• 1. 四川大學(xué)華西醫(yī)院神經(jīng)內(nèi)科,成都,6100412. 四川大學(xué)華西醫(yī)院針灸科;

目的 　系統(tǒng)評價針灸促進(jìn)Bell’s面癱康復(fù)和減少其遠(yuǎn)期發(fā)病率的效果.
方法 　計算機(jī)檢索MEDLINE、EMBASE、LILAS、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫和Cochrane肌肉疾病組注冊組資料庫,檢索時間截止至2002年12月;同時檢索其它相關(guān)灰色文獻(xiàn),獲取所有涉及針灸治療Bell’s面癱的隨機(jī)和半隨機(jī)對照試驗.而后選擇符合納入標(biāo)準(zhǔn)的臨床試驗,評價其方法學(xué)質(zhì)量,并從中提取患者基本情況、干預(yù)措施、終點指標(biāo)和結(jié)果等相關(guān)資料進(jìn)行系統(tǒng)評價.
結(jié)果 　共有3個小規(guī)模的臨床隨機(jī)對照試驗,合計288例患者符合納入標(biāo)準(zhǔn),但因其在試驗設(shè)計、報道上存在明顯缺陷,以及試驗之間存在較大差異,不符合Meta分析條件,因而只進(jìn)行了定性分析.結(jié)果顯示,針灸治療Bell’s面癱有一定療效(P均 lt;0.01).
結(jié)論 　針灸治療Bell’s面癱有效,但入選的3個隨機(jī)對照試驗規(guī)模小,質(zhì)量不高,降低了這一結(jié)論的可靠性.開展高質(zhì)量、內(nèi)在真實性好的相關(guān)隨機(jī)對照試驗非常必要.

引用本文： 何 俐,周沐科,周 東,李 寧,吳 濱. 針灸治療Bell’s面癱療效的系統(tǒng)評價. 中國循證醫(yī)學(xué)雜志, 2005, 05(2): 106-109. doi: 復(fù)制

1. 邵書鳳, 王中欣, 王莉. 針灸與西藥聯(lián)用治療周圍性面神經(jīng)癱瘓58例[J]. 新醫(yī)學(xué), 1999;30(1): 14.
2. 劉敏. 淺刺多針法和藥物療法治療面癱130例療效的對比觀察[J]. 針灸臨床雜志, 1996;12(5): 56.
3. 任留江. 針灸治療面癱450例[J]. 中國針灸, 1987;(3):13～14.
4. 吳經(jīng)偉. 針灸面神經(jīng)干治療周圍性面癱220例臨床觀察[J]. 中國針灸, 1987;(3): 19～20.
5. 李志明. 針灸為主治療面癱1 014例療效分析[J]. 中國針灸, 1987;(2): 1～3.
6. 劉桂珍. 電針為主治療急性周圍性面神經(jīng)癱瘓100例[J]. 上海針灸雜志, 1995;14(6): 257.
7. Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
8. May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
9. McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
10. Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
11. Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
12. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
13. Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
14. Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
15. Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
16. Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
17. Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
18. Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
19. He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
20. Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
21. Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
22. Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
23. Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
24. Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
25. Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
26. Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
27. Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
28. Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
29. Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
30. Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
31. Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
32. Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
33. Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
34. Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
35. Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
36. Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
37. Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.
  1. 1. 邵書鳳, 王中欣, 王莉. 針灸與西藥聯(lián)用治療周圍性面神經(jīng)癱瘓58例[J]. 新醫(yī)學(xué), 1999;30(1): 14.
  2. 2. 劉敏. 淺刺多針法和藥物療法治療面癱130例療效的對比觀察[J]. 針灸臨床雜志, 1996;12(5): 56.
  3. 3. 任留江. 針灸治療面癱450例[J]. 中國針灸, 1987;(3):13～14.
  4. 4. 吳經(jīng)偉. 針灸面神經(jīng)干治療周圍性面癱220例臨床觀察[J]. 中國針灸, 1987;(3): 19～20.
  5. 5. 李志明. 針灸為主治療面癱1 014例療效分析[J]. 中國針灸, 1987;(2): 1～3.
  6. 6. 劉桂珍. 電針為主治療急性周圍性面神經(jīng)癱瘓100例[J]. 上海針灸雜志, 1995;14(6): 257.
  7. 7. Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
  8. 8. May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
  9. 9. McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
  10. 10. Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
  11. 11. Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
  12. 12. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
  13. 13. Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
  14. 14. Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
  15. 15. Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
  16. 16. Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
  17. 17. Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
  18. 18. Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
  19. 19. He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
  20. 20. Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
  21. 21. Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
  22. 22. Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
  23. 23. Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
  24. 24. Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
  25. 25. Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
  26. 26. Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
  27. 27. Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
  28. 28. Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
  29. 29. Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
  30. 30. Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
  31. 31. Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
  32. 32. Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
  33. 33. Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
  34. 34. Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
  35. 35. Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
  36. 36. Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
  37. 37. Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.