Effects of gastrointestinal motility therapy combined with acupuncture on gastrointestinal function in patients after laparoscopic radical surgery

Abstract

BACKGROUND

Gastrointestinal (GI) dysfunction is common after laparoscopic radical gastrectomy for gastric cancer and affects rehabilitation. While conventional treatments can alleviate symptoms to a certain extent, they often fail to fully address the issue of insufficient GI motility. The GI motility therapeutic apparatus promotes dynamic recovery by simulating GI electric waves, whereas acupuncture regulates zang-fu qi movement, both offering effective interventions. However, there are few clinical studies investigating the combined use of GI motility therapy and acupuncture to promote GI function recovery in patients after GI laparoscopic radical surgery.

AIM

To evaluate the effects of combining GI motility therapy devices with acupuncture on GI function in patients undergoing radical laparoscopic surgery.

METHODS

This retrospective study included 196 patients who underwent radical GI endoscopic surgery at the Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, from June 2022 to May 2024. Patients were classified into a normal group (conventional treatment, n = 96) and an integrated group (conventional + GI motility therapy device + acupuncture, n = 100). The effects on GI function, hormone levels pre- and post-treatment, GI symptoms, immune function, adverse reactions, and patient satisfaction in both groups were assessed.

RESULTS

Compared with the normal group, the integrated group demonstrated significantly better overall effectiveness (93.00% vs 84.3%; P < 0.05) and shorter durations for first exhaust, feeding, defecation, and hospital stay (P < 0.05). Post-treatment, the integrated group had lower gastrin and GI symptom rating scale scores and higher motilin, vasoactive intestinal peptide, and immune marker (CD3+, CD4+, CD4+/CD8+, and natural killer cells) levels (P < 0.05). The integrated group, compared to the normal group, also reported fewer adverse reactions (5.00% vs 14.58%) and higher patient satisfaction (97.00% vs 84.38%), both statistically significant (P < 0.05).

CONCLUSION

The combination of a GI motility therapy device and acupuncture promotes GI function recovery after radical gastrectomy, regulates GI hormones and immune function, and is safe and effective.

Key Words: Laparoscopic radical surgery; Gastrointestinal functional disorders; Gastrointestinal motility therapy device; Acupuncture therapy; Zusanli acupoint; Curative effect

Core Tip: Gastrointestinal (GI) laparoscopic surgery causes GI dysfunction, with signs of changes in defecation patterns, adhesive intestinal obstruction, and abdominal pain. We found that compared with conventional treatment, GI motility therapy combined with acupuncture can effectively promote the recovery of postoperative GI function, regulate GI hormones and immune function, and improve patient satisfaction with good safety.

INTRODUCTION

With advancements in minimally invasive surgical techniques, laparoscopic radical gastrectomy has become an increasingly popular surgical option among surgeons[1]. Despite the reduction in surgical trauma caused by laparoscopic techniques, postoperative gastrointestinal (GI) dysfunction (GID) remains a significant factor affecting patient recovery. GID encompasses various conditions, including delayed gastric emptying, gastroparesis, reduced GI motility, intestinal adhesions, and Roux stasis syndrome. These conditions not only prolong hospitalization but also increase the risk of postoperative complications, significantly affecting overall patient recovery[2,3].

GID includes delayed gastric emptying, gastroparesis, decreased GI peristalsis, intestinal adhesion, and Roux stasis syndrome. These conditions not only prolong hospital stays but also increase the risk of postoperative complications, significantly influencing the overall recovery of patients[2,3]. While conventional treatments can alleviate the symptoms of patients, their effectiveness is often limited, particularly in addressing the underlying issue of GID. Therefore, more effective approaches must be explored.

