Study on the Efficacy of Targeted Acupuncture Treatment for Oculomotor Nerve Palsy

Abstract

Background

Oculomotor nerve palsy (ONP) often causes persistent ocular motility disorder and diplopia. Conventional acupuncture is effective but lacks targeting precision. This study aimed to evaluate the clinical efficacy of targeted acupuncture based on Jingjin (tendino-muscular) theory for ONP.

Methods

A single-blind (patients and outcome assessors) randomized controlled trial was conducted. Forty-eight ONP patients were randomly allocated 1:1 to a targeted acupuncture (observation) or a conventional acupuncture (control) group (24 cases each). All patients received oral mecobalamin and compound anisodine injection near the affected superficial temporal artery. The control received routine periorbital acupunctures; the observation received targeted penetration needling plus distal points. After the 4-week treatment, pupil diameter, palpebral fissure height, diplopia score, and total effective rate were compared.

Results

All 48 patients completed the trial. Posttreatment, all indices improved significantly in both groups (P < 0.001). The observation group was significantly better in pupil constriction (4.61 ± 0.63 mm vs 5.01 ± 0.59 mm, P = 0.028), palpebral fissure height increase (7.08 ± 0.95 mm vs 6.40 ± 1.19 mm, P = 0.033), and diplopia score reduction (1.83 ± 1.37 vs 2.63 ± 1.25, P = 0.042), with moderate effect sizes (Cohen's d = 0.604–0.653). The total effective rate was higher in the observation group (95.83% vs 83.33%) but without statistical significance (P = 0.156).

Conclusion

Targeted acupuncture with precise penetration needling and directional qi conduction is superior to conventional acupuncture in improving objective ocular functions in ONP patients, with definite incremental clinical value.