What is hay fever (allergic rhinitis)?
Hay fever is an allergic reaction to pollen, causes cold-like signs and symptoms, typically when it comes into contact with your mouth, nose, eyes and throat. With the rapid changes in modern lifestyles and the human environment, the prevalence of allergic rhinitis ranges from 10% to 25% worldwide. Some people also have allergies to dogs or cats. The UK has some of the highest prevalence rates of allergic conditions in the world, with over 20% of the population affected by one or more allergic disorder. (M. L. Levy, 2004)
Acupuncture for Hayfever - Does it Help?
Acupuncture offers a solution to manage hayfever symptoms. Some research shows that acupuncture can help with the management of the symptoms of hay fever. Much of the evidence is either high or moderate-quality evidence that shows a positive effect of acupuncture for allergic rhinitis.
Symptoms
Hay fever occurs throughout the year but is mainly concentrated in the spring and autumn months, February to May and July to November. There are three main manifestations of pollen allergy: allergic rhinitis, asthma and allergic dermatitis. Allergic rhinitis symptoms are nasal congestion and runny nose, or nasal congestion and runny nose with sneezing called '鼻鼽(Bi Qiu)' in Chinese medicine and fundamentally different from sinus rhinitis. Sometimes a sudden sneeze after exposure to an allergen, with more than five sneezes in a row and multiple episodes a day. Hay fever symptoms can include:
Runny nose and sneezing
Itchy, watery, red eyes
Itchy nose or throat
Pain around your temples and forehead
Earache
Cough, A hay fever cough is usually caused by postnasal drip.
Dark circles under the eyes caused by congestion of the nose (allergic shiners)
Fatigue, Up to 57% of adults and up to 88% of children with allergic rhinitis have sleep problems, including micro-arousal disorders, leading to fatigue and decreased cognitive functioning. (Pawankar R, et al, 2013)
Causes
Hay fever symptoms usually start right after being exposed to the allergen. The immune system then produces antibodies(IgE) signal your body to release chemicals(histamine) into your bloodstream, which cause reactions of the body and hay fever symptoms. It's unclear why the immune system reacts in this way, but some risk factors may increase your risk of developing hay fever:
Having asthma or another allergic condition, such as eczema
Having a family history(parent or sibling) of hay fever
Being exposed to an environment that has allergens
Being exposed to smoke in your early childhood(first year of life)
The causes of hay fever are complex, and it isn't easy to find a quick cure. Hay fever is closely related to pollen, environment, family history, diet, lifestyle and emotions. Not only does pollen allergy cause itching and insomnia, but taking medication can also cause fatigue and sleepiness, which can cause many problems in daily life.
Does acupuncture for hay fever work?-Research shows acupuncture may help hay fever symptoms
Here is a few research about acupuncture for hay fever allergies:
One systematic review and bayesian meta-analysis of randomised controlled trials found acupuncture is effective and safe for AR. Moreover, either moxibustion or manual acupuncture plus conventional medicine are potentially the most effective AR treatments. 39 studies with 3433 participants were covered in this meta-analysis. (Yin, 2020)
A systematic review of acupuncture's clinical effectiveness for allergic rhinitis - Allergies cause a considerable burden to both sufferers and the National Health Service. There is growing interest in acupuncture as a treatment for a range of conditions. Since acupuncture may modulate the immune system, it could be a useful treatment. (Roberts,2008)
Acupuncture in patients with allergic rhinitis: a pragmatic randomised trial - PubMed - The results of this trial suggest that treating patients with allergic rhinitis in routine care with additional acupuncture leads to clinically relevant and persistent benefits. (Brinkhaus,2008)
How can acupuncture help with treating hay fever?
The efficacy of acupuncture in allergic rhinitis and other allergic diseases, such as asthma or allergic eczema, appears to be due to the cytokine profile regulation of Th1/Th2 cells and particularly in the expression of IL-10, IL-2 and IFN-γ. (Hauswald, 2014 )
In one study, scientists found acupuncture may down-regulate certain proinflammatory neuropeptides, neurotrophins, Th2 cytokines and proinflammatory cytokines, thereby producing a shift in the Th1/Th2 balance of T helper cells towards Th1. Together these hypothesised actions would be expected to alleviate clinical signs and symptoms of allergic rhinitis. (McDonald,2013)
Acupuncture and Chinese Medicine For Hayfever
Chinese medicine has a long and well-documented history of treating pollen allergies. As early as two thousand years ago, allergic rhinitis was discussed in detail in some Chinese medicine books.
