Diabetic foot (DF), is called "foot gangrene" (gangrene) or "nerve gangrene" (gangrene of the nerve area) in traditional Chinese medicine. It is a severe complication of diabetes, whose incidence rate is high, and the consequences is serious. Acupuncture is a promising therapy, it is effective, it can alleviate symptoms, accelerate the wound healing and reduce the risk of amputation. This consensus includes clinical evidence and expert practical experience, it shows acupuncture is an effective supportive treatment methods. Its main purpose is to provide practical, standardized, and safe instructions for clinicians. It can promote the use of acupuncture in evidence-based treatment of diabetic foot ulcers. The innovation points of this consensus are: 1. Stage guidance: It includes the indications, contraindications and Wagner classification system, which adjusts the treatment measures for different conditions. 2. Integrated diagnosis: It includes modern vascular assessment, neurological examinations, and TCM syndrome, such as ankle-brachial index, arterial oxygen partial pressure and nerve conduction studies, finally formulating different treatment plans. 3. Focus on strict operating procedures: Formulating safe and controlling infection measures for patients with diabetic foot to conduct acupuncture treatment, and figuring out the risk factors.

Objective:To systemically evaluate the effectiveness and safety of acupuncture and moxibustion for chronic eczema,and to provide evidence for acupuncture and moxibustion in the treatment of chronic eczema. Methods:Randomized controlled trials(RCTs)were retrieved from PubMed,Cochrane Library,China Na-tional Knowledge Infrastructure(CNKI),VIP database,Wanfang database and China Biology Medicine disc(CBM),from the inception of the database to April 23,2025.The control group were sham acupunc-ture and moxibustion,no treatment,or conventional western medication.The intervention group were acupuncture and moxibustion therapy or acupuncture and moxibustion on the basis of the interventions as the control group.Meta-analysis was performed by using RevMan5.4.0 software according to Cochrane systematic evaluation method. Results:Ultimately,53 RCTs were included.The results of the meta-analysis showed that compared with sham acupuncture and moxibustion,no treatment,or conventional western medication,acupuncture and moxibustion treatment for eczema area and severity index(EASI)score(mean difference[MD]=-2.23,95％confidence interval[CI]-2.61 to-1.85;P＜0.00001),visual analogue scale(VAS)score(standard-ized mean difference[SMD]=-1.45,95％CI-2.04 to-0.87;P＜0.00001),dermatology life quality index(DLQI)score(MD=-2.36,95％CI-3.25 to-1.48;P＜0.00001),immunoglobulin E(IgE)(SMD=-1.26,95％CI-2.46 to-0.05;P=0.04),the overall response rate(odds ratio[OR]=4.58,95％CI 3.84 to 5.46;P＜0.00001)and the recurrence rate(OR=0.14,95％CI 0.09 to 0.21;P＜0.00001)were all better than those in the control group,and there were no severe adverse events reported. Conclusion:Acupuncture and moxibustion can reduce the lesion area and severity of the patients with chronic eczema,effectively alleviate pruritus,improve the quality of life and decrease serum IgE.This therapy owns high overall response rate with low recurrence rate,and without severe adverse events,which is associated with a favorable long-term prognosis.

Objective:To observe the effects of acupuncture on the clinical efficacy, TCM syndromes and quality of life of patients with chronic eczema (CE) of blood deficiency stirring wind. Methods:Forty-eight patients of CE with blood deficiency stirring wind were randomly divided into an observation group (24 cases, 1 case dropped out) and a control group (24 cases, 2 cases dropped out). Both groups received basic skin care. The observation group received acupuncture at bilateral Shenmai (BL62), Houxi (SI3), Yinlingquan (SP9), Quchi (LI11), Ligou (LR5), Sanyinjiao (SP6), Xuehai (SP10), additional acupoints were supplemented based on symptom differentiation, 20 min each time, 3 times a week for the first 2 weeks, 2 times a week for the subsequent 2 weeks. The control group was treated with mometasone furoate cream, once a day for the first 2 weeks, twice a week for the subsequent 2 weeks. Both groups were treated for 4 weeks. The scores of eczema area and severity index (EASI), itch visual analogue scale (VAS), TCM syndrome, dermatology life quality index (DLQI) of the two groups were observed before and after treatment, the serum level of immunoglobulin E (IgE) was detected, and the clinical efficacy after treatment and follow-up recurrence rate after 4 weeks of treatment completion of the two groups were observed. Results:After treatment, the scores of EASI, itch VAS, DLQI and serum levels of IgE in both groups and the score of TCM syndrome in the observation group were decreased compared with those before treatment (P<0.01)；the above indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). The total effective rate of the observation group was 91.3% (21/23), which was higher than 63.6% (14/22) in the control group (P<0.05). In follow-up, the difference in recurrence rates between the two groups was not statistically significant (P>0.05). Conclusion:Acupuncture can improve the clinical symptoms, TCM syndrome, quality of life of CE patients with blood deficiency stirring wind.

