Chronologically Change and Importance of Acupuncture Points Used in Bell’s Palsy in Classical Literature

Jung Eun Jang; Si-Hyun Park; Kyung Ho Kim; Seung Deok Lee; Jang, Jung Eun; Park,, Si-Hyun; Kim, Kyung Ho; Lee, Seung Deok

doi:10.13048/jkm.23033

JKM > Volume 44(3); 2023 > Article

Jang, Park, Kim, and Lee: Chronologically Change and Importance of Acupuncture Points Used in Bell’s Palsy in Classical Literature

Original Article

The Journal of Korean Medicine 2023; 44(3): 87-101.

Published online: September 1, 2023

DOI: https://doi.org/10.13048/jkm.23033

Chronologically Change and Importance of Acupuncture Points Used in Bell’s Palsy in Classical Literature

Jung Eun Jang

, Si-Hyun Park

, Kyung Ho Kim

, Seung Deok Lee^*

Department of Acupuncture and Moxibustion, Dongguk University Ilsan Oriental Hospital, Goyang, Korea

Correspondence to: Seung Deok Lee, Department of Acupuncture and Moxibustion, Dongguk University Ilsan Oriental Hospital, 32 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea. Tel: +82-31-961-5773, Fax: +82-31-961-9128, E-mai: chuckman@dgu.edu

Received August 1, 2023 Revised August 16, 2023 Accepted August 17, 2023

Abstract

Objectives

Many acupuncture points have been suggested for the treatment of Bell’s palsy, but information on which acupuncture points are more important in treatment is not provided. This study was conducted to investigate the importance of acupuncture points currently used clinically in Bell’s palsy.

Methods

By reviewing the full text of 11 books that recorded acupuncture prescriptions from the Qin Dynasty to the Qing Dynasty, the frequency of use of acupuncture points, their meridians, and their location were investigated.

Results

The average number of acupuncture points used for local, adjacent and distal points selection was 10.5, 2, 4 respectively. The number of acupuncture points increased from the Qin Dynasty to the Ming Dynasty 《Bojaebang》 and then decreased, but the proportion of local points has been still high. From the Ming Dynasty, ST4, ST6, GV26, and GV24 were mainly have been used as the local points. Except for the GB12, the use of the rest of the acupuncture points gradually decreased in the adjacent points. In the distal acupuncture points, it was summarized to point of lung and large intestine channel until the Ming Dynasty, and LI4 was mainly used in the Qing Dynasty. Yangming meridian has been most often used at the local and distal area except for the adjacent area.

Conclusions

In the treatment of facial paralysis, the lower part of the face had the highest proportion among local acupuncture points, and the Yangming had the highest proportion by meridian.

Keywords: Bell Palsy, Acupuncture Points, Literature Review, Frequency

Fig. 1

Changes over time in the number of acupoints used in facial paralysis by literature

Table 1

Published Age, Year and Terminology of Literature Related to Facial Paralysis.

Book	Age	Year	Terminology^*
鍼灸甲乙經	Qin Dynasties	282	口僻厥口僻, 鼻窒口僻, 瘛瘲口僻, 瘛瘲口沫出, 喎僻, 口喎僻, 喎僻口不能言, 口僻不正, 口喎戾頸強, 口喎喘悸, 口喎
千金要方	Sui and Tang Dynasties	652	喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口緩不收
鍼灸資生經	Song Dynasties	1220	口面喎, 偏風口目喎, 口眼喎, 口喎, 偏風口喎, 失欠口喎, 口喎眼瞤動, 瘛瘲口喎, 瘛瘲口噼, 口僻, 口喎僻, 喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口眼喎斜
普濟方	Ming Dynasty	1406	口喎僻不能言, 僻風口喎, 口僻, 口喎僻, 喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口面喎, 偏風口目喎, 口眼喎, 口喎, 偏風口喎, 失欠口喎, 口喎眼瞤動, 瘛瘲口喎, 瘛瘲口噼, 口眼喎斜
神應經	Ming Dynasty	1425	口眼喎, 口喎眼喎
名醫類案	Ming Dynasty	1552	口喎
鍼灸大成	Ming Dynasty	1601	口喎眼喎, 口轉喎
證治準繩	Ming Dynasty	1602	口眼喎斜
類經圖翼	Ming Dynasty	1624	口眼喎斜
鍼灸易學	Qing Dynasty	1798	口眼喎斜
鍼灸集成	Qing Dynasty	1874	口眼喎斜

* Duplicated terms are described only once.

Table 2

Time Course of Acupoints Used in the Treatment of Facial Paralysis.

