Bayesian network meta-analysis of different acupuncture methods in the treatment of intractable facial paralysis
Objective To evaluate clinical efficacy of different acupuncture methods in the treatment of intractable facial paralysis by using Bayesian network meta-analysis.Methods Randomized controlled trials of acupuncture methods in the treatment of intractable facial paralysis from databases such as China Biomedical Literature Service Ssystem,CNKI,VIP,Wanfang Data,PubMed,Embase,Cochrane Library,and Web of Science were retrieved.The search deadline was from the establishment of each database to March 2024.Two researchers independently searched,screened literature,extracted data,and included literature that met the criteria.The bias risk was evaluated by using Cochrane's recommended"bias risk assessment tool".Finally,network meta-analysis was conducted to analyze outcome indicators such as clinical efficacy,clinical cure rate,and Sunnybrook scores through Stata 17.0 software.Results A total of 29 randomized controlled trials were ultimately included,with total of 2 212 patients,included 1 108 in the experimental group and 1 104 in the control group,involed total of 15 acupuncture therapies.Clinical effective rates of floating needle,millifire needle+electroacupuncture,thread embedding,thread embedding+electroacupuncture,fire needle+electroacupuncture,point injec-tion+acupuncture,bloodletting+electroacupuncture,bloodlet-ting+acupuncture warm acupuncture and moxibustion+electr-oacupuncture,small needle knife+acupuncture,and electroacupuncture were higher than those of acupuncture,clinical effective rates of thread embedding+electroacupuncture,fire needle+electroacupuncture,bloodletting+electroacupuncture,warm acupuncture and moxibustion+electroacupuncture were higher than those of electroacupuncture,clinical efficacy rates of fire needle+electroacupuncture and bloodletting+electroacupuncture were higher than those of bloodletting+acupuncture,clinical efficacy rate of thread embedding+electroacupuncture was higher than that of fire needle+acupuncture(P＜0.05).Clinical cure rates of floating needle,millifire needle+electroacupuncture,thread embedding,thread embedding+electroacupuncture,fire needle+acupuncture,fire needle+electroacupuncture,acupoint injection+acupuncture,bloodletting+electroacupuncture,bloodletting+acup uncture,warming acupuncture and moxibustion+electroacupuncture,electroa-cupuncture were higher than those of acupuncture,clinical cure rates of bloodletting+electroacupuncture,warm acupuncture and moxibustion+electroacupuncture were higher than those of electroacupuncture,clinical cure rate of bloodletting+electroacupuncture was higher than that of bloodletting+acupuncture(P＜0.05).There were no statistically significant differences in Sunnybrook scores among patients with different intervention measures(P＞0.05).The top three intervention measures to improve clinical effective rate were warming acupuncture and moxibustion+electroacupuncture,millifire acupuncture+electroacupuncture,thread embedding+electroacupuncture;the top three intervention measures to improve clinical cure rate were warming acupuncture and moxibustion+electroacupuncture,bloodletting+electroacupuncture and fire acupuncture+electroacupuncture;the top three intervention measures to improve Sunnybrook score were floating needle,thread embedding,small needle knife+acupuncture.The scatter plots of clinical efficacy and cure rates were all located within the funnel plot and had roughly symmetrical distribution on both sides,indicated lower likelihood of publication bias risk.Conclusion Warm acupuncture and moxibustion combined with electroacupuncture has significant effect in improving clinical efficiency and cure rate,and floating acupuncture has obvious advantages in improving Sunnybrook score,but it still needs to be verified by high-quality clinical trials.
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