Effectiveness of Strengthened Stimulation During Acupuncture for the Treatment of Bell Palsy: A Randomized Controlled Trial
http://www.practiceupdate.com/journalscan/3584
CMAJ 2013 Apr 02;185(6)473-478, SB Xu, B Huang, CY Zhang, P Du, Q Yuan, GJ Bi, GB Zhang, MJ Xie, X Luo, GY Huang, W Wang
http://dx.doi.org/10.1503/cmaj.121108
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- Does the intensity of acupuncture stimulation affect functional outcomes in patients with Bell’s palsy?
- This prospective multicenter trial randomized 338 patients with Bell’s palsy to receive either acupuncture that achieved de qi or acupuncture that did not achieve de qi. Both groups were treated with steroids.
- Strong-stimulation acupuncture, which can elicit de qi, significantly improved the therapeutic effect—facial nerve function, disability, and quality of life at 6 months—in patients with Bell’s palsy who were treated with prednisone.
ABSTRACT
Background: The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to generate de qi, 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.
Methods: We performed a prospective multicentre randomized controlled trial involving patients with Bell palsy. Patients were randomly assigned to the de qi (n = 167) or control (n = 171) group. Both groups received acupuncture: in the de qi group, the needles were manipulated manually until de qi was reached, whereas in the control group, the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. The primary outcome was facial nerve function at month 6. We also assessed disability and quality of life 6 months after randomization.
Results: 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).
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.