Objective

2

To observe the clinical effect of distal acupoint acupuncture in treating gastrointestinal dysfunction in pseudomyxoma peritonei （PMP） patients after cytoreductive surgery with spleen-stomach

qi

deficiency syndrome.

Methods

2

A total of 88 PMP patients with spleen-stomach

qi

deficiency syndrome following cytoreductive surgery were randomized divided into an acupuncture group and a control group， each comprising 44 patients. Both

groups received standard Western perioperative care. Starting on the 2nd day after surgery， the acupuncture group received acupuncture selecting distal acupoints， while the control group received superficial non-acupoint sham acupuncture. Both groups received treatment on alternate days， three times weekly for a 14-day course. The following parameters were compared between groups， time to first spontaneous bowel movement， time to removal of nasogastric tube， and nasogastric tube drainage volume on days 3 and 7 after surgery； traditional Chinese medicine （TCM） symptoms scores of nausea/vomiting， fatigue， along with abdominal distension grading on days 7， 14， and 21 after surgery； and scores on Hospital Anxiety and Depression Scale （HADS） and nutritional status assessment at baseline and on day 7， 14， and 21 after surgery.

Results

2

The acupuncture group demonstrated shorter times of first spontaneous bowel movement and nasogastric tube removal compared to the control group （

P

＜0.05）. On day 7 after surgery， the acupuncture group exhibited lower nasogastric tube drainage volume than the control group （

P

＜0.05）. On days 7 and 14， the acupuncture group exhibited lower graded scores for nausea， vomiting， and abdominal distension compared to the control group. On day 14 and 21 after surgery， the acupuncture group also demonstrated lower fatigue scores than the control group （

P

＜0.05）. Compared with levels before surgery， the anxiety subscale scores in the acupuncture group decreased significantly at both day 14 and 21 after surgery （

P

＜0.05 or

P

＜0.01）. At day 7 and 14 after surgery， the anxiety subscale scores in the acupuncture group were lower than those in the control group （

P

＜0.05 or

P

＜0.01）. The depression subscale scores in the acupuncture group increased at day 7 after surgery compared to levels before surgery （

P

＜0.05）， but decreased at both day 14 and 2

1 after surgery compared to levels before surgery （

P

＜0.05 and

P

＜0.01）. On day 14 after surgery， the acupuncture group's depression subscale score was lower than that of the control group （

P

＜0.05）. Nutritional status scores on day 7 and 14 after surgery in the acupuncture group decreased compared to levels before surgery （

P

＜0.01）， but were higher than those of the control group on day 14 after surgery （

P

＜0.05）.

Conclusion

2

Acupuncture by selecting distal acupoints could help postoperative PMP patients with spleen-stomach

qi

deficiency syndrome shorten the time to spontaneous bowel movement and the duration of nasogastric tube retention， reduce the postoperative gastric tube drainage volume， improve symptoms such as nausea， vomiting， fatigue， and abdominal distension， and promotes the recovery of gastrointestinal function.