[an error occurred while processing this directive]

Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (9): 997-1002.doi: 10.3736/jcim20120908

Special Issue: Acupuncture & Moxibustion

Previous Articles     Next Articles

Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell’s palsy

Zhang-ling Zhou1(), Cheng-xin Li1, Yue-bo Jiang1, Cong Zuo2, Yun Cai3, Rui Wang3   

  1. 1. Department of Acupuncture and Moxibustion, General Hospital of the People’s Liberation Army, Beijing 100853, China;
    2. Department of Physiology, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
    3. School of Traditional Chinese Medicine, Hainan Medical College, Haikou 570102, Hainan Province, China
  • Received:2012-04-18 Accepted:2012-05-03 Online:2012-09-20 Published:2018-09-15
  • Contact: Zhang-ling Zhou E-mail:zhangling@sina.com

Objective: To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell’s palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis.

Methods: The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The authors gave acupuncture treatment according to the state of the disease without artificially setting the treatment period. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process.

Results: Fifty-three cases out of 68 patients with Bell’s palsy were cured and the overall rate of efficacy was 97%. Statistically significant differences (P<0.01) were perceived among the efficacy of five levels of facial nerve dysfunction. Efficacy was correlated with the damage level of the disease (correlation coefficient r=0.423, P<0.01). The course of treatment also extended with the severity of facial nerve dysfunction (P<0.01).

Conclusion: Differences exist in patients with Bell’s palsy in terms of severity of facial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease.

Key words: facial nerve, House-Brackmann scale, Bell palsy, acupuncture therapy, treatment outcome, clinical trial

Table 1

Basic characteristic data"

Level n Gender (n) Disease site (n) Average
age (years)
Male Female Left Right
Mild 15 9 6 8 7 35.67
Moderate 14 8 6 8 6 40.80
Moderately severe 13 8 5 7 6 32.76
Severe dysfunction 14 7 7 9 5 42.25
Complete paralysis 12 6 6 7 5 41.00

Table 2

Comparison of efficacy of facial nerve dysfunction with different levels"

Level n Distribution of efficacy (cases) Cure
rate (%)
Cure Excellent Effective Invalid
Mild 15 15 0 0 0 100.00
Moderate 14 13 1 0 0 92.86
Moderately severe 13 11 2 0 0 84.62
Severe dysfunction 14 9 4 1 0 64.29
Complete paralysis 12 5 3 2 2 41.67

Table 3

Pair comparison of efficacy of facial nerve dysfunction with different levels"

Compare Sample size t value P value
A & B nA nB
Mild & moderate 15 14 0.354 >0.05
Mild & moderately severe 15 13 0.739 >0.05
Mild & severe dysfunction 15 14 1.844 >0.05
Mild & complete paralysis 15 12 3.173 <0.01
Moderate & moderately severe 14 13 0.396 >0.05
Moderate & severe dysfunction 14 14 1.398 >0.05
Moderate & complete paralysis 14 12 2.789 <0.01
Moderately severe & severe
dysfunction
13 14 1.044 >0.05
Moderately severe & complete
paralysis
13 12 2.369 <0.05
Severe dysfunction & complete
paralysis
14 12 1.378 >0.05

Table 4

Comparison of treatment course of facial nerve dysfunction with different levels"

