Abstract

Background: Bell’s palsy is a common cranial nerve disorder, with approximately 30% of patients experiencing permanent sequelae. Although corticosteroids are the gold standard of treatment, they carry a risk of side effects in certain populations. This study aims to evaluate the efficacy of acupuncture and identify optimal factors for clinical practice through detailed subgroup analysis.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing acupuncture with other treatment methods for patients with Bell's palsy were conducted. The study followed the Cochrane and PRISMA 2020 guidelines, using the RoB 2 tool to assess the risk of bias and RevMan 5.4.1 software to process data under a random-effects model.

Results: Fifteen RCTs (primarily from China) were included in the analysis. The results showed that acupuncture has a significant advantage in improving symptoms, with an RR = 1.32 (95% CI: 1.14 – 1.54; P=0.0002), and leads to better recovery of facial nerve function via the House-Brackmann scale (MD = -0.65; P=0.009). Subgroup analysis confirmed high efficacy in the acute phase (RR = 1.38; P=0.001) and when combined with conventional medicine (RR = 1.48). However, 80% of the studies had a high risk of bias, and there was significant heterogeneity between the studies.

Conclusions: Acupuncture is an effective and safe supportive therapy that increases the probability of complete recovery by 32% in Bell's palsy patients. Clinical practice should prioritize early intervention in the acute phase and combine it with modern medicine to optimize treatment outcomes.