Li DH, Yuan J, Qiao C, Tian XT, Yang Q. Acupuncture regulating the gut-brain axis for postoperative ileus: Neuroimmune mechanisms and clinical translation prospects. World J Gastrointest Surg 2026; 18(2): 114417 [DOI: 10.4240/wjgs.v18.i2.114417]
Corresponding Author of This Article
Qian Yang, Chief Physician, Professor, Hebei Key Laboratory of Turbidity Toxin Syndrome, Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), No. 389 Zhongshan East Road, Shijiazhuang 050011, Hebei Province, China. yang0311qian@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2026; 18(2): 114417 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114417
Acupuncture regulating the gut-brain axis for postoperative ileus: Neuroimmune mechanisms and clinical translation prospects
De-Hui Li, Jia Yuan, Chang Qiao, Xiao-Tong Tian, Qian Yang
De-Hui Li, Oncology Department II, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research, Hebei Industrial Technology Institute for Traditional Chinese Medicine Preparation, Shijiazhuang 050000, Hebei Province, China
Jia Yuan, Chang Qiao, Xiao-Tong Tian, Graduate School, Hebei University of Chinese Medicine, Shijiazhuang 050091, Hebei Province, China
Qian Yang, Hebei Key Laboratory of Turbidity Toxin Syndrome, Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Shijiazhuang 050011, Hebei Province, China
Co-first authors: De-Hui Li and Jia Yuan.
Author contributions: Li DH and Yuan J contributed equally to this manuscript and are co-first authors. Li DH and Yuan J designed the overall concept and outline of the manuscript; Qiao C and Tian XT contributed to the writing and editing of the manuscript and review of the literature; Yuan J drew the figure for the manuscript; Yang Q directed and reviewed the paper. All authors have read and approved the final manuscript.
Supported by 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine, No. ZF2023165; Key Research and Development Projects of Hebei Province, No. 18277731D; Natural Science Foundation of Hebei Province, No. H2024423105; Hebei Provincial Administration of Traditional Chinese Medicine, Scientific Research Project, No. 2023045 and No. 2024023; Hebei Institute of Traditional Chinese Medicine Pharmaceutical Preparation Industry Technology Special Project, No. YJY2024006; and Scientific Research Project of Health Commission of Hebei Province, No. 20220962 and No. 20240282.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Qian Yang, Chief Physician, Professor, Hebei Key Laboratory of Turbidity Toxin Syndrome, Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), No. 389 Zhongshan East Road, Shijiazhuang 050011, Hebei Province, China. yang0311qian@126.com
Received: September 27, 2025 Revised: October 24, 2025 Accepted: November 27, 2025 Published online: February 27, 2026 Processing time: 152 Days and 21.3 Hours
Abstract
Postoperative ileus remains a significant challenge in surgical recovery. Increasing evidence highlights the gut-brain axis as a promising target for managing gastrointestinal motility disorders. Acupuncture, particularly at Zusanli (ST36), has shown considerable potential to regulate gut function, although its mechanisms warrant further investigation. This editorial discusses a clinical study demonstrating that electroacupuncture at Zusanli (ST36) accelerates gastrointestinal recovery in patients with postoperative ileus by activating the vagus nerve-cholinergic anti-inflammatory pathway, suppressing pro-inflammatory cytokines, and rebalancing gastrointestinal hormones. We further summarize how acupuncture modulates the gut-brain axis through neural, immune, endocrine, microbial, and central pathways, supporting integration with modern neuroimmunology. These findings support incorporating acupuncture into enhanced recovery after surgery protocols. Future studies should prioritize mechanistic investigations using multi-omics technologies, large-scale clinical trials to enable standardization, and exploration of acupuncture-microbiota-gut-brain interactions to broaden clinical applications in gastrointestinal disorders.
Core Tip: Based on emerging evidence for electroacupuncture at Zusanli (ST36) in treating postoperative ileus via the vagus nerve-mediated anti-inflammatory pathway, this article systematically details the mechanisms by which acupuncture regulates gastrointestinal motility through neural, immune, endocrine, and microbial pathways. It provides a strong rationale for integrating acupuncture, an effective non-pharmacological therapy, into enhanced recovery after surgery protocols. Future research focusing on multi-omics technologies, large-scale clinical trials, and microbiota-gut-brain interactions will be crucial for advancing the clinical application of acupuncture in gastrointestinal motility disorders.
