DOI QR코드

DOI QR Code

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline

알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로

  • Kang, Jeong-In (Department of Opthalmology, Otolaryngology and Dermatology, College of Oreiental Medicine, Woo-Suk University) ;
  • Lee, Dong-Hyo (Department of Opthalmology, Otolaryngology and Dermatology, College of Oreiental Medicine, Woo-Suk University)
  • 강정인 (우석대학교 한의과대학 안이비인후피부과학 교실) ;
  • 이동효 (우석대학교 한의과대학 안이비인후피부과학 교실)
  • Received : 2019.09.02
  • Accepted : 2019.10.27
  • Published : 2019.11.25

Abstract

Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

Keywords

References

  1. Jeung CW, Jo HG, Kim HH, Song MY. Current update on allergic rhinitis for Korean Medicine management. J Korean Med Ophthalmol Otolaryngol and Dermatol. 2016;29(4):95-113. https://doi.org/10.6114/jkood.2016.29.4.095
  2. Korea National Health Insurance Service and Korea Health Insurance Review and Assessment Services. National Health Insurance Statistical Annual Report. 2017.
  3. Lee DH. A Review of Economic Evaluations in Acupuncture for Allergic Rhinitis. J Korean Med Ophthalmol Otolaryngol and Dermatol. 2016;29(2):1-11. https://doi.org/10.6114/jkood.2016.29.2.001
  4. Jo SH, Jang BH, Lee SH, Kim EJ, Lee DH, Lee YJ, et al. Manual for developing Evidence-based Clinical Practice Guidelines of Korean Medicine. 2018:1-186.
  5. Brozek JL, Bousquet J, Naena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466-76. https://doi.org/10.1016/j.jaci.2010.06.047
  6. Kim YH, Kim MA, Yang HJ, Choi JH, Kim DK, You Y, et al. Clinical Guidelines of Allergic Rhinitis. Journal of the Korean Medical Association. 2015:1-83.
  7. Cheng L, Chen J, Fu Q, He S, Li H, Liu Z, et al. Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. Allergy, asthma & immunology research. 2018;10(4):300-53. https://doi.org/10.4168/aair.2018.10.4.300
  8. Sun YM. Clinical Observation on Yougui Decoction for the Treatment of Allergic Rhinitis with Deficiency of Kidney-yang. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2004;10(5):40-1.
  9. Lin HW, Shi ZX, Ma SM. Clinical study on the treatment of allergic rhinitis by replenishing qi and consolidating the exterior. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1989;9:263-6.
  10. Qiu BS, Liu P, Huang K, Ma LX, Zhong YP, Wang SZ. Experimental study of the correlation between allergic rhinitis and spleen deficiency. J Tradit Chin Med. 2003;21(7):1040-1.
  11. Qiu BS, Liu P, Huang K, Ma LX, Zhong YP, Wang SZ. Effect of Buzhong Yiqi Decoction for Allergic Rhinitis with Spleen-qi Deficiency in Guinea Pigs. Traditional Chinese Drug Research & Clinical Pharmacology. 2003;14(3):147-9. https://doi.org/10.3321/j.issn:1003-9783.2003.03.002
  12. Liao Y, A O, Xiang J, Wei Q. Clinical observation on the therapeutic effect of Metal-clearing method on allergic rhinitis and a study on the semeiological basis for this kind of therapy. Chin Otorhinolaryngol J Integr Med. 2007;15(6):427-9.
  13. Chan RY, Chien WT. The effects of two Chinese herbal medicinal formulae vs. placebo controls for treatment of allergic rhinitis: a randomised controlled trial. Trials. 2014;15:261. https://doi.org/10.1186/1745-6215-15-261
  14. Zhao Y, Woo KS, Ma KH, van Hansselt CA, Wong KC, Cheng KF, et al. Treatment of perennial allergic rhinitis using Shi-Bi-Lin, a Chinese herbal formula. J Ethnopharmacol. 2009;122(1):100-5. https://doi.org/10.1016/j.jep.2008.12.005
