A reasonable understanding of the treatment of Bell’s facial palsy

  Bell Palsy (BP) is a peripheral facial nerve palsy caused by acute nonsuppurative facial neuritis in the foramen ovale, which is a common clinical disease with a prevalence of 427.7 per 100,000 population in China.  It may be caused by acute viral infection and edema of the facial nerve in the foramen of the stem mammary foramen resulting in facial nerve compression or local blood circulation disorders, and facial palsy. BP pathology is mainly facial nerve edema, swelling and loss of myelin sheath, and axonal degeneration of varying degrees in the late stage, especially in the part of the stem mammary foramen and facial nerve canal.  As a common disease, multi-morbidity, there is no specific and effective therapy for BP in modern medicine. Modern medical treatment of Bell’s palsy mainly uses drugs and surgery, such as steroidal corticosteroid therapy (prednisone, etc.) vitamin therapy (vitb1, vitb12, methylcobalamin tablets, etc.), neurotrophic drug therapy (nerve growth factor, gangliosides), vasodilators, physical therapy, functional exercise and In the acute phase (within 7-10 days of onset), because adrenocorticotropic hormone has the function of inhibiting inflammatory reaction and reducing local edema of facial nerve, the use of hormone therapy in the acute phase of BP has almost become a widely used method.  The results of foreign studies have shown that the early use of prednisone is very beneficial, and the clinical recovery is better than that of aciclovir (ACV), which can reduce the chance of facial nerve damage and the sequelae of spasticity, and patients who cannot use prednisone then consider using aciclovir, Kiniski [5] found that 87% of complete Bell’s facial palsy treated with steroids recovered, while those treated with vitamins and vasodilation The efficacy of surgery is still difficult to determine and should only be tried in severe cases.  The efficacy of acupuncture in treating facial palsy has a history of more than 2,000 years, and its efficacy is certain. The treatment with acupuncture cured 85% and 92.3% of patients who did not improve significantly during the acute phase.  Various literature reports and clinical studies have shown that the key to the treatment of BP lies in the acute phase (within 7-10 days of onset), during which edema, swelling and loss of myelin sheaths, followed by axonal degeneration, occur in the facial nerve, eventually producing irreversible pathological damage.  The routine use of hormones in the acute phase can reduce inflammatory edema, but there is no specific effective therapy for viral infection.  In decades of acupuncture clinical work, it was found that the use of specialist Chinese medicine with acupuncture can play a targeted role in the treatment of acute BP patients with viral infection, which greatly shortens the course of the disease and increases the healing rate compared with the previous traditional therapy. It is estimated that the new treatment of acupuncture ten Chinese herbal medicine is aimed at the anti-viral, anti-inflammatory and de-facial nerve edema in the acute phase of BP.