Clinical Practice Guideline of Acupuncture for Bell’s Palsy

Xi Wu<sup>a</sup>; Ying Li<sup>a</sup>; Yi-Hui Zhu<sup>a</sup>; Hui Zheng<sup>a</sup>; Qin Chen<sup>b</sup>; Xue-Zhi Li<sup>c</sup>; Ling Luo<sup>a</sup>; Fang Zeng<sup>a</sup>; Wen-Jing Huang<sup>a</sup>; Ling Zhao<sup>a</sup>; Xiao-Dong Wu<sup>d</sup>; Hong Zhao<sup>e</sup>; Ming-Jie Zi<sup>f</sup>; Xu Guo<sup>g</sup>; Si-Yuan Zhou<sup>a</sup>; Hui-Juan Tan<sup>a</sup>; Fan-Rong Liang<sup>a*</sup>

Clinical Practice Guideline of Acupuncture for Bell’s Palsy

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DOI：10.15806/j.issn.2311-8571.2015.0016

KeyWord:Staging of Bell’s palsy, Acupuncture diagnosis and treatment, Evidence-based clinical practical guideline

Author	Institution
Xi Wu^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Ying Li^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Yi-Hui Zhu^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Hui Zheng^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Qin Chen^b	b.The Third Affiliated Hospital of Zhejiang Chinese Medical University, No.219 Moganshan Road, Moganshan Road Hospital District, , Hangzhou, Zhejiang Province, P.R. China
Xue-Zhi Li^c	c.Department of Traditional Chinese Medicine, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, , Chongqing, P.R. China
Ling Luo^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Fang Zeng^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Wen-Jing Huang^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Ling Zhao^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Xiao-Dong Wu^d	d.Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, No.16 Dongzhimen Inner South Alley, Chao Yang District, , Beijing, P.R. China
Hong Zhao^e	e.Acupuncture and Moxibustion Hospital, China Academy of Chinese Medical Sciences, No.16 Dongzhimen Inner South Alley, Chao Yang District, , Beijing, P.R. China
Ming-Jie Zi^f	f.Xiyuan Hospital, China Academy of Chinese Medical Sciences, No.1 Xiyuan playground, Haidian District, , Beijing, P.R. China
Xu Guo^g	g.Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chao Yang District, , Beijing, P.R. China
Si-Yuan Zhou^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Hui-Juan Tan^a	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China
Fan-Rong Liang^a*	a.School of Acupuncture & Moxibustion and Tuina, Chengdu University of TCM, No.37 Shierqiao Road, Jin Niu District, , Chengdu, Sichuan Province, P.R. China

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Abstract:

Backgroud: Acupuncture is common used for Bell’s palsy in clinic, however, recent systematic reviews all shows that there is no sufficient evidence to support the effectiveness of acupuncture for Bell’s palsy because ofthe poor quality and heterogeneity. It’s urgently necessary to develop a guideline of acupuncture for Bell’s palsy based on principles of evidence-based medicine to optimize acupuncture treating, standardize outcomes evaluating and to improve the quality of acupuncture for patients with Bell’s palsy under general circumstances. Objective: To improve the accuracy of diagnosing and managing Bell’s palsy, optimize acupuncture treating and outcomes evaluating for patients with Bell’s palsy, and to improve the quality of acupuncture for patients with Bell’s palsy in most instances. Methods: This guideline was developed using an explicit and transparent a priori protocol based on supporting evidences and experts’ consensus. The guideline developing Group followed the protocol through all stages of the development process: proposed clinical questions, searched clinical evidences, evaluated levels of evidences, developed recommendations, peer reviewed and consummated, and finally formed the draft of this guideline. Results: (1)The guideline development group made a Grade A recommendation that ①With a course of Bell’s palsy within 3 months, the patients with mild facial palsy may be treated with any one of acupuncture, western drugs, or acupuncture combing with western drugs, whereas the patients with severe facial palsy may be treated with acupuncture or acupuncture combing with western drugs. With a course of more than 3 months, acupuncture is more suitable. ②Acupuncture should be applied as early as possible for Bell’s palsy. ③The principle of selecting acupoints for Bell’s palsy is to select local points, points of corresponding meridians and those according to differentiation. Generally, the points of yangming meridians are the main ones. ④The various methods of acupuncture and moxibustion are adopted for Bell’s palsy, including filiform needling, moxibustion, electro-acupuncture, etc. Two or more methods are usually used together in clinical practice. (2) The development group formed expert consensus on the principles of acupuncture treatment for Bell’ palsy. Bell’s palsy is suitably treated according to the stages, differentiation and symptoms.