Acupuncture is independently associated with improved recovery in Guillain-Barré syndrome: a prospective
Shuping Liu1, Huiying Lu1, Yuge Kang1
1Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China.
Background And Purpose:
Despite receiving standard intravenous immunoglobulin (IVIG) therapy, patients with Guillain-Barré syndrome (GBS) frequently suffer from delayed neurological recovery and persistent deficits. This study investigated the prognostic value of acupuncture in GBS by evaluating whether adjuvant acupuncture is an independent predictor of short-term clinical outcomes.
Methods:
We prospectively enrolled 128 patients with GBS admitted between April 2025 and March 2026. The patients were stratified into acupuncture and control groups based on the treatment they received. Baseline characteristics, interventions, Medical Research Council (MRC) sum scores, and Hughes scores were systematically documented. Clinical improvement at 2 weeks was defined as a reduction of ≥ 1 point in the Hughes score and an increase of ≥ 6 points in the MRC score. Predictors of improvement were identified using univariate and multivariate logistic regression analyses. To ensure robustness, the primary outcomes were verified using Firth's penalized regression and an analysis of covariance (ANCOVA)-based sensitivity analysis for continuous scores.
Results:
Among the 128 enrolled GBS patients (58 in the acupuncture group and 70 in the control group), the baseline characteristics were well balanced (all p > 0.05). After 2 weeks, the acupuncture group achieved significantly higher rates of at least a 1-point reduction in Hughes scores (53.45% vs. 35.71%, p = 0.044) and at least a 6-point increase in MRC scores (56.90% vs. 37.14%, p = 0.026) than the control group. Univariate logistic regression screening (p < 0.10) identified acupuncture intervention, baseline Hughes score, baseline MRC sum score, and IVIG treatment as candidate variables for the multivariate models. After adjusting for confounding factors, a multivariate analysis using Firth's profile-likelihood shrinkage revealed that acupuncture was independently associated with a higher likelihood of achieving a Hughes score reduction of ≥1 (adjusted OR = 3.049, 95% CI: 1.263-7.652, p = 0.017) and an MRC score increase of ≥6 (adjusted OR = 3.165, 95% CI: 1.418-7.080, p = 0.005). Similarly, IVIG treatment remained an independent protective factor for both clinical improvements (all p < 0.05). The Hosmer-Lemeshow test indicated a satisfactory model fit (p > 0.05). Sensitivity analyses using ANCOVA further confirmed the robustness of acupuncture's efficacy on post-treatment Hughes scores (p = 0.025) and MRC scores (p = 0.008).
Conclusion:
This study demonstrates that after adjusting for established confounding variables, acupuncture treatment is independently associated with improved recovery in GBS.
