Comparison of the Efficacy between Needle-embedding Therapy and Sweet Bee Venom Pharmacopuncture Therapy on Peripheral Facial Paralysis

Article information

J Korean Acupunct Moxib Soc. 2013;30(4):35-44
Publication date (electronic) : 2013 September 20
doi : https://doi.org/10.13045/acupunct.2013020
Department of Acupuncture & Moxibustion Meridian & Acupoint, College of Oriental Medicine, Dong-Eui University
*Corresponding author : Department of Acupuncture & Moxibustion Meridian & Acupoint, College of Oriental Medicine, Dong-Eui University, 62, Yangjeong-ro, Busanjin-gu, Busan, 614-851, Republic of Korea, Tel : +82-51-850-8934 E-mail : 3rdmed@hanmail.net
Received 2013 July 17; Revised 2013 August 23; Accepted 2013 August 23.

Abstract

Objectives :

This study was designed to compare the effect between needle-embedding therapy and sweet bee venom pharmacopuncture therapy on early stage of peripheral facial paralysis.

Methods :

We investigated 60 patients with peripheral facial paralysis. Subjects were randomly divided into two groups and dropped out 20 patients. : needle-embedding therapy group(group A, n=20, dropped out 9 cases among 29 cases) and sweet bee venom pharmacopuncture therapy group(group B, n=20, dropped out 11 cases among 31 cases). needle-embedding therapy was performed for group A three times a week dividing face into three areas during 4 weeks and Sweet bee venom pharmacopuncture therapy was performed for group B two or three times a week during 4 weeks. To evaluate the effect of treatment applied for two groups, we used Yanagihara’s unweighed grading system and House-Brachmann grading system at before treatment, after one week from visit, two weeks from visit, three weeks from visit, and four weeks from visit.

Results :

After treatment, Yanagihara’s score and House-Brachmann grading system were improved in each group except during first week. But there was no significant difference in improvement between group A and group B.

Conclusions :

Needle-embedding therapy would be as effective to improve symptoms of early stage of peripheral facial paralysis as sweet bee venom pharmacopuncture therapy.

Yanagihara’s Unweighed Grading System

Facial Nerve Grading System by House-Brackmann

General Characteristics

Primary Cause of Disease

Distribution of Accompanied Symptoms at Onset

The Change of Y-score and HB-scale in Each Group

Improvement of Each Group During Period of Treatment(Y-score)

Improvement of Each Group During Period of Treatment(HB-scale)

