Effects of electroacupuncture on gastrointestinal dysfunction and serum metabolites in postoperative patients with gastric cancer

OBJECTIVE: To observe the promoting effect of electroacupuncture (EA) on gastrointestinal function recovery in patients after gastric cancer operation, and to explore the possible biological mechanisms by which EA regulates gastrointestinal motility using metabolomics. METHODS: A total of 60 patients who underwent laparoscopic radical gastrectomy were randomly divided into a treatment group and a control group, 30 cases in each group. An additional 20 healthy individuals were recruited as the healthy group. The patients in the control group received standardized perioperative care. In addition, the patients in the treatment group received acupuncture at bilateral Zusanli (ST36), Shangjuxu (ST37), and Neiguan (PC6) at 2, 24, 48, and 72 hours post‐anesthesia recovery. EA was applied between ipsilateral Zusanli (ST36) and Shangjuxu (ST37) using continuous waves at 50 Hz of frequency and 0.1‐1 mA intensity for 30 minutes per session. Postoperative gastrointestinal function indexes were observed, including time to first anal exhaust, time to first anal defecation, time to first oral fluid intake, and time to first ambulation. Pain visual analogue scale (VAS) scores were recorded at pre‐operation, 2 hours post‐operation, and 72 hours post‐operation. Serum metabolomics analysis was conducted to identify characteristic metabolites associated with the EA‐induced promotion of gastrointestinal recovery. RESULTS: Compared with the control group, the treatment group showed significantly earlier time to first anal exhaust, time to first anal defecation, time to first oral fluid intake, and time to first ambulation (P<0.05). Compared with the control group, the pain VAS score at 72 hours post‐operation was significantly lower in the treatment group (P<0.05). Through serum metabolomics analysis, a total of 10 characteristic metabolic biomarkers associated with EA in alleviating postoperative gastrointestinal dysfunction after gastric cancer operation were identified, including 1‐Methylguanine and (2‐Aminoethoxy) acetic acid. CONCLUSION: EA can promote postoperative gastrointestinal function recovery in postoperative patients with gastric cancer. The underlying mechanism may be related to alleviation of inflammatory responses, improvement of gut microbiota composition, and stabilization of intestinal barrier function.