Allergic Rhinitis

Rodsarin Yamprasert et al. (2020) · BMC complementary medicine and therapies

This randomized, double-blind, controlled trial with 80 adults (ages 18-70, about 70% female) compared ginger (Zingiber officinale) extract against loratadine, a standard non-drowsy antihistamine, for allergic rhinitis (AR) -- an immune reaction to airborne allergens that causes nasal itching, congestion, runny nose, and sneezing, affecting an estimated 400 million people worldwide. Ginger is a spice long used in Thai traditional medicine, and its active compounds 6-gingerol and 6-shogaol have shown anti-allergic activity in lab studies by blocking mast cells, the immune cells that release histamine during an allergic reaction. Antihistamines like loratadine work well but can cause drowsiness and dry mouth. Participants with moderate AR symptoms took either 500 mg of standardized ginger extract or 10 mg of loratadine daily, in identical-looking capsules, for 6 weeks. Researchers tracked nasal symptoms using the Total Nasal Symptom Score (TNSS, rating itching, runny nose, congestion, and sneezing on a 0-12 scale), objectively measured nasal airway size with acoustic rhinometry (a sound-wave-based nasal scan), and assessed quality of life with the 28-item Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Blood tests and blood pressure checks monitored safety at baseline, week 3, and week 6. Both treatments significantly reduced nasal symptom scores by week 6 (ginger: 7.48 to 3.42; loratadine: 7.38 to 4.11), with no statistically significant difference between them (p=0.276--meaning both worked about equally well). On the nasal airway scan, ginger significantly increased left-nostril airway volume compared to loratadine by week 6 (+0.094 cm3 vs -0.006 cm3, p=0.02--meaning ginger measurably relieved congestion where loratadine did not). Quality-of-life scores improved similarly in both groups across all seven RQLQ domains (p=0.660 at week 6). Side effects differed in kind more than in severity: ginger caused more digestive upset (eructation, or burping, in 72% vs 17% on loratadine), while loratadine caused more drowsiness (25% vs 3%), dizziness, and constipation. Neither treatment affected blood pressure or kidney function; loratadine modestly raised a liver enzyme (ALP) that ginger did not. These results suggest ginger extract works about as well as loratadine for relieving AR symptoms and improving quality of life, with a milder side-effect profile centered on digestion rather than sedation. The trial was short (6 weeks), single-site, and modestly sized (80 enrolled, 72 completing), so larger and longer studies are needed to confirm both the congestion benefit and long-term safety, including the loratadine-associated liver-enzyme signal seen here.

Min He et al. (2022) · European journal of medical research

This systematic review and meta-analysis combined 30 randomised controlled trials with 4,413 participants to test whether acupuncture helps allergic rhinitis — the sneezing, congestion and runny nose caused by an allergic reaction in the lining of the nose. What sets it apart is that the authors then stress-tested their own findings using trial sequential analysis, a method that asks whether enough participants have been studied for a pooled result to be trusted rather than treated as a chance finding. Trials came mostly from China (22 of 30), with others from Germany, Australia, South Korea and Sweden, ranging from 24 to 981 participants and lasting between two and twelve weeks. Three needling approaches were used: standard needle acupuncture, electroacupuncture, and warm needling, in which mugwort is burned on the needle to heat it. Acupuncture was compared against no treatment, against sham needling at non-acupuncture points, and against antihistamines including cetirizine and loratadine. Symptoms were scored with the Total Nasal Symptom Score and quality of life with the Rhinoconjunctivitis Quality of Life Questionnaire. Against no treatment, acupuncture improved both nasal symptoms and quality of life in adults. Against sham needling it also came out ahead, improving nasal symptoms (mean difference -0.60, 95% CI -1.16 to -0.04, from 489 participants) and quality of life (mean difference -8.47, 95% CI -14.91 to -2.03, from 248 participants) — both statistically significant, since neither confidence interval crosses zero. Against cetirizine or loratadine no clear difference appeared, suggesting acupuncture performs about as well as standard antihistamines. But the trial sequential analysis failed to confirm any of these results, meaning the pooled evidence has not yet accumulated enough participants to be considered reliable. Effects in children and adolescents could not be determined at all. The honest summary is a promising signal that has not yet been confirmed. Performance and attrition bias were serious in most of the included trials, and the authors' own robustness check contradicted their own positive findings. For an adult who would rather not take daily antihistamines, acupuncture is a defensible option on current evidence; it is not yet a demonstrated one. Larger and better-conducted trials, especially in children, are what would settle the question.