He L, Zhou D, Wu B, Li N, Zhou M K
Department of Neurology, First University Hospital, West China University of Medical Sciences, Chengdu 610041, Sichuan, China.
Cochrane Database Syst Rev. 2004(1):CD002914. doi: 10.1002/14651858.CD002914.pub2.
Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested acupuncture is beneficial for facial palsy.
The objective of this review was to examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell's palsy.
We searched the Cochrane Neuromuscular Disease Group Register, MEDLINE (January 1966 to December 2002), EMBASE (January 1980 to December 2002), LILACS (from January 1982 to December 2002) and the Chinese Biomedical Retrieval System (January 1978 to December 2002) for randomised controlled trials using 'Bell's palsy' and its synonyms, 'idiopathic facial paralysis' or 'facial palsy' as well as search terms including 'acupuncture'. Chinese journals in which we thought we might find randomised controlled trials or controlled clinical trials relevant to our study were handsearched. We reviewed the bibliographies of the randomised trials and contacted the authors and known experts in the field to identify additional published or unpublished data.
We included all randomised or quasi-randomised controlled trials involving acupuncture in the treatment of Bell's palsy irrespective of any language restrictions.
Two reviewers identified potential articles from the literature search and extracted data independently using a data extraction form. The assessment of methodological quality included allocation concealment, patient blinding, differences at baseline of the experimental groups and completeness of follow-up. Two reviewers assessed quality independently. All disagreements were resolved by discussion between the reviewers.
Three studies including a total of 238 patients met the inclusion criteria. Two of them used acupuncture while the third used acupuncture combined with drugs. No trials reported on the outcomes specified for this review. Three included studies showed that the therapeutic effect of acupuncture alone was superior to that of medication or that acupuncture combined with medication was better than medication alone. Harmful side-effects were not reported in any of the trials. Flaws in study design or reporting (particularly uncertain allocation concealment and substantial loss to follow-up) and clinical differences between trials prevented a meta-analysis.
REVIEWER'S CONCLUSIONS: The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.
贝尔面瘫或特发性面神经麻痹是一种因面神经炎症引起的急性面瘫。中国发表的多项研究表明针灸对面瘫有益。
本综述的目的是研究针灸在加速贝尔面瘫恢复及降低其长期发病率方面的疗效。
我们检索了Cochrane神经肌肉疾病组注册库、MEDLINE（1966年1月至2002年12月）、EMBASE（1980年1月至2002年12月）、LILACS（1982年1月至2002年12月）以及中国生物医学文献数据库（1978年1月至2002年12月），以查找使用“贝尔面瘫”及其同义词“特发性面神经麻痹”或“面瘫”以及包括“针灸”在内的检索词的随机对照试验。我们手工检索了我们认为可能找到与本研究相关的随机对照试验或对照临床试验的中文期刊。我们查阅了随机试验的参考文献，并联系了该领域的作者和知名专家以识别其他已发表或未发表的数据。
我们纳入了所有涉及针灸治疗贝尔面瘫的随机或半随机对照试验，不受任何语言限制。
两位综述作者从文献检索中识别出潜在的文章，并使用数据提取表独立提取数据。方法学质量评估包括分配隐藏、患者盲法、实验组基线差异及随访完整性。两位综述作者独立评估质量。所有分歧均通过综述作者之间的讨论解决。
三项研究共纳入238例患者，符合纳入标准。其中两项使用针灸，第三项使用针灸联合药物。没有试验报告本综述指定的结局。三项纳入研究表明，单纯针灸的治疗效果优于药物治疗，或者针灸联合药物治疗优于单纯药物治疗。所有试验均未报告有害副作用。研究设计或报告中的缺陷（特别是分配隐藏不确定和大量失访）以及试验之间的临床差异妨碍了进行荟萃分析。
纳入试验的质量不足以就针灸的疗效得出任何结论。需要更多高质量试验的研究。
