A Comparative Study of the Effects of  Pharmacopuncture Treatment and Bee Venom Pharmacopuncture Treatment on Peripheral Facial Paralysis

Se Hoon Im; Min Jun Lee; Seung Min Lee; Eun Seok Kim; Seung Hoon Lee; Jung Won Kang; Yong Suk Kim

doi:10.13045/acupunct.2014031

J Acupunct Res > Volume 31(2); 2014 > Article

Im, Lee, Lee, Kim, Lee, Kang, and Kim: A Comparative Study of the Effects of Jungsongouhyul Pharmacopuncture Treatment and Bee Venom Pharmacopuncture Treatment on Peripheral Facial Paralysis

Clinical Research

The Acupuncture 2014; 31(2): 135-144.

Published online: June 20, 2014

DOI: https://doi.org/10.13045/acupunct.2014031

A Comparative Study of the Effects of Jungsongouhyul Pharmacopuncture Treatment and Bee Venom Pharmacopuncture Treatment on Peripheral Facial Paralysis

Se Hoon Im, Min Jun Lee, Seung Min Lee, Eun Seok Kim, Seung Hoon Lee, Jung Won Kang, Yong Suk Kim^*

Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University

^*Corresponding author : Department of Acupuncture & Moxibustion Medicine, Kangnam Korean Hospital Kyung Hee University, 225, Yeongdong-daero, Gangnam-gu, Seoul, 135-501, Republic of Korea, Tel : +82-2-3457-9014 E-mail : ackys@hanmail.net

Received February 11, 2014 Revised May 09, 2014 Accepted May 21, 2014

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

See the Original "".

Abstract

Objectives:

This study was designed to compare the effects of Jungsongouhyul pharmacopuncture treatment with bee venom pharmacopuncture treatment in hospitalized patients with peripheral facial paralysis

Methods:

This study was done on a total of 41 patients with peripheral facial paralysis who were admitted into the Korean Medicine Hospital from February 1st, 2013 to April 30th, 2014. Wedivided patients into two groups. The Jungsongouhyul group was treated by Jungsongouhyul pharmacopuncture once a day and the bee venom group was treated by bee venom pharmacopuncture once a day. To compare the therapeutical effects of the two treatments, we used Yanagihara’s unweighted grading system, House-Brachmann grading system, lip-length & snout indices and facial disablity index twice - before initial treatment and after final treatment.

Results:

Both Yanagihara’s score and House-Brachmann grading system score improved in each group. However, there were no significant differences in improvement between the bee venom group and the Jungsongouhyul group.

Conclusions:

Jungsongouhyul pharmacopuncture treatment appears to be as effective as bee venom pharmacopuncture treatment to improve symptoms of peripheral facial paralysis.

Key Words: PPeripheral facial paralysis; Jungsongouhyul pharmacopuncture; Bee venom pharmacopuncture.

Table 1.

Y-System


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

Table 2.

H-B Grade

Grade	Description	Characteristics
I	Normal	Normal facial function all areas

II	Mild dysfunction	Gross : Slight weakness noticeable on close inspection may have very slight synkinesis
		At rest : Normal symmetry and tone
		Motion
		Forehead : Moderate to good function
		Eye : complete closure with minimum effort
		Mouth : Slight asymmetry

III	Moderate dysfunction	Gross : obvious but not disfiguring difference between two sides, noticeable but not severe synkinesis, contracture, and/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 : asymmetric 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

	Jungsongouhyul group(n=21)	BV group(n=20)	p-value
Sex(male/female)	21(9/12)	20(10/10)
Age	41.95±13.13(23∼69)	47.10±12.07(15∼65)	0.137^*
Left/right	11/10	8/12
Period of onset to first hospital visit	7.43±5.36(2∼21)	10.80±6.92(1∼30)	0.105^*
Hospitalization period	11.86±1.65(9∼15)	12.05±1.82(8∼14)	0.560^*
Past history of facial palsy	5	1	0.184^**
Steroid intake	13	16	0.306^**
DM	4	2	0.663^**

BV : bee venom.

DM : diabetes mellitus.

