Association of tongue diagnosis-guided acupuncture with postoperative nausea and vomiting in high-risk laparoscopic surgery patients.

OBJECTIVES: This study investigated whether using tongue diagnosis-guided acupuncture in combination with drugs could reduce the incidence of postoperative nausea and vomiting (PONV) in high-risk patients undergoing laparoscopic surgery. METHODS: We retrospectively reviewed and analyzed data from female patients who underwent laparoscopic surgery between April 2023 and March 2025. The patients were divided into four groups: the drug group, acupuncture plus drug (AD) group, constitution-based drug (CD) group, and constitution-based acupuncture plus drug (CAD) group. The primary outcomes included the incidence, onset time, and severity of PONV within 24 hours after surgery. Secondary outcomes included indicators of gastrointestinal function recovery, as well as the use of postoperative analgesic and antiemetic drugs. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for PONV. RESULTS: Among 248 patients, the CAD group had the lowest PONV incidence (18.97% vs. drug group: 79.17%, AD group: 46.97%, CD group: 61.54%; all P<0.05). Gastrointestinal recovery was significantly faster in the CAD group, with shorter times to bowel sound recovery, first flatus, and first defecation (all p<0.05). The CAD group also showed the highest serum motilin levels and the lowest vasoactive intestinal peptide levels (both P<0.05). Opioid consumption and rescue antiemetic requirements were significantly lower in the CAD group (both P<0.05). CONCLUSIONS: Constitution-based stratification guided by tongue diagnosis, combined with targeted acupuncture was associated with reduced PONV incidence, accelerated gastrointestinal recovery, and decreased opioid and antiemetic requirements in high-risk patients undergoing laparoscopic surgery.