Staging of facial palsy: Facial palsy refers to peripheral facial nerve paralysis caused by facial neuritis, and there are two common types of facial palsy, Bell’s palsy and Hunter’s palsy (caused by herpes zoster). Generally speaking, within 1 week of onset, it is the progressive phase of facial palsy; 2 – 3 weeks, it is the resting phase of facial palsy; more than 3 weeks, it enters the recovery phase of facial palsy. Bell’s facial palsy can be cured in 2 – 3 weeks for mild cases; about 1 month for moderate cases; and 1.5 – 2 months for severe cases for basic recovery. Hunter’s facial palsy has a longer recovery time, mostly 2 – 4 months or even longer, and some do not recover completely. What is meant by persistent facial palsy? Persistent facial palsy, which some people call refractory facial palsy, is mostly of moderate or severe degree and does not recover well after a longer period of treatment. For example, Bell’s facial palsy for more than 2 months and Hunter’s facial palsy for more than 4 months still show no signs of improvement, or there is still obvious facial palsy, and even sequelae such as linkage (mouth and eyes moving together), inversion (reverse skew), crocodile tears (eating tears), facial muscle spasm and facial muscle atrophy. The author has studied and observed in detail the patients with persistent facial palsy who came to the clinic and found that one category of patients only had incomplete recovery, which was caused by inadequate treatment: because of poor physical condition, or old age, or some systemic diseases at the same time, and did not take into account the physical condition to administer treatment. The other category is due to over-treatment (personal opinion). In addition to incomplete recovery, these patients have sequelae such as linkage, inversion and facial spasm, which are difficult to treat. Acupuncture treatment plan suggestions: 1. For persistent facial palsy, suspend all facial acupuncture treatment and use bilateral symmetrical massage, with the strength as comfortable as possible, for 20 minutes. Once a day; the face can also be plastered with musk rheumatism paste, 5 – 6 points according to the acupuncture points. Each point ointment 1. 5 cm square can be, 1 time per night. 1 month 1 course of treatment. 2, facial fear of wind and cold, on the basis of the program 1, heavy moxibustion facial acupuncture points for half an hour – 1 hour, once a day, 1 month 1 course of treatment. 3, distal acupuncture points injection of Danshen injection (Danshen 5 ml, lidocaine 0. 5 ml): Fengchi, Sidu, Foot Sanli, Yanglingquan, Stomach Yu, Diaphragm Yu, 2 pairs of acupuncture points selected each time, 1. 5 ml per point, twice a week, 1 month 1 course. This regimen can be used alone or together with other regimens. 4. If the face is dull, the lips and tongue are purple, and the pulse is astringent, it is of the qi stagnation and blood stasis type. Selected points on the face are knocked with plum blossom acupuncture and cupped with fire cupping after bleeding. Acupuncture points: Yangbai, Sun, Shimonoseki, Sibai, Zygomatic Bureaucracy, Dicang, Cheek Car, Yingxiang. Select 4 points each time, 2 times a week, 1 month 1 course of treatment. Reflection on intractable facial palsy: 1. Severe patients should be treated comprehensively in the early stage. Those with severe onset should use herbs, western medicine and acupuncture to control the development of the disease in order to pass through the progressive and resting phase and enter the recovery phase as early as possible. This is quite important for the prognosis, do not single treatment. 2, avoid premature use of electro-acupuncture. The application of electroacupuncture should be in half a month later, early use will aggravate the nerve, muscle edema, affecting recovery. Can not use electro-acupuncture for a long time, only 20 minutes each time. 2-3 times a week. Once the facial muscle has involuntary spasm twitching, immediately stop using, while paying attention to reduce the number of needles, reduce the intensity of stimulation, it is best to add stabbing the opposite side of the facial acupuncture points, the use of balancing therapy to avoid overkill. 3, avoid acupuncture treatment too often. Medical patients are eager to heal, uninterrupted treatment, the treatment of moderate and severe patients for a long time is not suitable. I have seen patients who have been treated for 2 months, 3 months, or even 4 months without rest, except for Sundays. The effect of not giving the muscles and nerves a chance to rest is not good, and instead, there are backward errors, linkages, spasms and other corrective conditions, which is saddening. You should take a break for half a month – 1 month when the treatment plateau occurs and then treat again. This is called sharpening the knife and not cutting the wood. When I was a resident in my early years, I had a patient who was not well treated for a month, but was interrupted for a month by a business trip, and was only instructed to apply musk and tiger bone ointment every night, and was cured when he returned from the trip. From this I realized that, at certain stages of certain diseases, rest or gentle treatment is more important than acupuncture. 4. For those who are weak, old or have many systemic diseases, it is recommended to treat them with appropriate Chinese medicines or corresponding herbs. The classical ones are Tonic Chinese and Beneficial Qi Pills, Angelica Blood Nourishing Cream, Jin Gui Kidney and Qi Pills, Gui Spleen Pills, Xiang Sha Liu Jun Pills, and Zun Yao Pills. Ask your doctor, according to the deficiency of qi and blood or qi stagnation, phlegm trapped in the different selection of drugs, there are four two to dial the effect of a thousand pounds it! 5. treatment course suggestion: for patients with initial facial palsy, A. treat 5 times a week with 2 days rest, 1 month 1 course (20 times ). moderate or severe patients who do not recover after 20 times, rest 1 – 2 weeks and then continue the next course; B. treat 3 times a week, 6 weeks 1 course (18 times). those who do not recover after 18 times, rest 1 – 2 weeks and then continue the next course. The author applied the alternate-day treatment protocol and most of them recovered. There are also incomplete recoveries, and further recovery can be expected later. However, there have been no sequelae such as linkage, inversion, or spasticity. Once these symptoms appear, it is difficult to recover.