Catgut-embedding Treatment For Refractory Peripheral Facial Paralysis:systematic Review

Objective:to review trials on the efficacy and safety of acupoint-embedding treatment for refractory peripheral facial paralysis,to provide reference while treating refractory peripheral facial paralysis with catgut-embedding.Method:Formulate the searching strategy for original articles.Retrieve the articles according with the strategy in databases,which published from the establishment of these databases to June,2017.Those articles using randomized controlled trials are included,whose patients suffer from facial paralysis for more than 2 months and are treated by acupoint-embedding,comparing with other treatments.The extraction and analysis of data are fulfilled by two evaluators separately,and they are graded by improved Jadad Scale.Meta-analysis of the primary outcome indexes is performed using Review Manager 5.3.To evaluate its curative effect,enumeration data is analyzed by odds ratio(OR)while continuous data is analyzed by mean difference.Both enumeration data and continuous data are also analyzed by 95% confidence interval(CI).Sensitivity and subgroup analysis are applied to explain the source of heterogeneity,so that the facticity of the result can be ensured.Result: 85 articles accord with the searching strategy.After screening by two evaluator,10 articles are included in this meta-analysis,in which there are 1361 participants totally.The improved Jadad Score is used to assess the quality of the selected articles,which shows that only 1 article scores 4,2 score 1 and others score 3.The results of meta-analysis indicate that,in spite of the difference among number of acupoint,length of catgut and frequency of treatment,acupoint-embedding is more effective than other treatments.Moreover,acupoint-embedding can improve facial grading and electroneurogram of facial nerve.Conclusion: 1.acupoint-embedding is effective for refractory peripheral facial paralysis.2.It’s better than other treatments despite the difference among number of acupoint,length of catgut and frequency of treatment,which make it worth to popularize in clinical treatment.According to the result,to apply acupointembedding in 11-15 acupoints with material which is longer than 2cm and to rest 22-28 days between 2 treatments works out best.3.Acupoint-embedding can improve facial grading and electroneurogram of facial nerve.4.Acupoint-embedding is safe during the short-term observation;however,its safety and effect in the long period of time is still unknown.