OBJECTIVE: To explore the correlation between acupuncture treatment for allergic rhinitis(AR) and hypothalamic-pituitary-adrenal(HPA) axis regulation by investigating changes in serum immune factors, HPA axis-associated hormone levels, activation levels of paraventricular nucleus(PVN) neurons, and the severity of nasal mucosal lesions, in rats with AR before and after acupuncture treatment. METHODS: After establishing the AR rat model, ovalbumin was administered via nasal drip to all groups except the blank control. Each group received continuous treatment for 14 d: the acupuncture, acupuncture + RU-486(mifepristone), and RU-486 groups received acupuncture only, RU486 intraperitoneal injection and acupuncture, and RU-486 intraperitoneal injection only, respectively. Following the intervention period, behavioral scoring was performed on all AR rats, and peripheral blood, nasal mucosa samples, and brains tissue(containing PVN region) were obtained following euthanization. Interleukin(IL-4, IL-5, IL-13), interferon gamma(IFN-γ), corticosterone(CORT), and corticotrophin-releasing hormone(CRH) levels were evaluated in peripheral blood samples.Adrenocorticotropic hormone(ACTH) levels were determined using an enzyme-linked immunoassay assay, and hematoxylin and eosin staining was performed on the nasal mucosa samples. The expression levels of c-Fos in PVN neurons following acupuncture treatment were evaluated by immunofluorescent staining. RESULTS: Following the intervention period, the behavioral scores for the blank control group were lower than those of other groups(P < 0.05), while the acupuncture group scores were lower than those in the model control, acupuncture + RU486, and RU486 groups(P < 0.05). The blank control group had lower serum IL-4, IL-5, and IL-13 levels than those in the other groups(P < 0.05). The acupuncture group had lower serum IL-4, IL-5, and IL-13 levels than those in the model control, acupuncture + RU486, and RU486 groups(P < 0.05). The blank control group had the highest serum IFN-γ levels among all groups, followed by the acupuncture group. The serum CORT, CRH, and ACTH levels in the blank control group were lower than those in the remaining groups(P < 0.05). These biomarker levels were also lower in the acupuncture group than those in the model control, acupuncture + RU486, and RU486 groups(P < 0.05). Compared with model, rats in the acupuncture group exhibited an increased c-Fos expression in PVN neurons. CONCLUSION: Acupuncture can alleviate AR symptoms and regulate serum inflammatory factor levels and HPA axis-related hormones in AR rats. Moreover, these effects are inhibited by glucocorticoid antagonists, suggesting that acupuncture may regulate AR symptoms through HPA axis regulation.

Low back pain (LBP) is the common disease in the department of acupuncture and moxibustion in hospital and is treated basically in terms of kidney deficiency. Through clinical observation and in association with classic literature, the authors proposes that the five zang-organs all can lead to LBP relevant to internal injury. Based on the analysis of typical cases, the authors expounds the nature of pain caused by each zang-organ and clarified the keys of the differentiation. LBP related to the liver is manifested mainly as lumbar soreness and distending pain, accompanied by the limited forward and backward extension of the lumbar vertebra. When the dysfunction of the heart and lung are involved, the hollow pain is dominant, combined with the weakness and emptiness feeling in the lumbar region. When LBP is caused by the dysfunction of the spleen, muscular pain is the chief complaint, combined with heaviness and soreness in the local, and the stiffness on palpation. When rooted at the kidney, LBP is manifested chiefly by dull pain, with deep location of illness, mostly around the lumbar sacral region.