Comparison of Y-score between Two Group During Period of Treatment

Comparison of HB-scale between Two Group During Period of Treatment

References

1. Beak MK. The newest Otolaryngology Seoul: Ilmoongak; 1997. p. 121–7.
2. Daehanchimguuihakhoe Gyojaepyeonchanwiwondhoe. The Acupuncture and Moxibustion Medicine Paju: Jipmoondang; 2012. p. 625–9.
3. Kim MS, Kim HJ, Park YJ, Kim EH, Lee EY. The clinical research of the efficacy of bee venom aqua-acupuncture on peripheral facial paralysis. J Kor Acupunc & Moxibus 2004;21(4):251–62.
4. Yang KR, Song HS. Effect of bee venom pharmacopuncture complex therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus 2009;26(4):29–37.
5. Lee CW, Kim HG, Heo SW, et al. The clinical study about hominis placenta herbal acupuncture on bell’s palsy. J Kor Acupunc & Moxibus 2005;8(3):87–97.
6. Park JH, Jang JH, Lee CH, et al. The clinical research of the effectiveness of pharmacopuncture complex therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus 2010;27(2):79–87.
7. Lee CH, Ku JY, Park JA, et al. Comparison of the efficacy between method of regulating ascending kidney water and descending heart fire and sweet bee venom pharmacopuncture on peripheral facial paralysis. J Kor Acupunc & Moxibus 2011;28(4):85–92.
8. An BJ, Song HS. Effect of electroacupuncture on patients with peripheral facial paralysis. J Kor Acupunc & Moxibus 2005;22(4):121–9.
9. Choi CH, Song HS. Effect of electroacupuncture complex therapy on peripheral facial paralysis according to the wave forms. J Kor Acupunc & Moxibus 2010;27(5):43–50.
10. Choi CH, Song HS. Effect of Moxibustion on peripheral facial paralysis according go selection method of acupoints. J Kor Acupunc & Moxibus 2008;25(3):87–94.
11. Choi YJ, Yoon KJ, Kim MS, et al. Effects of scalp acupuncture with usual acupuncture on peripheral facial paralysis in comparison with usual acupuncture only. J Kor Acupunc & Moxibus 2010;27(6):101–9.
12. Oh MJ, Song HS. Effect of scratching method complex therapy on the patients with peripheral facial paralysis. J Kor Acupunc & Moxibus 2011;28(5):1–7.
13. Oh HJ, Song HS. Effect of cupping complex therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus 2011;28(4):119–25.
14. Lee SY, Ko JM, Kim JH, et al. Case study of Miso facial rejuvenation acupuncture on intractable facial palsy. J Kor Acupunc & Moxibus 2009;26(1):163–71.
15. Lee KH, Lee DH, Kwon KR, Park HS, Park YY. A literary study on embedding therapy. Journal of Korean Pharmacopuncture institute 2003;6(3):15–21.
16. Lee EM, Park DS, Kim DH, et al. A literature study and recent tendency on oriental correcion of deformities and ‘Needle-embedding therapy’. J Kor Acupunc & Moxibus 2008;25(3):229–36.
17. Hong KE. Comprehension of embedding therapy through meridian muscle system;Focused on face. J Kor Acupunc&Moxibus 2008;25(3):215–9.
18. Kang EK, Kim JH, Seo HS. The clinical investigation studies in peripheral facial paralysis using Needle-embedding therapy. The Jouranl of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology 2009;22(2):118–27.
19. Lee CW, Lee SM, Jeon JH, Kim JI, Kim YI. Effects of Needle-embedding therapy on sequelae of peripheral facial palsy: A case series. J Kor Acupunc & Moxibus 2011;28(4):93–103.
20. Han JM, Yoon JW, Kang NR, Ko WS, Yoon HJ. The clinical investigation studies in early stage of intractable peripheral facial paralysis using Needle-embedding therapy. The Jouranl of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology 2012;25(3):113–28.
21. Shin HY, Kwon HJ, Lee YK, et al. The effect of thread-embedding therapy on 9 patients with partial obesity. J Kor Acupunc & Moxibus 2011;28(6):27–34.
22. Lee KS, Ko MK, Lee JH, Kim MJ, Hong KE. The effect of facial embedding therapy on skin elasticity and moisture content. J Kor Acupunc & Moxibus 2011;28(5):111–9.
23. Lee SM, Lee CW, Jeon JH, Kim YI. The effect of needle-embedding therapy on the improvement against facial wrinkles: A case series. J Kor Acupunc & Moxibus 2011;28(4):143–7.
24. Daehannyakchimhakhoe Haksurwiwonhoe. Pharmacopuncturology Seoul: Elsevier Korea LLC; 2011. p. 208–15.
25. Park YU. The Thread-embedding Therapy Seoul: Hanglimseowon; 2003. p. 152–3.
26. Kim JH, Kwon HJ, Song JH, Choi DY, Lee SH, Lee JD. A review of the anatomy of face for the clinical application of facial acupuncture. J Kor Acupunc & Moxibus 2008;25(3):221–8.
27. House JW. Brachmann De. Facial nerve grading system. Otolaryngol Head Neck Sug 1985;93:146–7.
28. Yanagihara N. Grading of Facial palsy. Facial Nerve Surgery, Zurich 1976. In : Fisch U, ed. Amstelveen, Netherlands: Kugler Medical Publications. Birmingham, Al : Aesculapius Publishing Co. 1977. p. 533–5.
29. Korean society of Otorhinolaryngology-Head and Neck surgery. Ibiinhugwahakdukyeongbuoegwahak I Seoul: Iljogak; 2009. p. 951.
30. Kenneth WL, Ian B. Neurology and neurosurgery illustrated Seoul: E-public; 2006. p. 228.
31. Jun Heo. Donguibogam Gyeong Nam: Donguibogamchulpansa; 2005. p. 1003–5.
32. Daehanchimguuihakhoe Gyojaepyeonchanwiwonhoe. The Acupuncture and Moxibustion Medicine Paju: Jipmoondang; 2012. p. 200–3.
33. Daehannyakchimhakhoe Haksurwiwonhoe. Pharmacopuncturology Seoul: Elsevier Korea LLC; 2011. p. 247–56.
34. Lee CW, Park IB, Kim SW, et al. Case reports: The effect of acupuncture and Dong’s acupuncture about bell’s palsy. J Kor Acupunc & Moxibus 2004;21(2):287–300.
35. Won JS, Chou KY, Cho AR, Kim JH, Kim CH. The clinical observation of acute bell’s pasly 80 case. The Jouranl of Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology 2010;23(2):151–62.

