<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">OALibJ</journal-id><journal-title-group><journal-title>Open Access Library Journal</journal-title></journal-title-group><issn pub-type="epub">2333-9705</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/oalib.1103714</article-id><article-id pub-id-type="publisher-id">OALibJ-77386</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Business&amp;Economics</subject><subject> Chemistry&amp;Materials Science</subject><subject> Computer Science&amp;Communications</subject><subject> Earth&amp;Environmental Sciences</subject><subject> Engineering</subject><subject> Medicine&amp;Healthcare</subject><subject> Physics&amp;Mathematics</subject><subject> Social Sciences&amp;Humanities</subject></subj-group></article-categories><title-group><article-title>
 
 
  Chinese Acupuncture in Treatment of Bell’s Palsy Clinical Study
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hadi</surname><given-names>Mohammed Mujlli</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Abdulraman</surname><given-names>Sallam Alkubaty</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Thamar Medical College, Thamar University, Dhamar, Yemen</addr-line></aff><aff id="aff2"><addr-line>Sana’a Medical College, Sana’a University, Sana’a, Yemen</addr-line></aff><author-notes><corresp id="cor1">* E-mail:<email>dr.hadimujlli@gmail.com(HMM)</email>;</corresp></author-notes><pub-date pub-type="epub"><day>06</day><month>06</month><year>2017</year></pub-date><volume>04</volume><issue>06</issue><fpage>1</fpage><lpage>6</lpage><history><date date-type="received"><day>June</day>	<month>6,</month>	<year>2017</year></date><date date-type="rev-recd"><day>Accepted:</day>	<month>June</month>	<year>26,</year>	</date><date date-type="accepted"><day>June</day>	<month>30,</month>	<year>2017</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Objective: To observe the therapeutic effects of acupuncture for treatment of different stages of Acute Bell’s palsy, and its relationship to age and sex. Patients and Methods: 152 patients of Bell’s palsy, were acute cases in different grade of paralysis. Following up with combined drugs and acupuncture therapy for one month, which were diagnosed clinically and proved by electromyography EMG, these cases of acu
  te Bell’s palsy were collected from Apr. 2016 to Feb. 2017 in Thamar governorate 100 km south to Sana’a capital city of Yemen. These cases were divided in to three groups, according to Hous-Brackmann grading system, HBGS: 1—marked improvement (very good) when patients improved completely within two weeks; 2—mild improvement (good) when patients improved within one months; 3—resistant in which there is no improvement within one months. EMG was used in diagnosis various stages of peripheral facial paralysis, evaluation of prognosis and guidance in clinical treatment with combined drugs and Chinese acupuncture for one month of clinical follow up. Statistical significance was assessed by P-values for Chi square test analysis by Epi info statistical analysis of single and stratified tables. Results: During the study period 152 patients were diagnosed as acute Bell’s palsy. Of these 81 (53%) cases were females and 71 (47%) were males. The improvement of acute facial paralysis was related to patients’ ages which were divided as three groups: 1-29 y, 30-59 y, more than 60 years old. The results shows that the younger age group have a better chance to improve; 1
  <sup style="text-align:justify;white-space:normal;">st</sup>
  group 61 (40.5%), 2
  <sup style="text-align:justify;white-space:normal;">nd</sup>
   group 48 (31.5%) and 3
  <sup style="text-align:justify;white-space:normal;">rd</sup>
   group 43 (28%). Conclusion: The electro-acupuncture in treatment of acute stage peripheral facial paralysis is effective and the improvement in the young age group shows very good improvement than old age.
 
</p></abstract><kwd-group><kwd>Bell’s Palsy</kwd><kwd> Acupuncture</kwd><kwd> Age</kwd><kwd> Sex</kwd><kwd> Facial Paralyses</kwd><kwd> Improvement</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>Acupuncture is a choice for treatment of patients suffering from Bell’s palsy; therapeutic effectiveness of the combined method of acupuncture with otopoints is far better than the therapeutic methods used alone [<xref ref-type="bibr" rid="scirp.77386-ref1">1</xref>] . Acupuncture is an ancient healing system developed over thousands of years in china and other eastern countries which is increasingly being recognized as “effective” by western health professionals and patients. Treatment can benefit almost any ill person as long as degeneration process is not too extensive. It’s very significant that EMG was used in diagnosis various stages of peripheral facial paralysis, evaluation of prognosis and guidance in clinical treatment [<xref ref-type="bibr" rid="scirp.77386-ref2">2</xref>] . Bell’s palsy is the most common disease of the facial nerve; it can strike almost any one at any age; however, it disproportionably attacks pregnant women [<xref ref-type="bibr" rid="scirp.77386-ref3">3</xref>] . In addition to one-sided facial paralysis with possible inability to close eye, symptoms of Bell’s palsy may include facial pain [<xref ref-type="bibr" rid="scirp.77386-ref4">4</xref>] , tearing, drooling, hypersensitivity to sound in the affected ear and impairment of taste. It’s presumably due to an inflammatory reaction in or around the facial nerve near the stylomastoid foramen when the