Observation On The Therapeutic Effect Of Waitai Liuwu Huangqin Decoction On Diarrhea Type Irritable Bowel Syndrome And Its Effect On Intestinal Flora

Objective: This study will evaluate the effect of Waitai Liuwu Huangqin Decoction on the quality of life of patients with cold-heat mixed IBS-D by analyzing the changes of relevant indicators,explore its safety and effectiveness,and analyze its impact on intestinal flora diversity and flora structure,so as to provide new diagnosis and treatment ideas for the treatment of IBS-D.Methods: This study included 30 patients with IBS-D(mixed cold and heat type)who were definitely diagnosed in the outpatient and inpatient departments of the Department of Spleen,Stomach and Liver Diseases of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2022 to December 2022.All subjects were treated with Waitai Liuwu Huangqin Decoction for 3 weeks and followed up 4 weeks after treatment to observe the recurrence of IBS-D.The score changes of patients before and after treatment and 4 weeks after treatment were analyzed with the Chinese version of SF-36 scale,IBS severity scale,Hamilton anxiety scale,Hamilton depression scale and TCM syndrome evaluation scale.At the same time,10 of the 30 observed patients were randomly selected for stool samples before and after treatment,and their intestinal flora was analyzed by16 S r DNA sequencing technology.Results:(1)Clinical efficacy observation:(1)After treatment with Waitai Liuwu Huangqin Decoction,the quality of life of IBS-D patients in terms of physiological function,physiological function,body pain,general health status,energy,social function,emotional function,mental health and health changes were significantly improved,with a statistically significant difference(P<0.05).At 4 weeks after treatment,the score of IBS-D patients in all dimensions was slightly lower than that at the end of treatment,but still significantly better than that before treatment,with a statistically significant difference(P<0.05).(2)After treatment and 4 weeks after treatment,the scores of HAMA and HAMD of the patients decreased compared with those before treatment,P=0.01<0.05,the difference was statistically significant.(3)After treatment,the patient’s stool characteristics,diarrhea frequency,abdominal pain or abdominal distension and other clinical symptoms were significantly improved,and the IBS-SSS score was significantly lower than that before treatment(P<0.05).Although the score at the 4th week after treatment was slightly higher than that after treatment,it was still lower than the score before treatment,and the difference was statistically significant.(4)The quantification of TCM symptoms after treatment was generally lower than that before treatment,P=0.01<0.05,with statistically significant difference.In terms of curative effect,8 of the 30 study cases were significantly effective,19 were effective,and 3 were ineffective.The overall effective rate was 90%.(2)Intestinal flora results(1)After treatment with Waitai Liuwu Huangqin Decoction,the distribution of intestinal flora has changed,but the alpha diversity and beta diversity of IBS-D patients have not changed significantly.(2)At the level of phylum,the abundance value of Thiobacillus after treatment is higher than that before treatment,while Proteobacteria,Bacteroides,Fusobacteria and Actinomycetes are lower than that before treatment.Although the overall decline of F/B value after treatment is not obvious,there are still 5 cases with a downward trend in 10 cases.At the department level,the abundance of enterobacteriaceae was significantly lower than that before treatment(P=0.013<0.05);The number of Trichospiridae and Ruminococcaceae increased,and the number of Bacteroides decreased after treatment compared with that before treatment,with no significant difference(P>0.05).The improvement of B/E value is relatively obvious.In 10 cases,a total of 7 patients have increased B/E value after treatment.At the genus level,Streptococcus and Prevotella decreased compared with those before treatment,while Fecal bacilli increased compared with those before treatment.Conclusions:(1)Waitai Liuwu Huangqin Decoction has obvious therapeutic effect on IBS-D patients,which can significantly improve the stool characteristics of patients,reduce the frequency of diarrhea,relieve abdominal pain or abdominal distension and other clinical symptoms,and is conducive to improving the quality of life of patients.(2)Waitai Liuwu Huangqin Decoction can regulate the mental and psychological conditions of IBS-D patients,and can also improve their psychological status and social functions.(3)After treatment with Waitai Liuwu Huangqin Decoction,the distribution of intestinal flora changed,and the B/E value showed an increasing trend.The abundance of potential beneficial bacteria such as Rochella and Chlorella increased,while the abundance of potential harmful bacteria such as Enterobacteriaceae and unclassified Clostridium decreased after treatment.