Study on the neuroimmune regulatory mechanism of electroacupuncture at Zusanli acupoint for postoperative intestinal paralysis after gastrointestinal surgery.

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-1β levels 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 anti-inflammatory pathway through electroacupuncture stimulation of the Zusanli acupoint.