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针灸治疗周围性面瘫的时机:系统评价和荟萃分析。

Timing of Acupuncture Treatment in Peripheral Facial Paralysis: A Systematic Review and Meta-Analysis.

机构信息

The First Clinical Medicine College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China.

The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, China.

出版信息

Comput Math Methods Med. 2021 Dec 15;2021:4221955. doi: 10.1155/2021/4221955. eCollection 2021.

Abstract

OBJECTIVE

Investigate the optimum time of acupuncture treatment in peripheral facial paralysis in order to provide evidence for clinical treatment.

METHODS

CNKI, Wanfang, PubMed, Cochrane Library, and EMBASE databases were systematically searched from the inception dates to February 20, 2020. Studies limited to participants with acute peripheral facial paralysis treated with acupuncture and patients without information of the stage were excluded. The primary outcomes were effective rate and cure rate (based on facial nerve function scores). This meta-analysis is registered with PROSPERO, number CRD42020169870.

RESULTS

15 randomized controlled trials that enrolled 2847 participants met the selection criteria. There was no significant differences in the effective rate (RR, 1.22; 95% CI, 0.70-2.11) when comparing acupuncture to prednisone therapy in acute facial paralysis. Acupuncture treatment in the acute stage increased both the effective rate (RR, 1.03; 95% CI, 1.00-1.07) and the cure rate (RR, 1.34; 95% CI, 1.14-1.58) compared to that in the nonacute stage.

CONCLUSIONS

In this meta-analysis, acupuncture showed a better effect in the acute stage than the nonacute stage for participants with peripheral facial paralysis. There was no statistical difference in the effective rate no matter the choice of acupuncture or prednisone therapies in the acute stage. These findings encourage early acupuncture treatment in peripheral facial paralysis.

摘要

目的

探索针灸治疗周围性面瘫的最佳时机,为临床治疗提供依据。

方法

计算机检索中国知网、万方、PubMed、Cochrane Library、EMBASE 数据库,检索时限均为建库至 2020 年 2 月 20 日,纳入针灸治疗急性周围性面瘫且排除失访及分期不详的随机对照试验。主要结局指标为有效率、治愈率(基于面神经功能评分)。本研究采用 PROSPERO 进行注册,注册号为 CRD42020169870。

结果

共纳入 15 项随机对照试验,2847 例患者符合标准。急性期针刺与泼尼松治疗比较,有效率差异无统计学意义[RR=1.22,95%CI(0.70,2.11)]。急性期针刺治疗有效率[RR=1.03,95%CI(1.00,1.07)]和治愈率[RR=1.34,95%CI(1.14,1.58)]均高于非急性期。

结论

本研究表明,与非急性期相比,急性期针刺治疗周围性面瘫的效果更好,但在急性期,无论选择针刺还是泼尼松治疗,有效率差异均无统计学意义。这些发现鼓励对面瘫患者进行早期针灸治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ebb/8694981/d6a36fa284c0/CMMM2021-4221955.001.jpg

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