Efficacy and safety of acupuncture-related therapies in the treatment of allergic rhinitis: a systematic review and meta-analysis.

Background: Acupuncture therapy, as a complementary and alternative approach for allergic rhinitis (AR), has received increasing attention. However, robust conclusions regarding its effectiveness and safety, either as a standalone treatment or in combination with conventional medication, are still lacking. To systematically assess the effectiveness and safety of acupuncture-related therapies in treating AR, a meta-analysis will be performed. This study is designed to directly compare the three primary interventions: acupuncture therapy plus medication, acupuncture therapy alone, and conventional medication therapy, thereby generating evidence-based recommendations for clinical practice. Methods: We searched relevant reports published in multiple scientific databases and related registration platforms from January 1, 2014 to December 31, 2025, including medical databases such as PubMed, Embase, the Cochrane Library, CNKI, Wanfang, and VIP. The search process was conducted in both Chinese and English. Randomized controlled trials (RCTs) that compared acupuncture therapy with conventional medication, or acupuncture therapy plus conventional medication with conventional medication for patients with AR were included. Two researchers independently extracted data from the included studies using a standardized form and cross-verified their results upon completion to ensure accuracy. For continuous outcomes, effect sizes were calculated as either the standardized mean difference (SMD) or mean difference (MD), both with 95% confidence intervals (CI). For dichotomous outcomes, risk ratios with 95% CI were used. All statistical meta-analyses, subgroup analyses, and assessment of publication bias were performed using RevMan 5.4 software. Results: This meta-analysis included 38 RCTs involving 3,349 participants. The results showed that, compared with conventional medication alone, both acupuncture therapy alone (SMD = -0.65, 95% CI [-1.17, -0.14]) and acupuncture therapy combined with conventional medication (SMD = -1.18, 95% CI [-1.84, -0.51]) reduced the Total Nasal Symptom Score (TNSS) at the end of treatment. Additionally, improvements were observed in Quality of Life Questionnaire (RQLQ) score (acupuncture therapy: SMD = -1.16, 95% CI [-1.42, -0.90]; combined therapy: SMD = -1.40, 95% CI [-1.95, -0.86]). The reported adverse effects associated with acupuncture therapy were mild and transient. These findings suggest that acupuncture-related therapies demonstrate significant improvements in key outcome measures and may represent an effective and safe approach for treating AR, although the quality of evidence remains low. Conclusion: Acupuncture-related therapies have shown promising effectiveness in treating AR, effectively alleviating symptoms, improving quality of life, and causing only mild adverse reactions. However, the quality of evidence for certain outcome indicators in the included studies remains low. It is recommended that further validation be conducted through large-scale, multi-center, high-quality RCTs to provide higher-level evidence-based medical support. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251160569, identifier CRD420251160569.