  15. Chui SH, Shek SL, Fong MY, Szeto YT, Chan K. A panel study to evaluate quality of life assessments in patients suffering from allergic rhinitis after treatment with a Chinese herbal nasal drop. Phytother Res. 2010;24(4):609-13. https://doi.org/10.1002/ptr.3058
  16. Jung JW, Kang HR, Ji GE, Park MS, Song WJ, Kim MH, et al. Therapeutic effects of fermented red ginseng in allergic rhinitis: a randomized, double-blind, placebocontrolled study. Allergy Asthma Immunol Res. 2011;3(2):103-10. https://doi.org/10.4168/aair.2011.3.2.103
  17. Hu G, Walls RS, Bass D, Ramon B, Grayson D, Jones M, et al. The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial. Ann Allergy Asthma Immunol. 2002;88(5):478-87. https://doi.org/10.1016/S1081-1206(10)62386-1
  18. Lenon GB, Li CG, Da Costa C, Thien FC, Shen Y, Xue CC. Lack of efficacy of a herbal preparation (RCM-102) for seasonal allergic rhinitis: a double blind, randomised, placebo-controlled trial. Asia Pac Allergy. 2012;2(3):187-94. https://doi.org/10.5415/apallergy.2012.2.3.187
  19. Brinkhaus B, Hummelsberger J, Kohnen R, Seufert J, Hempen CH, Leonhardy H, et al. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy. 2004;59(9):953-60. https://doi.org/10.1111/j.1398-9995.2004.00540.x
  20. Xue CC, Thien FC, Zhang JJ, Yang W, Da Costa C, Li CG. Effect of adding a Chinese herbal preparation to acupuncture for seasonal allergic rhinitis: randomised double-blind controlled trial. Hong Kong Med J. 2003;9(6):427-34.
  21. Wang S, Tang Q, Qian W, Fan Y. Meta-analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis. Allergy. 2012;67(5):583-92. https://doi.org/10.1111/j.1398-9995.2012.02806.x
  22. Zhang X, Lan F, Zhang Y, Zhang L. Chinese herbal medicine to treat allergic rhinitis: evidence from a meta-analysis. Allergy Asthma Immunol Res. 2018;10(1):34-42. https://doi.org/10.4168/aair.2018.10.1.34
  23. Lenon GB, Li CG, Da Costa C, Thien FC, Shen Y, Xue CC. Lack of efficacy of a herbal preparation (RCM-102) for seasonal allergic rhinitis: a double blind, randomised, placebo-controlled trial. Asia Pac Allergy. 2012;2(3):187-94. https://doi.org/10.5415/apallergy.2012.2.3.187
  24. Zhang YQ. Clinical experience in acupuncture treatment of allergic rhinitis. J Tradit Chin Med. 2009;29(3):186-9. https://doi.org/10.1016/S0254-6272(09)60062-5
  25. Chen ZX. Clinical observation on acupuncture for treatment of allergic rhinitis. Zhongguo Zhenjiu. 2007;27(8):578-80.
  26. Chen Y, Jin X, Yu M, Qiu H, Fang Y, Zhang S, et al. Efficacy of acupuncture on moderate and severe allergic rhinitis. Zhongguo Zhenjiu. 2015;35(4):339-43.
  27. Chen S, Wang J, Bai P, Zhao Q, Tan C, Wang B, et al. Moderate and severe persistent allergic rhinitis treated with acupuncture: a randomized controlled trial. Zhongguo Zhenjiu. 2015;35(12):1209-13.
  28. Choi SM, Park JE, Li SS, Jung H, Zi M, Kim TH, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365-74. https://doi.org/10.1111/all.12053
  29. 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;101(5):535-43. https://doi.org/10.1016/S1081-1206(10)60294-3
  30. Liu TS, Qiu R, Lai XS. Efficacy on perennial allergic rhinitis treated with acupuncture at three nasal poinits and the acupoints selected by syndrome differentiation. Zhongguo Zhenjiu. 2014;34(11):1083-6.
  31. Han D, Liu C, Qie L, Wang F, Wang Z. Acupoint selection and medication rules analysis for allergic rhinitis treated with acupoint application-based on data mining technology. Zhongguo Zhenjiu. 2015;35(11):1177-80.
  32. Xie Y, Wan W, Zhao Y, Ye Z, Chen H, Hong X, et al. Impacts on the life quality of the patients with allergic rhinitis treated with warming acupuncture in winter and summer. Zhongguo Zhenjiu. 2015;35(12):1215-20.
  33. Ou WX, Luo QY, Lin QM, Lin XH, Cao YM, Ma XW, et al. Efficacy observation on Jin's three-needle therapy for allergic rhinitis of lung qi deficiency and cold syndrome. Zhongguo Zhenjiu. 2014;34(5):445-8.
  34. Wang H, Li W, Ju XF, Yu XG. Effect of penetrating needling at head acupoints on perennial allergic rhinitis. Zhongguo Zhenjiu. 2013;33(9):789-92.
  35. Rao YQ, Han NY. Therapeutic effect of acupuncture on allergic rhinitis and its effects on immunologic function. Zhongguo Zhenjiu. 2006;26(8):557-60.
  36. Chen C, Li YC, Qiu BS, Huang XP, Zhuang LX. Observation of long-term efficacy and life quality in allergic rhinitis treated with acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy. Zhongguo Zhenjiu. 2014;34(5):439-43.
  37. Zhang H, Zhao M, Fu L. Short effect and adverse reaction of dog days plaster for allergic rhinitis. Zhongguo Zhenjiu. 2016;36(1):33-6.
  38. Tang ZM, Chen JX, Tan JS. Therapy of cantharides extract for perennial allergic rhinitis and its effect on total IgE in serum. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1995;15(6):334-6.
  39. Cao W, Qiao P, Pang W, Liu M, Li A. Triple-strong stimulation therapy at Dazhui (GV 14) in prevention and treatment of children allergic rhinitis: a randomized controlled trial. Zhongguo Zhenjiu. 2015;35(1):38-42.
  40. Wang K, Chen L, Wang Y, Wang C, Zhang L. Sphenopalatine ganglion acupuncture improves nasal ventilation and modulates autonomic nervous activity in healthy volunteers: a randomized controlled study. Sci Rep. 2016;6:29947. https://doi.org/10.1038/srep29947
  41. Zhang L, Yang W, Wang KJ. Acupuncture at ganglion pterygoplatinum for 71 cases of chronic simple rhinitis. Zhongguo Zhenjiu. 2013;33(6):495-6.
  42. Xinwu L. The mechanism analysis of treating nasal disease by sphenopalatine ganglion (acupoint “ZhiBi 3”) stimulation with acupuncture needle and an introduction to the relevant needling method. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011;21:193-6.
  43. Kim SY, Choi MY, Shin SS, Ji SM, Park JJ, You JH, et al. NECA's Handbook for Clinical Practice Guideline Developer. 2015:1-428.
  44. Kim YE, Jeong UM, Lee DH. A survey on treatment trend for allergic rhinitis in Korean medicine clinic. J Korean Med Ophthalmol Otolaryngol Dermatol. 2017;30(4):75-96. https://doi.org/10.6114/jkood.2017.30.4.075
  45. Choi S, Park JE, Li SS, Jung H, Zi M, Kim TH, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365-74. https://doi.org/10.1111/all.12053
  46. Shin JH, Lee JC, Kim KB. Recent Clinical Research on Effect of Acupuncture for Rhinitis-Within RCT, Review. The Journal of Pediatrics of Korean Medicine. 2012;26(1):46-59. https://doi.org/10.7778/jpkm.2012.26.1.046
  47. Song JH, Lee JH, Kim YH. A Study on Effect and Satisfaction of Acupoint Sticking in Hottest Period of Summer. The Journal of Pediatrics of Korean Medicine. 2018;32(1):1-10. https://doi.org/10.7778/jpkm.2018.32.1.001