It is written in the Ling Shu Ben Shen Lun: "When the lung is deficient in Qi, the nose is stuffy and unfavourable". According to Chinese medicine, allergic rhinitis is caused by the attack of seasonal diseases that hinder the Lung Qi, which cannot be purified and lowered, causing nasal congestion, runny nose, sneezing, itchy eyes, itchy ears, itchy tongue, skin rash, and even cough and asthma.
In the "Treatise on the Origin of Diseases"(诸病源候论) of the Sui Dynasty, it is stated that "Lung Qi is connected to the nose. When the Lungs are invaded by wind and cold, the nose is not harmonised, and the fluids are congested. The cold fights with the Blood and Qi and stops in the nose, It should be treated with herbs, needle, heat, and Bian stones." Acupuncture for allergies and sinus has thousands of years of history.
Chinese medicine believes that this disease is closely related to the Lung, Spleen, and Kidney organs. The disease's primary pathological mechanism is internal heat, malfunction of the lungs, and external wind-heat. Acupuncture can regulate and maintain the neurological, endocrine, and immune balance in the body, enhance the body's ability to resist disease and increase its immune capacity.
Chinese herbal medicine treatment.
Based on the above pathological features, examples of Chinese herbal medicine typology and treatment are as follows.
Weakness of Lung Qi and lack of consolidation of the body surface(Wei). Symptoms: itchy nose, sneezing, clear snot, nasal congestion, swollen and pale nasal membranes, fear of wind and cold, general laziness, shortness of breath; pale tongue, thin white tongue coating, weak pulse. Suggested remedy: Wen Fei Zhi Liu Dan
Lung and Spleen Qi deficiency, dampness flooding the nose. Symptoms: Nasal congestion, clear and thin nasal discharge, dripping nose, dull sense of smell; pale or greyish, or polyp-like changes. Heavy head and dizziness, fatigue and shortness of breath, sleepiness of the limbs, poor appetite, loose stools, pale or pale fat tongue with tooth marks on the sides, white tongue coating and slow pulse. Recommended prescription: Bu Zhong Yi Qi Tang. In addition to Lung Qi's weakness, this type has a deficiency of the spleen and stomach and should be treated using the "cultivating earth to produce metal method" in the five elements theory.
Deficiency of Kidney Qi and loss of warmth in the Lung. Symptoms: nasal congestion with itchy nose and sneezing, worse in the morning and evening, pale and edematous nasal orifice membranes, the patient is usually afraid of wind and cold, the limbs are not warm, the face is pale, or the waist is sore, the knees are weak, urine is clear, nocturnal and frequent urination, the tongue is pale, and the pulse is sunken and weak. Recommended formula: Jin Kui Shen Qi Wan
Acupuncture treatment.
Acupuncture unblocks the meridians, dispels wind and heat, and tonifies the vital energy. Modern medicine believes that acupuncture can reduce and inhibit the release of the immune mediator histamine, improve microcirculation, relieve inflammatory reactions.
1. Body acupuncture: the principle of taking acupuncture points proximally and distally and following the meridians to achieve the effect of transporting the meridians and regulating the Qi. Feng Chi (GB 20)and Ying Xiang(LI 20) are the main points; Lung Shu(BL 15), Spleen Shu(BL 20), and Kidney Shu（BL 23） are the supporting points, GB 20 is an acupuncture point of the Foot Shaoyang Gallbladder meridian, which has the function of draining the wind and clearing the head; LI 20 has the function of regulating the Hand Yangming meridian and promoting the Lung orifice.
2. Moxa: take the acupuncture points of Bai Hui(DU 20), Shen Zhu(DU 12), Ming Men(DU 4), Shen Que(REN 8), Qihai(REN 6), Zu Sanli(ST 36), San Yinjiao(SP6), Yongquan(KI 1), etc., REN 8 and KI 1 cannot be moxibuted directly, choose 3-4 points each time, moxibustion for 20 minutes, this method has the effect of warming the meridians, moving Qi and invigorating Blood, and promoting the nasal orifices.
3. Ear acupuncture: can be used for acupuncture or the ear pressure method. Acupuncture points selection: allergy points, Lung, spleen, kidney, adrenal gland, endocrine and internal nasal. Choose 3 to 5 points each time. If using the compression method, use the Chinese herbal medicine Wang Bu Liuxing, alternating between both ears, change once every 3 days, and ask the patient to press 2 to 3 times a day.
