摘要
BACKGROUND Post-operative nausea and vomiting(PONV)after cholecystectomy occurs in 40%-75%of patients,significantly affecting recovery and satisfaction.AIM To evaluate the effectiveness and safety of acupuncture at Hegu(LI4)and Zusanli(ST36)acupoints in preventing PONV in patients undergoing cholecystectomy.METHODS This retrospective study included 240 patients undergoing cholecystectomy(January 2022 to December 2023),randomized to acupuncture(n=120)or control groups(n=120).The acupuncture group received bilateral LI4 and ST36 acupuncture immediately post-surgery and 6 hours later;controls received routine care.Primary outcomes included PONV incidence,severity(visual analogue scale score),and time to first occurrence.RESULTS The total PONV incidence in the acupuncture group was significantly lower than in the control group(28.3%vs 47.5%,P<0.01).Stratified analysis showed that in the laparoscopic group,the acupuncture group’s PONV incidence was 26.7%,significantly lower than the control group’s 45.6%(P<0.01);in the open surgery group,the acupuncture group was 33.3%,lower than the control group’s 53.3%(P<0.05).The acupuncture group showed significantly reduced symptom severity(visual analogue scale score 2.7±1.4 vs 4.5±1.8,P<0.01),delayed time to first occurrence(8.4±2.1 hours vs 4.2±1.5 hours,P<0.01),with the symptom-free period extended by 4.2 hours.The acupuncture group had a higher proportion of mild symptoms(76.5%vs 35.1%)and a significantly increased proportion of symptom-free patients within 6 hours post-surgery(67.6%vs 28.1%,P<0.01).Rescue antiemetic medication usage was significantly reduced in the acupuncture group(18.3%vs 35.8%,P<0.01).Patient satisfaction scores in the acupuncture group were significantly better than the control group(4.6±0.7 vs 3.8±0.9,P<0.01),with hospital stay shortened by 0.5 days(2.1±0.8 days vs 2.6±1.1 days,P<0.05).Subgroup analysis showed that acupuncture was more effective in patients≤45 years(incidence reduction 23.5%vs>45 years group 16.8%),with significant efficacy in high-risk patients(Apfel score≥3)(36.2%vs 62.2%,P<0.01).Safety analysis showed only 7 cases(5.8%)of mild adverse reactions in the acupuncture group,all self-resolved with no serious adverse events.CONCLUSION Acupuncture at LI4 and ST36 acupoints significantly reduces PONV incidence and severity after cholecystectomy,with an excellent safety profile.This non-pharmacological intervention offers particular value for high-risk patients and those with medication contraindications.
