Efficacy and safety of press-needle therapy for allergic rhinitis in children: A systematic review and meta-analysis.

AIMS: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of press-needle therapy for allergic rhinitis in children.

METHODS

We comprehensively searched for relevant randomized controlled trials (RCTs) on press-needle therapy for pediatric AR. After strict screening of literature, data extraction and assessment of methodological quality, meta-analysis was performed using appropriate statistical methods. A random-effects model was adopted to synthesize the results, considering differences in follow-up duration and intervention period among included studies. Pre-specified further analyses were conducted for the primary outcome to compare press-needle plus medication vs medication alone, press-needle alone vs medication alone, and press-needle plus medication vs press-needle alone. The primary and secondary outcome measures included clinical efficacy, symptom and sign score, Visual Analogue Scale (VAS) score, Total Nasal Symptom Score (TNSS), Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) score, Eosinophil Ratio (EOSR), serum immunoglobulin E (IgE) levels, adverse drug reactions (ADRs) and recurrence rate.

RESULTS

24 RCTs with 1625 participants were included. Press-needle therapy significantly improved clinical efficacy (OR = 3.75, 95 CI: 2.59-5.42; I2 = 0%). Further analysis showed that press-needle plus medication was superior to medication alone (OR = 4.60, 95% CI: 3.08-6.86), whereas press-needle monotherapy did not show a significant advantage over medication alone. Significant reductions were observed in VAS (SMD = -1.30), TNSS (SMD = -0.74), PRQLQ (SMD = -1.16), and serum IgE (SMD = -2.06; based on only 3 studies, I2 = 96%, interpret with caution). No significant differences were found in symptom and sign score, EOSR, or ADRs. Recurrence rate was significantly lower in the intervention group (OR = 0.37, 95% CI: 0.23-0.61).

CONCLUSION

Press-needle therapy, primarily as an adjunct to pharmacotherapy, may be a well-tolerated and potentially effective option for pediatric AR, improving clinical response, symptoms, quality of life, and recurrence without increasing adverse events. Evidence for press-needle monotherapy and for immunological outcomes (IgE, EOSR) remains limited. Multi-center, three-arm RCTs with standardized protocols and long-term follow-up are needed to isolate its independent effect.

SYSTEMATIC REVIEW REGISTRATION: The protocols for this meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261307545.).