ObjectiveTo observe the clinical effect of garlic moxibustion with herbal medicinals in treating allergic rhinitis （AR） with latent heat in lung meridian and explore the potential mechanisms. MethodsA total of 70 AR patients with the latent heat in lung meridian were randomly divided into loratadine group （35 cases） and moxibustion group （35 cases）. The loratadine group was treated with loratadine tablets orally， 10mg each time， once a day， one week as a course for 4 courses. The moxibustion group received garlic moxibustion with herbal medicinals once a day， 7 times as one course， for a total of 4 courses. The primary outcome was total nasal symptom score （TNSS）， measured before and after treatment， and at the 1-month follow-up. Secondary outcomes included traditional Chinese medicine （TCM） syndrome score， immunoglobulin E （IgE） level and eosinophils （EOS） level before and after 4 weeks of treatment. Efficacy was evaluated based on the changes in TNSS after treatment. Adverse reactions and events during treatment were observed， and safety evaluation was performed. ResultsA total of 33 patients from each group were included in the final analysis. The moxibustion group had a total effective rate of 93.94% （31/33）， significantly higher than the 75.76% （25/33） of the loratadine group （P＜0.05）. After treatment， both groups showed a significant reduction in TNSS， TCM syndrome score， IgE and EOS levels （P＜0.05 or P＜0.01）， and more reductions were seen in the moxibustion group （P＜0.05）. During follow-up， the moxibustion group also had a lower TNSS than the loratadine group （P＜0.05）. During treatment， one patient in the moxibustion group experienced shortness of breath， and one patient in the loratadine group experienced headache. Both symptoms were mild and improved after symptomatic treatment， allowing them to continue the treatment. ConclusionGarlic moxibustion with herbal medicinals can alleviate nasal inflammatory symptoms， reduce allergic reactions in AR patients， and effectively control AR flare-ups and related inflammatory responses， superior to oral loratadine alone and of good safety.