Tuina combined with pulsed dry cupping for constipation and gastrointestinal recovery in severe traumatic brain injury: a multidimensional rehabilitation study

Vollständiger Abstract

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Objective To evaluate the efficacy of Tuina combined with pulsed dry cupping for constipation management and gastrointestinal (GI) function recovery in severe traumatic brain injury (sTBI), and its associations with nutritional status, neurological function, and patient satisfaction. Methods This study was a prospective real-world observational cohort study. A total of 120 patients with severe traumatic brain injury (sTBI) were consecutively enrolled between March 2023 and March 2024. Patients were classified into routine care or combined intervention groups according to routine clinical care pathways without randomization or investigator-driven assignment. Participants in the combined intervention group received Tuina combined with pulsed dry cupping once daily, five times per week for 4 consecutive weeks. Outcomes included constipation-related measures, gastrointestinal function, nutritional indicators, neurological function, and patient-reported outcomes. Appropriate statistical methods were applied for comparisons. Results Post-intervention, the combined intervention group showed increased completely spontaneous bowel movements, reduced defecation effort, higher BSS scores, and lower PAC-SYM and GSRS scores versus the routine care group ( p < 0.05). Serum Hb, ALB, and PA levels and GCS scores were higher in the combined intervention group ( p < 0.05), while GFAP and NSE levels showed non-significant decreasing trends. PGIC scores were lower in the combined intervention group ( p < 0.05). Conclusion In this prospective real-world observational cohort study, Tuina combined with pulsed dry cupping was associated with improvements in constipation-related symptoms, gastrointestinal function, nutritional indicators, and patient-reported outcomes in patients with severe traumatic brain injury. However, given the observational design, causal inferences regarding efficacy cannot be established.