Auricular acupressure for postoperative pain and recovery in patients with anal fistula and abscess

doi:10.4240/wjgs.v18.i3.116214

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Mar 27, 2026 (publication date) through Mar 30, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Mar 27, 2026; 18(3): 116214
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.116214

Auricular acupressure for postoperative pain and recovery in patients with anal fistula and abscess

Li-Na Wang, Bing-Xin Shi, Man-Jun Liu, Yan-Yan Wang

Li-Na Wang, Bing-Xin Shi, Department Brain Disease, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China

Man-Jun Liu, Yan-Yan Wang, Department of Anorectal, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China

Author contributions: Wang LN performed the majority of experiments and wrote the manuscript; Shi BX designed the study and revised the manuscript; Liu MJ performed the statistical analysis; Wang YY collected data. All authors have read and approved the final manuscript.

Supported by Scientific Research Plan Project of Hebei Provincial Administration of Traditional Chinese Medicine, No. 2022028.

Institutional review board statement: This study was approved by the Hebei Provincial Hospital of Traditional Chinese Medicine (Hebei, China, approval No. HBZY2021-KY-072-01).

Clinical trial registration statement: This single-center, prospective, observational clinical study aimed to investigate the effect of auricular acupressure on postoperative recovery in patients with perianal abscesses and fistulas. The study design was approved by the institutional ethics committee and adhered to the principles of the Declaration of Helsinki. However, it has not been prospectively registered in the Chinese Clinical Trial Registry for several reasons.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author upon request.

Corresponding author: Bing-Xin Shi, Department Brain Disease, Hebei Provincial Hospital of Traditional Chinese Medicine, No. 389 Zhongshan East Road, Shijiazhuang 050000, Hebei Province, China. shi_bingxin@163.com

Received: November 7, 2025
Revised: December 9, 2025
Accepted: January 23, 2026
Published online: March 27, 2026
Processing time: 140 Days and 4 Hours

Abstract

BACKGROUND

Anal pain, slow wound healing, and a high risk of complications after surgical treatment of a perianal abscess combined with an anal fistula affect a patient’s quality of life and sleep.

AIM

To analyze syndrome-differentiated auricular acupressure for postoperative recovery in patients who underwent anorectal surgery.

METHODS

We included 100 patients hospitalized with anal fistulas and perianal abscesses at the Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023. The patients were divided into two groups using a 1:1 randomized controlled design. Patients in the control group (n = 50) were admitted for routine nursing intervention, and those in the observation group (n = 50) received auricular acupressure with Wangbuliuxing seeds based on syndrome differentiation and acupoint selection based on routine nursing. The outcomes included urinary symptoms, healing time, pain, sleep, and complications.

RESULTS

The first urinary symptom score (lower abdominal symptoms, waiting time for urination, incomplete urination, and urinary difficulty, healing time) was lower in the observation group (3.90 ± 1.39, 3.66 ± 1.26, 3.54 ± 1.16, 3.48 ± 1.11, and 16.70 ± 3.05) than in the control group (5.94 ± 0.96, 5.28 ± 1.29, 5.40 ± 1.21, 5.34 ± 1.26, and 21.26 ± 3.37). Wound healing time was shorter in the observation group than in the control group. On postoperative days 3, 7, and 14, Pittsburgh Sleep Quality Index scores and visual analog scale scores were lower in the observation group (4.30 ± 0.46, 3.42 ± 0.50, 2.26 ± 0.44, 10.86 ± 2.04, 8.92 ± 1.21, and 6.26 ± 1.03) than in the control group (4.90 ± 0.42, 3.92 ± 0.27, 2.78 ± 0.42, 12.46 ± 2.12, 10.36 ± 1.38, and 8.02 ± 1.24). The incidence of complications was significantly lower in the observation group (4.00%) than in the control group (16.00%).

CONCLUSION

Syndrome-based auricular acupressure in patients with anal fistula/abscess improved postoperative urination, pain, wound healing, and sleep and reduced complications.

Keywords: Perianal abscess; Anal fistula; Syndrome differentiation and acupoint selection; Auricular acupressure with seeds; Pain; Sleep

Core Tip: This study applied auricular acupressure with seeds based on syndrome differentiation and acupoint selection for the postoperative care of perianal abscesses complicated by anal fistulas. The feasibility of achieving rapid postoperative recovery by selecting auricular acupressure with seeds based on syndrome differentiation and acupoint selection was verified by observing effective indicators such as the first postoperative urinary symptom score, wound healing time, pain, sleep status, and complications from traditional Chinese medicine and dialectical nursing, which provide a safe and new approach for postoperative pain relief.