OBJECTIVES: To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication. METHODS: Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups. RESULTS: After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05). CONCLUSIONS The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.
Humans ; Facial Paralysis/therapy* ; Moxibustion ; Acupuncture Therapy ; Bell Palsy/therapy* ; Face

The specific therapeutic regimen of Bell's palsy was proposed in association with the common refractory factors and the clinical experience of professor -. It is viewed that aging, absent intervention standard treatment at early stage, no prodromal symptoms and progressive onset are the refractory factors. Acupuncture at the local area is predominated in treatment. The different acupoint prescription regimens of acupuncture therapy are selected depending on muscle relaxation, muscle stiffness and specific accompanying symptoms, associated with electric stimulation, moxibustion and the tapping technique with plum-blossom needle so as to ensure the improvement of clinical therapeutic effect.
Acupuncture Points ; Acupuncture Therapy ; Bell Palsy ; therapy ; Facial Paralysis ; therapy ; Humans ; Moxibustion

OBJECTIVE: To observe the effect of different acupuncture frequency and duration of needle retention on idiopathic facial paralysis, and optimize the acupuncture treatment plan. METHODS: A total of 140 patients were randomized into a group A (37 cases, 3 cases dropped off), a group B (35 cases, 3 cases dropped off), a group C (34 cases, 1 case dropped off) and a group D (34 cases, 1 case dropped off). Under the same basic treatment, acupuncture intervention time (day 8 of morbidity), acupoint selection [Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Jiache (ST 6), Dicang (ST 4) on the affected side, Chengjiang (CV 24) and Hegu (LI 4) on the unaffected side] and electroacupuncture intervention, different acupuncture interval time and duration of needle retention were applied. In the group A, the treatment was given 20 min once a day, while the group B 30 min once a day, the group C 20 min once every 2 days, the group D 30 min once every 2 days. Totally 20-day treatment were required. The House-Brackmann (H-B) facial nerve function grading system was used to evaluate the improvement of clinical symptom, the situation and latency periods of the R1 wave in blink reflex and facial nerve motor conduction before and after treatment were observed in the 4 groups. RESULTS: After treatment, the cured rates in the 4 groups were 44.1% (15/34), 46.9% (15/32), 57.6% (19/33) and 51.5% (17/33), there was no significant difference among 4 groups (>0.05). The situation and latency periods of the R1 wave in blink reflex and latency periods and amplitude of facial nerve motor conduction after treatment were improved in the 4 groups (<0.01, <0.05), there was no significant difference among 4 groups (>0.05). CONCLUSION Acupuncture 20 min once a day, 30 min once a day, 20 min once every 2 days and 30 min once every 2 days have significant effect on the recovery of idiopathic facial paralysis, and the effect is comparable.
Acupuncture Points ; Acupuncture Therapy ; Bell Palsy ; therapy ; Electroacupuncture ; Facial Paralysis ; therapy ; Humans ; Treatment Outcome

OBJECTIVE: To explore the correlation of the electric excitability treated with electroacupuncture (EA) at different acupoints and the prognosis of Bell's palsy, using the Logistic regression analysis. METHODS: A total of 93 patients of Bell's palsy were collected in the retrospective analysis. Acupuncture was applied to Cuanzu (BL 2), Yangbai (GB 14), Yingxiang (LI 20), Dicang (ST 4), Xiaguan (ST 7) and Qianzheng (Extra point) on the affected side. The electric stimulation was added at the three pairs of points, named Cuanzu (BL 2) and Yangbai (GB 14) (A group), Yingxiang (LI 20) and Dicang (ST 4) (B group) and Qianzheng (Extra point) and Xiaguan (ST 7) (C group), continue wave, 1 Hz at current frequency, for 30 min in one treatment. EA was given once every two days. The endpoint outcome evaluation was conducted when the facial nerve function was recovered completely after treatment or in 16 weeks after onset. On the 8th day of onset, the prognosis-related indexes were collected, such as the electric excitability grade in the A, B and C groups, gender, age, the facial nerve lesion segment and type 2 diabetes mellitus (T2DM). The Logistic regression analysis was conducted on these indexes and the prognosis. RESULTS: The single factor Logistic regression analysis showed that the gender, age and the electric excitability of the C group were negatively correlated with the prognosis statistically (>0.05). T2DM, the facial nerve lesion segment and the electric excitability of the A and B groups were positively correlated with the prognosis statistically (<0.05). The multivariate Logistic regression analysis indicated that the electric excitability in the A and B groups was the independent predictor of Bell's palsy prognosis (<0.05). values were 8.410 (1.176-60.113) and 12.589 (1.355-116.922) respectively. CONCLUSION The electric excitability of EA at the pairs of Cuanzu (BL 2) and Yangbai (GB 14), and of Yingxiang (LI 20) and Dicang (ST 4) is one of the indexes for the prognosis evaluation of Bell's palsy. It contributes to the early identification of the severity of facial nerve lesion, the regulation of the therapeutic regimen and the improvement of the clinical effects.
Acupuncture Points ; Bell Palsy ; therapy ; Diabetes Mellitus, Type 2 ; Electroacupuncture ; Facial Paralysis ; Humans ; Prognosis ; Retrospective Studies