Level Treatment course (n, %) Total
1 week to 4 weeks 5 to 8 weeks 9 to 12 weeks Over 12 weeks
Mild 12 (80.00%) 2 (13.30%) 1 (6.70%) 0 15
Moderate 9 (64.29%) 2 (14.29%) 0 3 (21.45%) 14
Moderately severe 6 (46.15%) 3 (23.08%) 0 4 (30.77%) 13
Severe dysfunction 2 (14.30%) 5 (35.70%) 2 (14.30%) 5 (35.70%) 14
Complete paralysis 3 (25.00%) 0 4 (33.30%) 5 (41.70%) 12
Total 32 (47.06%) 12 (12.65%) 7 (10.29%) 17 (25.00%) 68
[1] Chen HZ. Practical internal medicine.10th ed[M]. Beijing: People’s Medical Publishing House, 1998,2185
陈灏珠 . 实用内科学.第10版[M]. 北京: 人民卫生出版社, 1998,2185
[2] Du YH. Modern disease menu of acupuncture and moxibustion therapy[M]. Beijing: People’s Medical Publishing House, 2009,416
杜元灏 . 现代针灸病谱[M]. 北京: 人民卫生出版社, 2009,416
[3] House JW, Brackmann DE . Facial nerve grading system[J]. Otolaryngol Head Neck Surg, 1985,93(2):146-147
doi: 10.1177/019459988509300202
[4] Bei ZP. Diagnostic criteria of internal diseases[M]. Beijing: Science Press, 2001,813
贝政平 . 内科疾病诊断标准[M]. 北京: 科学出版社, 2001,813
[5] Yu GY, Gu XM, Cai ZG. The peripheral facial paralysis[M]. Beijing: People’s Medical Publishing House, 2005,69
俞光岩, 顾晓明, 蔡志刚 . 周围性面瘫[M]. 北京: 人民卫生出版社, 2005,69
[6] Chinese Medical Association. Clinical practice guidelines: Neurologic volume[M]. Beijing: People’s Medical Publishing House, 2011,192
中华医学会. 临床诊疗指南: 神经病学分册[M]. 北京: 人民卫生出版社, 2011,192
[7] Yu GY, Gu XM, Cai ZG. The peripheral facial paralysis[M]. Beijing: People’s Medical Publishing House, 2005,51
俞光岩, 顾晓明, 蔡志刚 . 周围性面瘫[M]. 北京: 人民卫生出版社, 2005,51
[8] Wang SQ, Bai YP, Yu S . Analysis on several influencing factors in acupuncture and moxibustion treatment of peripheral facial paralysis[J]. Zhongguo Zhen Jiu, 2003,23(6):367-370
王声强, 白亚平, 于溯 . 针刺治疗周围性面瘫若干影响因素的分析[J]. 中国针灸, 2003,23(6):367-370
[9] Gu JH, Jia SH . Clinical observation on acupuncture for 83 patients with facial paralysis[J]. Zhong Yi Yao Xue Bao, 1997,25(6):42
顾建华, 贾淑华 . 针灸治疗面瘫83例临床观察[J]. 中医药学报, 1997,25(6):42
[10] 朱美兰, 罗军, 戴江华 . 电针治疗时机的选择对面神经炎疗效的影响[J]. 实用临床医学, 2009,10(1):24
Zhu ML, Luo J, Dai JH . Influence of the timing choice of electroacupuncture treatment on theraputic effect for facial paralysis[J]. Shi Yong Lin Chuang Yi Xue, 2009,10(1):24
[11] Zhao H . Observation on the therapeutic effect of electroacupuncture combined with acupoint application in 45 cases of persistent facial paralysis[J]. Neimenggu Zhong Yi Yao, 2007,( 5):23-24
赵虹 . 电针配合穴位贴敷治疗顽固性面瘫45例疗效观察[J]. 内蒙古中医药, 2007,( 5):23-24
[12] Shang JY . Analysis on acupuncture for 256 cases of facial paralysis[J]. Zhongguo Wu Zhen Xue Za Zhi, 2009,9(13):3174
尚军英 . 针灸治疗面瘫256例分析[J]. 中国误诊学杂志, 2009,9(13):3174
[13] Yang ZY . Acupuncture plus acupoint application with Chinese medicine treatment for 136 cases of facial paralysis[J]. Shi Yong Zhong Yi Yao Za Zhi, 2008,24(5):291
杨智勇 . 针灸加中药穴位贴敷治疗面瘫136例[J]. 实用中医药杂志, 2008,24(5):291
[14] Pan HF . Electroacupuncture treatment and prognosis determination for peripheral facial paralysis[J]. Zhongguo Ming Jian Liao Fa, 2007,15(11):12-13
潘慧芬 . 电针用于周围性面瘫的治疗及预后测定[J]. 中国民间疗法, 2007,15(11):12-13
[15] An K . Correlation between localization diagnosis and acupuncture effect of peripheral facial paralysis[J]. Gansu Zhong Yi Xue Yuan Xue Bao, 2004,21(4):38-39
安珂 . 周围性面瘫定位诊断与针刺疗效关系[J]. 甘肃中医学院学报, 2004,21(4):38-39
[16] Zeng D, Li GQ . Effect of acupuncture on patient with facial neuritis with different degrees of injury[J]. Chongqing Yi Ke Da Xue Xue Bao, 2010,35(3):448-450
曾丹, 李光勤 . 针灸对不同损伤程度面神经炎患者治疗疗效的影响[J]. 重庆医科大学学报, 2010,35(3):448-450
[1] Lu Liu, Ying Gao. Study on the correlation between traditional Chinese medicine syndrome and short-term prognosis of ischemic stroke using logistic regression model and repeated-measures analysis of variance. Journal of Chinese Integrative Medicine, 2012, 10(9): 983-990.
