Efficacy of Acupuncture and Moxibustion in the Treatment of Chronic Urticaria and Its Effect on Cellular Immune Indexes and Th1/Th2 Cell Dysfunction

Abstract

Objective:

This study aimed to investigate the efficacy of acupuncture and moxibustion in the treatment of chronic urticaria and its effect on cellular immune indexes and the imbalance of T helper 1 (Th1)/T helper 2 (Th2) cell function.

Methods:

A total of 70 patients with chronic urticaria who were diagnosed and treated at Wuhan NO.1 Hospital from January 2020 to April 2022 were selected and divided into a control group and an observation group using the random number table method, with 35 cases in each group. The control group was treated with loratadine, whereas the observation group was treated with loratadine combined with acupuncture. The treatment effects, quality-of-life scores, IgE levels, Th1 and Th2 cytokine levels, and adverse reactions were compared between the two groups.

Results:

The total effective rate of treatment in the observation group was significantly higher than that in the control group (P < 0.05). After treatment, the dermatology life quality index score and serum IgE level of the observation group were significantly lower than those before treatment and those in the control group (P < 0.05). After treatment, the levels of IL-2, IFN-γ, and TNF-α in both groups were significantly higher than those before treatment; however, the levels in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-6 and IL-8 in the two groups were significantly higher than those before treatment, and the levels in the observation group were significantly higher than those in the control group (P < 0.05). The IL-2 and IL-4 levels were significantly lower than before treatment, and the levels in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05).

Conclusion:

Acupuncture and moxibustion in the treatment of chronic urticaria has good clinical efficacy, which is beneficial to improve the patient's cellular immune function, balance the function of Th1/Th2 cells, and improve the clinical symptoms and quality of life of the patient. Moreover, the therapeutic effect is safe and effective.

Keywords

acupuncture chronic urticaria clinical efficacy cellular immunity helper T lymphocytes

Get full access to this article

View all access options for this article.

References

Ayse Ornek

Orcen

Church

M. K.

Kocaturk

(2022). An evaluation of remission rates with first and second line treatments and indicators of antihistamine refractoriness in chronic urticaria. International Immunopharmacology, 112, 109198. https://doi.org/10.1016/j.intimp.2022.109198

Chen

Yang

Song

(2024). Atopy in chronic urticaria: An important yet overlooked issue. Frontiers in Immunology, 15, 1279976. https://doi.org/10.3389/fimmu.2024.1279976

Chiang

H. L.

Chen

C. H.

Koo

Tsai

T.-Y.

C.-H.

(2022). Predictors of response to oral medications and low-histamine diet in patients with chronic Urticaria. Journal of Immunology Research, 2022, 1. https://doi.org/10.1155/2022/5243825

Fayaz

S. H.

Varadarajan

Ansari

James

(2021). Loratadine vs rupatadine: Unearthing the capital choice in chronic idiopathic urticaria (CIU) - A randomized controlled trial. Indian Journal of Dermatology, 66(6), 704. https://doi.org/10.4103/ijd.ijd_1042_20

Gellrich

Pfab

Oliviera

Binting

Brinkhaus

Gröger

(2022). Acupuncture and its effect on cytokine and chemokine profiles in seasonal allergic rhinitis: A preliminary three-armed, randomized, controlled trial. European Archives of Oto-Rhino-Laryngology, 279(10), 4985–4995. https://doi.org/10.1007/s00405-022-07335-5

Ghazanfar

M. N.

Bartko

E. A.

Arildsen

N. S.

Poulsen

L. K.

Jensen

B. M.

Enevold

Holm

J. G.

Woetmann

Ødum

Thomsen

S. F.

(2022). Omalizumab serum levels predict treatment outcomes in patients with chronic spontaneous urticaria: A three-month prospective study. Clinical & Experimental Allergy, 52(5), 715–718. https://doi.org/10.1111/cea.14121

Hung

H. Y.

Song

Loo

S. K. F.

Chan

K. L.

Ching

J. Y. L.

Sum

C. H.

L. C. W.

Chia

S. C. P.

R. T. M.

Cheong

P. K.

Siu

T. H. C.

Leung

K. C.

Lin

Z.-X.

(2022). Efficacy and safety of modified Xiao-Feng Powder in the treatment of chronic urticaria: Protocol of a randomized double-blind placebo-controlled study. Chinese Medicine, 17(1), 87. https://doi.org/10.1186/s13020-022-00642-3

Kaplan

Lebwohl

Giménez-Arnau

A. M.

Hide

Armstrong

A. W.

Maurer

(2023). Chronic spontaneous urticaria: Focus on pathophysiology. Allergy, 78, 389–401. https://doi.org/10.1111/all.15603

Wang

Liu

Yao

(2022). Mast cells and acupuncture analgesia. Cells, 11(8), 1293. https://doi.org/10.3390/cells11081293

10.