BACKGROUNDIt has not been solved what kind of needle sensation might influence outcomes of acupuncture treatment. Effects of personality factors on the therapeutic effect of acupuncture have not been investigated. This study aimed to find the effects of the traits of personality on the objective outcome when different acupuncture techniques were used in treating patients with Bell's palsy.

METHODSWe performed a secondary analysis of a prospective multicenter randomized controlled trial of acupuncture for Bell's palsy. Patients were randomly assigned to the de qi and control groups, respectively. The primary outcome was facial nerve function at month 6. The intensity of each needle sensation was rated by a visual analog scale. Psychosocial factors were assessed by the pretreatment mediator questionnaire; 16 Personality Factor Questionnaire (16PF) was used for assessing personality factors and digit cancellation test for assessing attention.

RESULTSAfter 6 months, patients in the de qi group had better facial function (adjusted odds ratio [OR]: 4.16, 95% confidence interval [CI]: 2.23-7.78). Path analysis showed that intensity of needle sensation of fullness had direct effect on House-Brackmann (HB) score at month 6. In de qi group, the low HB score on day 1 (OR: 0.13, 95% CI: 0.03-0.45) and the low Social Boldness score (OR: 0.63, 95% CI: 0.41-0.97) in 16PF were associated with better facial function. In control group, low HB score on day 1 (OR: 0.25, 95% CI: 0.13-0.50), low Vigilance score (OR: 0.66, 95% CI: 0.50-0.88), and high Tension score (OR: 1.41, 95% CI: 1.12-1.77) in 16PF were related to better facial function.

CONCLUSIONSThe needle sensation of fullness could predict better facial function and personality traits might influence outcomes of acupuncture treatment. Both of them should be considered seriously in acupuncture treatment and research.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Bell Palsy ; psychology ; therapy ; Facial Nerve ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Needles ; Odds Ratio ; Personality Tests ; Recovery of Function ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult

Facial nerve paralysis is an unexpected or embarrassed disease which unilateral facial musculatures are suddenly or gradually paralyzed by various causes. However, the most common cause of acute facial paralysis is known to be Bell's palsy. Until now, various treatments are recommended to patients with acute facial paralysis. Especially in Asian countries such as Korea, Japan, and China, there are so many patients who be managed by acupuncture therapy as the initial treatment, even if there exists clearly proven steroid therapy that minimizes neural damage and the incidence of permanent facial complications could be reduced. In Korea, various procedures not clearly unverified or unproven such as acupuncture treatment, massage therapy and thermotherapy are performed without standards regimen instead of administering steroid to patients with acute facial paralysis in the early stages. It has been already known that any initial trials with un-established treatment without full understanding of pathophysiology of facial nerve injury worsen prognosis after acute facial paralysis. There are reports showing that the prognosis of Korean patients with Bell's palsy is worse than globally known prognosis of patients with Bell's palsy. Such reports may reflect unverified procedures and consequently putting off steroid treatment in the early stages. Therefore, this is a paper intended to investigate issues occurring in treating a patient with acute facial paralysis in Korea in order to prepare the medical guidelines for the better solution.
Acupuncture ; Acupuncture Therapy ; Asian Continental Ancestry Group ; Bell Palsy ; China ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis* ; Humans ; Hyperthermia, Induced ; Incidence ; Japan ; Korea* ; Massage ; Paralysis ; Prognosis

OBJECTIVEThere are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell's palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell's palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell's palsy.

METHODSThe facial nerve function of 68 patients with Bell's palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis.

RESULTSChecking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028 (P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading (rER = 0.789) was better than the House-Brackmann scale (rHB = 0.423).

CONCLUSIONElectrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bell Palsy ; diagnosis ; physiopathology ; therapy ; Electroacupuncture ; Electrophysiological Phenomena ; Facial Nerve ; physiopathology ; Facial Nerve Injuries ; diagnosis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Treatment Outcome ; Young Adult

INTRODUCTIONBell's palsy is a well-recognised disease with robust research on its possible aetiologies and epidemiology, but scant information on patients' concerns and concepts regarding the condition is available. We aimed to evaluate the ideas, concerns and expectations of patients with Bell's palsy in Singapore.

METHODSA cross-sectional study was conducted at a single tertiary-care hospital in Singapore. Participants were all patients with newly diagnosed Bell's palsy referred to the otolaryngology department either from the emergency department or by general practitioners. Participants were given a self-administered questionnaire and their facial nerve palsies were graded by the consultant doctor.

RESULTSA total of 52 patients were recruited, of which 41 were available for analysis. 78.0% of patients were concerned that they were having a stroke upon presentation of the symptoms. Other beliefs about the cause of the disease included overwork or stress (36.6%), something that the patient had eaten (9.8%) and supernatural forces (2.4%). About 50% of patients had tried some form of complementary or alternative therapy other than the steroids/medicines prescribed by their general practitioner or emergency physician. While 39.0% of patients agreed that the Internet had helped them understand more about their condition in addition to the information provided by the physician, 9.8% of them specifically disagreed with this statement.

CONCLUSIONWe have found that patients with Bell's palsy in Singapore are not very knowledgeable about the disease. Although the Internet is a useful resource, a physician's explanation of the disease and its natural progression remains of utmost importance.

Access to Information ; Bell Palsy ; diagnosis ; epidemiology ; psychology ; therapy ; Complementary Therapies ; Cross-Sectional Studies ; Facial Nerve ; physiopathology ; Facial Paralysis ; complications ; therapy ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Humans ; Internet ; Patient Education as Topic ; Singapore ; Surveys and Questionnaires

OBJECTIVETo observe the clinical efficacy and safety of electroacupuncture (EA) combined with herbal acupoint sticking in the treatment of Bell's palsy and provide optimizations for the clinic.

METHODSOne hundred and two cases of Bell's palsy were randomized into an EA combined with herbal acupoint sticking group (group A, 50 cases) and an EA group (group B, 52 cases), EA at Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Quanliao (SI 18),Xiaguan (ST 7), Yingxiang (LI 20), etc. were applied in both groups and "facial paralys No.I " was applied at Yifeng (TE 17) in group A, once daily and 10 times totally were needed. The score of facial nerve function, clinical efficacy were compared before and after treatment. At 1 and 3 month follow up visit, the quality of life scale( WHOQOL-BREF) and the occurrence of complication were observed.

RESULTSThe scores of facial nerve function in group A and group B were all significantly improved compared with those before treatment (48. 2+/- 2. 9 vs 25. 7 +/- 4. 9, 45. 9 +/- 6. 2 vs 25. 8 +/- 5. 5, both P0. 05). The occurrence of complication in group A (1 case) was significantly less than that in group B (8 cases, P 0. 05).

CONCLUSIONCompared with EA, the combination of EA and acupoint sticking therapy for Bell's palsy cannot only improve the clinical efficacy and reduce the occurrence of complication but also reliable without any side effect.

Acupuncture Points ; Administration, Cutaneous ; Adolescent ; Adult ; Aged ; Bell Palsy ; drug therapy ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the correlation of facial nerve injury degree with facial contraction degree induced by electric stimulation in the treatment of Bell's palsy with electroacupuncture, and the significance in elec tric reaction grading evaluation.

METHODSSixty-eight cases of Bell's palsy were enrolled. The positive and negative electrodes of the acupuncture treatment apparatus were attached to the needle handles at the 3 groups of points, named Taiyang (EX-HN 5)-Yangbai(GB 14), Xiaguan (ST 7)-Quanliao (SI 18) and Heliao (LI 19)-Jiachengjiang (Extra). The disperse-dense wave was applied. According to the severity of local muscle contraction after needling, the electric reaction was divided into 4 grades, named superior, moderate, poor and no reaction. After acupuncture and electroacupuncture, the efficacy was evaluated in accordance with the different electric reaction grades.

METHODSThe curative rate was 100.0% (44/44) in patients with superior electric reaction, was 100.0% (7/7) in patients with moderate electric reaction, was 18.2% (2/11) in patients with poor electric reaction and was 0 (0/6) in patients with noelectric reaction. The difference was significant statistically in comparison of 4 groups (P<0.01). The superiority correlation presented between the efficacy and electric reaction grade (P< 0.001). The higher the superiority of electric reaction grade was, the better the efficacy was. The difference in the efficacy among different electric reaction grades was significant statistically (P<0.001). And the course of treatment was the shortest for those with the high superiority of electric reaction.

CONCLUSIONThe reaction grade of electric stimulation is conform to the facial nerve injury grading in Bell's palsy. The contraction degree of facial mimetic muscle induced by electroacupuncture stimulation is closely correlated with severity of disease. Based on the electric reaction, the facial nerve injury severity can be understood generally and the prognosis be judged.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bell Palsy ; physiopathology ; therapy ; Electroacupuncture ; Facial Nerve ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult