Acupoint herbal patching for allergic rhinitis : a systematic review and meta-analysis of randomised controlled trials

Background: Acupoint herbal patching (AHP) is extensively used in treatment of allergic rhinitis in China. However, existing systematic review is insufficient. Objective of review: To evaluate the effectiveness and safety of AHP in treating allergic rhinitis. Search strategy: We searched seven electronic databases for randomised controlled trials (RCTs) from inception until August 2014. Evaluation method: Two authors selected studies, extracted data and evaluated risk of bias independently. The Cochrane risk of bias tool was applied to assess the methodological quality of the included trials, and RevMan 5.2 software was utilised to perform data analysis. Results: Twenty RCTs involving 2438 participants were included. Most of them were evaluated as high risk of bias. Acupoint herbal patching significantly decreased the recurrence rate at 6 months compared with Western medicine (RR 0.52; 95% CI 0.42-0.64), and similar effect was found for AHP plus Western medicine versus Western medicine (RR 0.53; 95% CI 0.44-0.65). Acupoint herbal patching appeared to be more effective than placebo in improving total clinical symptoms and signs after treatment and at 6 months, and in improving quality of life at <3 months and over 3 months. No severe adverse effects were found in the AHP groups. Conclusions: Acupoint herbal patching alone or combined with Western medicine appears to be more effective than placebo or Western medicine, respectively. Acupoint herbal patching seems to be a safe treatment. However, the findings should be interpreted with caution. Further large-scale, rigorously designed trials are warranted to confirm the findings.