Acupotomy combined with acupuncture for acute peripheral facial paralysis with mastoid region pain: a randomized controlled trial

OBJECTIVE: To observe the clinical efficacy of acupotomy combined with acupuncture for acute peripheral facial paralysis with mastoid region pain. METHODS: Sixty patients of acute peripheral facial paralysis with mastoid region pain were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 1 case dropped out and 1 case excluded). The control group was treated with conventional acupuncture at affected‐side Yangbai (GB14), Yifeng (TE17), Xiaguan (ST7), Quanliao (SI18), Yingxiang (LI20), Dicang (ST4), Chengjiang (CV24), Wangu (GB12), Qianzheng (EX‐HN16), Taiyang (EX‐HN5), Cuanzhu (BL2), as well as bilateral Hegu (LI4) and Zusanli (ST36), the treatment was administered once daily, six days per week with one day of rest, for a total of three weeks. In addition to the above acupuncture regimen, the observation group was treated with acupotomy treatment targeting areas near Wangu (GB12), Yifeng (TE17), Fengchi (GB20), Tianzhu (BL10), and muscular knotting sites of the hand and foot yangming, taiyang, and hand shaoyang meridians, treatment was performed once per week for three weeks. Before and after treatment, House‐Brackmann (H‐B) facial nerve grading scores, Sunnybrook facial grading scores, and the duration of mastoid region pain were evaluated. Electromyography (EMG) was used to assess latency and amplitude ratios (affected/healthy side) of the frontal, orbicularis oculi, and orbicularis oris muscles. Adler blood flow grading of the facial nerve was evaluated by ultrasound. Serum levels of hypersensitive C‐reactive protein (hs‐CRP), tumor necrosis factor‐α(TNF‐α), and interleukin‐6 (IL‐6) were measured. Clinical efficacy was also assessed in both groups. RESULTS: The duration of mastoid region pain in the observation group was shorter than that in the control group (P<0.05). Compared with before treatment, both groups showed increased H‐B facial nerve grading scores and Sunnybrook facial grading scores after treatment (P<0.05); latency of frontal, orbicularis oculi, and orbicularis oris muscles on the affected side was reduced (P<0.05); amplitude ratios of affected/healthy side were increased (P<0.05); Adler blood flow grades were improved (P<0.05); and serum levels of hs‐CRP, TNF‐α, and IL‐6 were decreased (P<0.05). Compared with the control group, the observation group showed better outcomes in all the above indexes after treatment (P<0.05). The total effective rate in the observation group was 93.1% (27/29), higher than that in the control group (82.1%, 23/28, P<0.05). CONCLUSION: Acupotomy combined with acupuncture could promote recovery of facial nerve function and shorten the duration of mastoid region pain in patients with acute peripheral facial paralysis with mastoid region pain.