To explore the dual regulatory effects of extracorporeal shock wave stimulation of Zusanli and Jianyu acupoints on gastrointestinal motility and autonomic nerve function in patients with diabetic gastroparesis (GDP).

A total of 180 patients with GDP admitted to First Hospital of Qinhuangdao from June 2023 to February 2025 were selected as the research subjects and randomly divided into three groups by random number table method, with 60 cases in each group. Group A received conventional diabetes management. Group B was treated with extracorporeal shock wave stimulation of the Zusanli acupoint. Group C was treated with extracorporeal shock wave stimulation of the Zusanli acupoint combined with the Jianyu acupoint. The treatment course was 8 weeks. The general data of three groups were collected and the clinical efficacy of the three groups after 8 weeks of treatment were compared. The scores of the Gastroparesis Symptom Severity Index (GCSI) before and after treatment, gastrointestinal motility indicators (gastric emptying time, gastric emptying rate, antral contraction frequency), gastrointestinal hormone levels (gastrin, motility, somatostatin), electrogastrogram indicators [gastric main power ratio (PDP), gastric main frequency ratio (PDF)], and heart rate variability performance indicators [standard deviation of RR interval mean (SDANN), root mean square of difference between adjacent RR intervals (RMSSD), standard deviation of RR intervals of all sinus beats (SDNN), ratio of power in the low-frequency range to power in the high-frequency range (LF/HF)] and adverse reaction conditions were compared.

There were no statistically significant differences in general data among groups A, B and C (P>0.05), and the baseline data were comparable. The total effective rate of group C (93.33%) was significantly higher than that of group B (80.00%) and group A (66.67%), with a statistically significant difference (P=0.023). Before treatment, there were no significant differences among the three groups in GCSI scores, gastrointestinal motility indicators, gastrointestinal hormone levels, electrogastrography indicators, and heart rate variability indicators (all P>0.05). After treatment, the GCSI scores of all three groups decreased significantly (all P<0.001), with group C showing the greatest improvement. The gastric emptying time of all three groups was shortened, the gastric emptying rate increased, and the antral contraction frequency rose. Moreover, the improvements in these indicators in group C were more significant than those in groups A and B (all P<0.001). The levels of gastrin and motility in group C were significantly higher, while the level of somatostatin was significantly lower than those in groups A and B (all P<0.001). The values of PDP and PDF in all three groups increased significantly, and those in group C were significantly higher than those in groups A and B (all P<0.05). SDANN, RMSSD, and SDNN in group C were significantly higher, and LF/HF was significantly lower than those in groups A and B (all P<0.001). There was no statistically significant difference in the total incidence of adverse reactions among the three groups (P>0.05).

Extracorporeal shock wave stimulation of Zusanli acupoint combined with Jianyu acupoint in the treatment of GDP can significantly improve the clinical efficacy, effectively improve the gastrointestinal motility and autonomic nerve function of patients.