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. 2025 Sep 13.
doi: 10.1111/all.70057. Online ahead of print.

International Evidence-Based Guidelines for Traditional Chinese Medicine Management of Allergic Rhinitis

Qin-Wei Fu  1   2   3 , Peng Liu  4 , Yan Ruan  4 , Xin-Rong Li  1   2 , Lan-Zhi Zhang  1   2 , Sha-Sha Yang  5 , Feng Chai  6 , Ji Chen  1 , Qiao-Yan Chen  7 , Shu-Cheng Chen  8 , Wen-Yong Chen  7 , Yong-Na Chen  9 , Hong-Bin Cheng  1   2 , Lei Cheng  10 , Lu-Jia Cui  11 , Ke-Bin Deng  12 , Cai-Shan Fang  1   2   13 , Rong-Chang Feng  14 , Li Fu  1   2 , Wen-Yang Fu  15 , Jian-Ying Gao  16 , Hong Guo  17 , Miao He  18 , Ko-Hsin Hu  19 , Chun-Jiang Huang  20 , He-Yin Huang  21 , Lu-Yun Jiang  1   2 , Feng-Ying Qiao  22 , Hui Leng  23 , Yun-Ying Li  7 , Chun-Song Liu  4 , Da-Xin Liu  11 , Jian-Hua Liu  24 , Jin-Hui Liu  25 , Jing Liu  26 , Min Liu  27 , Wei-Ting Liu  28 , Yuan-Xian Liu  15 , Yang Liu  1   2 , Ying Liu  1   2 , Zhi-Qing Liu  1   2 , Qiu-Lan Luo  7 , Yu Ma  29 , De-Hong Mao  30 , Juan Meng  31 , Kai-Yun Pang  32 , Shun-Lin Peng  1   2 , Xuan-Fu Tong  33 , Ji Wang  34 , Jia-Xi Wang  11 , Jun-Ge Wang  35 , Ren-Zhong Wang  36 , Shi-Zhen Wang  4 , Ji-Yan Xia  7 , Hui Xie  1   2 , Qiang Xie  37 , Yan Xie  1   2 , Da-Jing Xiong  1   2 , Zhan-Feng Yan  24 , Hui Yang  1   2 , Da-Zheng Zhang  38 , Fu-Bing Zhang  39 , Shi-Peng Zhang  1   2 , Zhi-Cheng Zhang  40 , Ji-Ping Zhao  24 , Yu Zhao  31 , Yun Zheng  31 , Dan-Zhu Zhong  41 , Li Zhou  1   2 , Valentin Mikhailovich Knyazev  42 , Irina Viktorovna Kostrova  41 , Wing-Fai Yeung  8 , Qi Wang  34 , De-Yun Wang  13 , Qin-Xiu Zhang  1   2   43   44
Affiliations

International Evidence-Based Guidelines for Traditional Chinese Medicine Management of Allergic Rhinitis

Qin-Wei Fu et al. Allergy. .

Abstract

Background: Allergic rhinitis (AR) is a prevalent chronic condition that significantly impacts patients' quality of life and poses challenges to effective management. Traditional Chinese medicine (TCM) offers a holistic approach, emphasizing syndrome differentiation, individualized care, and natural treatment strategies.

Objective: To develop comprehensive evidence-based guidelines for AR management using TCM interventions, incorporating rigorous evidence assessment and expert consensus.

Methods: The guidelines were developed using the GRADE-TCM framework, analyzing 351 randomized controlled trials (RCTs) involving 43,276 participants. Supplementary evidence from published textbooks, standardized documents, ancient literature, and TCM medical records was incorporated. Five rounds of expert consensus, involving 80 expert person-times and over 10,000 valid responses, refined the recommendations.

Results: The guidelines provide 32 recommendations covering four primary TCM syndromes (Deficiency-cold of Lung Qi, Spleen Qi Deficiency and Weakness, Kidney-yang Deficiency, and Latent Heat in Lung Meridian) which are mainly involved in AR. These recommendations include both internal interventions (such as herbal and patent medicines) and external therapies (such as acupuncture, moxibustion, and other acupoint-based treatment). Of these interventions, 10 received strong recommendations, while 22 were classified as weak recommendations. TCM treatments demonstrated significant efficacy in alleviating AR symptoms, reducing recurrence, and improving quality of life. Additionally, TCM can complement conventional AR treatments by reducing the need for pharmacological therapy while maintaining a favorable safety profile.

Conclusion: The guidelines integrate classical TCM principles with modern evidence-based methodologies, offering a structured framework for AR management. They serve as clinical references for practitioners worldwide, supporting a promising approach to AR treatment. Future updates will incorporate emerging evidence and real-world clinical data to further optimize the role of TCM in AR management.

Keywords: Traditional Chinese Medicine; allergic rhinitis; evidence‐based; guideline; international practice.

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