In recent years, GI motility therapy has demonstrated remarkable efficacy in facilitating the recovery of GI motility. Based on the principle of GI pacemaker electrical activity, this therapy mimics the natural GI radio waves of the human body by stimulating specially synthesized bioaudio electrical signals, acting on the GI pacemaker to induce normal rhythmic contraction and propulsive peristalsis of the GI tract, thereby effectively ameliorating the symptoms of GI motility disorders[4,5]. In traditional Chinese medicine, postoperative GID belongs to the categories of “intestinal obstruction” and “intestinal paralysis”. It is mostly caused by insufficient innate endowment, postoperative disorders of the visceral qi circulation, weakness of the spleen and stomach, obstruction of the visceral qi circulation, and loss of communication between the stomach and intestine[6,7]. Acupuncture, a traditional Chinese medical treatment method, can improve GID by needling acupoints, such as Zusanli, Neiguan, and Shangjuxu, to regulate visceral function, enhance qi circulation, and improve blood flow[8,9]. Previous studies have confirmed that acupuncture can modulate GI motility and promote the recovery of GI function in patients with postoperative GID[10,11]. In recent years, combining acupuncture with modern medical techniques, such as electroacupuncture therapy, has further improved the efficacy and safety of acupuncture. However, studies have yet to reach a consensus on the optimal combination of acupoints, frequency, and duration when acupuncture is used alone. In other disease fields, a few preliminary exploratory studies have suggested that combining the two may theoretically have synergistic effects[12,13]. However, clinical reports on the use of a GI motility therapeutic instrument combined with acupuncture and moxibustion for the recovery of GI function after GI laparoscopic radical surgery remain limited.

This study explored the clinical effects of this combined approach in patients after laparoscopic radical surgery.

MATERIALS AND METHODS

Study participants

This retrospective study included 196 patients who underwent radical GI laparoscopic surgery at the Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University (Shanghai, China), between June 2022 and May 2024. Patients were divided into two groups: Those treated between June 2022 and May 2023 formed the normal group (n = 96), while those treated between June 2023 and May 2024 formed the integrated group (n = 100). Inclusion criteria: (1) Patients diagnosed with gastric and colorectal cancer confirmed by clinical, imaging, and pathological examinations; (2) All patients who underwent GI laparoscopic radical surgery; and (3) General anesthesia was administered, following the classification standards of the American Society of Anesthesiologists I-III[14]. Exclusion criteria: (1) Patients who underwent combined resection of other organs; (2) Those who developed severe postoperative complications; (3) Patients who required conversion to open surgery due to failed laparoscopic procedures; (4) Patients with coagulation disorders; (5) Patients who needed urgent surgery due to significant GI bleeding; (6) Individuals with mental or neurological disorders causing cognitive impairment; and (7) Patients with severe diseases of the heart, liver, kidneys, or other organs. This study was approved by the Ethics Committee of Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University.

Methods

Normal group: This group received conventional therapy, which included fasting, anti-infection, acid suppression, inhibition of intestinal fluid secretion, and maintenance of water, electrolyte, and acid-base balance. Supportive symptomatic treatment, such as enhanced nutrition and antispasmodic analgesia, was also provided. Specific medications included: Pantoprazole sodium injection (Batch No. H2008391; Hainan Weikang Pharmaceutical (Qianshan) Co., Ltd., Anhui Sheng, China) 60 mg twice daily; ceftriaxone sodium and tazobactam sodium for injection (Batch No. H20090177; Haikou Qili Pharmaceutical Co., Ltd., Haikou, China) 2 g twice daily; parecoxib sodium for injection (Batch No. H20173309; Hunan Kelun Pharmaceutical Co., Ltd., Yueyang, China) 20 mg twice daily; ambroxol hydrochloride injection (Batch No. H20203220; Huazhong Pharmaceutical Co., Ltd., Shenzhen, China) 30 mg twice daily; and somatostatin for injection (Batch No. H20044101; Shenzhen Hanyu Pharmaceuticals Co., Ltd., Shenzhen, China) 6 mg once daily.

