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

Special Issue: Acupuncture & Moxibustion

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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
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