Acupuncture for Bell’s Palsy: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

HE Li ¹ , ZHOU Mu ke ¹ , ZHOU Dong ¹ , LI Ning ² , WU Bin ²

1. Neurology Department; West China Hospital; Sichuan University; Chengdu 610041; China2. Acupuncture Department; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Acupuncture; Bell s Palsy; Randomized controlled trial; Systematic review

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Objective 　To examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell’s palsy.
Methods 　We searched the Cochrane Neuromuscular Disease Group Register Group (Till Feb. 2002), MEDLINE (Jan. 1966 to Dec. 2002); EMBASE (Jan. 1980 to Dec. 2002), LILACS (Jan. 1982 to Dec. 2002) and Chinese Biomedical Retrieval System (Jan. 1978 to Dec. 2002). We also searched grey literature. We identified all randomised or quasi-randomised controlled trials involving acupuncture in the treatment of Bell’s palsy, selected the trials ment the inclusion criteria, assessed the methodological quality, extracted data on trials’ patients, interventions, outcome measurements and results and undertook analysis.
Results 　Three small randomised controlled trials were included but due to some flaws in study designs or reporting and clinical differences between trials, data from trials were not combined in a meta-analysis，and a descriptive analysis was performed.The result indicated a positive effect of acupuncture (all P lt;0.01).
Conclusions 　Three small studies in this review suggested a beneficial effect but the poor quality of the trials precludes us from drawing firm conclusions. There is a need for high quality randomized controlled trials (RCTs) using a study design which assures high internal validity.

Citation： HE Li,ZHOU Mu ke,ZHOU Dong,LI Ning,WU Bin. Acupuncture for Bell’s Palsy: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2005, 05(2): 106-109. doi: Copy

1.	邵书凤, 王中欣, 王莉. 针灸与西药联用治疗周围性面神经瘫痪58例[J]. 新医学, 1999;30(1): 14.
2.	刘敏. 浅刺多针法和药物疗法治疗面瘫130例疗效的对比观察[J]. 针灸临床杂志, 1996;12(5): 56.
3.	任留江. 针灸治疗面瘫450例[J]. 中国针灸, 1987;(3):13～14.
4.	吴经伟. 针灸面神经干治疗周围性面瘫220例临床观察[J]. 中国针灸, 1987;(3): 19～20.
5.	李志明. 针灸为主治疗面瘫1 014例疗效分析[J]. 中国针灸, 1987;(2): 1～3.
6.	刘桂珍. 电针为主治疗急性周围性面神经瘫痪100例[J]. 上海针灸杂志, 1995;14(6): 257.
7.	Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
8.	May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
9.	McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
10.	Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
11.	Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
12.	Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
13.	Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
14.	Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
15.	Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
16.	Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
17.	Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
18.	Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
19.	He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
20.	Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
21.	Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
22.	Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
23.	Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
24.	Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
25.	Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
26.	Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
27.	Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
28.	Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
29.	Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
30.	Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
31.	Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
32.	Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
33.	Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
34.	Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
35.	Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
36.	Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
37.	Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.

1. 邵书凤, 王中欣, 王莉. 针灸与西药联用治疗周围性面神经瘫痪58例[J]. 新医学, 1999;30(1): 14.
2. 刘敏. 浅刺多针法和药物疗法治疗面瘫130例疗效的对比观察[J]. 针灸临床杂志, 1996;12(5): 56.
3. 任留江. 针灸治疗面瘫450例[J]. 中国针灸, 1987;(3):13～14.
4. 吴经伟. 针灸面神经干治疗周围性面瘫220例临床观察[J]. 中国针灸, 1987;(3): 19～20.
5. 李志明. 针灸为主治疗面瘫1 014例疗效分析[J]. 中国针灸, 1987;(2): 1～3.
6. 刘桂珍. 电针为主治疗急性周围性面神经瘫痪100例[J]. 上海针灸杂志, 1995;14(6): 257.
7. Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
8. May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
9. McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
10. Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
11. Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
12. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
13. Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
14. Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
15. Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
16. Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
17. Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
18. Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
19. He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
20. Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
21. Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
22. Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
23. Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
24. Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
25. Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
26. Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
27. Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
28. Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
29. Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
30. Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
31. Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
32. Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
33. Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
34. Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
35. Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
36. Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
37. Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.

Chinese Journal of Evidence-Based Medicine

Acupuncture for Bell’s Palsy: A Systematic Review

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