The formulation of recommendations is a crucial step in the development of clinical practice guidelines, which requires tools provided by the GRADE methodology. These tools include the evidence quality assessment tool, the evidence summary tool, and the evidence-to-decision (EtD) framework. Although there is a methodologically guided standard pathway for formulating recommendations in clinical practice guidelines, it remains unclear how to translate this theoretical pathway into the practical process for formulating recommendations and what the specific steps in this process entail. Therefore, this paper takes the World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guidelines on Acupuncture and Moxibustion: Allergic Rhinitis as an example to detail the full process of formulating recommendations and summaries it into a three-step method. Step one: Collect original materials from different sources to create EtD table. Step two: Distribute and collect EtD table, and preliminarily gather the recommendation voting results. Step three: Organize "salami-slicing pattern" guideline development group consensus meeting to formulate recommendations. The three-step method for formulating recommendations in clinical practice guidelines fully utilizes the GRADE EtD table to provide guideline development group with decision-making foundation and reference from multiple dimensions, including the importance of clinical questions, balance of benefits and harms, quality of evidence, resource required, values and preferences, health equity, acceptability, and feasibility. This approach enhances the scientific and practical nature of guideline recommendations. This paper provides a standard operating procedure to formulate recommendations for the incoming clinical practice guidelines, which aims to establish a standard pathway for the formulation of acupuncture clinical practice guideline recommendations.

Urinary incontinence (UI) is a common problem worldwide. It has a major impact on physical and social activities and interpersonal relationships. UI is common in women, but is under-reported and under-treated. It affects the quality of life of female patients severely. Acupuncture and moxibustion have been proposed as potentially effective interventions for female UI. Hence, for the benefit of acupuncture practitioners around the world, the World Federation of Acupuncture-moxibustion Societies initiated a project to develop a clinical practice guideline (CPG) for the use of acupuncture and moxibustion to treat female UI. This CPG was developed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, referring to the principles of the World Health Organization Handbook for Guideline Development. During the development of the CPG, the guideline development group (GDG) played an important role. The clinical questions, recommendations and therapeutic protocols were all formulated by GDG using the modified Delphi method. This CPG contains ten recommendations about the use of acupuncture and moxibustion interventions for ten clinical questions, which include nine conditional recommendations for the intervention and one conditional recommendation for either the intervention or the comparison. This CPG also provides one protocol for conventional filiform needle therapy, two therapy protocols for deep needling stimulation on lumbosacral acupoints, and four moxibustion therapy protocols, based on the protocols presented in randomized controlled trials reviewed by the GDG. Please cite this article as: Yang C, Wang SZ, Chen S, Du S, Wang GQ, Guo W, Xie XL, Peng BH, Du SH, Zhao JP. Clinical practice guideline for acupuncture and moxibustion: Female urinary incontinence. J Integr Med. 2024; 22(3): 258-269.

Clinical Practice Guideline on Acupuncture and Moxibustion: Allergic Rhinitis was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for allergic rhinitis approved by an international academic organization, which provides evidence-based recommendations and the practical therapeutic protocols for acupuncture practitioners globally. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the principles of the World Health Organization Handbook for Guideline Development. The members in the guideline development group (GDG) were from different countries, with different professions, and they played a critical role in the development of clinical questions, recommendations, and therapeutic protocols. Recommendations are the core of a CPG and the direct answers to clinical questions, due to which this article focuses on the recommendations of this CPG. The recommendations were developed by using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of 15 recommendations for 15 clinical questions were developed in this CPG, including one strong recommendation for intervention based on high-quality evidence, three conditional recommendations for either the intervention or the comparison based on very low quality of evidence, and 11 conditional recommendations for the intervention based on very low quality of evidence.

