Comparison of acupuncture intervention from the acute phase or the non-acute phase in patients with peripheral facial paralysis: a systematic review and meta-analysis.

Background: The optimal timing of acupuncture intervention in peripheral facial paralysis (PFP) remains uncertain. This study compared the effectiveness of acupuncture administered during the acute versus non-acute phases of PFP. Methods: A systematic search of eight databases was conducted for relevant literature published from inception until July 1, 2025. This study included randomized controlled trials (RCTs) that met the predetermined inclusion criteria. The evaluated outcomes encompassed the clinical effective rate, House-Brackmann Facial Nerve Grading Scale (H-B scale), Facial Disability Index (FDI), cure time, Portmann Simple Score Scale (Portmann score), and non-cure rate at 1-month follow-up. Study selection and data extraction were performed independently by two reviewers. This study utilized the Cochrane Risk of Bias tool and the GRADE framework to assess methodological quality and evidence certainty, respectively. Data analysis was conducted using Review Manager 5.4 and Stata 15.0, with results expressed as relative risk (RR) or mean difference (MD) with corresponding 95% confidence intervals (95% CI). Results: This meta-analysis included 15 randomized controlled trials involving 771 patients, with the majority demonstrating an unclear or low risk of bias. Pooled results indicated that acupuncture as an adjunctive therapy significantly improved the clinical effective rate (RR = 1.11, 95% CI [1.06, 1.16], Conclusion: This synthesis provides preliminary evidence that integrating acupuncture with Western medicine during the acute phase of PFP may enhance clinical response rates and accelerate facial functional recovery. However, these conclusions are tempered by methodological limitations observed in the included trials, particularly concerning potential biases and small sample sizes. Consequently, these findings highlight the imperative for more rigorously designed, large-scale randomized controlled trials to establish definitive evidence for clinical application. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/myprospero, Unique Identifier: CRD420251084963.