Integrated group: In addition to the conventional therapy administered to the control group, a combination of GI motility therapy devices and acupuncture was used for treatment. GI motility therapy device: 24 hours post-surgery, the BE6000 GI motility therapy device (Yu Mechanical Registration No. 20182090807; Henan Boen Medical New Technology Co., Ltd., Henan, China) was selected. The positive electrode of the device was placed below the xiphoid process to the right of the midpoint connected to the umbilicus to locate the gastric pacemaker on the body surface. The negative electrode was placed below the xiphoid process to the left of the midpoint connected to the umbilicus and then 1 cm upward. The pacemaker frequency was maintained at 3-6 times per minute. For positioning of the intestinal pacemaker, the positive electrode was placed at the central position 1-2 cm above the umbilicus, while the negative electrode was positioned 5-10 cm to the right of the midpoint between the xiphoid process and umbilicus. The pacing frequency was maintained at 3-6 times per minute. Each treatment duration lasted 30 minutes, 1-2 times daily, until anal exhaust and defecation occurred, after which eating was resumed. Before using the GI dynamic therapy instrument, nurses received conduct operational training and were tested to ensure accurate electrode placement. Acupuncture methodology: 10 minutes after completing the GI motility therapy, acupuncture was commenced at points such as Zusanli, Neiguan, Yinlingquan, Sanyinjiao, Shangjuxu, and Xiajuxu. The disposable needle was 0.35 mm × 75 mm from the Huatuo brand (Suzhou Medical Supplies Factory Co., Ltd., Suzhou, China). Patients were asked to lie in a supine position, and the acupuncture sites were disinfected before insertion. All points except Sanyinjiao were penetrated perpendicularly at 90°. The Sanyin cross needle was obliquely inserted towards the posterior border of the tibia, with a depth not exceeding 1.5 inches. Local sensations of soreness, numbness, distension, pain, and qi were considered standards. If the needle sensation was not prominent, methods such as lifting, twisting, and filling were employed until the needle sensation became obvious for 30 minutes, once or twice daily. Both groups received treatment for 1 week.

Observation index

Primary outcome measure: Therapeutic effect: The therapeutic effect was evaluated based on criteria from relevant literature[15]. Cure: The first exhaust or defecation occurred within 24 hours of treatment, with no abdominal distension, nausea, vomiting, or abdominal pain at rest and normal bowel sounds. Marked effect: The first exhaust or defecation occurred within 24-48 hours after treatment, with no obvious abdominal pain, abdominal distension, nausea, or vomiting, and normal bowel sounds. Improvement: The first exhaust or defecation occurred within 48-72 hours after treatment, with mild abdominal distension, abdominal pain, occasional nausea and vomiting, and abnormal bowel sounds. Ineffective: No spontaneous exhaust occurred within 72 hours after surgery, and there were no significant changes in symptoms before and after treatment. Abdominal distension and pain, nausea, vomiting, and absent or very weak bowel sounds persisted. GI function recovery: The time of the patient’s first exhaust, feeding, defecation, and length of stay after the operation were recorded.

Secondary outcome measure: GI hormone levels: Before and 1 week after treatment, 10 mL fasting venous blood was collected from both groups in the morning. The blood was separated into two 5 mL samples and centrifuged at a radius of 10 cm and a speed of 3500 rpm for 10 minutes. The supernatant was collected, and the levels of gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP) were measured using radioimmunoassays. Shanghai Enzyme-Linked Biotechnology Co., Ltd. (Shanghai, China) provided the assay kit. GI symptoms: The GI symptom rating scale (GSRS)[16] was employed for overall assessment. The scale has a total score of 56 points, with higher scores indicating more severe GI symptoms. Immune function: An additional 5 mL blood sample was collected before and after treatment (1 week). After serum separation, an automatic cell analyzer was used to detect peripheral T cell subsets (CD3+, CD4+, CD8+) and natural killer (NK) cell levels. These results were recorded for analysis. Adverse reactions and patient satisfaction: The incidence of postoperative adverse reactions, such as dry mouth, diarrhea, and nausea, was recorded. Postoperatively, the self-developed satisfaction scale of our hospital was used to assess the scores, which ranged from 1 to 3. Here, 1 indicated satisfaction, 2 represented relative satisfaction, and 3 signified dissatisfaction. Overall satisfaction was calculated as: Total satisfaction = number of satisfied cases/total cases × 100.

Statistical analyses

Data were analyzed using IBM SPSS software (version 29.0; IBM SPSS Statistics, Armonk, NY, United States). Measurement data adhering to a normal distribution are presented as mean ± SD, while categorical variables are depicted as counts and percentages, n (%). A t-test was used for comparisons of continuous data, and a χ² test for categorical data. Statistically significant differences were observed (P < 0.05).

RESULTS

Patient baseline characteristics

The baseline data of the two groups were comparable, with no significant differences (P > 0.05) (Table 1).

Table 1 Patient baseline characteristics, n (%).

Group	Sex		Age (years)	Disease type		BMI (kg/m2)	Staging of TNM
	Male	Female		Gastric cancer	Colorectal cancer		Phase I	Phase II	Phase III	Phase IV
Integrated group (n = 100)	60	40	58.16 ± 9.27	46 (46.00)	54 (54.00)	23.53 ± 2.44	21	26	36	17
Normal group (n = 96)	59	37	57.86 ± 10.05	41 (42.70)	55 (57.29)	23.46 ± 2.52	19	26	32	19
χ2/t	0.015		0.214	0.215		0.196	0.043
P value	0.834		0.831	0.643		0.845	0.947

BMI: Body mass index; TNM: Tumor-node-metastasis.

Therapeutic effect

The integrated group showed a significantly higher overall therapeutic effectiveness rate (93.00%) compared to the normal group (84.3%) (P < 0.05) (Table 2).

Table 2 Comparison of treatment effects between the integrated group and the normal group, n (%).

Group (n = 100)	Cure	Remarkable	Improvement	In vain	Overall effective rate
Integrated group (n = 100)	28 (28.00)	35 (35.00)	30 (30.00)	7 (7.00)	93 (93.00)
Normal group (n = 96)	18 (18.75)	29 (30.20)	30 (31.25)	19 (19.79)	81 (84.38)
χ2					6.366
P value					0.012

Recovery of GI function after treatment

Post-treatment, the integrated group showed faster recovery times compared to the normal group. The first exhaust time was 56.20 ± 15.65 hours vs 75.44 ± 9.74 hours. The first feeding time was 56.97 ± 15.96 hours vs 78.34 ± 10.22 hours. The first defecation time was 63.34 ± 13.58 hours vs 86.22 ± 8.75 hours. The hospital stay time was 9.50 ± 1.62 hours vs 12.32 ± 4.05 hours. All differences were statistically significant (P < 0.05), as shown in Figure 1.

Figure 1 Recovery of gastrointestinal function in the two groups post-treatment. A: Time of first exhaust; B: Time of first feeding; C: Time of first defecation; D: Length of hospital stay. ^fP < 0.000001.

Levels of GI hormones

Pre-treatment, the levels of GAS, MTL, and VIP were similar between the two groups (P > 0.05). In the integrated group the levels of GAS, MTL, and VIP were 196.55 ± 20.56 pg/mL, 250.13 ± 29.55 pg/mL, and 45.81 ± 16.31 pg/mL, respectively, while in the normal group, the levels were 200.31 ± 18.60 pg/mL, 248.30 ± 27.79 pg/mL, and 48.35 ± 15.89 pg/mL. Post-treatment, the GAS levels were lower in the integrated group 118.30 ± 29.55 pg/mL, compared to the normal group 158.40 ± 25.59 pg/mL; MTL levels were higher in the integrated group 318.35 ± 30.88 pg/mL compared to the normal group 275.34 ± 26.37 pg/mL; and VIP levels were also higher in the integrated group 78.91 ± 18.63 pg/mL compared to the normal group 67.57 ± 20.28 pg/mL. All differences were statistically significant (P < 0.05), as shown in Figure 2.

Figure 2 Comparison of gastrointestinal hormone levels between the two groups. A: Comparison of gastrin (GAS) between the two groups; B: Comparison of motilin (MTL) between the two groups; C: Vasoactive intestinal peptide (VIP) comparison between the two groups. NS: Not significant. ^dP < 0.0001; ^fP < 0.000001.

GSRS score

Both groups showed a reduction in GI symptoms and GSRS scores post-treatment compared to pre-treatment, with the integrated group showing a greater improvement (P < 0.05). Further details are presented in Table 3.

Table 3 Comparison of gastrointestinal symptom rating scale scores pre- and post-treatment between the two groups.

Group	Pre-treatment	Post-treatment
Integrated group (n = 100)	40.53 ± 2.46	26.25 ± 3.16f
Normal group (n = 96)	39.86 ± 2.31	31.05 ± 3.93f
t	1.950	-9.446
P value	0.053	< 0.001

^fP < 0.000001.

Immune function index

Pre-treatment, the numbers of CD3+, CD4+, CD4+/CD8+, and NK cells were similar in both groups (P > 0.05). Post-treatment, these levels were significantly elevated in both groups, with the integrated group showing higher values than the normal group (P < 0.05) (Table 4).

Table 4 Comparison of immune function indexes pre- and post-treatment between the two groups.

Group	CD3+		CD4+		CD4/CD8+		NK
	Pre	Post	Pre	Post	Pre	Post	Pre	Post
Integrated group (n = 100)	61.85 ± 3.51	71.05 ± 5.11f	27.39 ± 2.95	35.98 ± 3.15f	0.95 ± 0.31	1.30 ± 0.43	11.45 ± 1.15	15.05 ± 1.50f
Normal group (n = 96)	61.98 ± 3.60	67.15 ± 1.85f	27.52 ± 3.05	32.42 ± 2.93f	0.93 ± 0.29	1.05 ± 0.35	11.55 ± 1.07	13.02 ± 0.87f
t	-0.256	7.021	0.030	8.220	0.466	4.689	-0.695	11.572
P value	0.798	< 0.001	0.762	< 0.001	0.641	0.833	0.488	< 0.001

^fP < 0.000001.

NK: Natural killer.

Adverse reactions and satisfaction

The total incidence of adverse reactions and the total satisfaction rate in the integrated group were 5.00% and 97.00%, respectively, which were superior to 14.58% and 84.38% in the normal group (P < 0.05) (Table 5).

Table 5 Comparison of adverse reactions and satisfaction between the two groups, n (%).

Group	Adverse reactions				Satisfaction
	Dry mouth	Diarrhea	Nausea	Total incidence	Satisfaction	Be satisfied with	Dissatisfy	Overall satisfaction
Integrated group (n = 100)	2 (2.00)	2 (2.00)	1 (1.00)	5 (5.00)	46 (46.00)	51 (51.00)	3 (3.00)	97 (97.00)
Normal group (n = 96)	5 (5.21)	5 (5.21)	4 (4.17)	14 (14.58)	32 (33.00)	48 (50.00)	15 (15.62)	81 (84.38)
t				5.138				9.360
P value				0.023				0.002

DISCUSSION

Radical GI endoscopic surgery often requires general anesthesia or combined spinal-epidural anesthesia. Anesthetic drugs can paralyze the central nervous system, leading to dysfunction or suppression, which poses a risk to the body[17]. Patients undergoing radical GI endoscopic surgery often experience pneumoperitoneum, surgical trauma, and anesthesia. They are prone to postoperative GID, mainly manifested as nausea and vomiting, cessation or difficulty in passing gas or stool, abdominal distension, and pain, reduced intestinal peristalsis, and decreased or absent bowel sounds[18,19]. GI motility therapy devices are simple to operate, painless, and pose a low risk. They have been clinically used for the treatment of GI motility disorders and functional constipation with ideal results. GI pacemakers drive pacing points in the GI tract at a specific electric current frequency to regulate electrical rhythm disturbances and promote rapid recovery. The principle of GI motility therapy devices is consistent with that of gastric pacemakers: They can coordinate the basic gastric rhythm of the body, stimulate the GI tract, and enhance contractile force, thereby preventing intestinal bloating[20,21]. However, their effectiveness as a single treatment is limited.

