| ObjectivesThe randomized controlled trials of warm acupuncture and moxibustion for periphera 1 facial paralysis were collected,screened,and evaluated.Through systematic evaluation a nd meta-analysis,the clinical curative effect of warm acupuncture and moxibustion for pe ripheral facial paralysis and its effect on various score indicators were discussed.Provide evidence-based medical evidence for clinical use of warm-needle moxibustion for periph eral facial paralysis.MethodsSearch terms were set up and searched in the Chinese Biomedical Literature Databas e(CBM),China Knowledge Network Database(CNKI),Wanfang Database,Chongqing V IP Chinese Science and Technology Journal Database(VIP),PuMed,Cochrane Library,a nd Embase.The time limit for database construction is January 2018.The search results were selected according to the inclusion criteria and exclusion criteria and finally include d in the literature.The Cochrane Collaboration’s tool for assessing risk of bias was used to assess the risk of bias in the included literature.The included literature was reviewed and processed using Review Manager 5.3 softw are recommended by the Cochrane Collaboration.The bivariate data were statistically ana lyzed using relative risk(RR)and 95%confidence interval(CI);continuity The variable data is preferably the mean difference(MD).If there is a large difference in the continu ous variables between the studies,consider the difference in measurement methods and u se the standard mean difference(SMD)for the meta-analysis.Heterogeneity between stud ies,subgroup analysis if clinical heterogeneity is considered,and statistical heterogeneity testing,the main statistics are Q and I2,when the statistical heterogeneity is small(I2<50%The heterogeneity can be neglected,and the fixed effect model combined with the ef fect amount is used for analysis;if the heterogeneity is large(I2＞50%),sensitivity analys is is performed to understand the source of heterogeneity,and a meta-analysis is perform ed by a random effect model.Finally,a funnel plot derived from meta analysis was use d to evaluate publication bias.ResultsIn the literature research,a total of 25 documents that meet the inclusion and exclus ion criteria were obtained,all of which are Chinese documents.The year of publication was between 2002 and 2017.A total of 2132 patients were included,1073 in the observ ation group and 1059 in the control group.There are two types of randomized controlled trials involving warm acupuncture and moxibustion and other measures and warm needl e acupuncture combined with control measures and VS control measures.There were 25 cases of incomplete information,unclear descriptions,etc.in the 25 papers on randomization,hidden grouping,blind implementation,outcome data integrity,s elective reporting,and other biases.The methodological quality is not high and there is a high risk of potential bias.In terms of total efficiency,the meta-analysis suggested that warm acupuncture is su perior to other measures,RR=1.11,95%CI[1.03,1.19].Subgroup analysis:1 warm acupu ncture moxibustion is more effective than simple drug therapy,RR=1.21,95%CI[1.04,1.40];2 warm acupuncture moxibustion is more effective than ordinary acupuncture,RR=1.10,95%CI[1.02,1.20];3 Cannot prove that warming acupuncture moxibustion is higher tha n electroacupuncture in total effective rate,RR=1.19,95%CI[0.72,1.95];4 Temporarily una ble to prove that warm acupuncture moxibustion is more efficient than common acupunct ure + pricking and cupping,RR=1.01,95%CI[0.97,1.06].In reducing the H-B score and improving facial nerve paralysis,warm-needle acupuncture was superior to conventional a cupuncture control study,SMD=-0.49,95%CI[-0.82,-0.15].In terms of improving facial di sability index social function score(FDIS),warm-needle acupuncture was superior to com mon acupuncture,MD=-4.64,95%CI[-5.24,-4.04].In the change of conduction nerve ampl itude,warm-needle acupuncture was superior to acupuncture,MD=0.30,95%CI[0.16,0.44].The effective rate of warm acupuncture moxibustion and control measures was highe r than that of simple control measures RR=1.14,95%CI[1.09,1.18].Subgroup analysis:warm needle acupuncture and electroacupuncture VS electroacupuncture effective than sim ple electroacupuncture,RR=1.16,95%CI[1.09,1.22];warm acupuncture moxibustion and drug efficiency is higher than simple drug,RR=1.13,95%CI[1.02,1.25];temporarily can not prove warm needle moxibustion and electro-acupuncture and drug efficiency is highe r than electro-acupuncture and drug,RR=1.06,95%CI[0.89,1.26];can not explain the wa rm needle moxibustion combined rehabilitation efficiency better than Rehabilitation alone,RR=1.11,95%CI[0.98,1.27].In the reduction of House-Brackmann score,warm acupunct ure combined with other measures was better than simple control measures,MD=-4.57,95%CI[-5.00,-4.13].Subgroup analysis,warm acupuncture and moxibustion combined with electro-acupuncture was superior to electro-acupuncture alone,MD=-4.57,95%CI[-5.22,-2.76];warm acupuncture and moxibustion combined with electroacupuncture and drug was superior to simple electroacupuncture plus drug,MD=-4.65,95%CI[-5.12,-4.18].In terms of improving the Portmann score,warm acupuncture moxibustion and control measures were superior to simple control measures,MD=4.42,95%CI[2.61,6.24].Subgroup analysi s,warm acupuncture combined with electro-acupuncture was superior to simple electroacu puncture,MD=7.30,95%CI[5.34,9.26];warm acupuncture combined with rehabilitation w as better than rehabilitation alone,MD=2.60,95%CI[1.47,3.73];Warm acupuncture and moxibustion combined with electro-acupunctureand drugs were superior to electro-acupunc ture combined drugs,MD=4.03,95%CI[3.56,4.50].For the reduction of facial disability i ndex social function score(FDIS),warm acupuncture and electroacupuncture and drug wa s superior to electroacupuncture and drug MD=-2.56,95%CI[-3.01,-2.11].Intermediate:warm acupuncture moxibustion and control measures VS control measu res Effectiveness rating;low:warm acupuncture moxibustion VS other measures effective,warm acupuncture moxibustion and control measures VS control measures HB score,wa rm acupuncture moxibustion VS other measures facial disability index social function sco re(FDIS),Warm acupuncture and control measures VS control measures Facial disabilit y index social function score(FDIS),electromyography;very low grade:warm acupunctu re moxibustion VS other measures HB score,warm acupuncture moxibustion and control measures VS control measures portmann score.ConclusionThe results of meta-analysis showed that warm-needle acupuneture can effectively tre at peripheral facial paralysis,reduce the degree of facial paralysis,increase the amplitude of facial nerve conduction,and improve the social life function of patients with periphe ral facial paralysis.However,the quality of literature included in this study was low,and the risk of potential bias was high.Meta analysis of some outcomes and sub-group anal ysis under the number of documents,may lead to inaccurate results,the need for more 1 arge-sample randomized controlled trials of similar measures.And according to the GRA DE evidence quality evaluation results,the evidence quality is low,suggesting that the re sults of this study should be treated with caution. |
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