Acupuncture is one of the most effective complementary therapies for allergic rhinitis (AR) and has been recommended by several clinical practice guidelines (CPGs) for AR. However, these CPGs mentioned acupuncture without making recommendations for clinical implementation and therapeutic protocols, therefore limiting the applicability of acupuncture therapies for AR. Hence, for the benefit of acupuncture practitioners around the world, the World Federation of Acupuncture-moxibustion Societies have initiated a project to develop the CPG for the use of acupuncture and moxibustion to treat AR. This CPG was developed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, referring to the principles of the World Health Organization Handbook for Guideline Development. During the development of the CPG, the guideline development group (GDG) played an important role. The clinical questions, recommendations and therapeutic protocols were all formulated by the GDG using the modified Delphi method. The CPG contains recommendations for 15 clinical questions about the use of acupuncture and moxibustion interventions. These include one strong recommendation for the intervention based on high-quality evidence, three conditional recommendations for either the intervention or standard care, and 11 conditional recommendations for the intervention based on very low quality of evidence. The CPG also provides one filiform needle acupuncture protocol and five moxibustion protocols extracted based on the protocols presented in randomized controlled trials reviewed by the GDG.Please cite this article as: Du SH, Chen S, Wang SZ, Wang GQ, Du S, Guo W, Xie XL, Peng BH, Yang C, Zhao JP. Clinical practice guideline for acupuncture and moxibustion: Allergic rhinitis. J Integr Med. 2024; Epub ahead of print.

Clinical Practice Guideline on Acupuncture and Moxibustion: Allergic Rhinitis was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for allergic rhinitis approved by an international academic organization, which provides evidence-based recommendations and the practical therapeutic protocols for acupuncture practitioners globally. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the principles of the World Health Organization Handbook for Guideline Development. The members in the guideline development group (GDG) were from different countries, with different professions, and they played a critical role in the development of clinical questions, recommendations, and therapeutic protocols. Recommendations are the core of a CPG and the direct answers to clinical questions, due to which this article focuses on the recommendations of this CPG. The recommendations were developed by using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of 15 recommendations for 15 clinical questions were developed in this CPG, including one strong recommendation for intervention based on high-quality evidence, three conditional recommendations for either the intervention or the comparison based on very low quality of evidence, and 11 conditional recommendations for the intervention based on very low quality of evidence.

Urinary incontinence (UI) is common in women and affects the quality of life in female patients severely. But the clinical consideration and treatment are insufficient. Acupuncture and-moxibustion has been proposed as a potentially effective intervention for female UI. Hence, the World Federation of Acupuncture-moxibustion Societies (WFAS) have initiated a project to develop the clinical practice guideline (CPG) on acupuncture and moxibustion for female UI towards global acupuncture practitioners. The CPG was developed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, referring to the principles of the World Health Organization Handbook for Guideline Development. During the development of the CPG, the guideline development group (GDG) played an important role, which is composed of multi-national and multi-disciplinary experts. The clinical questions, recommendations and therapeutic protocols were all formulated by GDG using the modified Delphi method and basing on the results of the latest systematic review. This article focuses on the recommendations in the CPG. The CPG contains ten recommendations for ten clinical questions, including nine conditional recommendations for the intervention, one conditional recommendations for either the intervention or the comparison. The CPG also provides one conventional filiform needle therapy protocol, two deep puncturing stimulation on lumbosacral acupoints therapy protocols, and four moxibustion therapy protocols, extracted from the included clinical evidence of this CPG.

The formulation of recommendations is a crucial step in the development of clinical practice guidelines, which requires tools provided by the GRADE methodology. These tools include the evidence quality assessment tool, the evidence summary tool, and the evidence-to-decision (EtD) framework. Although there is a methodologically guided standard pathway for formulating recommendations in clinical practice guidelines, it remains unclear how to translate this theoretical pathway into the practical process for formulating recommendations and what the specific steps in this process entail. Therefore, this paper takes the World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guidelines on Acupuncture: Allergic Rhinitis as an example to detail the full process of formulating recommendations and summaries it into a three-step method. Step one: Collect original materials from different sources to create EtD table. Step two: Distribute and collect EtD table, and preliminarily gather the recommendation voting results. Step three: Organize “salami-slicing pattern” guideline development group consensus meeting to formulate recommendations. The three-step method for formulating recommendations in clinical practice guidelines fully utilizes the GRADE EtD table to provide guideline development group with decision-making foundation and reference from multiple dimensions, including the importance of clinical questions, balance of benefits and harms, quality of evidence, resource required, values and preferences, health equity, acceptability, and feasibility. This approach enhances the scientific and practical nature of guideline recommendations. This paper provides a standard operating procedure to formulate recommendations for the incoming clinical practice guidelines, which aims to establish a standard pathway for the formulation of acupuncture clinical practice guideline recommendations.