1. 鍼灸甲乙經 2. 千金要方 3. 鍼灸資生經 4. 普濟方 5. 神應經 6. 名醫類案 7. 鍼灸大成 8. 證治準繩 9. 類經圖翼 10. 鍼灸易學 11. 鍼灸集成	Part	Acupoint (International Code)	Qin Dynasties	Sui and Tang Dynasties	Song Dynasties	Ming Dynasty	Qing Dynasty

	Upper part of face	絲竹空 (TE23)				5, 7

	Middle part of face	顴髎 (SI18)	1	2	3	4
		下關 (ST7)	1		3	4
		巨髎 (ST3)	1	2	3	4
		上關 (GB3)	1	2	3	4
		承泣 (ST1)	1	2	3	4, 8, 9
		迎香 (LI20)	1	2	3	4
		四白 (ST2)		2	3	4
		顴骨 (N/A)		2	3	4
		聽會 (GB2)			3	4, 9
		和髎 (TE22)			3	4

	Lower part of face	齦交 (GV28)	1	2	3	4
		大迎 (ST5)	1	2	3	4	11
		禾髎 (LI19)	1	2	3	4
		水溝 (GV26)	1	2	3	4, 5, 7, 9	10
		地倉 (ST6)		2	3	4, 5, 6, 7, 9	10
		地倉 (ST4)		2	3	4, 5, 6, 7, 8, 9	10, 11
		承漿 (CV24)			3	4, 7, 9	10, 11

	Head & Neck	完骨 (GB12)	1		3	4, 9
		翳風 (TE17)	1		3	4
		强間 (GV18)	1	2	3	4
		風池 (GB20)		2	3	4
		承光 (BL6)			3	4
		通天 (BL7)			3	4
		百會 (GV20)					10

	Limbs	太淵 (LU9)	1		3	5, 7
		偏歷 (LI6)	1		3	4
		行間 (LR2)	1		3	4, 5
		內庭 (ST44)			3	4, 5
		足三里 (ST36)					11
		合谷 (LI4)				5, 7, 9	10, 11
		列缺 (LU7)			3	4, 5, 7
		衝陽 (ST42)			3	4
		溫溜 (LI7)			3	4
		二間 (LI2)			3	4, 5, 7
		腹通谷 (KI20)			3	4, 5
		間使 (PC5)					11
		申脈 (BL62)				5

Table 3

Number of Acupoints Used for Facial Paralysis out of Total Acupoints on the Face

Meridian	Upper Part		Middle Part		Lower Part		Total

	Acupoint	Number	Acupoint	Number	Acupoint	Number
Large intestine meridian			LI20	4	LI19	5	9

Stomach meridian	ST8	0	ST1	8	ST4	18	61
			ST2	3	ST5	8
			ST3	8	ST6	13
			ST7	3

Small intestine meridian			SI18	6			6
			SI19	0

Bladder meridian	BL2	0	BL1	0			0

Triple energizer meridian	TE23	2	TE21	0			4
			TE22	2

Gallbladder meridian	GB14	0	GB1	0			9
			GB2	3
			GB3	6

Governing vessel			GV25	0	GV26	12	15
					GV27	0
					GV28	3

Conception vessel					CV24	8	8

Total	2		43		67		112

Table 4

Frequency of Use of Facial Acupoints Used in Facial Paralysis.

Rank	Acupoint	International Code	Muscle	Number
1	地倉	ST4	orbicularis oris m., zygomaticus major m., levator anguli oris m.	18

2	頰車	ST6	masseter m.	13

3	水溝	GV26	orbicularis oris m.	12

4	承漿	CV24	orbicularis oris m., mentalis m.	8
	大迎	ST5	masseter m.
	巨髎	ST3	zygomaticus minor m., levator labii superioris m., levator angulioris m.
	承泣	ST1	orbicularis oculi m., zygomatic m.

5	顴髎	SI18	zygomaticus major m., masseter m., buccinator m.	6
	上關	GB3	masseter m., temporalis m.

6	禾髎	LI19	orbicularis oris m.	5

7	迎香	LI20	levator labii superioris m., levator anguli oris m.	4

8	下關	ST7	zygomaticus major m., masseter m., buccinator m.	3
	四白	ST2	orbicularis oculi m., infraorbital m.
	顴骨	N/A	N/A
	聽會	GB2	temporalis m.
	齦交	GV28	orbicularis oris m.

9	絲竹空	TE23	orbicularis oculi m., temporalis m.	2
	和髎	TE22	epicranius m. temporoparietal m.

Table 5

Frequency of Use of Acupoints in the Head and Neck and Limbs Used in Facial Paralysis.