^* calculated by Mann-Whitney U test, p >0.05.

^** calculated by Fisher’s exact test, p >0.05.

Table 4.

The Changes of Scale Score between before Treatment and after Final Treatment in Jungsongouhyul Group

	Before treatment	After treatment	p-value
Y-score	11.52±3.86	19.28±7.46	0.001^*
H-B grade	3.57±0.51	2.81±0.75	0.001
Lip-length	14.66±6.71	22.10±7.63	0.001^*
Snout	17.96±5.59	23.09±5.74	0.001^*
FDI	126.24±27.65	159.95±19.79	0.001^*

Y-score : Yanagihara’s score.

H-B grade : House-Brackmann grade.

FDI : facial disablilty index.

^* p-value<0.05 by Wilcoxon’s signed-rank test.

Table 5.

The Changes of Scale Score between before Treatment and after Final Treatment in BV Group

	Before treatment	After treatment	p-value
Y-score	9.35±3.15	15.80±6.03	0.001^*
H-B grade	3.85±0.59	3.20±0.70	0.001^*
Lip-length	11.84±6.51	20.10±9.82	0.001^*
Snout	15.34±4.37	19.64±4.50	0.001^*
FDI	127.65±27.61	152.90±20.12	0.001^*

Y-score : Yanagihara’s score.

H-B grade : House-Brackmann grade.

FDI : facial disablilty index.

^* p-value<0.05 by Wilcoxon’s signed-rank test.

Table 6.

Comparison of Scale Score before Treatment between Jungsongouhyul Group and BV Group

	Jungsongouhyul group	BV group	p-value
Y-B	11.52±3.86	9.35±3.15	0.053^*
HB-B	3.57±0.51	3.85±0.59	0.132^*
LL-B	14.66±6.71	11.84±6.51	0.188^*
S-B	17.96±5.59	15.34±4.37	0.230^*
FDI-B	126.24±27.65	127.65±27.61	0.686^*

^* calculated by Mann-Whitney U test, p >0.05.

Y-B : Y-score of before treatment.

HB-B : H-B grade of before treatment.

LL-B : LL of before treatment.

S-B : S of before treatment.

FDI-B : FDI of before treatment.

Table 7.

Comparison of Scale Score after Final Treatment between Jungsongouhyul Group and BV Group

	Jungsongouhyul group	BV group	p-value
Y-A	19.28±7.46	15.80±6.03	0.065^*
HB-A	2.81±0.75	3.20±0.70	0.092^*
LL-A	22.10±7.63	20.10±9.82	0.465^*
S-A	23.09±5.74	19.64±4.50	0.052^*
FDI-A	159.95±19.79	152.90±20.12	0.389^*

^* calculated by Mann-Whitney U test, p >0.05.

Y-A : Y-score of after final treatment.

HB-A : H-B grade of after final treatment.

LL-A : lip-length of after final treatment.

S-A : snout of after final treatment.

FDI-A : FDI of after final treatment.

VI. References

1. Ahn HY. Clinical otolaryngology head and neck surgery. Seoul: Koonja. 2008:76–8.

2. Korean Society of Otorhinolaryngology - Head and Neck Surgery. Ibiinhugwahakdukyeongbuoegwahak I. Seoul: Iljogak. 2002:833–68.

3. Korean Acupuncture & Moxibustion Medicine Society Textbook Compilation Committe. The acupuncture and moxibustion medicine. Paju: Jipmoondang. 2012:625–9.

4. Grogan PM, Gronseth GS. Practice parameter: steroids, acyclovir, and surgery for Bell’s palsy(an evidence-based review). Neurology. 2001;56(7):830–6.

5. Tark KC. Facial reanimation. Korean J Head Neck Oncol. 2008;24(1):15–25.

6. Gronseth GS, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell’s palsy. Neurology. 2012;79(22):2209–13.

7. Choi KW, Kang JH, Kim YI, Hong KE, Lee H. Clinical comparison studies on 30cases of Bell’s palsy patients with posterior ear pain by Sa-Am acupuncture Sojangjeonggyeok & general acupuncture. J Kor Acupunc & Moxibus. 2004;21(8):125–34.

8. Yoo JH, Kim KW, Kim DH, et al. A controlled trial on the effect of complex oriental medical treatment with or without Pyung-Hyung acupuncture on the treatment of peripheral facial palsy. J Kor Acupunc & Moxibus. 2012;29(3):121–8.

9. Kwon SJ, Song HS, Kim KH. The influence of moxibustion and basic compound therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus. 2000;17(4):160–71.

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. An BJ, Song HS. Effect of electroacupuncture on patients with peripheral facial paralysis. J Kor Acupunc & Moxibus. 2005;22(4):121–9.

12. 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.

13. 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.

14. 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.

15. Oh HJ, Song HS. Effect of cupping complex therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus. 2011;28(4):119–25.

16. 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.

17. 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.

18. 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.

19. Hwang JH, Lee DG, Lee HJ, Cho HS, Kim KH, Kim KS. Effect of combined silver spike point therapy and electroacupuncture on patients with peripheral facial paralysis. J Kor Acupunc & Moxibus. 2008;24(4):69–80.

20. Yang KR, Song HS. Effect of bee venom pharmacopuncture complex therapy on peripheral facial paralysis. J Kor Acupunc & Moxibus. 2009;26(4):29–37.

21. Choi JY, Lee H, Kang JH, et al. Comparative study of general oriental medical treatment and bee venom pharmacopuncture on acute peripheral facial paralysis patient with postauricular pain. J Kor Acupunc & Moxibus. 2009;26(5):95–103.

22. Oh HJ, Song HS. Effect of bee venom pharmacopuncture complex therapy at Yepung on peripheral facial paralysis. J Kor Acupunc & Moxibus. 2010;27(4):179–85.

23. 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.

24. 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.

25. Choi YJ, Kim JH, Yoon KJ, et al. Comparative study of BUM pharmacopuncture and Soyeom pharmacopuncture on peripheral facial paralysis with postauricular pain. J Kor Acupunc & Moxibus. 2012;29(5):31–7.

26. Lee JD. Bee-venom therapy : method of clinical approach. J of Korean Med. 2000;20(3):3–8.

27. Daehannyakchimhakhoe. The out line of herbal acupuncture therapy. Seoul: Daehannyakchimhakhoe. 1999:313.

28. Lee SH, So WR, Shin KH, Kim JK, Kim JU. A clinical study carried out blood stasis herbal acupuncture therapy to low back pain. The Journal of the Korea Institute of Oriental Medical Informatics. 2003;9(2):59–73.

29. Seol H, Sin MS, Song BR, Yook TH. Effects of Jungsungouhyul herbal acupuncture(JSO) multi-treatment for whiplash injury by traffic accident. Journal of Pharmacopuncture. 2005;8(1):59–65.

30. Yoon IJ. Effect of Jungsongouhyul herbal acupuncture therapy for neck pain patients. Daejeondaehakgyo Hanuihangnyeonguso Non-munjip. 2007;16(2):1–5.

31. Choi EH, Chun HS, Ryu HS, Lee JH, Yang DS, Hong S. Case report of radial nerve palsy patients treated with additional Jungsongouhyul pharmacopuncture. Journal of Pharmacopuncture. 2011;14(4):63–9.

32. Yanagihara N. Grading of facial palsy. In: Facial Nerve Surgery, Zurich. 1976:Edited by Fisch U. Amstelveen, Netherlands: Kugler Medical Publications. Birmingham Al: Aesculapius Publishing Co. 1977:533–5.

33. House JW, De Brackmann. Facial nerve grading system. Otolaryngol Head Neck Sug. 1985;93(2):146–7.

34. Jansen C, Jennekens FG, Wokke JH, Leppink GJ, Wijnne HJ. Lip-length and snout indices: methods for quantitative assessment of peri-oral facial muscle strength. J Neurol Sci. 1990;97(2–3):133–42.

35. Van Swearingen JM, Brach JS. The facial disability index : reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system. Physical Therapy. 1996;76(12):1288–300.