Abstract
To determine if the effect of manipulative acupuncture monitored by laser speckle contrast imaging (LSCI) can improve facial blood perfusion in patients with severe Bell's palsy. This randomized, single-blind, controlled trial included 120 newly diagnosed patients (within 14 days) with severe Bell's palsy (House–Brackmann grading system (HBGS) ≥ grade IV). The patients were randomized (1 : 1) to receive either acupoints acupuncture combined with manipulations of twirling, lifting, and thrusting treatments (manipulative acupuncture) or acupoints acupuncture therapy alone (simple acupuncture). These treatments consisted of a total of 24 sessions, three times per week, and each treatment lasted for 30 min. Following 8 weeks of treatment and 6 months after the initial onset of facial palsy, facial nerve functioning was scored (HBGS) and clinical efficacy was measured. The patients' facial blood perfusion significantly improved following manipulative acupuncture assisted by LSCI compared with that at baseline (P < 0.01). At the conclusion of the 8-week treatment, both groups showed improvement; however, the recovery rate was significantly different (manipulative acupuncture 53.3% vs. simple acupuncture 33.9%, P < 0.05). Follow-up analysis at 6 months after the onset of facial palsy revealed a significantly higher recovery rate (91.7% vs. 78.0%; P < 0.05). In addition, the number of treatments in the observation group was less than that in the simple acupuncture therapy group (P < 0.05). Compared with simple acupuncture therapy, manipulative acupuncture therapy led to a more significant recovery rate in the treatment of severe Bell's palsy and required a shorter course of treatment. This trial was registered with ChiCTR1800019463.
Highlights
Bell’s palsy is an acute peripheral facial nerve palsy of unknown cause and accounts for 50% of all cases of facial nerve palsy [1]. e annual incidence rate is between 13 and 34 cases per 100,000 individuals [2]
Sample size calculation was dependent on a randomized pilot study of 16 patients with severe facial paralysis before the trial. e pilot study found that the cure rate of manipulative acupuncture under laser speckle contrast imaging (LSCI) was 87.5% and that of simple acupuncture treatment was 62.5%. en, we calculated the sample size of the two groups as 116, with an α of 0.05 and statistical power of 0.90
120 patients completed randomization; 60 patients aged 20–69 years underwent manipulative acupuncture treatment, and 60 patients aged 19–69 years underwent simple acupoints acupuncture treatment (Figure 1)
Summary
Bell’s palsy is an acute peripheral facial nerve palsy of unknown cause and accounts for 50% of all cases of facial nerve palsy [1]. e annual incidence rate is between 13 and 34 cases per 100,000 individuals [2]. Ese findings suggest that acupuncture plays a beneficial role in Bell’s palsy. Blood perfusion of acute facial palsy, metabolic activity of the affected facial tissues, and facial nerve function have been shown to be significantly improved by acupuncture [7]. All these studies are observational; the causal relationship has not yet been elucidated. Is study was designed as a randomized, single-blind, controlled trial to evaluate whether the treatment of manipulative acupuncture monitored by LSCI technology could improve blood perfusion, enhance the curative effect, and reduce the recovery time of patients with severe Bell’s palsy All these studies are observational; the causal relationship has not yet been elucidated. is study was designed as a randomized, single-blind, controlled trial to evaluate whether the treatment of manipulative acupuncture monitored by LSCI technology could improve blood perfusion, enhance the curative effect, and reduce the recovery time of patients with severe Bell’s palsy
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