Efficacy Of Acupoint Application Combined With Enhanced Recovery After Surgery On Postsurgical Gastrointestinal Function And Cellular Immune Function In Patients Undergoing Gastrointestinal Surgery

Objectives:To investigate the efficacy of acupoint application combined with enhanced recovery after surgery on postsurgical gastrointestinal function and cellular immune function in patients undergoing gastrointestinal surgery.Methods:We conducted a prospective,randomized and controlled interventional study.Patients diagnosed with gastrointestinal malignancy in the Department of Gastroenterology,Affiliated Hospital of North Sichuan Medical College were selected to participate in this study from June 2019 to December 2019.According to the random number table method,they were divided into the observation group and the control group.Patients in the control group were treated with ERAS alone,while those in the observation group received ERAS combined with acupoint application.We collected information to document the indicators,including age,gender,types of disease,surgical procedure,operation time,intraoperative bleeding,TNM stages,ASA classification,single symptom score,postoperative first exhaust time,first defecation time,and time to bowel sounds recovery,resuming food intake,postoperative complications.And levels of MTL,VIP,CD4+,CD8+,CD4+/CD8+,NK Cell were measured on preoperative and postoperative days 1,3,5.Results:A total of 80 patients were randomly divided into control group and observation group with 40 cases in each group.There were no significant differences in age,gender,types of disease,surgical procedure,operation time,intraoperative bleeding,TNM stage,and ASA classification between the groups(P>0.05).Differences regarding the MTL and VIP levels before operation,and 1 day after the operation between the two groups were not statistically significant(P>0.05).Our study showed an increased tendency in the level of MTL in contrast to a downward trend for VIP as time progressed on postoperative days 3,5.Additionally,3 and 5 days after operation,the MTL levels of the observation group were significantly higher than those of the control group,and the VIP levels were significantly lower than the control group(P<0.05).The anal exhaust time[(59.62±18.68)h vs(71.67±24.23)h,P=0.015],anal defecation time[(81.48±22.25)h vs(91.74± 23.64)h,P=0.049]and the time for bowel sounds to recovery[(69.51 ± 21.17)h vs(80.81 ± 25.41)h,P=0.034]were shorter in the observation group in comparison with the control group,while there was no significant difference in time of resuming food intake(P>0.05).In observation group,after treatment,the symptom scores of abdominal pains,abdominal distension significantly better than those in control group(P<0.05),while there was no significant difference between the two groups in incidence of nausea and vomiting(P>0.05).Postoperative complications rate was lower in observation group than in control group,but the difference was not statistically significant(20.0%vs 37.5%,P=0.137).In observation group,the total hospitalization time,postoperative hospitalization time and hospitalization costs were lower than the control group(P<0.05).Intergroup comparison between the two groups showed no statistically significant difference with the proportion of CD4+,CD8+,CD4+/CD8+and NK cells in both groups on preoperative and postoperative days 1,3,5(P>0.05).Conclusions:Acupoint application can effectively promote the recovery of gastrointestinal function,decrease the time of anal exhaustion,anal defecation,and bowel sound recovery,alleviate postoperative abdominal pain and abdominal distension,reduce the length of hospitalization and hospitalization expenses and accelerate postoperative recovery in patients undergoing gastrointestinal surgery.Acupoint application was well-tolerated,without significant adverse events,but the benefit on immune function was not obvious.Therefore,the combined treatment of acupoint applications safe,effective,and worthy of further research and clinical promotion.