Acupuncture for Bell's palsy: A systematic review and meta-analysis

Objective: To assess the clinical evidence for and against acupuncture as a treatment for Bell's palsy. Methods: We conducted a literature search of 15 databases from their inception to December 2010 without language restrictions. We included all randomized clinical trials (RCTs) regardless of their controls. Methodological quality was evaluated using the Cochrane risk of bias assessment tool. Results: Of the 3 474 articles, only eight RCTs met our inclusion criteria. Four RCTs tested the effects of acupuncture against drug therapy on disease response rate. The meta-analysis of these data showed significant improvements in the acupuncture group [n=463, risk ratio (RR)=1.07, 95% CI: 1.02 to 1.13; P=0.006, I 2=0%]. Six RCTs tested the effects of acupuncture plus drug therapy versus drug therapy alone. The meta-analysis of this set of RCTs also showed the favorable effects of acupuncture on disease response rate (n=512, RR=1.11, 95% CI: 1.05 to 1.17; P=0.001, I 2=13%). Conclusions: The evidence supporting the effectiveness of acupuncture for treating Bell's palsy is limited. The number and quality of trials are too low to form firm conclusions. Further rigorous RCTs are warranted but need to overcome the many limitations of the current evidence. © 2011 Chinese Association of the Integration of Traditional and Western Medicine and Springer-Verlag Berlin Heidelberg