BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electr...BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.展开更多
BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gas...BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients.展开更多
文摘BACKGROUND Postoperative intestinal paralysis is common in gastrointestinal surgery,and the study of electroacupuncture mechanisms is of great significance.AIM To explore the neuroimmune regulatory mechanism of electroacupuncture at the Zusanli acupoint(ST36)in postoperative intestinal paralysis following gastrointestinal surgery.METHODS A total of 156 patients admitted to the Affiliated Hospital of Jiangnan University between January 2022 and October 2024 for postoperative intestinal paralysis following gastrointestinal surgery were randomly divided into two groups:A control group and an electroacupuncture group,with 75 patients in each.The control group received conventional Western medical treatment,while the electroacupuncture group received electroacupuncture in addition to this,at the bilateral Zusanli acupoints.Both groups received treatment for 7 days.Clinical efficacy,gastrointestinal function recovery,and gastrointestinal hormone[motilin(MTL),gastrin(GAS)],neurotransmitter[vasoactive intestinal peptide(VIP),nitric oxide(NO)],and inflammatory cytokine[tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6),interleukin-1β(IL-1β)]levels were compared between the two groups before and seven days after treatment.Adverse reactions were also recorded.RESULTS The electroacupuncture group demonstrated a higher overall treatment effectiveness rate and faster recovery of bowel sounds,as well as faster first defecation and first flatus than the control group(P<0.05).After seven days of treatment,MTL and GAS levels were significantly higher and VIP,NO,TNF-α,IL-6 and IL-1βlevels were significantly lower in the electroacupuncture group than in the control group(P<0.05).No adverse reactions were observed in either group during treatment.CONCLUSION Electroacupuncture at the Zusanli acupoint can enhance clinical efficacy,promote the recovery of gastrointestinal function,and regulate the neuroimmune microenvironment in patients with intestinal paralysis after gastrointestinal surgery.This mechanism may involve excitation of the vagus nerve and activation of the cholinergic antiinflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.
文摘BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.AIM To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.METHODS Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and Weipu Chinese Journal Database self-established until October 1,2022.Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included studies.RESULTS A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.CONCLUSION There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients.
