Randomized controlled trial demonstrates intense acupuncture linked to better outcomes
Bell’s palsy (facial palsy) causes sudden weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing, according to the Mayo Clinic.
Bell Palsy can affect anyone at any age. The exact cause is unknown, but the theory suggests it is a result of swelling and inflammation of the 7th cranial nerve (the nerve that controls muscles on one side of the face). It could be a reaction that occurs after a viral infection. Symptoms usually start to improve within a few weeks, with complete recovery in about six months however, there are a small number of people that continue to have the symptoms for life.
The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to achieve de qi (the term used for the sensation felt when an acupuncturist (or acupressure/shiatsu practitioner) which is necessary to achieve the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints. However, the notion that de qi must be achieved for maximum benefit has not been confirmed by modern scientific evidence, according to study’s background.
In this prospective multicenter randomized controlled trial, researchers strived to understand the effectiveness of acupuncture with weak stimulation or strong (de qi) stimulation.
The trail involved 338 patients with Bell’s palsy. The trial was conducted at 11 tertiary hospitals (medical research) in China with 15 experienced acupuncturists administering the acupuncture to both patient groups.
Patients were randomly assigned to either the di qi group (167 patients) or the control group (171). Both groups received acupuncture. In the de qi group the needles were manually stimulate until de qi had been reached. In the control group the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. Prednisone prevents the release of substances in the body that cause inflammation.
Patients' facial expressions, a marker of facial-nerve function, were rated on a 6-point scale and videotaped to ensure consistent findings across hospital sites. Researchers also evaluated disability and quality of life at six months after randomization.
Six months after randomization the de qi group had improved facial muscle recovery, disability and quality of life among patients with Bell palsy.
The researchers write in their interpretation “Among patients with Bell palsy, acupuncture with strong stimulation that elicited de qi had a greater therapeutic effect, and stronger intensity of de qi was associated with the better therapeutic effects.”
The researchers conclude “"De qi and its related techniques should be properly appreciated in acupuncture practice and research, and should be considered for inclusion in clinical guidelines for acupuncture.”
The information for this randomized controlled trial can be seen online at Clinical Trials.gov.
Information regarding acupuncture can be viewed online at the National Center for Complementary and Alternative Medicine.
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