Search JIM Advanced Search

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

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
13 14 1.044 >0.05
Moderately severe & complete
13 12 2.369 <0.05
Severe dysfunction & complete
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] Pratya Phetkate, Tanawan Kummalue, Prasob-orn Rinthong, Somboon Kietinun, Kusuma Sriyakul. Study of the safety of oral Triphala aqueous extract on healthy volunteers. Journal of Integrative Medicine, 2020, 18(1): 35-40.
[2] Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[3] L. Elisabeth Burton, Fares Qeadan, Mark R. Burge. Efficacy of equine-assisted psychotherapy in veterans with posttraumatic stress disorder. Journal of Integrative Medicine, 2019, 17(1): 14-19.
[4] Ubiratan Cardinalli Adler, Ana Carolina Acorinte, Fernando Oliveira Calzavara, Adriano Andréda Silva, Amarilys de Toledo Cesar, Maristela Schiabel Adler, Edson Zangiacomi Martinez, José Carlos Fernandes Galduróz. Double-blind evaluation of homeopathy on cocaine craving: A randomized controlled pilot study. Journal of Integrative Medicine, 2018, 16(3): 178-184.
[5] Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[6] Maryam Sharifi-Ardani, Leili Yekefallah, Saeed Asefzadeh, Marjan Nassiri-Asl. Efficacy of topical chamomile on the incidence of phlebitis due to an amiodarone infusion in coronary care patients: A double-blind, randomized controlled trial. Journal of Integrative Medicine, 2017, 15(5): 373-378.
[7] Susana Seca, Sebastian Kirch, António S.Cabrita, Henry J.Greten. Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double-blind, randomized clinical trial. Journal of Integrative Medicine, 2016, 14(3): 219-227.
[8] Maria T.Chao, AlexandraChang, SanjayReddy, James D.Harrison, JosephAcquah, MiriaToveg, TrilceSantana, Frederick M.Hecht. Adjunctive acupuncture for pain and symptom management in the inpatient setting: Protocol for a pilot hybrid effectiveness-implementation study. Journal of Integrative Medicine, 2016, 14(3): 228-238.
[9] Paulo AraujoDias, André Brito Bastos Guimarães, Andrea de Oliveira Albuquerque, Karoline Lucasde Oliveira, Maria Luzete CostaCavalcante, Sergio BotelhoGuimarães. Short-term complementary and alternative medicine on quality of life in women with fibromyalgia. Journal of Integrative Medicine, 2016, 14(1): 29-35.
[10] Bosch Peggy, van den Noort Maurits, Yeo Sujung, Lim Sabina, Coenen Anton, van Luijtelaar Gilles. The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 2015, 13(6): 380-390.
[11] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part III: Sample size calculation. Journal of Integrative Medicine, 2015, 13(4): 209-211.
[12] Sung Min Lim, Sook-Hyun Lee. Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: A systematic review and meta-analysis. Journal of Integrative Medicine, 2015, 13(4): 241-247.
[13] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part II: Zelen design and effectiveness dilutions. Journal of Integrative Medicine, 2015, 13(3): 136-139.
[14] Arthur Yin Fan. The methodology flaws in Hinman’s acupuncture clinical trial, Part I: Design and results interpretation. Journal of Integrative Medicine, 2015, 13(2): 65-68.
[15] Marco Gemma, Elisa Nicelli, Luigi Gioia, Elena Moizo, Luigi Beretta, Maria Rosa Calvi. Acupuncture accelerates recovery after general anesthesia: A prospective randomized controlled trial. Journal of Integrative Medicine, 2015, 13(2): 99-104.
Full text



[1] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[2] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. Guiding principles of clinical research on mild cognitive impairment (protocol). Journal of Chinese Integrative Medicine, 2008, 6(1): 9-14
[3] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[4] Bo Wang , Wei Yan , Li-hui Hou, Xiao-ke Wu. Disorder of Tiangui (kidney essence) and reproductive dysfunction in patients with polycystic ovary syndrome. Journal of Chinese Integrative Medicine, 2010, 8(11): 1018-1022
[5] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[6] Ya-hui Liang , Ping Li, Jing-xia Zhao, Xin Liu, Qi-fu Huang. Acetyl-11-keto-beta-boswellic acid and arsenic trioxide regulate the productions and activities of matrix metalloproteinases in human skin fibroblasts and human leukemia cell line THP-1. Journal of Chinese Integrative Medicine, 2010, 8(11): 1060-1069
[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] Chan Chen, Yong-mei Meng , Peng Zhang, Juan Wang, Hui-hui Zhao, Shu-zhen Guo , Wei Wang. Diagnosis and treatment rule of traditional Chinese medicine for syndrome factors of chronic congestive heart failure: a study based on Shannon entropy method. Journal of Chinese Integrative Medicine, 2010, 8(11): 1080-1084
[9] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[10] 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