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.