The Clinical Research Of Tiaofei Shugan Jianpi Treats Irritable Bowel Syndrome (D-IBS) Of Liver Stagnation And Spleen Deficiency Type Patient

Objectives:The diarrhea-predominant of irritable bowel syndrome,and of the Liver Stagnation and Spleen Deficiency in our country is higher incidence.To observe the changing scores of symptom scale of irritable bowel syndrome(D-IBS) of Liver Stagnation and Spleen Deficiency Type Patient、self-rating depression scale(SDS)、self-rating anxiety scale(SAS), probe into the relationship between IBS and psychological factor,then evaluate objectively the clinical curative effect of Tiaofei Shugan Jianpi which is my tutor’s experiential prescription of TCM,and futher open up the new train of thought and method for the treatment of the diarrhea-predominant of irritable bowel syndrome(D-IBS)。Materials and Methods:To base on RomeⅢdiagnostic standard that agreed in meeting Rome in 2006,and refer to《Irritable bowel syndrome in traditional Chinese and western medicine diagnosis and treatment program(Draft)》compassed by The light of China Institute of Traditional Chinese and Western Medicine Professional Committee of digestive diseases in 2003 in Chongqing launched.we choosed 60 patients with IBS-D(Gan-stagnation with Pi-deficiency type),who were divided into two groups at random,the control group received tongxie yaofang;the treated group received tongxie yaofang and plus pulmonary stretch of goods.The two groups and treatment regimens are the same.And given patients the relevant explain of state of an illness in order to eliminate the doubt,but didn’t give them mental consultation and treatment deeply.Then graded scores of symptom scale、SDS、SAS before and after the course,analysed the statistics,observed the clinical effects、the changs between the dyspeptic symptom and the psychological mental factors、ill-effects of the medicament and the rate of recrudescence four weeks after the treatment ended;and through one-month follow-up patients whose efficacy index>30%,after treatment to understand the situation of the disease relapse.Results:(1) Before therapy,the state of illness between two groups could be compared with each other,the symptom of treated groups alleviated obviously after treatment(p<0.01), and show excellent efficience for the scores of SDS and SAS;the symptom of control groups alleviated obviously except Shiyubuzhen after treatment(p<0.01),and it were not be amended obviously in SDS、SAS;the therapeutic effects in "dabian xiexie、futongyuxie xiehoutongjiani、shantaixi"were similar,the treated group was superior in alleviating abdominal pain、xiongxie zhangtong、changmingshiqi(p<0.05);The effect of the treated group was 93.3%,and the control group was90.0%,but the treated group was superior in curable rate(p<0.05);and the relapse rate of the treated group was lower(p<0.05).(2)Among the 60 patients with IBS-D,the rate with depression was 31.7%,that with anxiety was 16.7%, while 10 patients contained both depression and anxiety,the total psychological abnormity was 31.7%statistics show.(3) The symptomatic scores of dyspepsia were positively correlated to the leves of SDS,SAS(r=0.414～0.441,p<0.05);After therapy,the relationships between the scores in indigestive symptom and SDS、SAS were both declined in the two groups,especially for the control group;As the period of treatment ended,the relationships between them turned to insignificant(p>0.05):The relievable rate of psychological abnormality in the treated group was higher than the control group for the patients with IBS-D; (4) During the therapy,the two groups have no ill-effects appeared.Conclusions:(1) The rate of patients with IBS-D of Liver Stagnation and Spleen Deficiency Type Patient,psychological abnormity was higher than patients with IBS reported before,perhaps it has certain connection with the inferior type of IBS or TCM symptomatology(Gan-stagnation with Pi-deficiency type);(2) To patients with IBS-D (Gan-stagnation with Pi-deficiency type) the relationships between occurance of the diseases、the grade of illness and the psychological factors were explicit,while therapy could affect them evidently;(3) Tiaofei Shugan Jianpi could remarkably improve the clinical efficacy of treatment and the corresponding incidental psychological abnormity.