Non-Cochrane · intervention · PM42760088
Effectiveness and safety of electroacupuncture combined with conventional therapy for peripheral facial palsy: a systematic review and meta-analysis.
Zhou Chen, Yuan Peisen, Fang Jin, et al. · BMJ open · 2026 · PubMed · doi:10.1136/bmjopen-2026-121577
Findings
17 findings
| Population | ||||
|---|---|---|---|---|
| Patients with peripheral facial palsy (any cause, acute or recovery phase) | Electroacupuncture combined with conventional therapy | Control regimen (conventional pharmacotherapy in 8 trials; manual acupuncture plus same pharmacotherapy in 1; pharmacotherapy then acupuncture after day 10 in 1) | Cure rate End of treatment · Sensitivity: leave-one-out omitting Li 2019 | RR 1.20 [1.07, 1.35] GRADE not reported 9 studies |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Cure rate Up to 3 weeks · End-of-treatment timing: Up to 3 weeks | RR 1.42 [0.95, 2.12] GRADE not reported 3 studies · 220 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Total effective rate Up to 3 weeks · End-of-treatment timing: Up to 3 weeks | RR 1.15 [1.03, 1.28] GRADE not reported 3 studies · 220 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Adverse events End of treatment | OR 0.36 [0.11, 1.22] Low Downgraded: risk of bias, imprecision 2 studies · 170 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Facial nerve function End of treatment | SMD 1.91 [0.51, 3.3] Low Downgraded: risk of bias, imprecision, inconsistency 3 studies · 220 participants |
| Patients with peripheral facial palsy (any cause, acute or recovery phase) | Electroacupuncture combined with conventional therapy | Control regimen (conventional pharmacotherapy in 8 trials; manual acupuncture plus same pharmacotherapy in 1; pharmacotherapy then acupuncture after day 10 in 1) | Facial nerve function score End of treatment · Sensitivity: Zhang 2025 FDIP scale replacing Modified Portmann | SMD 1.69 [0.62, 2.77] GRADE not reported 3 studies · 220 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Cure rate Unclear/course-based · End-of-treatment timing: Unclear/course-based | RR 1.39 [0.96, 2.02] GRADE not reported 4 studies · 328 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Cure rate End of treatment | RR 1.37 [1.13, 1.67] Low Downgraded: risk of bias, inconsistency 10 studies · 888 participants |
| Patients with peripheral facial palsy (any cause, acute or recovery phase) | Electroacupuncture combined with conventional therapy | Control regimen (conventional pharmacotherapy in 8 trials; manual acupuncture plus same pharmacotherapy in 1; pharmacotherapy then acupuncture after day 10 in 1) | Facial nerve function score End of treatment · Sensitivity: Zhang 2025 FDIS scale replacing Modified Portmann | SMD 1.51 [0.71, 2.32] GRADE not reported 3 studies · 220 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Cure rate About 1 month · End-of-treatment timing: About 1 month | RR 1.38 [0.95, 2.01] GRADE not reported 3 studies · 340 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Total effective rate End of treatment | RR 1.21 [1.07, 1.36] Low Downgraded: risk of bias, inconsistency 10 studies · 888 participants |
| Patients with peripheral facial palsy (any cause, acute or recovery phase) | Electroacupuncture combined with conventional therapy | Control regimen (conventional pharmacotherapy in 8 trials; manual acupuncture plus same pharmacotherapy in 1; pharmacotherapy then acupuncture after day 10 in 1) | Total effective rate End of treatment · Sensitivity: leave-one-out omitting Li 2019 | RR 1.14 [1.05, 1.25] GRADE not reported 9 studies |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Total effective rate Unclear/course-based · End-of-treatment timing: Unclear/course-based | RR 1.32 [0.93, 1.89] GRADE not reported 4 studies · 328 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Control regimens including pharmacotherapy or acupuncture | Total effective rate About 1 month · End-of-treatment timing: About 1 month | RR 1.18 [0.97, 1.43] GRADE not reported 3 studies · 340 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Pharmacotherapy only | Total effective rate End of treatment · Pharmacotherapy-only control | RR 1.26 [1.11, 1.42] GRADE not reported 8 studies · 716 participants |
| Patients with peripheral facial palsy | Electroacupuncture-containing regimens, usually with conventional therapy | Pharmacotherapy only | Cure rate End of treatment · Pharmacotherapy-only control | RR 1.48 [1.12, 1.96] GRADE not reported 8 studies · 716 participants |
| Patients with peripheral facial palsy (any cause, acute or recovery phase) | Electroacupuncture | Sham electroacupuncture | Any prespecified outcome (cure, total effective rate, facial function, adverse events) Control comparator: sham electroacupuncture | no estimate extracted No studies found 0 studies |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Cai 2022 DOI:10.19621/j.cnki.11-3555/r.2022.0932 | NR | this review only | not stated | not extracted yet |
| Chen 2004 DOI:10.16025/j.1674-1307.2004.02.020 | NR | this review only | not stated | not extracted yet |
| Chen 2005 DOI:10.3969/j.issn.0411-8421.2005.06.023 | NR | this review only | not stated | not extracted yet |
| Chen 2022 DOI:10.3969/j.issn.1004-745x.2022.05.034 | NR | this review only | not stated | not extracted yet |
| Fang 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Li 2015 DOI:10.16662/j.cnki.1674-0742.2015.03.002 | NR | this review only | not stated | not extracted yet |
| Li 2019 DOI:10.19613/j.cnki.1671-3141.2019.72.138 | NR | this review only | not stated | not extracted yet |
| Xu 2006 DOI:10.3969/j.issn.1008-1879.2006.06.005 | NR | this review only | not stated | not extracted yet |
| Zhang 2025 DOI:10.16344/j.cnki.10-1669/r4.2025.07.010 | NR | this review only | not stated | not extracted yet |
| Zhao 2013 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zhao 2013 PMID:822013 | NR | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with peripheral facial palsy of any cause, duration or severity (acute and recovery phases); no age, sex or setting restriction; central, congenital, tumor, trauma or iatrogenic facial palsy excluded | Patients with peripheral facial palsy (n=888 participants in 10 RCTs; 60-180 per trial) |
| Intervention | Electroacupuncture alone or combined with standard care (EA effect isolatable) | Electroacupuncture combined with conventional therapy (n=10 trials) |
| Comparison | Conventional Western pharmacologic therapy, primarily corticosteroid-based, with or without antiviral, neurotrophic or adjunctive agents | Pharmacotherapy only (n=8); manual acupuncture plus the same pharmacotherapy (n=1); pharmacotherapy followed by acupuncture after day 10 (n=1); no sham electroacupuncture control (n=0) |
| Outcomes | Cure rate; total effective rate; facial nerve function (validated scales); adverse events | Cure rate (n=10); total effective rate (n=10); facial nerve function (n=3); adverse events (n=2); no extractable long-term sequelae (n=0) |
| Study designs | RCTs published in Chinese or English | RCTs (n=10) |
| Timing | End of the assigned treatment course; longer-term data when available | End of treatment: within 3 weeks (n=3), about 1 month (n=3), unclear or course-based (n=4) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | Yes | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |