Rule of acupoint selection in auricular therapy of gastrointestinal dysfunction after laparoscopic surgery, based on data mining

Rule of acupoint selection in auricular therapy of gastrointestinal dysfunction after laparoscopic surgery, based on data mining | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rule of acupoint selection in auricular therapy of gastrointestinal dysfunction after laparoscopic surgery, based on data mining Guozhi Liu, Wenxin Wu, Guanglin Sang, Jiuli Li, Chang Liu, Yingqi She, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7600458/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Gastrointestinal dysfunction is a common complication of patients following laparoscopic surgery, prolonging recovery and increasing healthcare costs. With Western medicine approaches having limitations, traditional Chinese medicine (TCM), particularly auricular therapy, has shown promise in managing this condition, previous research has lacked standardization in acupoint selection and has not fully utilized data mining techniques to uncover patterns in acupoint combinations. This study aims to identify auricular acupoint patterns for treating gastrointestinal dysfunction after laparoscopic surgery via data mining, guiding clinical practice. Methods: This study systematically analyzed auricular therapy for gastrointestinal dysfunction after laparoscopic surgery. Data were retrieved from multiple Chinese and English databases up to April 30, 2025, using relevant search terms. Studies were filtered based on inclusion criteria and exclusion criteria. The included studies were standardized according to the Chinese national standard for auricular point nomenclature. Study information was organized using EndNote X9 and Excel 2021. Data underwent frequency analysis, association rule analysis, cluster analysis and network analysis to uncover patterns in acupoint selection and combinations. Results: A total of 118 papers were included in the study, featuring 28 types of auricular points used 632 times. High-frequency points included Stomach, Large Intestine, and Small Intestine. Association rule analysis revealed 48 rules with lift values greater than 1, indicating significant correlations between certain acupoint combinations. Cluster analysis grouped the 28 auricular points into five clusters, while network analysis identified 12 strong connections between acupoints. Conclusion: This study provides a systematic analysis of auricular acupoint selection patterns for gastrointestinal dysfunction after laparoscopic surgery, offering a reference for clinical practice. The findings highlight the potential of auricular therapy in this context and suggest directions for future studies, including expanding data sampling and integrating modern medical diagnostic techniques to enhance the reliability and applicability of the results. Gastrointestinal dysfunction Traditional Chinese Medicine Auricular therapy Selection rule Data mining Figures Figure 1 Figure 2 Figure 3 Figure 4 1 Background Laparoscopic surgery, which is a minimally invasive procedure performed through a small incision in the abdominal wall, where laparoscopic instruments and a camera are inserted with the help of real-time image guidance. Compared with traditional open abdominal surgery, its core advantages include less trauma, less bleeding, quicker recovery, and a more aesthetically pleasing incision[ 1 , 2 ]. Since the first laparoscopic cholecystectomy in 1987, this technique has been widely used in the fields of gastrointestinal, hepatobiliary, gynaecological and urological surgery, and has become an important symbol of modern surgery. Gastrointestinal dysfunction after laparoscopic surgery is a common complication that significantly affects patients' postoperative recovery and quality of life. Song J[ 3 ] reported that the incidence of postoperative gastrointestinal dysfunction ranged from 4.5% to 71.2%, which plagues healthcare professionals and patients, affecting the recovery process of patients and leading to prolonged hospital stays and increased financial burdens[ 4 , 5 ]. This condition falls within the scope of TCM syndromes such as pi-man, abdominal distension, abdominal pain, intestinal obstruction, intestinal knotting, and constipation. Western medicine typically addresses these issues through gastrointestinal decompression, fasting, and the use of gastrointestinal motility drugs. However, these methods have limitations in clinical efficacy, including drug tolerance issues and the potential for intestinal dysbiosis[ 6 ]. Traditional Chinese medicine (TCM) has accumulated extensive experience in treating gastrointestinal diseases[ 7 , 8 ]. Auricular therapy, a unique TCM therapy, has demonstrated remarkable efficacy in alleviating postoperative gastrointestinal dysfunction[ 9 ]. The ear, as a micro-acupuncture system, contains numerous acupoints corresponding to different body parts and organs. Stimulating these acupoints can regulate the functions of the corresponding organs and improve gastrointestinal motility[ 10 , 11 ]. However, existing research exhibits two major limitations: Firstly, acupoint selection protocols vary significantly, with common points including Stomach, Large Intestine, and Sympathetic, yet a standardized selection criterion is lacking. Secondly, most studies remain at the level of clinical observation, failing to utilize data mining techniques to reveal the intrinsic patterns governing acupoint combinations. This current state leads to arbitrary point selection in clinical practice, highlighting an urgent need for systematic analysis of selection patterns to guide standardized application. Our study aims to fill this gap by analyzing the acupoint selection patterns in auricular acupuncture for treating gastrointestinal dysfunction after laparoscopic surgery. By summarizing the common acupoints and their underlying mechanisms, this study provides a reference for clinical practice and further research in this field. 2 Data and methods 2.1 Data resource A systematic search in Chinese databases including China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (CQVIP), China Biology Medicine (CBM), and Wanfang Data, and English databases including PubMed, Embase, and Cochrane Library was conducted to retrieve papers. The time span for the paper retrieval was set from the foundations of the databases to April 30, 2025, using the following search terms: “Auricular Acupuncture” OR “Ear Acupuncture” OR “Auricular Therapy” OR “Ear Acupressure” OR “Auricular Point” OR “Ear Point Stimulation”, “Post-laparoscopic Surgery” OR “Post-laparoscopy” OR “Laparoscopic Surgery” OR “Laparoscopy” OR “Postoperative Recovery after Laparoscopy”, “Gastrointestinal Dysfunction” OR “GI Dysfunction” OR “Gastrointestinal Motility Disorder” OR “Postoperative Gastrointestinal Recovery” OR “Gastrointestinal Function Recovery” OR “Digestive System Dysfunction” OR “Postoperative Gastrointestinal Recovery”. 2.2 Criteria for inclusion and exclusion 2.2.1 Inclusion criteria Studies were included if: (1)they were about randomized controlled trials and quasi-trials; (2)they were subject to patients who had undergone laparoscopic surgery; (3)they were with auricular therapy as the main intervention, alone or in combination with other treatments; (4)they were clearly given the specific auricular acupoint; (5)The outcome index was the recovery of gastrointestinal function. 2.2.2 Exclusion criteria Studies were excluded if: (1)they were published in more than one place; (2)they only presented a program or an abstract; (3)their data were incomplete or unobtainable; (4)they were with ambiguous diagnosis and primary treatment; (5)they were about Meta-analysis, systematic review, review, case report or animal experiment. 2.3 Standardization According to the “National Standard of the People's Republic of China: Auricular Point Name and Location” (GB/T 13734 − 2008)[ 12 ], the name and location of auricular points were standardized. For instance, “Cortex” was changed to “Subcortex”, “Pancreas” and “Gallbladder” were changed to "Pancreas-Gallbladder", etc. 2.4 Database establishment All the retrieved studies were imported into EndNote X9( https://endnote.com ) for screening, deduplication and classification. In addition, Excel 2021 was used for data extraction and database establishment. According to the title, year, author information, auricular point location and intervention method, the study information was input and sorted out. If there were two or more groups of schemes used alternately in one article, these schemes will be individually segregated and systematically entered into the data sheet. If the primary acupoints in a literature source include multiple groups due to different syndrome differentiation types, the corresponding prescriptions will be divided into distinct entries and recorded separately. To ensure the authenticity and accuracy of the data, each eligible study was reviewed independently by two researchers, if there was any difference in information input, a third researcher was responsible for proofreading and reviewing to prevent duplications, input errors, and omissions. 2.5 Data mining analysis The frequency method was utilized to count the preparations of prescriptions that met the inclusion and exclusion criteria in the Excel worksheet. Association rules[ 13 , 14 ] were generated from these frequent item sets, followed by analysis based on the number of the common appearances of items. The analysis results were expressed in terms of “Support" “Confidence", and“Lift". Support is defined as the frequency with which the items in the antecedent and consequent appear together in the dataset. A higher support value indicates that the rule is more general and applicable to a larger portion of the data. Confidence is a reliable metric for evaluating the efficacy of the rule. This probability is defined as the probability that a specific occurrence will transpire subsequent to the occurrence of another specific event. A confidence value greater than 80% suggests that the rule is reasonably reliable. Lift is a method of comparing the observed support of a given rule to what would be expected if the antecedent and consequent were independent. A lift value greater than 1 indicates a positive correlation between the antecedent and the consequent, signifying that the occurrence of the antecedent increases the likelihood of the consequent occurring. Cluster analysis[ 15 ] was conducted utilizing the OriginPro 2025, with a genealogical map being developed in order to explore the clustering relationship between the acupoints. Each sample set in the data sets is regarded as a cluster, and then the clusters with close distances are merged step by step to achieve the expected number of clusters. Network construction based on the Apriori algorithm by SPSS Modeler 18.0 was established, and X was set as the first term and Y as the second term. The nodes represent individual acupoints and the lines represent the correlation between acupoints. The thickness of the line is indicative of the strength of the correlation, with a thicker line denoting a stronger correlation. The dotted line, conversely, indicates a weaker correlation. 3 Results 3.1 General information A total of 275 papers were retrieved from the databases initially, with 85 remaining after removing duplicates. Then, 69 papers were excluded judging by their titles and abstracts. Meanwhile, 3 papers were excluded with unclear acupoints selection. Finally, 118 papers were included. The detailed information can be seen in Fig. 1 . 3.2 Frequency analysis Among the 118 included papers in this study, there were 28 types of auricular points with a total of 632 occurrences, as seen in Table 1 . Among them, there are 12 auricular points with a frequency of occurrence greater than or equal to 10, with a cumulative frequency of 575, which constituted 90.98% of the total percentage, shown in Fig. 2 , including Stomach, Large Intestine, Small Intestine, Sympathetic, Spleen, Shenmen, Sanjiao, Subcortex, Liver, Endocrine, Kidney and Pancreas-Gallbladder. 3.3 Association rule analysis In association rule analysis, the associations were investigated under the criteria of Support ≥ 20% and Confidence ≥ 80%. We generated 48 association rules with lift > 1 which are shown in Table 2 , Table 3 and Table 4 , including 11 second-order association rules, 25 third-order association rules, and 12 fourth-order association rules. 3.4 Clustering analysis We put 28 high-frequency ear points into OriginPro 2025 for analysis, results of clustering analysis are shown in Fig. 3 , totally, five clusters are presented, which are: Cluster 1(red): Bladder, Ureter and Kidney. Cluster 2(blue): Lung, Distension area, Abdomen, Adrenal gland, Middle triangular fossa, Rectum, Brainstem and Subcortex. Cluster 3(green): Liver, Pancreas-Gallbladder, Endocrine, Duodenum and Spleen. Cluster 4(purple): Sympathetic, Shenmen, Heart, Occiput, Brain and Uterus. Cluster 5(yellow): Cardia, Appendix, Large intestine, Small intestine, Sanjiao and Stomach. 3.5 Network analysis We set the lower threshold of strong connections at 35 and the upper limit of weak connections at 15. In order to facilitate observation of the network diagram, the display has been set to indicate the strength of the network connections. In network analysis, connections are shown as thick lines for strong connections, solid lines for normal connections, and dotted lines for weak connections. Following a rigorous examination, 12 sets of strong links were discovered; these are detailed below in Fig. 4 : Large Intestine-Stomach, Large intestine-Small intestine, Stomach-Small intestine, Large Intestine-Spleen, Spleen-Stomach, Sympathetic-Stomach, Spleen-Small intestine, Large Intestine-Sympathetic, Shenmen-Stomach, Large Intestine-Sanjiao, Sanjiao-Stomach and Sympathetic-Shenmen. 4 Discussion Gastrointestinal dysfunction after laparoscopic surgery falls within the scope of TCM syndromes including pi-man (fullness), abdominal distension, abdominal pain, intestinal obstruction (bi-syndrome), intestinal knotting (jie-syndrome), and constipation. Its etiology and pathogenesis are closely associated with surgical trauma, disharmony of qi and blood, and visceral functional impairment. Treatment must target the core pathogenesis of "root deficiency with branch excess" and "obstructed fu-organ qi", addressing three key therapeutic dimensions: fortifying healthy qi while expelling pathogenic factors, harmonizing qi dynamics and Restoring the normal descent function of the six fu-organs. Our study demonstrates that the stomach, large intestine, and small intestine acupoints rank among the highest in frequency of use in auricular therapy. This reflects the holistic concept in Traditional Chinese Medicine (TCM), which is expressed by the axiom, "The ear is the convergence point of all meridians." Auricular therapy works by stimulating specific areas of the ear to regulate the function of their corresponding internal organs. The Stomach (96 cases, 15.19%) functions as a core target within the digestive system. As stated in Chap. 26 ("Questions About Mouth and Ears") of the Lingshu (Spiritual Pivot): "The ear is connected by the collaterals of the stomach." The stomach point’s frequent use directly corresponds to the pathogenesis of "impaired gastric descent"(wei qi bu jiang)[ 16 ] in patients with gastrointestinal dysfunction. Stimulating the stomach point may promote gastrin secretion via the vagus nerve, enhance pepsin activity, accelerate gastric emptying, and improve postoperative digestive function[ 17 , 18 ]. The Large intestine (92 cases, 14.56%) and Small intestine (81 cases, 12.82%) correspond respectively to the intestinal functions of conveyance and separation of the clear from the turbid. The large intestine governs conveyance (chuan dao), while the small intestine governs transformation (hua wu), aligning with the theory from Suwen・Linglan Midian Lun (The Divine Pivot): "The large intestine plays a pivotal role in the process of elimination and transformation, serving as the primary conduit through which these changes occur." Modern research indicates that stimulating the large intestine point can regulate Substance P expression in the Enteric Nervous System (ENS), enhance colonic transit motility, alleviate postoperative constipation and abdominal distension, and restore intestinal peristalsis rhythm[ 19 , 20 ]. The Sympathetic (59 cases, 9.33%) has been identified as a critical acupoint for autonomic nervous regulation. Research indicates that by stimulating branches of the great auricular nerve, it can relieve gastrointestinal smooth muscle spasms and alleviate abdominal pain and distension[ 21 , 22 ]. This is indicative and analogous to the regulatory mechanism of the autonomic nervous system on gastrointestinal smooth muscle in modern medicine. The Spleen (58 cases, 9.18%) fortifies the spleen and boosts qi to consolidate the acquired foundation (hou tian zhi ben). The Shenmen (54 cases, 8.54%) tranquilizes the mind and stabilizes the mental state, mitigating the impact of postoperative anxiety on gastrointestinal function. Co-administration of these two points has been evidenced to regulate the limbic-hypothalamic pathway, reduce fluctuations in gastric mucosal blood flow under stressful conditions, and collaboratively enhance gastrointestinal barrier function[ 23 , 24 ]. Experimental studies demonstrate that TCM formulations regulating Sanjiao(39 cases, 6.17%), specifically in the transformation of Qi, as evidenced by the significant enhancement of water metabolism in mice observed in studies involving Wuling San (Five-Ingredient Powder with Poria)[ 25 ]. Mice treated with Wuling San showed marked improvements in both fecal output volume and water metabolism parameters in the large intestine. The Subcortex (36 cases, 5.70%) has been demonstrated to modulate cerebral cortical function[ 26 ], suggesting potential relevance to pain management, emotional regulation, or neurological disorders. As Sanjiao serves as the pathway for primordial qi (yuan qi), while Subcortex corresponds to the projection area of the cerebral cortex, their combined application regulates gastrointestinal motility rhythm through the central-peripheral pathway. This approach is particularly suitable for patients with functional gastrointestinal disorders (FGIDs). The Liver (22 cases, 3.48%) has been proven to soothe the liver, promote gallbladder function, and regulate qi movement to enhance digestion[ 24 ]. The Endocrine (16 cases, 2.53%) has been demonstrated to modulate hormonal balance (e.g., gastrin, insulin)[ 27 ]. The Kidney (11 cases, 1.74%) has been identified as a crucial point for supporting splenic yang, thereby facilitating the maintenance of metabolic warmth. Similarly, the Pancreas-Gallbladder (11 cases, 1.74%) has been noted to play a regulatory role in glucose metabolism and bile secretion. Collectively, these points establish a "zang-fu simultaneous regulation" framework, covering multifaceted mechanisms of postoperative gastrointestinal functional recovery. The auricular points that correspond to the Stomach, Large intestine, and Small intestine are located in the cymba conchae and cavum conchae and correspond to the projection zones of the digestive tract on the auricle. These points form a holographic correspondence with gastrointestinal organs derived from endodermal differentiation during embryonic development. Their innervation is closely associated with the auricular branch of the vagus nerve and the auricular branches of the cervical plexus. Stimulation of these points can directly modulate the myoelectrical activity of gastrointestinal smooth muscle. The Sympathetic is adjacent to the great auricular nerve branches (C2-C3). Its afferent fibers project to the celiac plexus, where they regulate gastrointestinal vasomotor activity and glandular secretion[ 28 ]. Simultaneously, stimulation can additionally inhibit abnormal discharge frequency in the gastrointestinal smooth muscle of rats and reduce visceral pain sensitivity, known as visceral hyperalgesia[ 29 , 30 ]. The Shenmen point is located in the triangular fossa, which has a direct effect on gastrointestinal regulatory centers, including the celiac plexus and the nucleus tractus solitarius (NTS) in the medulla oblongata, thereby inhibiting over-secretion of acid by gastric parietal cells[ 31 , 32 ]. It further regulates the limbic-hypothalamic-vagus pathway to stabilize gastric mucosal blood flow, exhibiting partial mechanistic overlap with the molecular targets of proton pump inhibitors (PPIs)[ 33 , 34 ]. The association rule analysis of auricular acupoints for treating postoperative gastrointestinal dysfunction following laparoscopic surgery reveals a systematic pattern of acupoint compatibility. This pattern aligns with TCM theories of visceral correlation and meridian conduction. The frequent co-occurrence of acupoints such as Large Intestine, Small Intestine, Stomach, Spleen, and Sanjiao reflects the TCM principle that "the fu-organs function by maintaining unobstructed passage," underscoring the importance of regulating fu-qi for gastrointestinal recovery. The second-order association rules indicate that the Large Intestine-Small Intestine pairing occurs most frequently (81 cases; support: 68.64%, confidence: 95.06%; Table 2 ). In TCM theory, both acupoints correspond to yang fu-organs responsible for food waste transformation and transportation. Their clinical compatibility embodies the principle of "coordination of fu-qi," wherein the Small Intestine separates the clear from the turbid while the Large Intestine regulates defecation. This synergy is clinically significant: auricular stimulation of the Large Intestine acupoint enhances intestinal peristalsis and reduces postoperative ileus duration[ 35 ]. Similarly, the high-confidence Large Intestine-Sanjiao combination (39 cases; support: 33.05%, confidence: 94.87%; Table 2 ) demonstrates Sanjiao’s role in regulating qi movement and fluid metabolism. With the passage of water and qi, Sanjiao collaborates with the Large Intestine to eliminate damp-turbidity—a mechanism critical for resolving postoperative gastrointestinal stasis[ 36 ]. Third-order association rules reveal two clinically significant combinations. First, the Large Intestine-Sympathetic-Small Intestine triad (35 cases; support: 29.66%, confidence: 100%; Table 3 ) modulates autonomic function to regulate intestinal motility. The Sympathetic acupoint specifically inhibits excessive sympathetic excitability, reducing intestinal smooth muscle spasm[ 37 ], demonstrating the TCM concept of regulating qi movement through neuro-endocrine pathways. Second, the Large Intestine-Spleen-Small Intestine combination (43 cases; support: 36.44%, confidence: 97.67%; Table 3 ) integrates spleen-strengthening with intestinal regulation, addressing the core pathogenesis of "spleen deficiency causing intestinal dysfunction." Clinically, this trio shortens the time to the first postoperative flatus in laparoscopic cases[ 35 ]. Fourth-order association rules, exemplified by the Large Intestine-Sympathetic-Small Intestine-Stomach combination (31 cases; support: 26.27%; confidence: 100%; Table 4 ), demonstrate comprehensive regulation of qi-blood-fluid balance. The inclusion of the Stomach acupoint enhances gastric motility modulation, while Sympathetic and Small Intestine collectively maintain intestinal rhythm. This multi-target approach conceptually parallels the TCM formula "Four Miraculous Powder" (Si Miao San), synergistically restoring qi flow in the middle jiao. Experimental studies confirm that such multi-acupoint auricular therapy regulates enteric nervous system neurotransmitters (e.g., acetylcholine) to promote gastrointestinal mucosal repair [ 38 ]. The consistently high lift values (≥ 1.21) across associations indicate significant synergistic effects, aligning with the TCM principle of "acupoint compatibility for enhanced efficacy." For instance, the Large Intestine-Small Intestine pair demonstrates a lift of 1.21 (Table 2 ), predicting 21% higher co-occurrence than expected if used independently. This synergism may arise from their shared vagal innervation, as functional MRI studies confirm that simultaneous stimulation enhances bilateral insular cortex activation[ 39 ]—a key region for gastrointestinal sensory processing. According to the literature we retrieved, the five clusters cover the main pathological aspects of gastrointestinal dysfunction after laparoscopic surgery, including inflammation, neurological disorders, digestive impairment and psychological stress, through a step-by-step therapeutic mechanism: ”Regulating Body Fluid Metabolism (Cluster 1) → Diffusing Lung Qi and Regulating Qi Movement (Cluster 2) → Soothing the Liver and Fortifying the Spleen (Cluster 3) → Calming the Spirit and Regulating Shen (Cluster 4) → Unblocking the Fu Organs and Regulating the Intestines (Cluster 5)”. Cluster 5 (Yellow: Stomach, Large Intestine, Small Intestine, Sanjiao, etc.) – Core Regulation of Gastrointestinal Motility, which is associated with elevated short-chain fatty acids and enhances intestinal mucosal energy metabolism, embodying the TCM principle of "Unblocking Yangming Fu Organs Regulates Intestinal Qi Dynamics". "The stimulation of specific auricular points along the gastrointestinal tract has been shown to directly activate Interstitial Cells of Cajal, elevate motilin levels, and restore gastrointestinal slow-wave rhythm[ 40 , 41 ]. Concurrently, Sanjiao point modulates the thoraco-abdominal pressure gradient, further promotes motilin secretion, optimizes peristaltic biomechanics, and accelerates CO₂ clearance from the intestinal lumen[ 42 ]. This mechanism corresponds to the concept of "Unblocking Fu Organs and Regulating Qi". Clinical case[ 43 ] have been shown the efficacy of immediate postoperative application of auricular acupressure (Large Intestine, Sympathetic, Stomach, Spleen points) combined with moxibustion at Zusanli in facilitating the passage of flatus within 24 hours and achieving a complete resolution of abdominal distension. Preventive applications[ 44 , 45 ] have been shown to demonstrate the efficacy of Cardia point in reducing delayed gastric emptying incidence, and Appendix point in suppressing postoperative intestinal adhesion formation. Cluster 4 (Purple: Sympathetic, Shenmen, Heart, etc.) – Modulation of the Neuro-Psycho-Gastrointestinal Axis. The Sympathetic point has been shown to inhibit sympathetic overactivation, suppresses vestibular-vagal nerve excitability, reduces 5-HT release, and restores gastrointestinal smooth muscle rhythm[ 46 ]. Shenmen point, a traditional Chinese medicine (TCM) point, activates the nucleus tractus solitarius (NTS) in the medulla oblongata, inhibiting the hypothalamic–pituitary–adrenal (HPA) axis, lowering cortisol levels, and ameliorating stress responses in the "gut-brain axis"[ 47 ]. As demonstrated in Ma’s study[ 48 ], Shenmen point combined with moxibustion reduced anxiety scores, validating the gastrointestinal protective effects of "Calming the Spirit and Regulating Shen." Research[ 49 ] also shows auricular acupressure using sympathetic and stomach reduced the incidence of postoperative nausea and vomiting. Therefore, by regulating the autonomic nervous system, calming the spirit, and improving circulation, which approach alleviates postoperative stress responses and promotes gastrointestinal functional recovery. Cluster 3 (Green: Liver, Pancreas-Gallbladder, Spleen, etc.) – Harmonizing Liver-Spleen and Reconstructing Digestive Function. This approach has been shown to enhance digestive function and promote gastrointestinal motility by regulating liver qi, stimulating digestive fluid secretion, and modulating hormone levels. Liver-Pancreas-Gallbladder points has been demonstrated to enhance bile acid concentration and pancreatic lipase activity, which can improve fat digestion[ 50 ]. Spleen point has been demonstrated to promote the secretion of gastrointestinal hormones, such as cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), and to enhance mucosal barrier function, as evidenced by an increase in Lactobacillus[ 51 ]. As discussed, auricular acupressure at Spleen point demonstrated a significant reduction in postoperative steatorrhea incidence[ 50 ], validating the improvement in digestive function through "Fortifying the Spleen and Harmonizing the Stomach." Researches[ 52 , 53 ] also demonstrated that auricular acupressure (Spleen, Liver, Pancreas-Gallbladder points) combined with acupoint massage resulted in a significant reduction in bowel sound recovery time, whose mechanism is associated with elevated bile acids and pancreatic lipase. In addition, careful consideration is needed when patients have other underlying conditions at the same time. For diabetic patients[ 54 ], the incorporation of Endocrine point has been demonstrated to effectively modulate insulin resistance. However, it is imperative to exercise caution when administering strong stimulation at Liver point in patients with acute hepatitis[ 55 ], as this may exacerbate hepatic stress responses. Consequently, it is imperative to take patient medical history into consideration when formulating point protocols to ensure optimal therapeutic outcomes. Cluster 2 (Blue: Lung, Abdominal Distension Area, Adrenal Gland, etc.) – Lung-Intestine Qi Dynamics Coordination and Inflammation Suppression. This approach has been proven to alleviate postoperative respiratory discomfort and abdominal bloating by regulating respiratory function and attenuating inflammatory responses in surgical patients. The Lung point has been shown to activate the vagus nerve, reduce intra-luminal CO₂ pressure and enhance intestinal motility[ 56 ]. The Adrenal Gland point has been evidenced to inhibit inflammatory cytokines such as tumor necrosis factor-α (TNF-α)[ 57 ]. As detailed in Liu’s research[ 56 ], stimulation at the Lung point activates via the vagus nerve-intestinal smooth muscle pathway, leading to a reduction in flatus passage time. Cluster 1 (Red: Bladder, Ureter, Kidney) – Indirect Regulation of Fluid Metabolism and Gastrointestinal Function. The stimulation of specific points on the kidneys and bladder has been proven to modulate the secretion of anti-diuretic hormone (ADH) and aldosterone[ 58 ]. This stimulation has been observed to enhance the contractility of the detrusor muscle in the bladder, promote urination, and reduce intestinal wall edema. This approach has been demonstrated to alleviate the mechanical compression of intestinal structures caused by bladder distension, consequently restoring the spatial capacity for gastrointestinal motility. In postoperative urinary retention following gynecological laparoscopy procedures, such as myomectomy, the combination of Uterus point has been demonstrated to enhance efficacy[ 59 ]. The findings of the integration of auricular acupressure with Zusanli resulted in a significant reduction in the incidence of urinary retention[ 60 ]. However, our current study also has some limitations. First, the literature incorporated in this study did not differentiate between auricular stimulation modalities—such as auricular plaster therapy, electro-stimulation, or needle embedding. Efficacy variations attributable to differences in manipulation techniques were not analyzed. Furthermore, controversies regarding the regional localization of acupoints like Sanjiao and Subcortex may compromise result consistency. Secondly, the data samples utilized in this analysis may have certain limitations, such as the scope of data sources and individual patient variations. These factors could affect the generalizability and accuracy of the association rules. Moreover, association rule mining reveals associations between variables but cannot establish direct causal relationships. Future studies should expand the scope of data sampling by enrolling patients from diverse regions, age groups, and genders to enhance the reliability and representativeness of the association rules. Future studies should integrate modern medical diagnostic modalities and experimental methodologies, such as functional gastrointestinal disorder examinations, neurotransmitter quantification, and animal experimentation. Employing advanced technologies like functional Near-Infrared Spectroscopy (fNIRS)[ 61 ] and Positron Emission Tomography–Computed Tomography (PET-CT)[ 62 ], researchers could dynamically monitor real-time regulatory effects of auricular stimulation on brain-gut axis pivotal nodes (e.g., insula , amygdala ) to elucidate underlying mechanisms[ 63 ]. Further investigation into the biological mechanisms of visceral interactions and their crosstalk with the nervous system is essential to establish causal relationships, thereby providing robust support for modernizing TCM theory and enabling precision clinical interventions. Multicenter randomized controlled trials (RCTs) should be conducted to explore disease-specific core acupoint clusters. Additionally, synergistic mechanisms combining auricular therapy with body acupuncture[ 64 ] and probiotics[ 65 ] warrant investigation to optimize integrated TCM-Western medicine protocols, ultimately enhancing the management of gastrointestinal dysfunction after laparoscopic surgery. 