Clinical Observation On Laser Acupoint Irradiation Plus Acupuncture In Treatment Of Initial Phase Of Peripheral Facial Paralysis

Peripheral facial paralysis, a commonly seen disease in clinic, could occur at any age and is commonly seen in the winter and summer. Its etiology is mainly due to the cold impulse to the facial nerves in the stylomastoid foramen and spasm, which cause the nerve tissue ischemia, edema and pressed hence the occurrence of the disease. It occurs suddenly and commonly at one side of the face. The manifestations are as follows: paralysis of facial expression muscles of the affected side, disappearance of the forehead wrinkles, widening of the palperbral fissure, failure of the eyelid of the affected side in closing or incomplete closing, lacrimation, being shallow of the nasolabial groove, deviation of the mouth angle towards the healthy side when showing teeth and leaking air when trying to fill mouth with air. In TCM, it belongs to the categories of "deviated eye and mouth", "wry mouth", etc. TCM holds that it is mainly due to the hollowing of the meridians and collaterals, and the pathogenic wind-cold invading Yangming and Shaoyang meridians in the face, leading to obstruction of meridian qi, malnutrition of the muscle and flaccidity of the tendons and muscles. The therapeutic principles are to expel wind, disperse cold and dredge meridians and collaterals.Under the theoretical guidance of meridians and collaterals and syndrome differentiation of TCM, laser acupoint irradiation is applied to prevent and treat diseases, which is the integration of modern laser techniques and acupuncture. Current clinical reports indicate that laser irradiation could produce the heat, electro-magnetic and photo-chemical effects, which has the functions of eliminating edema, enlarging vessels, improving the partial circulation and promoting the tissue restoration, etc, hence enlarge the vessels and accelerate the local blood flow.ObjectiveTo observe the clinical effects of laser acupoint irradiation plus acupuncture in the treatment of initial phase of peripheral facial paralysis with random design hence explore the influence and mechanism.MethodsAll the patients are from the out-patient and in-patient departments, the first affiliated hospital and the out-patient department of affiliated Foshan hospital of Chinese medicine, Guangzhou university of Chinese medicine, from June,2010 to February,2011. With strict scientific research methods,60 cases of peripheral facial paralysis were randomly divided into treatment group (with laser acupoint irradiation plus acupuncture) and control group (with simple acupuncture), with 30 cases in each group, which was in accordance with the criteria of H-B evaluation system and the facial function evaluation and analysis table made by the Japan CNVII facial nerve research institute.Acupuncture methods:Acupoint selection:with the main acupoints, acupoint according to the meridians and the accompanying acupoints with different symptoms. Main acupoints were as follows:Cuanzhu (BL 2), Taiyang (EX-HN 5), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Yingxiang (LI 20), Xiaguan (ST 7), Yifeng (SJ 17), Fengchi (GB 20) and Hegu (LI 4). To the symptom of deviated nasolabial groove, Shuigou (DU 26) was added; to the symptom of deviated mentolabial groove, Chengjiang (RN 24) was applied; to the symptoms of disappearance of taste and numbness of tongue, Lianquan (RN 23) was used; to the symptom of lacrimation, Jingming (BL 1) was utilized; to the wind-heat syndrome, Dazhui (DU 14) was added; to the wind-cold syndrome, Quchi (LI 11) was used. Needling technique:For the deficiency type, reinforcing needling technique was applied; for the excess type, reducing needling technique was applied. All the needles were retained for 30 minutes. In the treatment group, besides the acupuncture, semiconductor laser acupoint irradiation was applied, with the continuous output, wavelength of 632.18 nm, output power of 5.0 mW, spot diameter of 1.0 cm and the irradiating distance from the skin of 0.5 cm.Manipulation:After acupuncture, adjust the output power and put the probe near the acupoints on the face with the patients'tolerance, Yifeng (SJ 17) at the affected side and Hegu (LI 4) at the healthy side were applied each time. During the treatments, make sure that the probe was vertical to the skin and radiate for 15 minutes. All the treatments above were carried once daily,5 times a week and continuously for 4 weeks. After that, all the symptoms were assessed.ResultsAccording to the analyses table of the extent of the facial paralysis, in the treatment group, there were 8 slight cases,10 moderate cases and 12 severe cases and in the control group, there were 9 slight cases,10 moderate cases and 11 severe cases. After the treatments, the comprehensive scores in the both groups apparently increased respectively, with significant difference (P<0.05); after the treatments, the comprehensive scores in the treatment group is superior to that in the control group with significant difference (P<0.05), which indicated that the therapeutic effects in the treatment group was better than that in the control group.After the Ridit analyses, there was significant difference of the therapeutic effects between the two groups (P<0.05). In the treatment group,18 cases were cured,8 cases were remarkably improved,6 cases were effective,1 case was ineffective; in the control group,10 cases were cured,7 cases were remarkably improved,10 cases were effective,7 cases were ineffective. There was significant difference of the total effective rates between the two groups (P<0.05), With the effective rate of 96.66% in the treatment group higher than that of 76.67% in the control group, which indicated that laser acupoint irradiation plus acupuncture therapy is superior to the simple routine acupuncture therapy in the treatment of initial phase of peripheral facial paralysis and could obviously improve the cured and effective rates.Conclusion1. Both of the integrated laser acupoint irradiation plus acupuncture therapy and the simple routine acupuncture therapy have the good therapeutic effects in the treatment of initial phase of peripheral facial paralysis, with the former therapy apparently better than the latter therapy.2. Laser acupoint irradiation plus acupuncture therapy has the advantages of high cured rate, safety, simple manipulation and little side effects, which provides a new study strategy for the treatment of peripheral facial paralysis and is worthy of being further popularized.