{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:38:49Z","timestamp":1788219529528,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bell\u2019s palsy is an acute peripheral facial neuropathy, which is one of the most common causes of facial palsy of lower motor neurons. Facial nerve swelling is commonly observed in Bell\u2019s palsy. Acupuncture therapy has been widely used in the treatment of Bell\u2019s palsy. However, whether acupuncture can be effectively used in the acute stage is still controversial. There are no clinical trials conducted previously to evaluate the effect of acupuncture on facial nerve edema in Bell\u2019s palsy patients. The study aims to evaluate the potential efficacy of different acupuncture modalities on Bell\u2019s palsy patients in the acute phase, its effect on facial nerve edema, and to preliminarily explore its possible mechanism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>In this randomized, controlled trial, 165 Bell\u2019s palsy patients with unilateral onset within 3\u2009days will be recruited and randomly assigned to either the electroacupuncture group (<jats:italic>n<\/jats:italic>\u2009=\u200933), the acupuncture group (<jats:italic>n<\/jats:italic>\u2009=\u200933), the sham acupuncture group (<jats:italic>n<\/jats:italic>\u2009=\u200933), the blank control group (<jats:italic>n<\/jats:italic>\u2009=\u200933), or the acupuncture control group (<jats:italic>n<\/jats:italic>\u2009=\u200933) in a 1:1:1:1:1 ratio. The participants will receive 4\u2009weeks of treatment and 8\u2009weeks of follow-up. The five groups of participants will receive the following treatments: A: Electroacupuncture + Medication (prednisone acetate tablets, mecobalamin tablets, and vitamin B1 tablets); B: Acupuncture + Medication; C: Sham Acupuncture + Medication; D: Medication only; and E: Acupuncture only. The primary outcome will be the effectiveness rate of different acupuncture modalities in improving facial nerve function after the intervention period. The secondary outcomes will be the recovery speed, the diameter of the facial nerve, the echo intensity and thickness of facial muscles, blood flow parameters of the facial artery, the serum inflammatory level, safety evaluation, and adverse events. Preliminary exploration of its mechanism of action occurs through inflammation and immune response. The difference between groups will be assessed using repeated measure analysis of covariance (ANCOVA) and trend chi-square.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The trial will evaluate the efficacy and facial nerve edema of acupuncture for Bell\u2019s palsy patients in the acute phase and preliminarily explore its possible mechanism. The results thus may provide evidence for clinical application.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn\/bin\/project\/edit?pid=133211<\/jats:ext-link>, identifier ChiCTR2100050815.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1327206","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T04:32:37Z","timestamp":1713241957000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of acupuncture for Bell\u2019s palsy patients in the acute phase and its impact on facial nerve edema: a study protocol for a randomized, controlled trial"],"prefix":"10.3389","volume":"15","author":[{"given":"Zhidan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoshi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1080\/000164802320401694","article-title":"Bell\u2019s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies","volume":"122","author":"Peitersen","year":"2002","journal-title":"Acta Otolaryngol Suppl"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/S0030-6665(20)31118-X","article-title":"Differential diagnosis of facial nerve palsy","volume":"24","author":"May","year":"1991","journal-title":"Otolaryngol Clin N Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1177\/0194599813506835","article-title":"Clinical practice guideline: Bell\u2019s palsy executive summary","volume":"149","author":"Baugh","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1177\/003591575104400711","article-title":"The pathology and surgical treatment of Bell\u2019s palsy","volume":"44","author":"Cawthorne","year":"1951","journal-title":"J Laryngol Otol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1056\/NEJMe078188","article-title":"Bell\u2019s palsy\u2014is glucocorticoid treatment enough?","volume":"357","author":"Gilden","year":"2007","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.cct.2009.02.006","article-title":"A randomized controlled trial of acupuncture and moxibustion to treat Bell\u2019s palsy according to different stages: design and protocol","volume":"30","author":"Chen","year":"2009","journal-title":"Contemp Clin Trials"},{"key":"ref7","first-page":"209","article-title":"Common Questions About Bell Palsy","volume":"89","author":"Albers","year":"2014","journal-title":"Am Fam Physician"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1503\/cmaj.131801","article-title":"Bell palsy working group, Canadian Society of Otolaryngology \u2013 head and neck surgery and Canadian neurological sciences federation bell palsy working group, Canadian Society of Otolaryngology-Head and Neck Surgery and Canadian neurological sciences federation. 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