From the perspective of traditional Chinese medicine, GID aligns with the conditions of “Pi Man” and “constipation”. GID involves the spleen, stomach, large intestine, and small intestine, with its core pathogenesis in stomach deficiency and descent, leading to disrupted fu qi flow. Therefore, the treatment focuses on regulating fu qi. Acupuncture, a characteristic therapy in traditional Chinese medicine, can stimulate local acupoints, allowing the internal flow of meridian qi to regulate the function of zang-fu organs. Acupuncture has a good bidirectional regulatory effect on GI function and is now widely used in the treatment of GI diseases such as functional dyspepsia, functional constipation, irritable bowel syndrome, and gastroesophageal reflux disease[11,22,23]. Zusanli is a combined acupoint of the Zuyangming Stomach Meridian and the lower junction point of the stomach. As mentioned in the “Ancient and Modern Medical Records”, “Zusanli pertains to the stomach. It induces Yang to descend and Yin to ascend, and also benefits stomach qi”. Acupuncture at Zusanli can improve the function of the spleen and stomach, dredge channels and collaterals, supplement qi, and improve blood circulation. Acupuncture at the Neiguan point can regulate and access the qi mechanism of the three jiao and maintain the balance of qi and blood, Yin and Yang, and zang-fu organs in the body. Yin Ling Quan is the Shu point of the foot Taiyin spleen and regulates qi and the spleen. Three Yin Jiao is the Shu point of the foot Taiyin spleen meridian, which can strengthen the spleen, soothe the liver, and regulate blood circulation. The combined application of all these factors can achieve the effects of invigorating the spleen and supplementing qi, promoting blood circulation, removing blood stasis, soothing the liver, regulating qi, and lowering the stomach. Shangjuxu harmonizes the spleen and stomach and activates collaterals through channels. Acupuncture at Shangjuxu can stimulate the vagus nerve and enhance GI peristalsis[10,24].

The findings of this study revealed that the integrated group had a significantly higher total effectiveness rate compared to the normal group. Additionally, patients in the integrated group experienced faster recovery in terms of the first exhaust, feed, defecation, and hospital stay than those of the normal group. These results are consistent with findings reported by Wang et al[9]. The results indicated that GI motility therapy combined with acupuncture could effectively alleviate clinical symptoms, facilitate the recovery of GI function, and shorten the hospital stay. This may be because a specific region of the GI tract regulates the fundamental bioelectric rhythm of the GI tract and induces contraction of the GI smooth muscle, which serves as a GI pacemaker. Under the pacemaker control, the GI tract undergoes ganglionic peristalsis, and the mechanical activity of the GI smooth muscle is predicted by GI bioelectrical activity. A GI motility therapy device generates currents of varying frequencies to drive electrical rhythm activity (GI pacemaker) and emulates normal GI biological signals through advanced electronic technology, with an electrode placed on the body surface. Thus, the abnormal activity of the GI electrical rhythm can be effectively rectified, the contraction and advancement of the GI rhythm can be facilitated, and GID can be improved[25-27]. Acupuncture at Zusanli can strengthen the body and mind, whereas acupuncture at Tianshu can lift and clear turbidity. Acupuncture in Tianshu and Zusanli can effectively enhance gastric motility, promote GI motility, and alleviate abdominal distension, anal exhaust, and a series of GI symptoms[28]. The combination of the two can greatly promote the recovery of GI function in patients after radical GI laparoscopic surgery, which fully reflects the superiority of GI motility therapy instruments combined with acupuncture and moxibustion. The results of this study showed some discrepancies compared with similar research. Liu et al[29] found that, compared with conventional treatment, electroacupuncture was more effective in promoting the first exhaust and defecation and in reducing hospitalization time. However, their study focused on patients with GID after surgery under anesthesia.