5 Conclusion Our study employs multidimensional data mining (frequency→ association→ clustering→ network) to elucidate the intrinsic logic of auricular acupoint association rules, providing medical staff with a precision correspondence framework of "disease pattern→ pathogenesis→ acupoint cluster". The auricular point formulations for postoperative gastrointestinal dysfunction are guided by TCM principles of viscera correspondence theory, and meridian connectivity, with scientific validation from modern neuroendocrine and microcirculation research. The identified core formula—comprising the Stomach-Large Intestine-Sanjiao acupoints as the foundational protocol, Sympathetic-Shenmen as the synergistic module, and Spleen as the pivotal modulator for pattern differentiation, which heralds an era of "precision brain-gut co-regulation" in acupuncture gastroenterology, establishing an evidence-based framework for clinical auricular therapy. Further investigation into molecular mechanisms (e.g., gut microbiome modulation, inflammatory cytokine profiling) of these acupoint combinations may deepen our understanding of TCM auricular therapy in postoperative rehabilitation. We will continue to focus on the relevant clinical literature and integrate, further verify and improve the acupoint selection rules of acupoint therapy in the treatment of gastrointestinal dysfunction after laparoscopic surgery, providing a further reference for a future acupoint selection programme of acupoint therapy in the treatment. Abbreviations TCM: Traditional Chinese medicine. Declarations Clinical trial number Not applicable. Acknowledgements Not applicable. Authors' contributions GL: Data curation, Investigation, Conceptualization, Formal analysis, Methodology, Software, Validation, Visualization, Writing-original draft, Critical revision. WW: Software, Methodology, Data curation, Investigation, Validation. GS: Software, Data curation, Investigation, Validation. LL: Project administration, Visualization, Supervision, Validation, Writing-review& editing. CL: Supervision, Validation, Writing-review & editing. YS: Project administration, Supervision, Validation, Writing-review & editing. YO: Data curation, Investigation, Validation. HC: Project administration, Resources, Supervision, Writing–review & editing All authors read and approved the final manuscript. Funding Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate Informed consent of the study and a statement on ethics approval was waived because of the retrospective nature and the analysis used anonymous clinical data. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Author details Guozhi Liu, Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Wenxin Wu, Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Guanglin Sang, Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Jiuli Li , Proctology Department, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Chang Liu , Department of Critical Care Medicine, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Yingqi She , Department of Critical Care Medicine, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Yixuan Ou , Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China Huibing Chen (corresponding author) , Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China References Pascual, M., Salvans, S., & Pera, M. 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Pharmacology & therapeutics , 231 , 107978. https://doi.org/10.1016/j.pharmthera.2021.107978 Tables Table 1 Frequency of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery No. Auricular acupoint Frequency(n) Rate(%) 1 Stomach 96 15.19 2 Large Intestine 92 14.56 3 Small Intestine 81 12.82 4 Sympathetic 59 9.33 5 Spleen 58 9.18 6 Shenmen 54 8.54 7 Sanjiao 39 6.17 8 Subcortex 36 5.70 9 Liver 22 3.48 10 Endocrine 16 2.53 11 Kidney 11 1.74 12 Pancreas-Gallbladder 11 1.74 13 Cardia 7 1.10 14 Lung 7 1.10 15 Duodenum 6 0.95 16 Heart 6 0.95 17 Appendix 5 0.79 18 Brainstem 5 0.79 19 Uterus 5 0.79 20 Occiput 4 0.63 21 Abdomen 2 0.32 22 Distension area 2 0.32 23 Brain 2 0.32 24 Rectum 2 0.32 25 Bladder 1 0.16 26 Middle Triangular Fossa 1 0.16 27 Adrenal Gland 1 0.16 28 Ureter 1 0.16 29 Total 632 100 Table 2 Second-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery Succedent Antecedent Frequency(n) Support Confidence Lift Large Intestine Small Intestine 81 68.64 95.06 1.21 Large Intestine Sanjiao 39 33.05 94.87 1.21 Stomach Sanjiao 39 33.05 92.30 1.13 Large Intestine Spleen 58 49.15 86.20 1.10 Stomach Spleen 58 49.15 86.20 1.05 Stomach Large Intestine 92 77.96 85.86 1.05 Small Intestine Sanjiao 39 33.05 84.61 1.23 Stomach Small Intestine 81 68.64 83.95 1.03 Small Intestine Large Intestine 92 77.96 83.69 1.21 Large Intestine Stomach 96 81.35 82.29 1.05 Stomach Sympathetic 59 50 81.35 1 Table 3 Third-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery Succedent Antecedent Frequency(n) Support Confidence Lift Large Intestine Sympathetic + Small Intestine 35 29.66 100 1.28 Large Intestine Spleen + Small Intestine 43 36.44 97.67 1.25 Large Intestine Small Intestine + Stomach 68 57.62 97.05 1.24 Large Intestine Sanjiao + Small Intestine 33 27.96 96.96 1.24 Large Intestine Subcortex + Small Intestine 24 20.33 95.83 1.22 Large Intestine Sanjiao + Stomach 36 30.50 94.44 1.21 Stomach Sanjiao + Large Intestine 37 31.35 91.89 1.12 Stomach Sanjiao + Small Intestine 33 27.96 90.90 1.11 Stomach Sympathetic + Small Intestine 35 29.66 88.57 1.08 Small Intestine Sanjiao + Large Intestine 37 31.35 86.48 1.25 Stomach Spleen + Small Intestine 43 36.44 86.04 1.05 Stomach Small Intestine + Large Intestine 77 65.25 85.71 1.05 Stomach Sympathetic + Large Intestine 42 35.59 85.71 1.05 Small Intestine Subcortex + Large Intestine 27 22.88 85.18 1.24 Large Intestine Shenmen + Small Intestine 26 22.03 84.61 1.08 Small Intestine Large Intestine + Stomach 79 66.94 83.54 1.21 Small Intestine Sympathetic + Large Intestine 42 35.59 83.33 1.21 Small Intestine Sanjiao + Stomach 36 30.50 83.33 1.21 Stomach Shenmen + Large Intestine 30 25.42 83.33 1.02 Stomach Sympathetic + Spleen 32 27.11 87.5 1.07 Stomach Spleen + Large Intestine 50 42.37 86 1.05 Large Intestine Spleen + Stomach 50 42.37 86 1.10 Small Intestine Spleen + Large Intestine 50 42.3 84 1.22 Large Intestine Subcortex + Stomach 25 21.18 84 1.07 Large Intestine Sympathetic + Spleen 32 27.11 81.25 1.04 Table 4 Fourth-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery Succedent Antecedent Frequency(n) Support Confidence Lift Large Intestine Sympathetic + Small Intestine + Stomach 31 26.27 100 1.28 Large Intestine Spleen + Small Intestine + Stomach 37 31.35 97.29 1.24 Large Intestine Sanjiao + Small Intestine + Stomach 30 25.42 96.66 1.23 Stomach Sympathetic + Small Intestine + Large Intestine 35 29.66 88.57 1.08 Stomach Sympathetic + Spleen + Large Intestine 26 22.03 88.46 1.08 Small Intestine Sympathetic + Large Intestine + Stomach 36 30.50 86.11 1.25 Stomach Spleen + Small Intestine + Large Intestine 42 35.59 85.71 1.05 Small Intestine Sanjiao + Large Intestine + Stomach 34 28.81 85.29 1.24 Small Intestine Sympathetic + Spleen + Large Intestine 26 22.03 84.61 1.23 Small Intestine Spleen + Large Intestine + Stomach 43 36.44 83.72 1.21 Large Intestine Sympathetic + Spleen + Stomach 28 23.72 82.14 1.05 Stomach Sanjiao + Small Intestine + Large Intestine 32 27.11 90.62 1.11 Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":148375,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of the study design\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7600458/v1/1d7d21037323e92f0a0d0c54.png"},{"id":93243258,"identity":"f14cf82f-ff2c-478d-8ab0-c8effbbed0d0","added_by":"auto","created_at":"2025-10-10 14:57:26","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":35616,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery (frequency ≥ 10)\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7600458/v1/3c8e517bb9ec4384b186a58f.png"},{"id":93244331,"identity":"8d3cc896-0150-4fc7-956b-73b5f4079182","added_by":"auto","created_at":"2025-10-10 15:05:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":42131,"visible":true,"origin":"","legend":"\u003cp\u003eCluster analysis of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7600458/v1/af950e9a59e148c214593757.png"},{"id":93243265,"identity":"1f768506-97d6-4b5b-893c-863545e0fd60","added_by":"auto","created_at":"2025-10-10 14:57:26","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":206044,"visible":true,"origin":"","legend":"\u003cp\u003eNetwork analysis of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7600458/v1/edc897d4bc6a4ad0bcb25d3f.png"},{"id":101184083,"identity":"d2812f06-f489-45dd-81b8-02e2a0182782","added_by":"auto","created_at":"2026-01-27 05:26:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1570680,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7600458/v1/fe0c45b4-f735-497f-b2f6-8a39a27daa28.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Rule of acupoint selection in auricular therapy of gastrointestinal dysfunction after laparoscopic surgery, based on data mining","fulltext":[{"header":"1 Background","content":"\u003cp\u003eLaparoscopic surgery, which is a minimally invasive procedure performed through a small incision in the abdominal wall, where laparoscopic instruments and a camera are inserted with the help of real-time image guidance. Compared with traditional open abdominal surgery, its core advantages include less trauma, less bleeding, quicker recovery, and a more aesthetically pleasing incision[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Since the first laparoscopic cholecystectomy in 1987, this technique has been widely used in the fields of gastrointestinal, hepatobiliary, gynaecological and urological surgery, and has become an important symbol of modern surgery.\u003c/p\u003e\u003cp\u003eGastrointestinal dysfunction after laparoscopic surgery is a common complication that significantly affects patients' postoperative recovery and quality of life. Song J[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] reported that the incidence of postoperative gastrointestinal dysfunction ranged from 4.5% to 71.2%, which plagues healthcare professionals and patients, affecting the recovery process of patients and leading to prolonged hospital stays and increased financial burdens[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This condition falls within the scope of TCM syndromes such as pi-man, abdominal distension, abdominal pain, intestinal obstruction, intestinal knotting, and constipation. Western medicine typically addresses these issues through gastrointestinal decompression, fasting, and the use of gastrointestinal motility drugs. However, these methods have limitations in clinical efficacy, including drug tolerance issues and the potential for intestinal dysbiosis[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTraditional Chinese medicine (TCM) has accumulated extensive experience in treating gastrointestinal diseases[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Auricular therapy, a unique TCM therapy, has demonstrated remarkable efficacy in alleviating postoperative gastrointestinal dysfunction[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The ear, as a micro-acupuncture system, contains numerous acupoints corresponding to different body parts and organs. Stimulating these acupoints can regulate the functions of the corresponding organs and improve gastrointestinal motility[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. However, existing research exhibits two major limitations: Firstly, acupoint selection protocols vary significantly, with common points including Stomach, Large Intestine, and Sympathetic, yet a standardized selection criterion is lacking. Secondly, most studies remain at the level of clinical observation, failing to utilize data mining techniques to reveal the intrinsic patterns governing acupoint combinations. This current state leads to arbitrary point selection in clinical practice, highlighting an urgent need for systematic analysis of selection patterns to guide standardized application.\u003c/p\u003e\u003cp\u003eOur study aims to fill this gap by analyzing the acupoint selection patterns in auricular acupuncture for treating gastrointestinal dysfunction after laparoscopic surgery. By summarizing the common acupoints and their underlying mechanisms, this study provides a reference for clinical practice and further research in this field.\u003c/p\u003e"},{"header":"2 Data and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Data resource\u003c/h2\u003e\u003cp\u003eA systematic search in Chinese databases including China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (CQVIP), China Biology Medicine (CBM), and Wanfang Data, and English databases including PubMed, Embase, and Cochrane Library was conducted to retrieve papers.\u003c/p\u003e\u003cp\u003eThe time span for the paper retrieval was set from the foundations of the databases to April 30, 2025, using the following search terms: \u0026ldquo;Auricular Acupuncture\u0026rdquo; OR \u0026ldquo;Ear Acupuncture\u0026rdquo; OR \u0026ldquo;Auricular Therapy\u0026rdquo; OR \u0026ldquo;Ear Acupressure\u0026rdquo; OR \u0026ldquo;Auricular Point\u0026rdquo; OR \u0026ldquo;Ear Point Stimulation\u0026rdquo;, \u0026ldquo;Post-laparoscopic Surgery\u0026rdquo; OR \u0026ldquo;Post-laparoscopy\u0026rdquo; OR \u0026ldquo;Laparoscopic Surgery\u0026rdquo; OR \u0026ldquo;Laparoscopy\u0026rdquo; OR \u0026ldquo;Postoperative Recovery after Laparoscopy\u0026rdquo;, \u0026ldquo;Gastrointestinal Dysfunction\u0026rdquo; OR \u0026ldquo;GI Dysfunction\u0026rdquo; OR \u0026ldquo;Gastrointestinal Motility Disorder\u0026rdquo; OR \u0026ldquo;Postoperative Gastrointestinal Recovery\u0026rdquo; OR \u0026ldquo;Gastrointestinal Function Recovery\u0026rdquo; OR \u0026ldquo;Digestive System Dysfunction\u0026rdquo; OR \u0026ldquo;Postoperative Gastrointestinal Recovery\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Criteria for inclusion and exclusion\u003c/h2\u003e\u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\u003ch2\u003e2.2.1 Inclusion criteria\u003c/h2\u003e\u003cp\u003eStudies were included if: (1)they were about randomized controlled trials and quasi-trials; (2)they were subject to patients who had undergone laparoscopic surgery; (3)they were with auricular therapy as the main intervention, alone or in combination with other treatments; (4)they were clearly given the specific auricular acupoint; (5)The outcome index was the recovery of gastrointestinal function.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\u003ch2\u003e2.2.2 Exclusion criteria\u003c/h2\u003e\u003cp\u003eStudies were excluded if: (1)they were published in more than one place; (2)they only presented a program or an abstract; (3)their data were incomplete or unobtainable; (4)they were with ambiguous diagnosis and primary treatment; (5)they were about Meta-analysis, systematic review, review, case report or animal experiment.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Standardization\u003c/h2\u003e\u003cp\u003eAccording to the \u0026ldquo;National Standard of the People's Republic of China: Auricular Point Name and Location\u0026rdquo; (GB/T 13734\u0026thinsp;\u0026minus;\u0026thinsp;2008)[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], the name and location of auricular points were standardized. For instance, \u0026ldquo;Cortex\u0026rdquo; was changed to \u0026ldquo;Subcortex\u0026rdquo;, \u0026ldquo;Pancreas\u0026rdquo; and \u0026ldquo;Gallbladder\u0026rdquo; were changed to \"Pancreas-Gallbladder\", etc.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Database establishment\u003c/h2\u003e\u003cp\u003eAll the retrieved studies were imported into EndNote X9(\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://endnote.com\u003c/span\u003e\u003cspan address=\"https://endnote.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) for screening, deduplication and classification. In addition, Excel 2021 was used for data extraction and database establishment. According to the title, year, author information, auricular point location and intervention method, the study information was input and sorted out. If there were two or more groups of schemes used alternately in one article, these schemes will be individually segregated and systematically entered into the data sheet. If the primary acupoints in a literature source include multiple groups due to different syndrome differentiation types, the corresponding prescriptions will be divided into distinct entries and recorded separately.\u003c/p\u003e\u003cp\u003eTo ensure the authenticity and accuracy of the data, each eligible study was reviewed independently by two researchers, if there was any difference in information input, a third researcher was responsible for proofreading and reviewing to prevent duplications, input errors, and omissions.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Data mining analysis\u003c/h2\u003e\u003cp\u003eThe frequency method was utilized to count the preparations of prescriptions that met the inclusion and exclusion criteria in the Excel worksheet. Association rules[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] were generated from these frequent item sets, followed by analysis based on the number of the common appearances of items. The analysis results were expressed in terms of \u0026ldquo;Support\" \u0026ldquo;Confidence\", and\u0026ldquo;Lift\". Support is defined as the frequency with which the items in the antecedent and consequent appear together in the dataset. A higher support value indicates that the rule is more general and applicable to a larger portion of the data. Confidence is a reliable metric for evaluating the efficacy of the rule. This probability is defined as the probability that a specific occurrence will transpire subsequent to the occurrence of another specific event. A confidence value greater than 80% suggests that the rule is reasonably reliable. Lift is a method of comparing the observed support of a given rule to what would be expected if the antecedent and consequent were independent. A lift value greater than 1 indicates a positive correlation between the antecedent and the consequent, signifying that the occurrence of the antecedent increases the likelihood of the consequent occurring. Cluster analysis[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] was conducted utilizing the OriginPro 2025, with a genealogical map being developed in order to explore the clustering relationship between the acupoints. Each sample set in the data sets is regarded as a cluster, and then the clusters with close distances are merged step by step to achieve the expected number of clusters. Network construction based on the Apriori algorithm by SPSS Modeler 18.0 was established, and X was set as the first term and Y as the second term. The nodes represent individual acupoints and the lines represent the correlation between acupoints. The thickness of the line is indicative of the strength of the correlation, with a thicker line denoting a stronger correlation. The dotted line, conversely, indicates a weaker correlation.\u003c/p\u003e\u003c/div\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.1 General information\u003c/h2\u003e\u003cp\u003eA total of 275 papers were retrieved from the databases initially, with 85 remaining after removing duplicates. Then, 69 papers were excluded judging by their titles and abstracts. Meanwhile, 3 papers were excluded with unclear acupoints selection. Finally, 118 papers were included. The detailed information can be seen in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Frequency analysis\u003c/h2\u003e\u003cp\u003eAmong the 118 included papers in this study, there were 28 types of auricular points with a total of 632 occurrences, as seen in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Among them, there are 12 auricular points with a frequency of occurrence greater than or equal to 10, with a cumulative frequency of 575, which constituted 90.98% of the total percentage, shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, including Stomach, Large Intestine, Small Intestine, Sympathetic, Spleen, Shenmen, Sanjiao, Subcortex, Liver, Endocrine, Kidney and Pancreas-Gallbladder.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Association rule analysis\u003c/h2\u003e\u003cp\u003eIn association rule analysis, the associations were investigated under the criteria of Support\u0026thinsp;\u0026ge;\u0026thinsp;20% and Confidence\u0026thinsp;\u0026ge;\u0026thinsp;80%. We generated 48 association rules with lift\u0026thinsp;\u0026gt;\u0026thinsp;1 which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, including 11 second-order association rules, 25 third-order association rules, and 12 fourth-order association rules.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.4 Clustering analysis\u003c/h2\u003e\u003cp\u003eWe put 28 high-frequency ear points into OriginPro 2025 for analysis, results of clustering analysis are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, totally, five clusters are presented, which are: Cluster 1(red): Bladder, Ureter and Kidney. Cluster 2(blue): Lung, Distension area, Abdomen, Adrenal gland, Middle triangular fossa, Rectum, Brainstem and Subcortex. Cluster 3(green): Liver, Pancreas-Gallbladder, Endocrine, Duodenum and Spleen. Cluster 4(purple): Sympathetic, Shenmen, Heart, Occiput, Brain and Uterus. Cluster 5(yellow): Cardia, Appendix, Large intestine, Small intestine, Sanjiao and Stomach.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003e3.5 Network analysis\u003c/h2\u003e\u003cp\u003eWe set the lower threshold of strong connections at 35 and the upper limit of weak connections at 15. In order to facilitate observation of the network diagram, the display has been set to indicate the strength of the network connections. In network analysis, connections are shown as thick lines for strong connections, solid lines for normal connections, and dotted lines for weak connections. Following a rigorous examination, 12 sets of strong links were discovered; these are detailed below in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: Large Intestine-Stomach, Large intestine-Small intestine, Stomach-Small intestine, Large Intestine-Spleen, Spleen-Stomach, Sympathetic-Stomach, Spleen-Small intestine, Large Intestine-Sympathetic, Shenmen-Stomach, Large Intestine-Sanjiao, Sanjiao-Stomach and Sympathetic-Shenmen.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eGastrointestinal dysfunction after laparoscopic surgery falls within the scope of TCM syndromes including pi-man (fullness), abdominal distension, abdominal pain, intestinal obstruction (bi-syndrome), intestinal knotting (jie-syndrome), and constipation. Its etiology and pathogenesis are closely associated with surgical trauma, disharmony of qi and blood, and visceral functional impairment. Treatment must target the core pathogenesis of \"root deficiency with branch excess\" and \"obstructed fu-organ qi\", addressing three key therapeutic dimensions:\u003c/p\u003e\u003cp\u003efortifying healthy qi while expelling pathogenic factors, harmonizing qi dynamics and Restoring the normal descent function of the six fu-organs.\u003c/p\u003e\u003cp\u003eOur study demonstrates that the stomach, large intestine, and small intestine acupoints rank among the highest in frequency of use in auricular therapy. This reflects the holistic concept in Traditional Chinese Medicine (TCM), which is expressed by the axiom, \"The ear is the convergence point of all meridians.\" Auricular therapy works by stimulating specific areas of the ear to regulate the function of their corresponding internal organs.\u003c/p\u003e\u003cp\u003eThe Stomach (96 cases, 15.19%) functions as a core target within the digestive system. As stated in Chap.\u0026nbsp;26 (\"Questions About Mouth and Ears\") of the Lingshu (Spiritual Pivot): \"The ear is connected by the collaterals of the stomach.\" The stomach point\u0026rsquo;s frequent use directly corresponds to the pathogenesis of \"impaired gastric descent\"(wei qi bu jiang)[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] in patients with gastrointestinal dysfunction. Stimulating the stomach point may promote gastrin secretion via the vagus nerve, enhance pepsin activity, accelerate gastric emptying, and improve postoperative digestive function[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The Large intestine (92 cases, 14.56%) and Small intestine (81 cases, 12.82%) correspond respectively to the intestinal functions of conveyance and separation of the clear from the turbid. The large intestine governs conveyance (chuan dao), while the small intestine governs transformation (hua wu), aligning with the theory from Suwen・Linglan Midian Lun (The Divine Pivot): \"The large intestine plays a pivotal role in the process of elimination and transformation, serving as the primary conduit through which these changes occur.\" Modern research indicates that stimulating the large intestine point can regulate Substance P expression in the Enteric Nervous System (ENS), enhance colonic transit motility, alleviate postoperative constipation and abdominal distension, and restore intestinal peristalsis rhythm[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The Sympathetic (59 cases, 9.33%) has been identified as a critical acupoint for autonomic nervous regulation. Research indicates that by stimulating branches of the great auricular nerve, it can relieve gastrointestinal smooth muscle spasms and alleviate abdominal pain and distension[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This is indicative and analogous to the regulatory mechanism of the autonomic nervous system on gastrointestinal smooth muscle in modern medicine. The Spleen (58 cases, 9.18%) fortifies the spleen and boosts qi to consolidate the acquired foundation (hou tian zhi ben). The Shenmen (54 cases, 8.54%) tranquilizes the mind and stabilizes the mental state, mitigating the impact of postoperative anxiety on gastrointestinal function. Co-administration of these two points has been evidenced to regulate the limbic-hypothalamic pathway, reduce fluctuations in gastric mucosal blood flow under stressful conditions, and collaboratively enhance gastrointestinal barrier function[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Experimental studies demonstrate that TCM formulations regulating Sanjiao(39 cases, 6.17%), specifically in the transformation of Qi, as evidenced by the significant enhancement of water metabolism in mice observed in studies involving Wuling San (Five-Ingredient Powder with Poria)[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Mice treated with Wuling San showed marked improvements in both fecal output volume and water metabolism parameters in the large intestine. The Subcortex (36 cases, 5.70%) has been demonstrated to modulate cerebral cortical function[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], suggesting potential relevance to pain management, emotional regulation, or neurological disorders. As Sanjiao serves as the pathway for primordial qi (yuan qi), while Subcortex corresponds to the projection area of the cerebral cortex, their combined application regulates gastrointestinal motility rhythm through the central-peripheral pathway. This approach is particularly suitable for patients with functional gastrointestinal disorders (FGIDs). The Liver (22 cases, 3.48%) has been proven to soothe the liver, promote gallbladder function, and regulate qi movement to enhance digestion[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The Endocrine (16 cases, 2.53%) has been demonstrated to modulate hormonal balance (e.g., gastrin, insulin)[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The Kidney (11 cases, 1.74%) has been identified as a crucial point for supporting splenic yang, thereby facilitating the maintenance of metabolic warmth. Similarly, the Pancreas-Gallbladder (11 cases, 1.74%) has been noted to play a regulatory role in glucose metabolism and bile secretion. Collectively, these points establish a \"zang-fu simultaneous regulation\" framework, covering multifaceted mechanisms of postoperative gastrointestinal functional recovery.\u003c/p\u003e\u003cp\u003eThe auricular points that correspond to the Stomach, Large intestine, and Small intestine are located in the cymba conchae and cavum conchae and correspond to the projection zones of the digestive tract on the auricle. These points form a holographic correspondence with gastrointestinal organs derived from endodermal differentiation during embryonic development. Their innervation is closely associated with the auricular branch of the vagus nerve and the auricular branches of the cervical plexus. Stimulation of these points can directly modulate the myoelectrical activity of gastrointestinal smooth muscle. The Sympathetic is adjacent to the great auricular nerve branches (C2-C3). Its afferent fibers project to the celiac plexus, where they regulate gastrointestinal vasomotor activity and glandular secretion[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Simultaneously, stimulation can additionally inhibit abnormal discharge frequency in the gastrointestinal smooth muscle of rats and reduce visceral pain sensitivity, known as visceral hyperalgesia[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The Shenmen point is located in the triangular fossa, which has a direct effect on gastrointestinal regulatory centers, including the celiac plexus and the nucleus tractus solitarius (NTS) in the medulla oblongata, thereby inhibiting over-secretion of acid by gastric parietal cells[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. It further regulates the limbic-hypothalamic-vagus pathway to stabilize gastric mucosal blood flow, exhibiting partial mechanistic overlap with the molecular targets of proton pump inhibitors (PPIs)[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The association rule analysis of auricular acupoints for treating postoperative gastrointestinal dysfunction following laparoscopic surgery reveals a systematic pattern of acupoint compatibility. This pattern aligns with TCM theories of visceral correlation and meridian conduction. The frequent co-occurrence of acupoints such as Large Intestine, Small Intestine, Stomach, Spleen, and Sanjiao reflects the TCM principle that \"the fu-organs function by maintaining unobstructed passage,\" underscoring the importance of regulating fu-qi for gastrointestinal recovery.\u003c/p\u003e\u003cp\u003eThe second-order association rules indicate that the Large Intestine-Small Intestine pairing occurs most frequently (81 cases; support: 68.64%, confidence: 95.06%; Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). In TCM theory, both acupoints correspond to yang fu-organs responsible for food waste transformation and transportation. Their clinical compatibility embodies the principle of \"coordination of fu-qi,\" wherein the Small Intestine separates the clear from the turbid while the Large Intestine regulates defecation. This synergy is clinically significant: auricular stimulation of the Large Intestine acupoint enhances intestinal peristalsis and reduces postoperative ileus duration[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Similarly, the high-confidence Large Intestine-Sanjiao combination (39 cases; support: 33.05%, confidence: 94.87%; Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) demonstrates Sanjiao\u0026rsquo;s role in regulating qi movement and fluid metabolism. With the passage of water and qi, Sanjiao collaborates with the Large Intestine to eliminate damp-turbidity\u0026mdash;a mechanism critical for resolving postoperative gastrointestinal stasis[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Third-order association rules reveal two clinically significant combinations. First, the Large Intestine-Sympathetic-Small Intestine triad (35 cases; support: 29.66%, confidence: 100%; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) modulates autonomic function to regulate intestinal motility. The Sympathetic acupoint specifically inhibits excessive sympathetic excitability, reducing intestinal smooth muscle spasm[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], demonstrating the TCM concept of regulating qi movement through neuro-endocrine pathways. Second, the Large Intestine-Spleen-Small Intestine combination (43 cases; support: 36.44%, confidence: 97.67%; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) integrates spleen-strengthening with intestinal regulation, addressing the core pathogenesis of \"spleen deficiency causing intestinal dysfunction.\" Clinically, this trio shortens the time to the first postoperative flatus in laparoscopic cases[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Fourth-order association rules, exemplified by the Large Intestine-Sympathetic-Small Intestine-Stomach combination (31 cases; support: 26.27%; confidence: 100%; Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), demonstrate comprehensive regulation of qi-blood-fluid balance. The inclusion of the Stomach acupoint enhances gastric motility modulation, while Sympathetic and Small Intestine collectively maintain intestinal rhythm. This multi-target approach conceptually parallels the TCM formula \"Four Miraculous Powder\" (Si Miao San), synergistically restoring qi flow in the middle jiao. Experimental studies confirm that such multi-acupoint auricular therapy regulates enteric nervous system neurotransmitters (e.g., acetylcholine) to promote gastrointestinal mucosal repair [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. The consistently high lift values (\u0026ge;\u0026thinsp;1.21) across associations indicate significant synergistic effects, aligning with the TCM principle of \"acupoint compatibility for enhanced efficacy.\" For instance, the Large Intestine-Small Intestine pair demonstrates a lift of 1.21 (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), predicting 21% higher co-occurrence than expected if used independently. This synergism may arise from their shared vagal innervation, as functional MRI studies confirm that simultaneous stimulation enhances bilateral insular cortex activation[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u0026mdash;a key region for gastrointestinal sensory processing.\u003c/p\u003e\u003cp\u003eAccording to the literature we retrieved, the five clusters cover the main pathological aspects of gastrointestinal dysfunction after laparoscopic surgery, including inflammation, neurological disorders, digestive impairment and psychological stress, through a step-by-step therapeutic mechanism: \u0026rdquo;Regulating Body Fluid Metabolism (Cluster 1) \u0026rarr; Diffusing Lung Qi and Regulating Qi Movement (Cluster 2) \u0026rarr; Soothing the Liver and Fortifying the Spleen (Cluster 3) \u0026rarr; Calming the Spirit and Regulating Shen (Cluster 4) \u0026rarr; Unblocking the Fu Organs and Regulating the Intestines (Cluster 5)\u0026rdquo;.\u003c/p\u003e\u003cp\u003eCluster 5 (Yellow: Stomach, Large Intestine, Small Intestine, Sanjiao, etc.) \u0026ndash; Core Regulation of Gastrointestinal Motility, which is associated with elevated short-chain fatty acids and enhances intestinal mucosal energy metabolism, embodying the TCM principle of \"Unblocking Yangming Fu Organs Regulates Intestinal Qi Dynamics\". \"The stimulation of specific auricular points along the gastrointestinal tract has been shown to directly activate Interstitial Cells of Cajal, elevate motilin levels, and restore gastrointestinal slow-wave rhythm[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Concurrently, Sanjiao point modulates the thoraco-abdominal pressure gradient, further promotes motilin secretion, optimizes peristaltic biomechanics, and accelerates CO₂ clearance from the intestinal lumen[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This mechanism corresponds to the concept of \"Unblocking Fu Organs and Regulating Qi\". Clinical case[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] have been shown the efficacy of immediate postoperative application of auricular acupressure (Large Intestine, Sympathetic, Stomach, Spleen points) combined with moxibustion at Zusanli in facilitating the passage of flatus within 24 hours and achieving a complete resolution of abdominal distension. Preventive applications[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] have been shown to demonstrate the efficacy of Cardia point in reducing delayed gastric emptying incidence, and Appendix point in suppressing postoperative intestinal adhesion formation. Cluster 4 (Purple: Sympathetic, Shenmen, Heart, etc.) \u0026ndash; Modulation of the Neuro-Psycho-Gastrointestinal Axis. The Sympathetic point has been shown to inhibit sympathetic overactivation, suppresses vestibular-vagal nerve excitability, reduces 5-HT release, and restores gastrointestinal smooth muscle rhythm[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Shenmen point, a traditional Chinese medicine (TCM) point, activates the nucleus tractus solitarius (NTS) in the medulla oblongata, inhibiting the hypothalamic\u0026ndash;pituitary\u0026ndash;adrenal (HPA) axis, lowering cortisol levels, and ameliorating stress responses in the \"gut-brain axis\"[\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. As demonstrated in Ma\u0026rsquo;s study[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], Shenmen point combined with moxibustion reduced anxiety scores, validating the gastrointestinal protective effects of \"Calming the Spirit and Regulating Shen.\" Research[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] also shows auricular acupressure using sympathetic and stomach reduced the incidence of postoperative nausea and vomiting. Therefore, by regulating the autonomic nervous system, calming the spirit, and improving circulation, which approach alleviates postoperative stress responses and promotes gastrointestinal functional recovery. Cluster 3 (Green: Liver, Pancreas-Gallbladder, Spleen, etc.) \u0026ndash; Harmonizing Liver-Spleen and Reconstructing Digestive Function. This approach has been shown to enhance digestive function and promote gastrointestinal motility by regulating liver qi, stimulating digestive fluid secretion, and modulating hormone levels. Liver-Pancreas-Gallbladder points has been demonstrated to enhance bile acid concentration and pancreatic lipase activity, which can improve fat digestion[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Spleen point has been demonstrated to promote the secretion of gastrointestinal hormones, such as cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), and to enhance mucosal barrier function, as evidenced by an increase in Lactobacillus[\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. As discussed, auricular acupressure at Spleen point demonstrated a significant reduction in postoperative steatorrhea incidence[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], validating the improvement in digestive function through \"Fortifying the Spleen and Harmonizing the Stomach.\" Researches[\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e] also demonstrated that auricular acupressure (Spleen, Liver, Pancreas-Gallbladder points) combined with acupoint massage resulted in a significant reduction in bowel sound recovery time, whose mechanism is associated with elevated bile acids and pancreatic lipase. In addition, careful consideration is needed when patients have other underlying conditions at the same time. For diabetic patients[\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e], the incorporation of Endocrine point has been demonstrated to effectively modulate insulin resistance. However, it is imperative to exercise caution when administering strong stimulation at Liver point in patients with acute hepatitis[\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e], as this may exacerbate hepatic stress responses. Consequently, it is imperative to take patient medical history into consideration when formulating point protocols to ensure optimal therapeutic outcomes. Cluster 2 (Blue: Lung, Abdominal Distension Area, Adrenal Gland, etc.) \u0026ndash; Lung-Intestine Qi Dynamics Coordination and Inflammation Suppression. This approach has been proven to alleviate postoperative respiratory discomfort and abdominal bloating by regulating respiratory function and attenuating inflammatory responses in surgical patients. The Lung point has been shown to activate the vagus nerve, reduce intra-luminal CO₂ pressure and enhance intestinal motility[\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. The Adrenal Gland point has been evidenced to inhibit inflammatory cytokines such as tumor necrosis factor-α (TNF-α)[\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]. As detailed in Liu\u0026rsquo;s research[\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], stimulation at the Lung point activates via the vagus nerve-intestinal smooth muscle pathway, leading to a reduction in flatus passage time. Cluster 1 (Red: Bladder, Ureter, Kidney) \u0026ndash; Indirect Regulation of Fluid Metabolism and Gastrointestinal Function. The stimulation of specific points on the kidneys and bladder has been proven to modulate the secretion of anti-diuretic hormone (ADH) and aldosterone[\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. This stimulation has been observed to enhance the contractility of the detrusor muscle in the bladder, promote urination, and reduce intestinal wall edema. This approach has been demonstrated to alleviate the mechanical compression of intestinal structures caused by bladder distension, consequently restoring the spatial capacity for gastrointestinal motility. In postoperative urinary retention following gynecological laparoscopy procedures, such as myomectomy, the combination of Uterus point has been demonstrated to enhance efficacy[\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. The findings of the integration of auricular acupressure with Zusanli resulted in a significant reduction in the incidence of urinary retention[\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, our current study also has some limitations. First, the literature incorporated in this study did not differentiate between auricular stimulation modalities\u0026mdash;such as auricular plaster therapy, electro-stimulation, or needle embedding. Efficacy variations attributable to differences in manipulation techniques were not analyzed. Furthermore, controversies regarding the regional localization of acupoints like Sanjiao and Subcortex may compromise result consistency. Secondly, the data samples utilized in this analysis may have certain limitations, such as the scope of data sources and individual patient variations. These factors could affect the generalizability and accuracy of the association rules. Moreover, association rule mining reveals associations between variables but cannot establish direct causal relationships. Future studies should expand the scope of data sampling by enrolling patients from diverse regions, age groups, and genders to enhance the reliability and representativeness of the association rules. Future studies should integrate modern medical diagnostic modalities and experimental methodologies, such as functional gastrointestinal disorder examinations, neurotransmitter quantification, and animal experimentation. Employing advanced technologies like functional Near-Infrared Spectroscopy (fNIRS)[\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e] and Positron Emission Tomography\u0026ndash;Computed Tomography (PET-CT)[\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e], researchers could dynamically monitor real-time regulatory effects of auricular stimulation on brain-gut axis pivotal nodes (e.g., \u003cem\u003einsula\u003c/em\u003e, \u003cem\u003eamygdala\u003c/em\u003e) to elucidate underlying mechanisms[\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. Further investigation into the biological mechanisms of visceral interactions and their crosstalk with the nervous system is essential to establish causal relationships, thereby providing robust support for modernizing TCM theory and enabling precision clinical interventions. Multicenter randomized controlled trials (RCTs) should be conducted to explore disease-specific core acupoint clusters. Additionally, synergistic mechanisms combining auricular therapy with body acupuncture[\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e] and probiotics[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e] warrant investigation to optimize integrated TCM-Western medicine protocols, ultimately enhancing the management of gastrointestinal dysfunction after laparoscopic surgery.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eOur study employs multidimensional data mining (frequency\u0026rarr; association\u0026rarr; clustering\u0026rarr; network) to elucidate the intrinsic logic of auricular acupoint association rules, providing medical staff with a precision correspondence framework of \u0026quot;disease pattern\u0026rarr; pathogenesis\u0026rarr; acupoint cluster\u0026quot;. The auricular point formulations for postoperative gastrointestinal dysfunction are guided by TCM principles of viscera correspondence theory, and meridian connectivity, with scientific validation from modern neuroendocrine and microcirculation research. The identified core formula\u0026mdash;comprising the Stomach-Large Intestine-Sanjiao acupoints as the foundational protocol, Sympathetic-Shenmen as the synergistic module, and Spleen as the pivotal modulator for pattern differentiation, which heralds an era of \u0026quot;precision brain-gut co-regulation\u0026quot; in acupuncture gastroenterology, establishing an evidence-based framework for clinical auricular therapy. Further investigation into molecular mechanisms (e.g., gut microbiome modulation, inflammatory cytokine profiling) of these acupoint combinations may deepen our understanding of TCM auricular therapy in postoperative rehabilitation. We will continue to focus on the relevant clinical literature and integrate, further verify and improve the acupoint selection rules of acupoint therapy in the treatment of gastrointestinal dysfunction after laparoscopic surgery, providing a further reference for a future acupoint selection programme of acupoint therapy in the treatment.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eTCM: Traditional Chinese medicine.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch4\u003eAcknowledgements\u003c/h4\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch4\u003eAuthors\u0026apos; contributions\u003c/h4\u003e\n\u003cp\u003eGL: Data curation, Investigation, Conceptualization, Formal analysis, Methodology, Software, Validation, Visualization, Writing-original draft, Critical revision.\u003c/p\u003e\n\u003cp\u003eWW: Software, Methodology, Data curation, Investigation, Validation.\u003c/p\u003e\n\u003cp\u003eGS: Software, Data curation, Investigation, Validation.\u003c/p\u003e\n\u003cp\u003eLL: Project administration, Visualization, Supervision, Validation, Writing-review\u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eCL: Supervision, Validation, Writing-review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eYS: Project administration, Supervision, Validation, Writing-review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eYO: Data curation, Investigation, Validation.\u003c/p\u003e\n\u003cp\u003eHC: Project administration, Resources, Supervision, Writing\u0026ndash;review \u0026amp; editing\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003ch4\u003eFunding\u003c/h4\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch4\u003eAvailability of data and materials\u003c/h4\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eInformed consent of the study and a statement on ethics approval was waived because of the retrospective nature and the analysis used anonymous clinical data.\u003c/p\u003e\n\u003ch4\u003eConsent for publication\u003c/h4\u003e\n\u003ch4\u003eNot applicable.\u003c/h4\u003e\n\u003ch4\u003eCompeting interests\u003c/h4\u003e\n\u003ch4\u003eThe authors declare that they have no competing interests.\u003c/h4\u003e\n\u003cp\u003eAuthor details\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGuozhi Liu,\u003c/strong\u003e Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWenxin Wu,\u003c/strong\u003e Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGuanglin Sang,\u0026nbsp;\u003c/strong\u003eDepartment of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJiuli Li\u003c/strong\u003e, Proctology Department, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eChang Liu\u003c/strong\u003e, Department of Critical Care Medicine, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eYingqi She\u003c/strong\u003e, Department of Critical Care Medicine, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eYixuan Ou\u003c/strong\u003e, Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuibing Chen (corresponding author)\u003c/strong\u003e, Department of Nursing, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, 528400, China\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePascual, M., Salvans, S., \u0026amp; Pera, M. 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Probiotics: Potential novel therapeutics for microbiota-gut-brain axis dysfunction across gender and lifespan. \u003cem\u003ePharmacology \u0026amp; therapeutics\u003c/em\u003e, \u003cem\u003e231\u003c/em\u003e, 107978. https://doi.org/10.1016/j.pharmthera.2021.107978\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eFrequency of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo.\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAuricular acupoint\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRate(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShenmen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubcortex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLiver\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEndocrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKidney\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePancreas-Gallbladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCardia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLung\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuodenum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeart\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAppendix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBrainstem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUterus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOcciput\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbdomen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDistension area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBrain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRectum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle Triangular Fossa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdrenal Gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSecond-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSuccedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAntecedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSupport\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConfidence\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLift\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e95.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e94.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e86.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e86.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e85.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e84.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e82.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThird-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSuccedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAntecedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSupport\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConfidence\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLift\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubcortex\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e94.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e65.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubcortex\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShenmen\u0026thinsp;+\u0026thinsp;Small Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e66.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShenmen\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Spleen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSubcortex\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Spleen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003ctable id=\"Tab4\" border=\"1\" class=\"fr-table-selection-hover\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eFourth-order association rules of auricular acupoints for treating gastrointestinal dysfunction after laparoscopic surgery\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSuccedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAntecedent\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency(n)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSupport\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eConfidence\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLift\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e97.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Spleen\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Large Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Large Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e85.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Spleen\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmall Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpleen\u0026thinsp;+\u0026thinsp;Large Intestine\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSympathetic\u0026thinsp;+\u0026thinsp;Spleen\u0026thinsp;+\u0026thinsp;Stomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStomach\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSanjiao\u0026thinsp;+\u0026thinsp;Small Intestine\u0026thinsp;+\u0026thinsp;Large Intestine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Gastrointestinal dysfunction, Traditional Chinese Medicine, Auricular therapy, Selection rule, Data mining","lastPublishedDoi":"10.21203/rs.3.rs-7600458/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7600458/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eGastrointestinal dysfunction is a common complication of patients following laparoscopic surgery, prolonging recovery and increasing healthcare costs. With Western medicine approaches having limitations, traditional Chinese medicine (TCM), particularly auricular therapy, has shown promise in managing this condition, previous research has lacked standardization in acupoint selection and has not fully utilized data mining techniques to uncover patterns in acupoint combinations. This study aims to identify auricular acupoint patterns for treating gastrointestinal dysfunction after laparoscopic surgery via data mining, guiding clinical practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis study systematically analyzed auricular therapy for gastrointestinal dysfunction after laparoscopic surgery. Data were retrieved from multiple Chinese and English databases up to April 30, 2025, using relevant search terms. Studies were filtered based on inclusion criteria and exclusion criteria. The included studies were standardized according to the Chinese national standard for auricular point nomenclature. Study information was organized using EndNote X9 and Excel 2021. Data underwent frequency analysis, association rule analysis, cluster analysis and network analysis to uncover patterns in acupoint selection and combinations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 118 papers were included in the study, featuring 28 types of auricular points used 632 times. High-frequency points included Stomach, Large Intestine, and Small Intestine. Association rule analysis revealed 48 rules with lift values greater than 1, indicating significant correlations between certain acupoint combinations. Cluster analysis grouped the 28 auricular points into five clusters, while network analysis identified 12 strong connections between acupoints.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThis study provides a systematic analysis of auricular acupoint selection patterns for gastrointestinal dysfunction after laparoscopic surgery, offering a reference for clinical practice. The findings highlight the potential of auricular therapy in this context and suggest directions for future studies, including expanding data sampling and integrating modern medical diagnostic techniques to enhance the reliability and applicability of the results.\u003c/p\u003e","manuscriptTitle":"Rule of acupoint selection in auricular therapy of gastrointestinal dysfunction after laparoscopic surgery, based on data mining","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-10 14:57:21","doi":"10.21203/rs.3.rs-7600458/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"83f763d9-b4e1-4bd2-9f46-2a37b5d4d452","owner":[],"postedDate":"October 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-27T05:25:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-10 14:57:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7600458","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7600458","identity":"rs-7600458","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}