the IAT significantly reduced the total nasal symptom score (MD -2.65, 95% CI -4.01 to -1.29, 1 RCT, 30 participants, moderate evidence). Compared to an antihistamine, IAT was associated with a lower total nasal non-symptom score (MD -0.44, 95% CI -0.64 to -0.25, 5 RCTs, 295 participants, moderate evidence) and a better quality of life measured by the rhinoconjunctivitis quality of life questionnaire (MD -13.72, 95% CI -18.01 to -9.43, 4 RCTs, 255 participants, moderate evidence). No serious adverse events were reported. Conclusion: The IAT may be beneficial for improving AR-related symptoms and quality of life. However, the safety of the IAT remains unclear due to inadequate reporting. Further high-quality, rigorously designed, and well-reported trials are needed. Protocol registration: PROSPERO, CRD42024526357.