title: Prednisolone and acupuncture in Bell's palsy: study protocol for a randomized, controlled trial.
abstract: BACKGROUND
  There are a variety of treatment options for Bell's palsy. Evidence from randomized controlled trials indicates corticosteroids can be used as a proven therapy for Bell's palsy. Acupuncture is one of the most commonly used methods to treat Bell's palsy in China. Recent studies suggest that staging treatment is more suitable for Bell's palsy, according to different path-stages of this disease. The aim of this study is to compare the effects of prednisolone and staging acupuncture in the recovery of the affected facial nerve, and to verify whether prednisolone in combination with staging acupuncture is more effective than prednisolone alone for Bell's palsy in a large number of patients.
  
  
  METHODS
  In this article, we report the design and protocol of a large sample multi-center randomized controlled trial to treat Bell's palsy with prednisolone and/or acupuncture. In total, 1200 patients aged 18 to 75 years within 72 h of onset of acute, unilateral, peripheral facial palsy will be assessed. There are six treatment groups, with four treated according to different path-stages and two not. These patients are randomly assigned to be in one of the following six treatment groups, i.e. 1) placebo prednisolone group, 2) prednisolone group, 3) placebo prednisolone plus acute stage acupuncture group, 4) prednisolone plus acute stage acupuncture group, 5) placebo prednisolone plus resting stage acupuncture group, 6) prednisolone plus resting stage acupuncture group. The primary outcome is the time to complete recovery of facial function, assessed by Sunnybrook system and House-Brackmann scale. The secondary outcomes include the incidence of ipsilateral pain in the early stage of palsy (and the duration of this pain), the proportion of patients with severe pain, the occurrence of synkinesis, facial spasm or contracture, and the severity of residual facial symptoms during the study period.
  
  
  CONCLUSIONS
  The result of this trial will assess the efficacy of using prednisolone and staging acupuncture to treat Bell's palsy, and to determine a best combination therapy with prednisolone and acupuncture for treating Bell's palsy.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01201642.
authors.affiliation: Department of Neurology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xia
authors.forename: Junliang
authors.initials: J
authors.lastname: Han
authors.forename: Xuedong
authors.initials: X
authors.lastname: Liu
authors.forename: Jingcun
authors.initials: J
authors.lastname: Wang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Jiang
authors.forename: Kangjun
authors.initials: K
authors.lastname: Wang
authors.forename: Songdi
authors.initials: S
authors.lastname: Wu
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
mesh_terms: D015670:Acupuncture Therapy; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D002681:China; D003131:Combined Modality Therapy; D005154:Facial Nerve / Q000503:physiopathology*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D020127:Recovery of Function; D012107:Research Design; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone