Effect of acupuncture and moxibustion on brain functional connectivity network in patients with refractory facial paralysis / 中国针灸

OBJECTIVE@#To observe the effects of acupuncture on resting-state functional connectivity (rs-FC) in patients with refractory peripheral facial paralysis, and to preliminarily explore the central mechanism of acupuncture for this disease.@*METHODS@#Twenty patients with refractory peripheral facial paralysis were selected as subject and treated with acupuncture at Qianzheng (EX-HN 16), Fengchi (GB 20), Cuanzhu (BL 2), Dicang (ST 4), Jiache (ST 6), Shuigou (GV 26), Chengjiang (CV 24), Yifeng (TE 17), Touwei (ST 8), Sibai (ST 2), Yingxiang (LI 20) and Hegu (LI 4), once every other day, three times a week, 15 times as a course of treatment. The 1-course treatment was given. The score of Sunnybrook (Toronto) facial grading system was used to evaluate the clinical efficacy before and after the treatment. In addition, 20 healthy volunteers were selected as control. For patients, the resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed before and after treatment, for healthy volunteers, the scans were performed when they were recruited. The brain magnetic resonance images were analyzed with left primary motor area (LMⅠ) and right primary motor area (RMⅠ) as regions of interest. The differences of rs-FC between patients with refractory peripheral facial paralysis before and after treatment and healthy volunteers were compared.@*RESULTS@#Compared before treatment, the Sunnybrook score was increased after the treatment (<0.05). Compared with healthy volunteers, the functional connection between bilateral primary motor areas (MⅠ) and multiple brain areas were enhanced in patients before treatment, and most of brain areas were located in the anterior motor area (middle frontal gyrus, superior frontal gyrus), posterior central gyrus, anterior cuneiform lobe, middle temporal gyrus, inferior temporal gyrus and cerebellum lobe. Compared before treatment, the left inferior frontal gyrus was the strong functional connection area between LMⅠ and whole brain after acupuncture treatment, and there was no significant difference between RMⅠ and resting-state whole brain. Compared with healthy volunteers, the functional connections between bilateral MⅠ and multiple brain regions were enhanced after acupuncture, and most of the main brain regions were consistent with those before treatment.@*CONCLUSION@#(1) Acupuncture could effectively improve the clinical symptoms of refractory peripheral facial paralysis. (2) The brain function of patients with refractory peripheral facial paralysis has been changed before acupuncture, which may be caused by the reactive compensation of the brain. (3) Acupuncture could enhance the functional connection between LMⅠ and left inferior frontal gyrus to promote the compensatory response, which may be one of the central mechanisms of acupuncture for refractory peripheral facial paralysis.

Special penetration needling for refractory peripheral facial paralysis / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical effect difference between special penetration needling and conventional penetration needling for the refractory peripheral facial paralysis.</p><p><b>METHODS</b>A total of 97 patients with intractable facial paralysis were randomized into an observation group (49 cases and 2 dropping) and a control group (48 cases and 4 dropping). In the observation group, special penetration needling at an angle about 45° between the penetration needle and paralysis muscle bundle was used, Yangbai (GB 14) through Touwei (ST 8), Yangbai (GB 14) through Shangxing (GV 23), Sizhukong (TE 23) through Yuyao (EX-HN 4), Qianzhen (Extra) through Yingxiang (LI 20), mutual penetration between Yingxiang (LI 20) and Jiache (ST 6). Conventional penetration needling was applied in the control group, Yangbai (GB 14) through Yuyao (EX-HN 4), Cuanzhu (BL 2) through Yuyao (EX-HN 4), mutual penetration between Dicang (ST 4) and Jiache (ST 6), Qianzheng (Extra) through Dicang (ST 4), Sibai (ST 2) through Yingxiang (LI 20). Three groups of electroacupuncture (discontinuous wave, 1 Hz) with tolerance were connected respectively in the two groups, Yangbai (GB 14) and Sizhukong (TE 23), Yangbai (GB 14) and Qianzheng (Extra), Yingxiang (LI 20) and Jiache (ST 6) in the observation group, Yangbai (GB 14) and Cuanzhu (BL 2), Dicang (ST 4) and Jiache (ST 6), Qianzheng (Extra) and Sibai (ST 2) in the control group. TDP was applied in the two groups at the affected Yifeng (TE 17), Jiache (ST 6) and Qianzheng (Extra), which were around the ear. Perpendicular insertion was used at Yifeng (TE 17) at the affected side and Hegu (LI 4) at the healthy side and bilateral Zusanli (ST 36). The needles were retained for 30 min. The treatment was given for 3 courses, once a day and 10 days as a course, 5 days at the interval. House-Brackmann (H-B) facial nerve grading score was recorded before and after treatment. The clinical effects were compared.</p><p><b>RESULTS</b>The H-B scores after treatment in the two groups were higher than those before treatment (both <0.05), with better result in the observation group (<0.05). The cured and markedly effective rate of the observation group was 74.5% (35/47), which was better than 47.7% (21/44) of the control group (<0.01).</p><p><b>CONCLUSION</b>Special penetration needling at an angle about 45° between the penetration needle and paralysis muscle bundle is better than conventional penetration needling for refractory facial paralysis.</p>

Efficacy Comparison Between Heat-sensitive Moxibustion and Ginger-partition Moxibustion for Refractory Peripheral Facial Paralysis / 广州中医药大学学报

Objective To compare the effects of heat-sensitive moxibustion and ginger-partition moxibustion on refractory peripheral facial paralysis. Methods Fifty-five patients with refractory peripheral facial paralysis were randomized into heat-sensitive moxibustion group (N=28) and ginger-partition moxibustion group (N=27). For two cases dropped out during the treatment, a total of 25 cases were finally enrolled into the ginger-partition moxibustion group. Two groups received oral use of mecobalamin tablets and conventional acupuncture, and heat-sensitive moxibustion group was given heat-sensitive moxibustion and ginger-partition moxibustion group was given ginger-partition moxibustion additionally. The moxibustion was performed once a day and ten times constituted one course, the treatment covered 6 courses. The clinical effect of the two groups was evaluated by 40-score method, House-Brackmann facial neurological function evaluation standard, blink reflex ( BR) , electromyogram and electroneurography. Results ( 1) Symptoms integral was increased in both groups after treatment ( P0.05). Conclusion The curative effect of heat-sensitive moxibustion for the treatment of refractory peripheral facial paralysis is better than that of ginger-partition moxibustion.