acupuncture initiated within three days’ post-onset, 100% of the patients were cured or there was marked improvement [<xref ref-type="bibr" rid="scirp.77386-ref5">5</xref>] . The demyelination triggered by viral infection may be responsible [<xref ref-type="bibr" rid="scirp.77386-ref6">6</xref>] . Early diagnosis and treatment within three days of the onset of the paralysis are necessary for maximal efficacy of combined acyclovir and prednisolone therapy for Bell’s palsy [<xref ref-type="bibr" rid="scirp.77386-ref7">7</xref>] . There is no relationship of Bell’s palsy and sex, age, diabetic and hypertension [<xref ref-type="bibr" rid="scirp.77386-ref8">8</xref>] . With removal of pathogenic factors and the recovery of the body resistance, stronger stimulation or electro-acupuncture can be used to accelerate the cure [<xref ref-type="bibr" rid="scirp.77386-ref9">9</xref>] .</p></sec><sec id="s2"><title>2. Patients and Methods</title><p>152 patients of Bell’s palsy, were acute cases in different grade of paralysis, all were patients with facial dysfunction from different causes, included the mild dysfunction (Global grade 2) and total paralysis according to Hous-Brackmann grading system (HBGS). Follow up with combined drugs and acupuncture therapy for one month, that diagnosed clinically and proved by EMG, these cases of acute Bells palsy were collcted from Apr 2016 to Feb 2017 in thamar governorate 100km south to Sanaa capital city of Yemen. The acupuncture points used in this research were: body acupuncture; Yan bai (GB20), Jia che (ST6), Di cang (ST4), He gu (L14), Tai chong (LR3), Ju lia (ST3), and Cheng jiang (CV24). Modification: for pain behind the ear Ye feng (TE17) is added, for the inability to close the eye Yang bai (GB14), and Cuan zhu (BL2), are added, for flattening of nasolabial fold Shui gou (GV26) is added, for prolong duration of illness, Zu san li (ST36) is added. For pain, redness of eye with facial palsy, Si bai ST2) is added. These cases were divided in to three groups; “according to HBGS” 1―marked improvement (very good) when patients improved completely within two weeks. 2―mild improvement (good) when patients improved within one months. 3― resistant in which there is no improvement within one months. Epi info 7 statistical method was used for analysis of data. Statistical significance assessed by P-values for Chi square test analysis by Epi info statistical analysis of single and stratified tables.</p></sec><sec id="s3"><title>3. Results</title><p>- Improvement of Bell’s palsy after combined treatment of drugs and acupuncture therapy in a period of one month follow up related to sex as shown in <xref ref-type="table" rid="table1">Table 1</xref>.</p><p>- Improvement of acute Bell’s palsy treated with acupuncture therapy in a period of one month follow up, related to age as shown in <xref ref-type="table" rid="table2">Table 2</xref>.</p><p>- Improvement of Bell’s palsy after combined treatment of drugs and acupuncture therapy in a period of one month follow up as shown in <xref ref-type="fig" rid="fig1">Figure 1</xref>.</p><p>- Relationship between male and female regarding he differences of improvement of the facial paralysis related to sex as shown in <xref ref-type="fig" rid="fig2">Figure 2</xref>.</p><p>- Improvement of Bell’s palsy related to the age of patients shows more toward the young age group comparing to the middle and old age group as shown in <xref ref-type="fig" rid="fig3">Figure 3</xref>.</p></sec><sec id="s4"><title>4. Discussion</title><p>According to the facial paralysis scale; House ? Brackmann Grading System HBGS [<xref ref-type="bibr" rid="scirp.77386-ref10">10</xref>] , used to evaluate the improvement of acute Bell’s palsy that including in this research, which shows very good improvement post one month of acupuncture therapy, markedly obvious effective in treatment of acute facial parlay-</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Improvement of acute Bell’s palsy related to sex</title></caption><table><tbody><thead><tr><th align="center" valign="middle"  rowspan="2"  >Total</th><th align="center" valign="middle"  colspan="3"  >Improvement</th><th align="center" valign="middle"  rowspan="2"  >Sex</th></tr></thead><tr><td align="center" valign="middle" >Non-improv</td><td align="center" valign="middle" >Good</td><td align="center" valign="middle" >Very good</td></tr><tr><td align="center" valign="middle" >81</td><td align="center" valign="middle" >15</td><td align="center" valign="middle" >24</td><td align="center" valign="middle" >42</td><td align="center" valign="middle" >Female</td></tr><tr><td align="center" valign="middle" >71</td><td align="center" valign="middle" >14</td><td align="center" valign="middle" >23</td><td align="center" valign="middle" >34</td><td align="center" valign="middle" >Male</td></tr><tr><td align="center" valign="middle" >152</td><td align="center" valign="middle" >29</td><td align="center" valign="middle" >47</td><td align="center" valign="middle" >76</td><td align="center" valign="middle" >Total</td></tr></tbody></table></table-wrap><table-wrap id="table2" ><label><xref ref-type="table" rid="table2">Table 2</xref></label><caption><title> Improvement of acute Bell’s palsy related to age</title></caption><table><tbody><thead><tr><th align="center" valign="middle"  rowspan="2"  >Total</th><th align="center" valign="middle"  colspan="3"  >Improvement</th><th align="center" valign="middle"  rowspan="2"  >Age</th></tr></thead><tr><td