Acupuncture Treatment for Postoperative Gastrointestinal Dysfunction: A Traditional Chinese Medicine Perspective

Traditional Chinese medicine (TCM) posits that surgical trauma can lead to a deficiency of qi and blood stasis in the body, resulting in a disruption of the qi flow and the manifestation of disharmony between the spleen and stomach, leading to gastrointestinal dysfunction. Additionally, patients often experience preoperative fear and postoperative anxiety, which can lead to liver stagnation and impairment of liver-governing bile flow, aggravating spleen deficiency. Furthermore, due to fasting and prolonged bed rest, patients experience weakened qi and blood circulation, resulting in the formation of pathological products such as phlegm-dampness and blood stasis, which further damage the spleen and stomach.

The meridians serve as the pathway system that connects and regulates the circulation of qi and blood throughout the body, fostering communication between organs and facilitating the flow of energy. Therefore, incorporating acupuncture treatment alongside routine care plays a crucial role in promoting the swift recovery of patients with postoperative gastrointestinal dysfunction (POGD). According to TCM, POGD is classified within the realms of 'intestinal disorders,' 'abdominal pain,' 'vomiting,' 'hiccups,' 'distension,' and 'constipation,' affecting the spleen, stomach, large intestine, small intestine, and other organs. Its underlying mechanism primarily involves stomach disharmony and impediment of visceral qi circulation. Thus, the primary focus of treatment lies in regulating and facilitating the smooth flow of visceral qi.

Acupuncture, as a distinctive therapeutic modality in TCM, exerts its effects by stimulating specific acupuncture points, allowing the flow of qi and achieving the regulation of organ functions. It demonstrates a favorable bidirectional regulatory effect on gastrointestinal function and has found wide application in the treatment of various gastrointestinal disorders, including functional dyspepsia, functional constipation, irritable bowel syndrome, and gastroesophageal reflux disease.

Electroacupuncture has been proven to promote postoperative gastrointestinal motility, alleviate nausea and vomiting, and possess analgesic and anti-inflammatory properties. Based on a comprehensive analysis of clinical literature on acupuncture treatment for POGD from the past decade and clinical guidance from acupuncture experts, this study has identified specific acupoints, such as PC6, ST36, and LI4. ST36, known as Zusanli, is an acupoint along the Stomach Meridian of Foot Yangming and lies below the stomach organ. It plays a role in regulating the spleen and stomach, harmonizing stomach descent, and nourishing primordial qi. PC6, also called Neiguan, is located on the Pericardium Meridian of Hand Jueyin and shares the same meridian as the Large Intestine Meridian of Hand Yangming. This combination of acupoints effectively facilitates the smooth flow of visceral qi. Therefore, the treatment principles of this study encompass not only the theoretical foundation of acupoint selection but also a comprehensive synthesis of published prescriptions and clinical experiences from the past decade.