[2] Jian-sheng Li, Ya Li, Su-yun Li, Yuan-yuan Wang, Li Deng, Yan-ge Tian, Su-li Jiang , Ying Wang. Long-term effects of Tiaobu Feishen therapies on systemic and local inflammation responses in rats with stable chronic obstructive pulmonary disease. Journal of Chinese Integrative Medicine, 2012, 10(9): 1039-1048.
[3] Ming T. Tan , Jian-ping Liu , Lixing Lao. Adequate application of quantitative and qualitative statistic analytic methods in acupuncture clinical trials. Journal of Chinese Integrative Medicine, 2012, 10(8): 847-852.
[4] Oing-na Li , Xiu-ling Huang , Rui Gao , Fang Lu. Discussion on developing a data management plan and its key factors in clinical study based on electronic data capture system. Journal of Chinese Integrative Medicine, 2012, 10(8): 841-846.
[5] Chen Xia , Qun-bang Zhu, Feng Huang, Jing-hui Huang, Hong-da Chen, Ming-jun Chen, Wei Gu, Bai Li, Fan-fu Fang, Liang-neng Wu . Traditional Chinese medicine constitution types in 127 elderly patients with insomnia: An investigation in communities of Yangpu District, Shanghai. Journal of Chinese Integrative Medicine, 2012, 10(8): 866-873.
[6] Wei-hua Xu, Ze-huai Wen, Wei-xiong Liang, Qi Wang. A review of research on the development of instruments for therapeutic efficacy evaluation of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(7): 726-737.
[7] Qin-hui Fu, Jian Pei, Qi Jia, Yi Song, Yue-hua Gu, Xiao-xin You . Acupuncture treatment programs for post-stroke motor rehabilitation in community hospitals: Study protocol of a multicenter, randomized, controlled trial. Journal of Chinese Integrative Medicine, 2012, 10(5): 516-524.
[8] Christoph A. Doenitz, Ana Anjos, Thomas Efferth , Tobias Greten, Henry J. Greten. Can heat and cold be parameterized? Clinical data of a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(5): 532-537.
[9] Hong-bo Cao, Hong-cai Shang . Connotations and extensions of comparative effectiveness research and feasibility analysis for clinical evaluation in traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(4): 369-374.
[10] De-bo Qi, Wei-min Li. Effects of electroacupuncture on expression of c-fos protein and N-methyl-D-aspartate receptor 1 in the rostral ventromedia medulla of rats with chronic visceral hyperalgesia. Journal of Chinese Integrative Medicine, 2012, 10(4): 416-423.
[11] Paula de Sousa Fragoso Ana, de Sá Ferreira Arthur. Evaluation of the immediate effects of manual acupuncture on brachial bicep muscle function in healthy individuals and poststroke patients: a study protocol of a parallel-group randomized clinical trial. Journal of Chinese Integrative Medicine, 2012, 10(3): 303-309.
[12] Li-xin Ma, Yu-yi Wang, Xin-xue Li, Jian-ping Liu . Systematic review on methodology of randomized controlled trials of post-marketing Chinese patent drugs for treatment of type 2 diabetes. Journal of Chinese Integrative Medicine, 2012, 10(3): 279-292.
[13] Gui-lin Ouyang, Xiao-hui Feng, Lian-bo Xiao, Zheng Huang, Qing Xia, Da-peng Han, Fei Zhu . Effects of Chinese herbal medicine Qianggu Capsule on patients with rheumatoid arthritis-induced osteoporosis: a report of 82 cases. Journal of Chinese Integrative Medicine, 2012, 10(12): 1394-1399.
[14] De-bo Qi, Wei-min Li. Effects of electroacupuncture on expression of c-fos protein in the spinal dorsal horn of rats with chronic visceral hyperalgesia. Journal of Chinese Integrative Medicine, 2012, 10(12): 1490-1496.
[15] Yu Zhao, Jing-hua Peng , Xue-mei Li , Qi-lin Fu, Tuan Cui , Qi Li, Ya-jun Tang , Qin Feng , Hua Zhang , Hua Zhou , Yi-yang Hu. Diagnostic value of clinical indices in syndrome differentiation of chronic hepatitis B: an exploration based on receiver operating characteristic curves and stepwise discriminant analysis. Journal of Chinese Integrative Medicine, 2012, 10(12): 1382-1387.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239
[an error occurred while processing this directive]