Clinical effect and safety of filiform-fire needle in treatment of peripheral facial paralysis: a Meta-analysis

Abstract

To systematically evaluate the clinical effect and safety of filiform-fire needle in the treatment of peripheral facial paralysis at different stages. Articles of the randomized controlled clinical trials (RCTs) about filiform fire needle treatment of peripheral facial paralysis published from the inception of the databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase and Cochrane Library to December 20th, 2021 were retrieved first. The Cochrane Handbook 5.1 system was used to extract data and evaluate the quality (risk of bias) of the included papers. The overall effective rate, cure rate, Sunnybrook facial nerve function score, facial disability index scale, physical and social function score and related adverse reactions were used as the outcome indicators. The RevMan5.3 software was used for heterogeneity test and Meta-analysis was performed on papers with little clinical heterogeneity. A total of eligible 9 RCTs were included, involving 519 patients. The results of Meta-analysis showed that: compared with the conventional acupuncture therapy, the filiform fire needle in the treatment of peripheral facial paralysis had significant advantages in raising the overall effective rate (RR=1.14, 95%CI［1.07,1.21］, P<0.000 1) and cure rate (RR=1.59, 95%CI［1.29,1.97］, P<0.000 1),and in improving Sunnybrook facial neurological function score (MD=17.85, 95%CI［15.72,19.97］, P<0.000 01), physical function score of facial disability index scale (MD=4.16, 95%CI［3.15,5.16］, P<0.000 01) and social function score (MD=2.47, 95%CI［1.53,3.41］, P<0.000 01). Safety analysis showed that there was no obvious adverse reaction during the filiform fire needle therapy, and the patients' tolerance to pain had no statistical difference relevant to the conventional acupuncture treatment (P>0.05). Filiform fire needle is superior to conventional acupuncture in the treatment of facial paralysis in all stages, but its reliability is limited due to fewer high-quality literature with scientific and rigorous methods and trial designs. Therefore, more large-sample and high-quality RCT studies are warranted for further verification.