Related studies discovered that following radical gastrectomy, the levels of GAS increased as a result of surgical stress and hormone imbalance in the GI tract, which facilitated the contraction of the gastric antrum, gastric body, and pyloric sphincter[30,31]. The overall aim was to retard gastric emptying. Similarly, MTL decreased and inhibited GI motility, influenced the decomposition of water and electrolytes, and thereby inhibited excretion. The primary function of VIP is to relax GI smooth muscle and stimulate intestinal peristalsis. VIP secretion decreased in patients with gastric cancer, thereby causing constipation[32]. It was discovered that in contrast to the normal group, the GAS level in the integrated group was lower, while MTL and VIP levels in the integrated group were higher. Thus, the combination of a GI dynamic therapy instrument and acupuncture can effectively regulate the level of GI hormone levels. An animal experiment demonstrated that electroacupuncture combined with acupoint intestinal embedding can improve GI motility and hormone levels in rats with functional dyspepsia, promote food intake, and reduce visceral hypersensitivity[33]. However, a systematic review and meta-analysis of randomized controlled trials found that electroacupuncture had no significant effect on GAS and VIP compared with the control group[34]. This suggests that acupuncture may accelerate the recovery of postoperative GI function through mechanisms independent of GAS or VIP mediation. Additionally, the lack of a standardized protocol for electroacupuncture, including acupoint selection, frequency, and number of sessions, may contribute to the inconsistency in findings. In this study, the combination of a GI motility therapeutic instrument and acupuncture provided positive stimulation to patients’ GI activity through current stimulation and acupuncture, promoting faster recovery of GI function.

GID during laparoscopic radical gastrectomy is also associated with inflammation and immune function[35,36]. T cell subsets and NK cell levels are important indicators for the assessment of GI function recovery following laparoscopic radical gastrectomy. When the cellular immunity of patients with gastric cancer was severely compromised, the expression of CD3+ and CD4+ cells declined, and the ratio of CD4+/CD8+ cells became imbalanced, which led to a reduction in NK cells, a decrease in activity, and a weakening of immune function. The findings of this study demonstrated that the immune function level in the integrated group was superior to that of the normal group, suggesting that the combined therapy could enhance the immune function of patients and facilitate the recovery of stomach function. The GI dynamic therapy instrument is capable of promoting rhythmic contractions of the GI tract and advancement. By stimulating specific acupoints, acupuncture, and moxibustion can exert the effects of strengthening the spleen and invigorating qi, promoting blood circulation and removing blood stasis, soothing the liver and regulating qi and stomach to reduce adverse effects, thereby accelerating the alleviation of clinical symptoms and regulating the balance of GI hormones[13]. Furthermore, the integrated group had fewer adverse reactions and higher patient satisfaction than the normal group, suggesting that the combination of GI dynamic therapy instruments and acupuncture can effectively and safely enhance patient satisfaction.

This study has some limitations. First, as a retrospective single-center study, it may have been subject to selection bias. Second, compared with previous studies, the discussion of the mechanism in this study does not introduce new insights. Therefore, future multicenter studies should aim to standardize protocols, further investigate the molecular, neurological, and immunomodulatory mechanisms of combined therapy, optimize treatment strategies, and conduct long-term follow-ups to assess the long-term efficacy.

CONCLUSION

The combination of GI dynamic therapy with acupuncture and moxibustion demonstrated a remarkable effect on the restoration of GI function after radical gastrectomy in patients with gastric cancer. This approach effectively alleviates clinical symptoms, regulates GI hormones and immune functions, enhances patient satisfaction, and is safe.