Clinical efficacy and safety of acupuncture therapy for central facial palsy after stroke: a systematic review and Meta-analysis

Objective: To systematically evaluate the efficacy and safety of acupuncture therapy in the treatment of central facial palsy after stroke.

Methods: A computerized search of articles on acupuncture treatment of central facial palsy was conducted from databases of China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform (Wanfang), VIP Information Chinese Journal Service Platform (VIP) , China Biomedical Literature Database(CBM), Cochrane Library, PubMed, Embase and Web of Science from their inception to September 25th, 2023. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias of all the included literature, and Meta-analysis on the extracted data was conducted using Review Manager 5.4 software.

Results: Eleven studies with a total of 893 patients were finally included, and the bias risks of the included studies were all "some concerns". The results of Meta-analysis suggested that:1) the observation group was superior to the control group in improving the the House-Brackmann facial nerve grading system (H-B) scores (MD=6.41, 95%CI [3.69, 9.14], Z=4.62, P<0.000 01), facial disability index (FDI) scores (somatic function) (MD=2.72, 95%CI [0.31, 5.12], Z=2.21, P=0.03), and clinical effective rate (RR=1.25, 95%CI [1.15, 1.35], Z=5.57, P<0.000 01);2) the observation group was not significantly different from the control group in improving the Toronto facial nerve assessment system (TFGS) scores (MD=3.66, 95%CI [ -2.33, 9.65], Z=1.20, P=0.23), the degrees of facial nerve paralysis (DFNP) scores (MD=4.60, 95%CI [ -1.14, 10.34], Z=1.57, P=0.12), FDI scores (social function) (MD=3.00, 95%CI [ -0.67, 6.66], Z=1.60, P=0.11).

Conclusions: Acupuncture therapy has advantages in clinical efficacy and safety than conventional drugs and other sports rehabilitation therapies in improving post-stroke central facial palsy. However, more high-quality clinical trials are warranted to provide adequate clinical evidence.