Effect of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis: A systematic review and meta-analysis

Abstract

ObjectiveThe goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis. MethodsPubMed (1979–2017), the Chinese National Knowledge Infrastructure database (CNKI, 1979–2017), Wanfang databases (1990–2017), and the Chongqing VIP full-text periodical database (VIP, 1989–2017) were searched by computer. Randomized controlled trials of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis were collected. The clinical trials that met the inclusion criteria were selected for quality assessment using the Cochrane 5.0 Handbook for systematic evaluation. RevMan5.3 was used for statistical analysis. ResultsA total of 23 articles with 1756 patients met the inclusion criteria. (1) The meta-analysis of 11 articles showed that the total effective rate of warm needling therapy for peripheral facial paralysis was higher than that of acupuncture [RR = 1.18, 95% CI (1.11,1.25) , P < 0.00001]. (2) The meta-analysis of 7 articles showed that the total effective rate of warm needling therapy combined with electroacupuncture in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with electroacupuncture [RR = 1.15, 95% CI (1.09, 1.21), P < 0.00001]. (3) The meta-analysis of 5 articles showed that the total effective rate of warm needling therapy combined with other therapies in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with other therapies [RR = 1.08, 95% CI (1.03, 1.14), P = 0.002]. (4) The meta-analysis of 5 articles showed that warm needling therapy could improve the House–Brackmann (H–B) scores of patients with peripheral facial paralysis more than acupuncture [mean difference (MD)=−2.85, 95% CI (−5.08, −0.62), Z = 2.51, P = 0.01], indicating that warm needling therapy provides superior improvement in the function of facial nerve innervation in the patients. No adverse events were reported in the included studies. The methodological quality of the included studies was generally low. ConclusionThe results of this meta-analysis showed that warm needling therapy is superior to acupuncture in treating peripheral facial paralysis, providing a therapeutic option for the treatment of peripheral facial paralysis. However, due to the small sample size and the low quality of the included studies, the above conclusion still needs to be validated with high-quality, large-scale, randomized, blinded controlled trials.