Part	Acupoint	International Code	Number
Head & Neck	完骨	GB12	6
	强間	GV18	4
	翳風	TE17	3
	風池	GB20
	承光	BL6	2
	通天	BL7
	百會	GV20	1

Limbs	列缺	LU7	7
	合谷	LI4	6
	太然	LU9	5
	二間	LI2
	偏歷	LI6	4
	行間	LR2
	內庭	ST44	3
	腹通谷	KI20
	衝陽	ST42	2
	溫溜	LI7
	足三里	ST36	1
	間使	PC5
	申脈	BL62

참고문헌

1. Yoon, H.C. (2023). A study on the characteristics of patients with facial palsy treated with Korean medicine - Based on the Korean National Health Insurance statistical yearbook. J Korean Med, 44(2), 10-19. http://dx.doi.org/10.13048/jkm.23013

2. Textbook compilation committee of acupuncture and moxibustion. (2016). Acupuncture and moxibustion medicine. Paju. Jipmoondang.

3. Lee, S.J., Kim, H.J., Seo, D.W., Sohn, C.H., Lee, J.H., & Oh, B.J., et al (2012). Analysis of Clinical Outcome and Effectiveness of Steroid and Antiviral Treatment in Patients with Bell’s Palsy in the Emergency Department. JKSEM, 23(4), 531-536.

4. Sim, S.Y. (2015). Clinical Research of Korean Medical Treatment for the Peripheral Facial Paralysis. J Korean Med Ophthalmol Otolaryngol Dermatol, 28(4), 62-73. http://dx.doi.org/10.6114/jkood.2015.28.4.062

5. Lee, S.B., Park, Y.B., & Kang, S.K. (1990). A Study on the Method of Acupuncture Point Prescription in the Symptomatic Treatment. J Acupunct Res, 7(1), 283-300.

6. Peter D., Al-Khafaji M., Baker K.(2001). A Manual of acupuncture. East Sussex, England. A Manual of Acupuncture Publications.

7. Oh, S.J., & Lee, S.R. (2005). Effects of Acupuncture at Right Nae-jong (ST44) on the Temperature and Humidity Changes of Sa-baek (ST2) Area. Korean J Acupunct, 22(3), 41-51.

8. Sun, T.X., Feng, S.W., Ren, Y.L., Li, P., & Fan, S.L. (2016). Regularities of Acupoint Combinations for Facial Paralysis in Chinese Ancient Times Analyzed in Accordance with Modern Complex Network Community Framework Partition. Acupunct Res, 41(3), 265-269. 10.13702/j.1000-0607.2016.03.014

9. Jeong, H.I., Kim, K.H., Oh, Y.T., Choi, Y.M., Song, B.Y., & Kim, J.U., et al (2018). Korean medicine for treating facial palsy - A literature review of case reports. J Pharmacopuncture, 21(4), 214-225. 10.3831/KPI.2018.21.025

10. Huang, W., Fu, C., Wu, T., Deng, Y., & Jiang, W. (2020). Rules of Acupoints in Treating Peripheral Facial Paralysis Based on Data Mining. Chin J Ethnomed Ethnopharm (Zhongguo Min Zu Min Jian Yi Yao), 29(21), 1-5.

11. Peng R.C.(1994). Zhen Jiu Chu Fang Daci Dian. Beijing. Beijing Publishing House.

12. Wang D.S.(1996). The abstract of Zhenjiu books and journals of China. Beijing. Renmin weisheng chubanshe.

13. Yuan Y.X., Ren J.X., et al(1996). Chinese-English Dictionary of Traditional Chinese Medicine (Han-Ying shuangjie Zhongyi da cidian). Beijing. Renmin weisheng chubanshe.

14. Seok, J.H., Yoon, J.H., Lee, J.H., Hwang, M.W., Cho, Y.J., & Kho, B.H., et al (2007). The upgrade of sasangin classification system by the morphologic study of head and face: Facial differences on sex and age. J of Sasang Constitutional Medicine, 19(3), 30-50.

15. Byun, J.Y., Son, I.C., & Um, T.S. (1992). A bibliographical study about the blood characteristics of Joksamni and Kwanwon points. The J of Korean Acupuncture & Moxibustion Society, 9(1), 173-178.

16. Textbook compilation committee of acupuncture and moxibustion. (2014). Acupuncture and moxibustion medicine. Seoul. Jipmoondang.

17. Lee, D.K., Seo, H.J., & Na, C.S. (2000). Pain and Muscle lasticity for Deficiency-Excessiveness Discussed by the View of Oriental and Western Medicine. J Kor. AM – Meridian & Pointology Soc, 17(1), 141-156.

18. Kim, Y.M., Baek, Y.H., Lee, J.D., Park, D.S., Kim, C.H., & Koh, H.K. (2002). Clinical Studies on 11 Cases of Facial Nerve Palsy in Herpes Zoster Oticus. The J of Korean Acupuncture & Moxibustion Society, 19(5), 234-246.

