Effect of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis:A systematic review and meta-analysis

Objective: The goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis.Methods: PubMed(1979-2017), the Chinese National Knowledge Infrastructure database(CNKI, 1979-2017), Wanfang databases(1990-2017), and the Chongqing VIP full-text periodical database(VIP, 1989-2017) were searched by computer. Randomized controlled trials of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis were collected. The clinical trials that met the inclusion criteria were selected for quality assessment using the Cochrane 5.0 Handbook for systematic evaluation.RevMan5.3 was used for statistical analysis.Results: A total of 23 articles with 1756 patients met the inclusion criteria.(1) The meta-analysis of 11 articles showed that the total effective rate of warm needling therapy for peripheral facial paralysis was higher than that of acupuncture [RR = 1.18, 95% Cl(1.11,1.25), P< 0.00001].(2) The meta-analysis of 7 articles showed that the total effective rate of warm needling therapy combined with electroacupuncture in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with electroacupuncture [RR= 1.15, 95% Cl(1.09, 1.21), P< 0.00001].(3) The meta-analysis of 5 articles showed that the total effective rate of warm needling therapy combined with other therapies in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with other therapies [RR= 1.08,95% Cl(1.03, 1.14), P=0.002].(4) The meta-analysis of 5 articles showed that warm needling therapy could improve the House-Brackmann(H-B) scores of patients with peripheral facial paralysis more than acupuncture [mean difference(MD)=-2.85, 95% Cl(-5.08,-0.62), Z = 2.51, P = 0.01], indicating that warm needling therapy provides superior improvement in the function of facial nerve innervation in the patients. No adverse events were reported in the included studies. The methodological quality of the included studies was generally low.Conclusion: The results of this meta-analysis showed that warm needling therapy is superior to acupuncture in treating peripheral facial paralysis, providing a therapeutic option for the treatment of peripheral facial paralysis. However, due to the small sample size and the low quality of the included studies, the above conclusion still needs to be validated with high-quality, large-scale, randomized, blinded controlled trials.

Mechanism of acupuncture on anti-neuronal apoptosis and the regulation of PI3K/AKT signaling pathway in heroin relapse rats

Objective:To explore the mechanism of acupuncture intervention on anti-neuronal apoptosis in heroindependent rats based on the PI3K/AKT signaling pathway.Methods:A total of 30 SD rats were randomly divided into a normal group,a model group and an acupuncture group,10 rats in each one.In the model group and the acupuncture group,the heroin relapse rat model was established by intramuscular incremental injection of heroin.In the model group,no any intervention was applied.In the acupuncture group,after modeling,acupuncture was applied at"Bǎihuì(百会GV20)"and"Dàzhuī(大椎GV14)".Transmission electron microscope(TEM)was adopted to observe neuronal apoptosis in the rats.The effect of acupuncture on anti-neuronal apoptosis was compared.Using reverse transcription-polymerase chain reaction(RT-PCR)and western blot methods,the mRNA and protein expressions of PI3 K and AKT were detected in ventral tegmental area(VTA).Results:It was found that edema was presented in VTA neuronal cytoplasm and organelles basically disappeared in the heroin relapse rats,nuclear chromatin aggregation,condensation and increased neuronal apoptosis were presented as well.After acupuncture at"Bǎihuì(百会GV20)"and"Dàzhuī(大椎GV14)",a small amount of mitochondria,rough endoiplasmic reticulum and glycogen granules were visible in the cytoplasm of VTA neurons.The nuclear membrane structure was clear and the chromatin in the nucleus was basically normal.The fluorescence quantitative polymerase chain reaction(PCR)and western blot methods were adopted to detect mRNA and protein expressions of PI3K and AKT.It was found that the mRNA and protein expressions of PI3K and AKT in the brain of the rats in the model group were lower than those in the normal group(all P<0.05).Compared with the model group,the mRNA and protein expressions of PI3K and AKT in the acupuncture group were increased(all P<0.05),tending to the levels as the normal group.Conclusion:The effect of acupuncture on anti-brain cell apoptosis in heroin relapse rats may be related to the inhibition of PI3K/AKT signaling pathway.