4. Acupuncture at the Sphenopalatine Ganglion(Xin Wu Point): One study found acupuncture at the Sphenopalatine Ganglion alleviated AR symptoms rapidly and safely, especially nasal obstruction, and improved the patients' life quality.(Mi, 2020)
Other Chinese medical methods.
Umbilical therapy: Use TCM herbal paste, apply it to the umbilicus (REN 8), then fix it with tape and remove it after two hours. Formula: Huang Qi,
Bai Zhu, Bo He, Xin Yi, Dan Pi, Bu Gu Zhi, Cang Zhu, Rou Gui.
Fire cupping: cupping on the Shen Que point can act on the immune system and inhibit allergic reactions. Cupping therapy raises the local temperature, dilates the blood vessels, increases blood flow, promotes blood circulation, and stimulates an active immune system, strengthens lymphatic circulation, enhances the phagocytic capacity of white blood cells and lymphocytes, and increases the skin's tolerance to external changes, thus enhancing the body's resistance to disease.
Tian Jiu(cold moxibustion therapy) can improve the body's cellular and humoral immune functions and the endocrine function of the hypothalamic-pituitary-adrenocortical system improving the body's resistance.
How often shall I have acupuncture for hay fever?
"Everyone accepts acupuncture differently, some quickly, some more slowly." Usually, 2-3 consecutive sessions are one course of treatment to improve the annoying itching, sneezing and stuffy nose symptoms. For some particularly severe pollen allergies, acupuncture is needed once in three weeks until the hay fever season is over.
How to use acupressure on acupuncture points for hay fever?
Self-massage points: to clear the nose: Bi Tong(EX-HN8), Yingxiang(LI20), press and knead from top to bottom with the index finger's fingertips. Clear the eyes: Cuan zhu(BL 2) points, using the thumb to press the Tai Yang(Ex-HN5) and the second knuckle of the index finger to push and scrape the two points. Dispelling wind: Feng Chi(GB 20) and He Gu(LI 4) points, using the two index fingers to press. Strengthen the Lung: Tai Yuan(LU 9)
What is the best natural remedy for hay fever?
Green tea and citrus fruits reduce your histamine levels. Vitamin C is a natural antihistamine.
Honey is a natural remedy for hay fever as the bee pollen in honey can desensitise your body reaction to other pollens. Local honey is a better option.
Garlic and onion have anti-allergen properties that make them an excellent natural remedy for hay fever allergies.
Healthy gut flora is essential for a robust immune system—some fermented foods such as sauerkraut, kimchi, miso, kombucha, pickles and Kefir yoghurt.
Reference
M. L. Levy, D. P. (2004). Inadequacies in UK primary care allergy services: national survey of current provisions and perceptions of need. Journal of Clinical and Experimental Allergy, 34, 518-520.
Pawankar R, C. G. (2013). The WAO White Book on Allergy (Update 2013).
Yin Z, Geng G, Xu G, Zhao L, Liang F. Acupuncture methods for allergic rhinitis: a systematic review and bayesian meta-analysis of randomised controlled trials. Chin Med. 2020;15:109. Published 2020 Oct 12. doi:10.1186/s13020-020-00389-9
Roberts J, Huissoon A, Dretzke J, Wang D, Hyde C. A systematic review of the clinical effectiveness of acupuncture for allergic rhinitis. BMC Complement Altern Med. 2008;8:13. Published 2008 Apr 22. doi:10.1186/1472-6882-8-13
Hauswald B, Yarin YM. Acupuncture in allergic rhinitis: A Mini-Review. Allergo J Int. 2014;23(4):115-119. doi:10.1007/s40629-014-0015-3
Brinkhaus B, Witt CM, Jena S, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Ann Allergy Asthma Immunol. 2008 Nov;101(5):535-43. doi: 10.1016/S1081-1206(10)60294-3. PMID: 19055209.
McDonald JL, Cripps AW, Smith PK, Smith CA, Xue CC, Golianu B. The anti-inflammatory effects of acupuncture and their relevance to allergic rhinitis: a narrative review and proposed model. Evid Based Complement Alternat Med. 2013;2013:591796. doi:10.1155/2013/591796
Mi JP, He P, Shen F, Yang X, Zhao MF, Chen XY. Efficacy of Acupuncture at the Sphenopalatine Ganglion in the Treatment of Persistent Allergic Rhinitis. Med Acupunct. 2020;32(2):90-98. doi:10.1089/acu.2019.1373
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