Acupuncture plus sphenopalatine ganglion needling shows higher response rate than loratadine for allergic rhinitis

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.