The Effect of Zusanli and Sanyinjiao Acupuncture on Abdominal Distension after Liver Cancer Surgery

Abstract

Objective: This study aimed to explore the effect of Zusanli and Sanyinjiao acupuncture on postoperative gastrointestinal dysfunction (POGD), inflammatory factors, and postoperative quality of recovery after liver cancer surgery. 

Methods: This retrospective study analyzed clinical data from 46 liver cancer patients who underwent surgery at Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, between January 2022 and January 2023. Patients were divided into two groups: an acupuncture group (n=20) receiving postoperative stimulation at Zusanli (ST36) and Sanyinjiao (SP6), and a control group (n=26) without acupuncture intervention. The following outcomes were compared between groups: incidence of postoperative gastrointestinal dysfunction (POGD); length of hospital stay; serum inflammatory biomarkers—including granulocyte count, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)—measured on postoperative days  3, 5, and 7. Additionally, Quality of Recovery-15 (QoR-15) scores were assessed on postoperative day 3 and 7.

Results:  Acupuncture at Zusanli (ST36) and Sanyinjiao (SP6) significantly reduced incidences of POGD on postoperative day 3 (5.56% vs 27.78%, p=0.007) and on postoperative day 7 (0% vs 11.11%, p=0.006), while shortening hospital stay (8.0±2.56 vs 10.2±2.34 days, p<0.01). Significant reductions in inflammatory biomarkers (granulocyte count, CRP, PCT, IL-6, TNF-α) were observed in the acupuncture group versus the control group at postoperative days 3 and 5 (all p<0.05). These reductions persisted and remained significant for all biomarkers at postoperative day 7 (p<0.05). QoR-15 scores were significantly higher in the acupuncture group at postoperative day 3 (81.67±19.71 vs 98.40±11.05, p<0.05) and postoperative day 7 (93.89±12.53 vs 120.38±12.11, p<0.001).

Conclusions: Acupuncture of Zusanli and Sanyinjiao helps reduce POGD incidence and postoperative inflammatory factor levels, including granulocyte count, CRP, PCT, IL-6, and TNF-α levels, improves the patient’s quality of life, and shortens hospitalization time after laparoscopic surgery for liver cancer.