Article information Continued

Table 1.

Yanagihara’s Unweighed Grading System

Scale of rating Scale of three rating
At rest 0 1 2 3 4 0 2 4
Wrinkle forehead 0 1 2 3 4 0 2 4
Blink 0 1 2 3 4 0 2 4
Closure of eye tightly 0 1 2 3 4 0 2 4
Closure of eye lightly 0 1 2 3 4 0 2 4
Closure of eye on involved side only 0 1 2 3 4 0 2 4
Wrinkle nose 0 1 2 3 4 0 2 4
Whistle 0 1 2 3 4 0 2 4
Grin 0 1 2 3 4 0 2 4
Depress lower lip 0 1 2 3 4 0 2 4

Table 2.

Facial Nerve Grading System by House-Brackmann

Grade Description Characteristics
I Normal Normal facial function all areas
II Mild dysfunction Gross : slight weakness is noted on close inspection may have a slight synkinesis
At rest : normal symmetry and tone Motion
  Forehead : motion is moderate to good function
  Eye : complete closure with minimal effort
  Mouth : slight asymmetry
III Moderate dysfunction Gross : obvious but not disfiguring difference between both sides, noticeable but not severe synkinesis, contracture, or hemifacial spasm
At rest : normal symmetry and tone Motion
  Forehead : slight to moderate movement
  Eye : complete closure with effort
  Mouth : slightly weak with maximum effort
IV Moderately severe dysfunction Gross : obvious weakness and/or disfiguring asymmetry
At rest : normal symmetry and tone Motion
  Forehead : none
  Eye : incomplete closure
  Mouth : asymmetry with maximum effort
V Severe dysfunction Gross : only barely perceptible
At rest : asymmetry
Motion
  Forehead : none
  Eye : incomplete closure
  Mouth : slight movement
VI Total paralysis No movement

Table 3.

General Characteristics

Group A (n=20) Group B (n=20) p-value
Age 48.25±10.34 50.05±11.63 0.655*
Sex(male/female) 20(12/8) 20(7/13) 0.113
Left/right 7/13 13/7 0.058
Inpatient/outpatient 14/6 12/8 0.507
Period of disease 3.35±2.32 2.35±1.76 0.186*

Values represent number or mean±standard deviation.

*:

using Mann-Whitney U test, p>0.05

†:

using pearson’s Chi-square test, p>0.05

Table 4.

Primary Cause of Disease

Cause Group A(%) Group B(%) Total(%)
Overwork 8(40.0) 6(30.0) 14(35.0)
Stress 0(0.0) 4(20.0) 4(10.0)
Coldness 0(0.0) 1(5.0) 1(2.5)
Stress + overwork 7(35.0) 3(15.0) 10(25.0)
Stress + overwork + coldness 2(10.0) 4(20.0) 6(15.0)
Overwork + coldness 0(0.0) 1(5.0) 1(2.5)
After cold 1(5.0) 0(0.0) 1(2.5)
Unknown 2(10.0) 1(5.0) 3(7.5)
Total 20(100.0) 20(100.0) 40(100.0)

Values represent number.

Table 5.

Distribution of Accompanied Symptoms at Onset

Symptom Group A Group B Total
Postauricular pain 13 11 24
Lacrimation 15 16 31
Dysgeusia 6 4 10
Hyperacusis 1 1 2
Scheroma 2 1 3
Headache or dizziness 3 1 4
Nausia 2 0 2
No symptom 0 2 2

Values represent number.

Table 6.

