Objective:

2

To evaluate the clinical effect and safety of acupuncture manipulation on treatment of intractable facial paralysis (IFP)

and verify the practicality and precision of the Anzhong Facial Paralysis Precision Scale (Eyelid Closure Grading Scale

AFPPS-ECGS).

Methods:

2

A multicentre

single-blind

randomized controlled trial was conducted from October 2022 to June 2024. Eighty-nine IFP participants were randomly assigned to an ordinary acupuncture group (OAG

45 cases) and a characteristic acupuncture group (CAG

44 cases) using a random number table method. The main acupoints selected included Yangbai (GB 14)

Quanliao (SI 18)

Yingxiang (LI 20)

Shuigou (GV 26)

Dicang (ST 4)

Chengjiang (CV 24)

Taiyang (EX-HN 5)

Jiache (ST 6)

Fengchi (GB 20)

and Hegu (LI 4). The OAG patients received ordinary acupuncture manipulation

while the CAG received characteristic acupuncture manipulation. Both groups received acupuncture treatment 3 times a week

with 10 times per course

lasting for 10 weeks. Facial recovery was assessed at baseline and after the 1st

2nd and 3rd treatment course by AFPPS-ECGS and the House-Brackmann (H-B) Grading Scale. Infrared thermography technology was used to observe the temperature difference between healthy and affected sides in various facial regions. Adverse events and laboratory test abnormalities were recorded. The correlation between the scores of the two scales was analyzed using Pearson correlation coefficient.

Results:

2

After the 2nd treatment course

the two groups showed statistically significant differences in AFPPS-ECGS scores (

P

<

0.05)

with even greater significance after the 3rd course (

P

<

0.01). Similarly

H-B Grading Scale scores demonstrated significant differences between groups following the 3rd treatment course (

P

<

0.05). Regarding temperature measurements

significant differences in temperatures of frontal and ocular areas were observed after the 2nd course (

P

<

0.05)

becoming more pronounced after the 3rd course (

P

<

0.01). Additionally

mouth corner temperature differences reached statistical significance by the 3rd course (

P

<

0.05). No safety-related incidents were observed during the study. Correlation analysis revealed that the AFPPS-ECGS and the H-B Grading Scale

were strongly correlated (

r

=0.86

0.91

0.93

and 0.91 at baseline

and after 1st

2nd

and 3rd treatment course

respectively

all

P

<

0.01).

Conclusions:

2

Acupuncture is an effective treatment for IFP

and the characteristic acupuncture manipulation enhances the therapeutic effect. The use of the AFPPS-ECGS can more accurately reflect the recovery status of patients with IFP. (Trial registration No. ChiCTR2200065442)