Allergic rhinitis affects roughly 40% of children worldwide, and conventional antihistamines and intranasal corticosteroids, while effective, carry concerns about long-term use, side effects, and recurrence. The possibility that a low-risk adjunct acupressure technique could meaningfully amplify standard treatment outcomes deserves serious attention from pediatric clinicians and parents navigating chronic symptom management.
This systematic review and meta-analysis pooled data from 24 randomized controlled trials encompassing 1,625 pediatric participants to evaluate press-needle therapy — a form of intradermal or surface acupressure using retained small needles on acupoints — for allergic rhinitis. The combination of press-needle therapy plus conventional medication produced a markedly superior clinical efficacy odds ratio of 4.60 (95% CI: 3.08–6.86) compared to medication alone. Notably, the heterogeneity for the primary clinical efficacy outcome was near-zero (I² = 0%), suggesting unusual consistency across included trials. Secondary measures including symptom scores (TNSS, VAS), quality-of-life questionnaires (PRQLQ), eosinophil ratios, and serum IgE levels also trended favorably. Press-needle monotherapy, however, did not demonstrate clear superiority over standard medication alone.
The heterogeneity picture deserves careful scrutiny. While the I² = 0% for the primary outcome is statistically reassuring, the overwhelming majority of these RCTs originate from Chinese clinical settings, where press-needle therapy (often called intradermal needling or "press tack" acupuncture) is routinely integrated into practice — raising questions about publication bias, blinding adequacy, and generalizability to Western pediatric populations. The absence of sham-controlled trials in this cohort is a recognized limitation that prevents ruling out a robust placebo component, which is particularly amplified in pediatric populations where caregiver expectation effects are known to be substantial. The finding that monotherapy underperforms while combination therapy excels suggests an adjunctive rather than standalone role — a clinically pragmatic distinction. Adverse drug reaction rates appear low, though systematic adverse event reporting across acupressure RCTs remains inconsistent. This meta-analysis is confirmatory within its evidence base but should be considered preliminary for broader clinical adoption pending diverse, sham-controlled trials.