The Change of Y-score and HB-scale in Each Group

Y-score HB-scale
Group A Group B Group A Group B
P0 8.75±4.76 7.70±2.77 3.90±0.45 3.85±0.49
P1 9.15±4.89 8.70±4.17 3.85±0.37 3.75±0.44
P2 15.05±8.99 13.65±7.48 3.55±0.69 3.50±0.61
P3 20.00±10.80 18.80±9.00 3.10±0.91 3.20±0.77
P4 24.55±12.27 23.75±10.17 2.55±1.23 2.80±1.06

P0 : score at before treatment.

P1 : score after one week from visit.

P2 : score after two weeks from visit.

P3 : score after three weeks from visit

P4 : score after four weeks from visit.

Values represent mean±standard deviation.

Table 7.

Improvement of Each Group During Period of Treatment(Y-score)

Group A Group B
Z or t p-value Z or t p-value
P01 −0.856 .392 −1.000 .318
P12 −4.457 .000 −4.726 .000
P23 −4.060 .001 −7.273 .000
P34 −6.492 .000 −6.492 .000
P02 −2.679 .007* −2.860 .004*
P03 −3.240 .001* −3.586 .001*
P04 −3.473 .001* −3.697 .001*

P01 : comparison between baseline and first week.

P12 : comparison between first week and second week.

P23 : comparison between second week and third week.

P34 : comparison between third week and fourth week.

P02 : comparison between baseline and second week.

P03 : comparison between baseline and third week.

P04 : comparison between baseline and fourth week.

*:

p-value<0.05 by Wilcoxon signed rank test.

†:

p-value<0.05 by paired t-test.

Table 8.

Improvement of Each Group During Period of Treatment(HB-scale)

Group A Group B
Mean±standard deviation p-value Mean±standard deviation p-value
P01 0.05±0.3 0.577 0.10±0.55 0.428
P12 0.30±0.47 0.010* 0.25±0.44 0.021*
P23 0.45±0.69 0.009* 0.30±0.47 0.010*
P34 0.55±0.61 0.001* 0.40±0.60 0.008*
P02 0.35±0.67 0.031* 0.35±0.67 0.031*
P03 0.80±0.89 0.001* 0.65±0.81 0.002*
P04 1.35±1.18 0.000* 1.05±1.05 0.000*

P01 : comparison between baseline and first week.

P12 : comparison between first week and second week.

P23 : comparison between second week and third week.

P34 : comparison between third week and fourth week.

P02 : comparison between baseline and second week.

P03 : comparison between baseline and third week.

P04 : comparison between baseline and fourth week.

*:

p-value<0.05 by paired t-test.

Table 9.

Comparison of Y-score between Two Group During Period of Treatment

Group A (mean±standard deviation) Group B (mean±standard deviation) p-value
Y-score Baseline 8.75±4.76 7.70±2.77 0.634
P01 0.40±6.00 1.00±4.27 0.935
P12 5.90±5.92 4.95±4.68 0.577
P23 4.95±5.45 5.15±3.17 0.888
P34 4.55±3.69 4.95±3.41 0.724
P02 6.30±8.93 5.95±7.77 0.860
P03 11.25±11.06 11.10±9.46 0.850
P04 15.80±12.68 16.05±10.57 1.000

P01 : difference between baseline and first week.

P12 : difference between first week and second week.

P23 : difference between second week and third week.

P34 : difference between third week and fourth week.

P02 : difference between baseline and second week.

P03 : difference between baseline and third week.

P04 : difference between baseline and fourth week.

p-value<0.05 by Mann-Whitney U test or Student t-test.

Table 10.

Comparison of HB-scale between Two Group During Period of Treatment

Group A (mean±standard deviation) Group B (mean±standard deviation) p-value
HB-scale Baseline 3.90±0.45 3.85±0.49 0.738
P01 0.05±0.39 0.10±0.55 0.744
P12 0.30±0.47 0.25±0.44 0.731
P23 0.45±0.69 0.30±0.47 0.425
P34 0.55±0.60 0.40±0.60 0.435
P02 0.35±0.67 0.35±0.67 1.000
P03 0.80±0.89 0.65±0.81 0.582
P04 1.35±1.18 1.05±1.05 0.401

P01 : difference between baseline and first week.

P12 : difference between first week and second week.

P23 : difference between second week and third week.

P34 : difference between third week and fourth week.

P02 : difference between baseline and second week.

P03 : difference between baseline and third week.

P04 : difference between baseline and fourth week.

p-value<0.05 by Mann-Whitney U test or Student t-test.