Effectiveness and safety of acupoint embedding therapy for treating intractable facial paralysis: A systematic review and meta-analysis.

OBJECTIVE: Limited systematic reviews have explored the impact of acupoint embedding (AE) therapy on intractable facial paralysis (IFP). This review presents the current evidence on the efficacy and safety of AE therapy in the treatment of IFP. METHODS: PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang databases were systematically searched from inception to February 2024 to identify randomized controlled trials (RCTs) without language restrictions. Data extraction and analysis were independently conducted by two reviewers. The Risk of Bias was assessed using the Risk of Bias tool (version 2.0), and a meta-analysis was performed using the RevMan software (V5.4). SETTING: Eighteen RCTs involving 1881 patients were included in the analysis. RESULTS: AE therapy demonstrated a higher total effective rate (relative risk [RR]: 1.28; 95 % confidence interval [CI]: 1.13-1.44; P < 0.0001), cure rate (RR: 1.81; 95 % CI: 1.05-3.12; P = 0.03), and facial nerve function score (standardized mean differences [SMD]: 1.57; 95 % CI: 1.16-1.99; P < 0.00001) compared to that of manual acupuncture. Additionally, AE therapy showed a higher total effective rate (RR: 1.16; 95 % CI: 1.10-1.22; P < 0.00001) and cure rate (RR: 1.70; 95 % CI: 1.46-1.98; P < 0.00001) in comparison to that of electroacupuncture. However, there were no significant differences in facial nerve function scores(SMD:2.04; 95 % CI: -1.25-5.32; P = 0.22) or adverse reactions(RR: 1.16; 95 % CI: 0.35-3.78; P = 0.81) between AE therapy and electroacupuncture therapy. Evidence supporting the efficacy and safety of AE treatment is also insufficient. CONCLUSION: Most of the included studies indicated that AE therapy was more effective than MA/EA therapy for IFP. However, the quality of evidence for the majority of these studies was low, and all were conducted in China, where limited information has been reported regarding the safety of AE therapy.