Effectiveness and safety of electroacupuncture combined with conventional therapy for peripheral facial palsy: a systematic review and meta-analysis.

OBJECTIVES

To evaluate the effectiveness and safety of electroacupuncture (EA), alone or combined with conventional therapy, for peripheral facial palsy.

DESIGN

Systematic review and pairwise meta-analysis of randomised controlled trials.

DATA SOURCES: PubMed, Embase.com, Web of Science Core Collection, the Cochrane Library, CNKI, Wanfang Data, VIP and SinoMed/CBM were searched from inception to 15 July 2026.

ELIGIBILITY CRITERIA: Chinese-language or English-language randomised trials enrolling patients with peripheral facial palsy and comparing an EA-containing regimen with a control regimen were eligible when at least one prespecified clinical outcome was reported.

DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened studies, extracted data and assessed risk of bias using Cochrane RoB 1.0. Random-effects risk ratios (RRs) were used for cure and total effective rates, standardised mean differences (SMDs) for facial-function scales and a Mantel-Haenszel OR for adverse events. Control-comparator and end-of-treatment timing subgroups were explored, and certainty was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE).

RESULTS

10 trials involving 888 participants were included. Outcomes were assessed at the end of treatment: three trials within 3 weeks, three at about 1 month and four at unclear or course-based endpoints. EA-containing regimens may improve cure and total effective rates (cure: RR 1.37, 95% CI 1.13 to 1.67; I²=57.0%; total effective rate: RR 1.21, 95% CI 1.07 to 1.36; I²=81.6%). Three independent trials reported facial function (SMD 1.91, 95% CI 0.51 to 3.30; I²=94.4%). Two trials reported adverse events (OR 0.36, 95% CI 0.11 to 1.22; I²=0%). Comparator subgroup differences were exploratory because two comparator categories contained only one study each. Certainty was low for all outcomes.

CONCLUSIONS

EA-containing regimens may improve short-term clinical response, but substantial heterogeneity, low-certainty evidence, variable comparators and limited follow-up preclude firm conclusions.