Taking the recommendations development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) standard Clinical Practice Guideline for Female Urinary Incontinence as an example, this study analyzed the consensus expert composition, specific consensus process, and results in the development of the guideline's recommendations. It systematically examined the advantages of using the modified Delphi method in the formation of recommendations for acupuncture and moxibustion clinical practice guideline, with the aim of providing reference for the development of acupuncture and moxibustion guidelines in the same field.

In 2012, RET rearrangements are observed in 1-2% of Non-Small-Cell Lung Cancer (NSCLC) patients and result in the constitutive activation of downstream pathways normally implied in cell proliferation, growth, differentiation and survival. Several compounds have been reported, including some traditional kinases inhibitors and the discovery of some new structure of natural products. Cabozantinib and vandetanib are multikinase inhibitors have been explored in the clinic for NSCLC patients. As a result of the nonselective nature of these multikinase inhibitors, patients had off-target adverse effects. Then, the discovery and clinical validation of highly potent selective RET inhibitors such as pralsetinib and selpercatinib demonstrating improved effificacy and a more favorable toxicity profile. However, acquired resistance mediated by secondary mutations in the solvent-front region of the kinase (e.g. G810C/S/R) becomes a major challenge for selective RET inhibitor therapies. In this review, we will highlight typical RET inhibitors developed during these years and provide a reference for more potential RET inhibitors exploration in the future.

With the expert consensus during the clinical questions determination in the World Federation of Acupuncture and Moxibustion Societies (WFAS) standard Practice Guideline of Acupuncture and Moxibustion for Urinary Incontinence in Women as an example, this paper focused on the specific process and results of three rounds of Delphi survey on clinical issues by experts of the guideline development group, and systematically analyzed the consistency of the modified Delphi method with the consensus of acupuncture and moxibustion experts, as well as the reflection and limitation of this consensus process, hoping to provide reference for the development of acupuncture guidelines in the same field.

Objective: Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines (CPGs). This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis (AR). Methods: PICO (patient, intervention, comparator, and outcome) question survey, Delphi survey, and consensus conference of the guideline development group (GDG) were employed. PICO questionnaires were used to gather and analyze the target users' key demands and interests. The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference.Results: Fifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents. After two rounds of the Delphi survey and complete discussions, a consensus was reached by the GDG that all potential questions were included. After three rounds of the Delphi survey and complete debate, the consensus was reached that nine outcomes were considered important.Conclusion: Fifteen key clinical questions and nine important outcomes were formulated for the CPG. These covered issues elicited the most attention from global users in acupuncture therapy and AR. The results will contribute to the CPGs development and future clinical studies. (c) 2022 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.

Objective: Formulating critical clinical questions and outcomes is essential for developing clinical practice guidelines (CPGs). This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis (AR). Methods: PICO (patient, intervention, comparator, and outcome) question survey, Delphi survey, and consensus conference of the guideline development group (GDG) were employed. PICO questionnaires were used to gather and analyze the target users' key demands and interests. The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference.Results: Fifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents. After two rounds of the Delphi survey and complete discussions, a consensus was reached by the GDG that all potential questions were included. After three rounds of the Delphi survey and complete debate, the consensus was reached that nine outcomes were considered important.Conclusion: Fifteen key clinical questions and nine important outcomes were formulated for the CPG. These covered issues elicited the most attention from global users in acupuncture therapy and AR. The results will contribute to the CPGs development and future clinical studies. (c) 2022 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.