Zhou

Chai

Yang

Wang

Luo

Cao

Tao

(2022). Efficacy and safety of Chinese medicine combined with acupuncture in the treatment of chronic urticaria: A meta-analysis. Medicine (Baltimore), 101(36), e30381. https://doi.org/10.1097/MD.0000000000030381

11.

Rodríguez-Garijo

Sabaté-Brescó

Azofra

Yang

Wang

Luo

Cao

Tao

(2022). Angioedema severity and impact on quality of life: Chronic histaminergic angioedema versus chronic spontaneous urticaria. The Journal of Allergy and Clinical Immunology: In Practice, 3039. https://doi.org/10.1016/j.jaip.2022.07.011

12.

Shah

Dhoot

Choudhary

Jangid

Mistry

Shah

Kamat

Barkate

(2022). A comparative, three-arm, randomized clinical trial to evaluate the effectiveness and tolerability of bilastine vs fexofenadine vs levocetirizine at the standard dose and bilastine vs fexofenadine at higher than the standard dose (up-dosing) vs levocetirizine and hydroxyzine (in combination) in patients with chronic spontaneous urticaria. Clinical, Cosmetic and Investigational Dermatology, 15, 261–270. https://doi.org/10.2147/CCID.S350122

13.

Shi

Guo

Wang

Shang

Wang

(2023). Acupuncture combined with pricking and cupping therapy is effective in patients with chronic spontaneous urticaria. American Journal of Translational Research, 15(2), 1195–1203. PMID: 36915747 PMCID: PMC10006817.

14.

Shi

Hou

Zheng

Liu

Yang

(2019a). Acupoint catgut embedding for patients with chronic urticaria: A systematic review protocol. Medicine (Baltimore), 98(24), e16036. https://doi.org/10.1097/MD.0000000000016036

15.

Shi

Zheng

Zhou

Zheng

Zhang

Xiao

Cao

Liu

(2019b). Efficacy and safety of acupuncture for patients with chronic urticaria: Study protocol of a randomized, sham-controlled pilot trial. Trials, 20(1), 326. https://doi.org/10.1186/s13063-019-3433-1

16.

Wei

Cao

, et al. (2025). Clinical efficacy and safety of acupuncture in the treatment for chronic spontaneous urticaria: A systematic review and meta-analysis. Frontiers in Medicine (Lausanne), 12, 1473989. https://doi.org/10.3389/fmed.2025.1473989

17.

Xiao

Shi

Zhang

Cao

Liu

Zhou

Chen

Zheng

(2019). Cupping for patients with chronic urticaria: A systematic review protocol. Medicine (Baltimore), 98(38), e17115. https://doi.org/10.1097/MD.0000000000017115

18.

Xiao

X. J.

Zhang

L. X.

Shi

Y. Z.

Yao

J.-p.

Cao

Liu

Zou

Z.-h.

Zhou

S.-y.

Chen

M.-l.

C.-x.

Zheng

Q.-h.

(2020). Cupping therapy for patients with chronic urticaria: A systematic review and meta-analysis. Journal of Integrative Medicine, 18(4), 303–312. https://doi.org/10.1016/j.joim.2020.05.004

19.

Zhang

Xiao

Hui

Shi

Deng

Zheng

Zhou

Yao

Cao

Liu

Hao

(2019). Autologous whole-blood or autologous serum acupoint injection therapy for chronic urticaria: A systematic review protocol. Medicine (Baltimore), 98(25), e16127. https://doi.org/10.1097/MD.0000000000016127

20.

Zhang

Song

Zhang

Huang

Liu

Liao

Luan

Zuberbier

Maurer

Zhao

Wang

(2022). Prevalence and risk factors of chronic urticaria in China: A nationwide cross-sectional study. Allergy, 77(7), 2233–2236. https://doi.org/10.1111/all.15287

21.

Zhao

J. Q.

T. M.

(2020). A meta-analysis of acupuncture therapy for chronic urticaria. Zhen Ci Yan Jiu, 45(1), 66–73. Chinese. https://doi.org/10.13702/j.1000-0607.1904826

22.

Zheng

Zhou

Shi

Zhang

Xiao

Zhang

Zhou

Huang

Chen

Zhong

Wang

(2022). Efficacy of acupuncture treatment for chronic spontaneous urticaria: Study protocol for a randomised controlled trial. BMJ Open, 12(2), e045027. https://doi.org/10.1136/bmjopen-2020-045027