19. Seo, J.C., Kim, S.Y., Seo, Y.J., Park, J.H., Lee, Y.J., & Ryu, H.M., et al (2016). The Effect of Korean Medical Treatments with Postural Yinyang Correction of Temporomandibular Joint on Bell’s Palsy. Korean J Acupunct, 33(4), 183-193. https://doi.org/10.14406/acu.2016.021

20. Zhou, H.X. (1989). Clinical Analysis on 172 Cases with Facial Paralysis Treated by Acupuncture in Both Hands. Zhongguo zhen jiu, (05), 37-38. 10.13703/j.0255-2930.1989.05.026

21. Ma, Y.S. (1991). Comparative Observation on Treatment of Joined-Puncture for 100 Cases of Peripheral Facial Neuritis. Zhongguo zhen jiu, (02), 23-24. 10.13703/j.0255-2930.1991.02018

22. Ren, L.J. (1987). Clinical Observation on Treatment of Joined-Puncture for 400 Patients Suffering from Facial Paralysis. Zhongguo zhen jiu, (03), 13-14. 10.13703/j.0255-2930.1987.03.011

23. Wang T.(1992). Oidaibiyo. Seoul. Daesung publisher;[No English title. Write it in native pronunciation.]

24. Xi F.Z.(1989). XiFangZiMingTangJiuJing. Shanghai. Shanghai traditional chinese medicine publishing house;[No English title. Write it in native pronunciation.]

25. He, S.H. (1985). Clinical Observation on 75 Cases of Facial Paralysis Treated by Acupuncture. Zhongguo zhen jiu, (03), 10-12. 10.13703/j.0255-2930.1985.03.00

26. Wu, J.W. (1987). Clinical Observation on 220 Cases of Peripheral Facial Paralysis Treated by Acupuncture and Moxibustion on Facial Nerve. Zhongguo zhen jiu, (03), 19-20. 10.13703/j.0255-29301.987.03.015

27. Kwon, S.O., Seo, B.K., & Kim, S.T. (2016). Research for the construction of six command points. Korean J Acupunct, 33(2), 47-57. http://dx.doi.org/10.14406/acu.2016.007

28. Zhang, L.Z., & Xu, N.G. (2017). Theoretical research on the theory of orofacial diseases can be treated with Hegu (LI4). CJTCMP, 32(3), 950-952.

29. Lee, J.H., Yu, S.A., & Lee, S.Y. (2013). Five Case Reports on Peripheral Facial Palsy in Children. J Pediatr Korean Med, 27(3), 20-28. http://dx.doi.org/10.7778/jpkm.2013.27.3.020

30. Liu, Q., Jia, W., & Wang, H.T. (2013). Wanghongjing zhuren yishi cong “yang ming zhu mian” lun zhi mianbu jibing de jingyan. CJGMCM, 28(10), 2009-2010. 10.3969/j.issn.1003-8914.2013.10.010[No English title. Write it in native pronunciation.]

31. Zhang, D., Wen, B., Wei, Z., Gao, H., Peng, Y., & Meng, J. (1990). The comparison of changes of the facial temperature after acupuncturing point of hand and foot-yangming meridians by the thermography. Zhen Ci Yan Jiu, 15(3), 191-193. 10.13702/j.1000-0607.1990.03008

32. Kim, J.H., Kwon, H.J., Song, J.H., Choi, D.Y., Lee, S.H., & Lee, J.D. (2008). A review of the anatomy of face for the clinical application of facial acupuncture. J of Korean Acupuncture & Moxibustion Society, 25(3), 221-228.

33. Xie, W.Z., & Shi, Y.C. (1996). De cang tou jia che zhiliao mianshenjing mabi. Nei Mongol J Tradit Chin Med, (S1), 57. 10.16040/j.cnki.cn15-1101.1996.s1.067[No English title. Write it in native pronunciation.]

34. Wang, Z.M., & Hao, Q.H. (2001). Zhen ci de cang tou jia che xue wei zhu zhiliao miantan. China’s Naturopathy, 9(2), 12-13. 10.19621/j.cnki.11-3555/r.2001.02.010[No English title. Write it in native pronunciation.]

35. Wang, M.Q. (1986). Zhen ci zhiliao mianshenjing mabi 100 li. Zhongguo zhen jiu, (04), 40. 10.13703.j.0255-2930.1986.04.026[No English title. Write it in native pronunciation.]

36. Rink, S., Bendella, H., Akkin, S.M., Manthou, M., Grosheva, M., & Angelov, D.N. (2019). Experimental studies on facial nerve regeneration. Anat Rec, 302(8), 1287-1303. https://doi.org/10.1002/ar.24123