Background: Filiform needle acupuncture（FNA）, the most classical and widely applied acupuncture method based on traditional Chinese medicine theory, has shown a promising effect in the treatment of allergic rhinitis（AR）.Objective: To evaluate the efficacy, safety, cost-effectiveness, and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture, no treatment, and conventional medication.Search strategy: Eight electronic databases were systematically searched from inception to October 14,2021. Additional studies were acquired from clinical trial registration platforms and reference lists.Inclusion criteria: Randomized controlled trials were included if they compared FNA with either sham acupuncture, no treatment or conventional medication for AR.Data extraction and analysis: Two researchers extracted data independently of each other using a predesigned data acquisition form, and results were cross-checked after completion. The primary outcome was symptom score（Total Nasal Symptom Score or Visual Analogue Scale）, and the secondary outcomes were the AR control questionnaire, quality of life（QoL） score（Different versions of Rhinoconjunctivitis Quality of Life Questionnaire）, medication score（use of rescue medication）, mental health score, total IgE, adverse event rate, clinical economic indicators, and patient satisfaction score. Standardized mean difference（SMD） or mean difference（MD） with 95% confidence interval was used to calculate the effect size for continuous data, while risk ratio with 95% CI was used for dichotomous data.Results: Thirty studies were included in this review. Compared with sham acupuncture, FNA significantly reduced the symptom score（SMD:-0.29 [-0.43,-0.15]）, AR’s impact on QoL（SMD:-0.23 [-0.37,-0.08]） and medication score（SMD:-0.3 [-0.49,-0.11]）. Compared with no treatment, FNA dramatically reduced the symptom score（SMD:-0.8 [-1.2,-0.39]） and AR’s impact on QoL（SMD:-0.82[-1.13,-0.52]）. There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment. FNA increased patient satisfaction and may be cost-effective. Most pieces of evidence from the above two comparisons were of high confidence. Moreover, FNA significantly outperformed conventional medication in reducing the symptom score（SMD:-0.48 [-0.85,-0.1]）and displayed a lower rate of adverse events, but the quality of evidence was very low.Conclusion: FNA is an effective and safe intervention for AR and can help with symptom relief, QoL improvement, reducing medication usage, and increasing patient satisfaction. Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.

患者,男,35岁,于2020年1月8日因"抑郁间断发作3月余,加重2 d"就诊.现病史:3个月前因离异出现心境低落,兴趣减低,对周围事物缺乏信任感,多疑,不愿与外人打交道,无端惶恐,如人将捕之,影响正常的工作和生活.于北京中医药大学东直门医院心理科就诊,诊断为适应障碍合并抑郁,予口服中药和抗抑郁药物(具体不详)治疗后有所缓解,但每谈及家庭时抑郁症状仍有发作.

Background Acupuncture and moxibustion have been widely applied in treating allergic rhinitis (AR). However, there is a lack of evidence-based guidelines for acupuncture and moxibustion for AR, thus we started a project on developing an international clinical practice guideline (CPG) for acupuncture and moxibustion for AR (WFASRP202001-SC05) approved by the World Federation of Acupuncture-Moxibustion Societies (WFAS). This study aims to formulate the clinical questions and important outcomes for this guideline. Methods Based on the principle of the WFAS standardization committee, multiple methods including the International PICO question survey, Delphi survey, and consensus conference of guideline development group (GDG) were applied. International PICO questionnaires widely gathered the demands from the target population. Then GDG selected clinical questions and important outcomes for the guideline via a mixed method of Delphi survey and consensus conference. Results 15 potential clinical questions and 10 sorts of outcomes were formulated under the supervision of a guideline steering group based on the analysis of 123 pieces of feedbacks from 17 countries of 5 continents. After 2 rounds of the Delphi survey, the consensus was reached in GDG that all of the potential questions were included. After 3 rounds of the Delphi survey, the consensus was reached that 9 of these outcomes were considered important outcomes. Conclusion 15 clinical questions and 9 important outcomes were selected for the CPG for acupuncture and moxibustion for AR. Since there has not established a standard method in formulating the clinical questions and important outcomes for CPGs in acupuncture and moxibustion, this one will be a useful reference.