align="center" valign="middle" >Non-improv</td><td align="center" valign="middle" >Good</td><td align="center" valign="middle" >Very good</td></tr><tr><td align="center" valign="middle" >61</td><td align="center" valign="middle" >14</td><td align="center" valign="middle" >12</td><td align="center" valign="middle" >35</td><td align="center" valign="middle" >1 - 29</td></tr><tr><td align="center" valign="middle" >48</td><td align="center" valign="middle" >11</td><td align="center" valign="middle" >18</td><td align="center" valign="middle" >19</td><td align="center" valign="middle" >30 - 59</td></tr><tr><td align="center" valign="middle" >43</td><td align="center" valign="middle" >16</td><td align="center" valign="middle" >15</td><td align="center" valign="middle" >12</td><td align="center" valign="middle" >&lt;60</td></tr><tr><td align="center" valign="middle" >152</td><td align="center" valign="middle" >41</td><td align="center" valign="middle" >45</td><td align="center" valign="middle" >66</td><td align="center" valign="middle" >Total</td></tr></tbody></table></table-wrap><fig id="fig1"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref></label><caption><title> Improvement of acute Bell’s palsy after acupuncture therapy of one month period follow up</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/77386x2.png"/></fig><fig id="fig2"  position="float"><label><xref ref-type="fig" rid="fig2">Figure 2</xref></label><caption><title> Relationship between male and female regarding the differences of improvement of acute Bell’s palsy paralysis related to sex</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/77386x3.png"/></fig><p>sis as shown in [<xref ref-type="bibr" rid="scirp.77386-ref1">1</xref>] . Most of the Bells palsy patients demonstrate facial nerve enhancement, usually in the tympanic and labyrinthine segments [<xref ref-type="bibr" rid="scirp.77386-ref11">11</xref>] . The electro- acupuncture in treatment of acute stage peripheral facial paralysis is effective [<xref ref-type="bibr" rid="scirp.77386-ref12">12</xref>] . In this research the percentage of the improvement resulting from the electro-</p><fig id="fig3"  position="float"><label><xref ref-type="fig" rid="fig3">Figure 3</xref></label><caption><title> Relationship between male and female regarding the differences of improvement of acute Bell’s palsy paralysis related to Age</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/77386x4.png"/></fig><p>acupuncture with drug therapy shows very good improvement of Bell’s palsy (58%), good improvement (24%), and non-improvement (18%), during the first two weeks, and one month therapy, although the non-improved case also improved in the next month with only two cases that shows a resistant and take longer time of treatment with residual facial paralysis. The acupuncture treatment skill is an effective way for treating old facial paralysis [<xref ref-type="bibr" rid="scirp.77386-ref13">13</xref>] . This results supports that the acupuncture play an important role to cure the Bells palsy.</p><p>Comparing the effect of acupuncture therapy between female and male patients shows that there are no differences of the effect related to the sex as shown in <xref ref-type="table" rid="table1">Table 1</xref>. That’s also documented in the treatment of Bell’s palsy with steroid; there is no difference in incidence according to sex or season [<xref ref-type="bibr" rid="scirp.77386-ref14">14</xref>] . Improvement of acute Bell’s palsy, related to the sex of the patients including in this research, shows that there is no significant relation-ship between males and females (P more than 0.05), that’s going with the above-mentioned documents. Although the numbers of the female’s patients cured are greater than males, sex has no great role to play in the effects of acupuncture and drug therapy see <xref ref-type="fig" rid="fig2">Figure 2</xref>. Regarding the improvement of acute facial paralysis related to patients age which divided as three groups (1 - 29, 30 - 59, more than 60 years old) the results shows that the younger age group have a better chance to improve than the mild and elder age groups with statistical significant (P &lt; 0.01), may be due to a general body condition as activity, resistance to illness, …etc. as shown in <xref ref-type="table" rid="table1">Table 1</xref>, and it’s clear that the improvement in the young age group shows very good improvement than old age see <xref ref-type="fig" rid="fig3">Figure 3</xref>. From our results, still we agree that the quality of the induced trails was inadequate to allow a better conclusion about the efficacy.</p></sec><sec id="s5"><title>5. Conclusion</title><p>Acupuncture is a choice for treatment of patients suffering from Bell’s palsy.</p><p>The electro-acupuncture in treatment of acute stage peripheral facial paralysis is effective and the improvement in the young age group shows very good improvement than old age.</p></sec><sec id="s6"><title>Cite this paper</title><p>Mujlli, H.M. and Alkubaty, A.S. (2017) Chinese Acupuncture in Treatment of Bell’s Palsy Clinical Study. Open Access Library Journal, 4: e3714. https://doi.org/10.4236/oalib.1103714</p></sec></body><back><ref-list><title>References</title><ref id="scirp.77386-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Baugh, R.F., Basura, G.J., Ishil, L.E., Schwaartz, S.R., Drumheller, C.M., Burkholder, R., et al. (2013) Clinical Practice Guideline; Bell’s Palsy Executive Summery. 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