Xie Hong-Yu, Wang Ze-Hua, Kan Wen-Jing, Yuan Ai-Hong, Yang Jun, Ye Min, Shi Jie, Liu Zhen, Tong Hong-Mei, Cha Bi-Xiang, Li Bo, Yuan Xu-Wen, Zhou Chao, Liu Xiao-Jun
Second Department of Acupuncture Rehabilitation, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China.
Anhui University of Chinese Medicine, Hefei, 230038, China.
Chin J Integr Med. 2025 Jul 25. doi: 10.1007/s11655-025-4135-z.
To evaluate the clinical effect and safety of acupuncture manipulation on treatment of intractable facial paralysis (IFP), and verify the practicality and precision of the Anzhong Facial Paralysis Precision Scale (Eyelid Closure Grading Scale, AFPPS-ECGS).
A multicentre, single-blind, randomized controlled trial was conducted from October 2022 to June 2024. Eighty-nine IFP participants were randomly assigned to an ordinary acupuncture group (OAG, 45 cases) and a characteristic acupuncture group (CAG, 44 cases) using a random number table method. The main acupoints selected included Yangbai (GB 14), Quanliao (SI 18), Yingxiang (LI 20), Shuigou (GV 26), Dicang (ST 4), Chengjiang (CV 24), Taiyang (EX-HN 5), Jiache (ST 6), Fengchi (GB 20), and Hegu (LI 4). The OAG patients received ordinary acupuncture manipulation, while the CAG received characteristic acupuncture manipulation. Both groups received acupuncture treatment 3 times a week, with 10 times per course, lasting for 10 weeks. Facial recovery was assessed at baseline and after the 1st, 2nd and 3rd treatment course by AFPPS-ECGS and the House-Brackmann (H-B) Grading Scale. Infrared thermography technology was used to observe the temperature difference between healthy and affected sides in various facial regions. Adverse events and laboratory test abnormalities were recorded. The correlation between the scores of the two scales was analyzed using Pearson correlation coefficient.
After the 2nd treatment course, the two groups showed statistically significant differences in AFPPS-ECGS scores (P<0.05), with even greater significance after the 3rd course (P<0.01). Similarly, H-B Grading Scale scores demonstrated significant differences between groups following the 3rd treatment course (P<0.05). Regarding temperature measurements, significant differences in temperatures of frontal and ocular areas were observed after the 2nd course (P<0.05), becoming more pronounced after the 3rd course (P<0.01). Additionally, mouth corner temperature differences reached statistical significance by the 3rd course (P<0.05). No safety-related incidents were observed during the study. Correlation analysis revealed that the AFPPS-ECGS and the H-B Grading Scale were strongly correlated (r=0.86, 0.91, 0.93, and 0.91 at baseline, and after 1st, 2nd, and 3rd treatment course, respectively, all P<0.01).
Acupuncture is an effective treatment for IFP, and the characteristic acupuncture manipulation enhances the therapeutic effect. The use of the AFPPS-ECGS can more accurately reflect the recovery status of patients with IFP. (Trial registration No. ChiCTR2200065442).
评估针刺手法治疗顽固性面瘫（IFP）的临床疗效和安全性，并验证安中面瘫精准量表（眼睑闭合分级量表，AFPPS - ECGS）的实用性和准确性。
于2022年10月至2024年6月进行一项多中心、单盲、随机对照试验。采用随机数字表法将89例IFP患者随机分为普通针刺组（OAG，45例）和特色针刺组（CAG，44例）。选取的主要穴位包括阳白（GB 14）、颧髎（SI 18）、迎香（LI 20）、水沟（GV 26）、地仓（ST 4）、承浆（CV 24）、太阳（EX - HN 5）、颊车（ST 6）、风池（GB 20）和合谷（LI 4）。OAG组患者接受普通针刺手法，而CAG组接受特色针刺手法。两组均每周进行3次针刺治疗，每个疗程10次，持续10周。在基线期以及第1、2和3个疗程治疗后，采用AFPPS - ECGS和House - Brackmann（H - B）分级量表对面部恢复情况进行评估。使用红外热成像技术观察面部各个区域健侧与患侧的温差。记录不良事件和实验室检查异常情况。采用Pearson相关系数分析两个量表评分之间的相关性。
在第2个疗程治疗后，两组在AFPPS - ECGS评分上显示出统计学显著差异（P < 0.05），在第3个疗程后差异更显著（P < 0.01）。同样，在第3个疗程治疗后，H - B分级量表评分在两组之间也显示出显著差异（P < 0.05）。关于温度测量，在第2个疗程后观察到额部和眼部区域温度存在显著差异（P < 0.05），在第3个疗程后差异更加明显（P < 0.01）。此外，到第3个疗程时，口角温度差异达到统计学显著水平（P < 0.05）。在研究过程中未观察到与安全相关的事件。相关性分析显示，AFPPS - ECGS与H - B分级量表高度相关（基线期以及第1、2和3个疗程治疗后的r值分别为0.86、0.91、0.93和0.91，均P < 0.01）。
针刺是治疗IFP的有效方法，特色针刺手法可提高治疗效果。AFPPS - ECGS的使用能够更准确地反映IFP患者的恢复状况。（试验注册号：ChiCTR2200065442）
