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Sunday, September 28, 2014

Acupuncture Sensation and Bell’s Palsy



Acupuncture Sensation and Bell’s Palsy

Acupuncture therapy emphasizes de qi (obtaining qi sensation) from the needling process is critical. De qi is a sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints when needling is performed. Can de qi be justified for treating Bell’s palsy? Does stronger stimulation have a better therapeutic effect? To answer these questions, a prospective multicenter randomized controlled trial involving patients with Bell’s palsy was conducted in the Department of Neurology, Key Laboratory of Neurological Diseases of Chinese Ministry of Education, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 338 patients were randomly assigned to two groups: the de qi group (167 patients) or control group (171 patients). The same acupuncture prescription was applied to both groups. In the de qi group, the needles were manipulated manually until qi sensation was obtained, while in the control group, the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. The primary assessed outcome was facial nerve function at month 6. The results showed that after 6 months, patients in the de qi group had better facial function (adjusted odds ratio [OR] 4.16, 95% confidence interval [CI] 2.23-7.78), better disability assessment (differences of least squares means 9.80, 95% CI 6.29-13.30) and better quality of life (differences of least squares means 29.86, 95% CI 22.33-37.38). Logistic regression analysis showed a positive effect of the de qi score on facial-nerve function (adjusted OR 1.07, 95% CI 1.04-1.09). The study concluded that 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.

Xu SB, Huang B, Zhang CY, Du P, Yuan Q, Bi GJ, Zhang GB, Xie MJ, Luo X, Huang GY, Wang W. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ. 2013 Apr 2;185(6):473-9.

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