RESUMO
Objective:To compare the efficacy between acupuncture and acupuncture with infrared thermography-guided Chinese massage (Tuina) in treatment of children with Bell′s palsy (BP).Methods:Seventy two children with BP admitted to the Rehabilitation Department of Beijing Children′s Hospital from October 2019 to April 2020 were randomly assigned into two groups: 35 cases were treated with acupuncture alone (acupuncture group) and 37 cases received acupuncture combined with Tuina for treatment (combination group). In combination group, the temperature of forehead, cheek and mandible areas was examined by infrared thermography before each course. Compared healthy side if the temperature on the affected side was lower, higher or the same, rubbing method, tapping method and one-finger meditation push method of Tuina was applied, afterwards the acupuncture treatment was given as in the acupuncture group. Patients in both groups were treated once a day with 5 days for a course and a total of 3 courses. The patients were assessed with House-Brackmann (H-B) facial nerve function evaluation scale and Portmann simple score scale before and after each course of treatment.Results:The H-B classification of the two groups of children at the end of the third course of treatment was significantly better than that before treatment (χ2=31.01, 56.41; P<0.01). There was no significant difference in H-B grading between the two groups before treatment, after the first and second course (χ2=0.58, 8.49, 6.79; P>0.05). After the third course of treatment, the H-B grading assessment of the combination group was significant better than that of the acupuncture group (χ2=10.03, P<0.05). The Portmann scores of the two groups were improved after each course of treatment ( F=9.68, 22.54; P<0.01); however, the facial nerve function of combination group was improved more significantly than that of acupuncture group [(13.97±4.58) vs.(10.97±5.40), t=2.55, P=0.01]. The total effective rate of combination group was higher than that of acupuncture group [51.35% (19/37) vs. 20.00% (7/35), χ2=6.79, P<0.05]. There was a significant difference in the application frequency of three Tuina methods among the forehead, cheek and mandibular areas in the first course and the third course (χ2=21.23, 13.33; P<0.05). In the same area (forehead, cheek and mandible) there was a significant difference in the application frequency of three massage techniques among the three courses of treatment (χ2=31.26, 21.35, P<0.01). Conclusion:With the guidance of infrared thermal imaging, individualized Chinese massage (Tuina) combined with acupuncture treatment is more effective in treatment of children with Bell′s palsy than using acupuncture alone.