Evidence-based acupuncture: Methodological insights and challenges in gastroenteroscopy recovery research

This editorial examines the emerging potential of traditional Chinese medicine (TCM) in enhancing postoperative recovery following gastroenteroscopy, highlighted by a 2025 randomized controlled trial by Hong et al. The study, involving 120 patients, demonstrates that meridian flow injection (MFI) combined with transcutaneous electrical acupoint stimulation (TEAS) significantly improves gastrointestinal (GI) function, evidenced by a reduced time to first defecation (3.20 ± 1.04 days vs 3.98 ± 1.27 days, P < 0.001), lowers stress biomarkers (e.g., reduced cortisol and norepinephrine), and enhances clinical efficacy (93.33% vs 75.00%, P = 0.006). Leveraging TCM's five-element theory and Ziwu Liuzhu timing, the intervention targets key acupoints such as Zusanli (ST36) with a herbal paste comprising Qingpi, Houpu, and rhubarb, delivered transdermally to optimize bioavailability. This approach harmonizes ancient TCM principles with contemporary evidence-based practice, offering a holistic strategy to address postoperative nausea, delayed motility, and patient discomfort. Currently, integrative methods like MFI-TEAS are gaining traction, supported by recent meta-analyses that affirm TEAS's efficacy in accelerating GI recovery across surgical contexts, including shortened times to first exhaust and defecation. This reflects a growing recognition of TCM's role in perioperative care amidst rising global endoscopy demands. Looking forward, future research should prioritize multicenter, double-blinded trials to enhance generalizability, adhere to standardized reporting frameworks such as CONSORT and STRICTA, and employ advanced tools like multi-omics and functional magnetic resonance imaging to elucidate mechanistic pathways, including gut-brain axis modulation and microbiota-immune interactions. Such developments promise to refine these interventions, fostering a seamless integration of TCM with Western medicine and delivering tailored, patient-centered solutions to improve postoperative outcomes worldwide.