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 <i>et al</i>. 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 <i>vs</i> 3.98 ± 1.27 days, <i>P</i> < 0.001), lowers stress biomarkers (<i>e.g.</i>, reduced cortisol and norepinephrine), and enhances clinical efficacy (93.33% <i>vs</i> 75.00%, <i>P</i> = 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.