| Objective:For patients with diarrhea-type irritable bowel syndrome(IBS-D),and the traditional Chinese medicine dialectic is liver stagnation and spleen deficiency type,the efficacy and safety of its clinical application were observed after the treatment of Qiweibaizhu Powder combined with Chaihu Shugan Powder,and the clinical application of traditional Chinese medicine to treat IBS-D with liver stagnation and spleen deficiency provided a new prescription.Methods::According to inclusion and exclusion criteria,60 patients with IBS-D from September 2021 to October 2022 were collected from Jiangxi Hospital of Traditional Chinese Medicine and randomly divided into treatment group and control group,with 30 patients in each group.The control group was given Bacillus subtilis dual live bacteria enteric-coated capsules(2 capsules/time 3 times/day after meals),and the treatment group was given Bacillus subtilis dual live bacteria enteric-coated capsules combined with Qiweibaizhu Powder combined with Chaihu Shugan Powder Plus and Subtraction(1 dose/day 2 times/day Half an hour after meals)for 4 weeks of treatment.Before and after treatment,the relevant changes of TCM syndrome,severity of illness,anxiety,depression and safety indexes of the two groups of patients were observed and recorded,including the comparison and difference of efficacy between the two groups after treatment;After 4 weeks of drug withdrawal,the patients with effective treatment were followed up with a questionnaire survey,and the relevant TCM symptom scores were observed and recorded.Statistical software was used to analyze the general data and efficacy indexes of the two groups of patients.Results: In the course of clinical treatment,1 patient in the control group fell out due to failure to take the drug as prescribed,so after the final treatment,a total of 59 patients with IBS-D with hepatic depression and spleen deficiency were included in this project,a total of 30 patients were included in the treatment group and 29 patients in the control group were included in the efficacy analysis.(1)Pre-treatment comparison:After examination,the two groups could be compared in terms of gender,age and course of disease(P>0.05).In addition,there was no statistical difference in the scores of TCM symptoms,disease severity,HAMA and HAMMD quantified scores before treatment by P>0.05,indicating that the symptoms of the two groups were comparable.(2)Total score of TCM symptoms:Compared with before treatment,the total scores of TCM syndromes in both groups were significantly decreased after treatment(P<0.01).indicating that the clinical medication of both groups could effectively alleviate clinical symptoms.Compared with the control group,clinical drugs in the treatment group had more obvious advantages in improving the overall efficacy of TCM syndromes(P<0.01).(3)Single points for TCM symptoms:The scores of TCM symptoms before and after treatment in the treatment group were all P<0.01,indicating that the medication in the treatment group had obvious alleviating effect on various TCM symptoms,while the TCM symptoms in the control group before and after treatment were P<0.05,the difference was statistically significant,and it had obvious effects in reducing abdominal pain and chest fullness,improving stool characteristics,reducing bowel frequency,and alleviating fatigue(P<0.01).The comparison between the two groups showed that the treatment group had a significant advantage over the control group in improving bowel frequency,sluggishness and flank tenderness(P<0.01),and the treatment group was also better than the control group in terms of abdominal pain and discomfort,fecal characteristics,irritability,and fatigue(P<0.05).(4)Efficacy of TCM symptoms:After treatment,27 of the 30 cases in the treatment group were effective,3 cases were ineffective,and the total effective rate was 90%.Among the 29 cases in the control group,20 were effective and 9were ineffective,with a total effective rate of 69%.The test showed that P=0.057 > 0.05,indicating that there was no statistical significance between the treatment of Western medicine combined with Qiwei Baizhu Powder combined with Chaihu Shugan powder and Western medicine alone.(5)IBS Severity Questionnaire:After testing the IBS-SSS scores of the two groups,it was found that the data of the two groups showed P<0.01 before and after treatment,indicating that the medication regimen of both groups could improve the severity of IBS-D patients.After comparing the treatment group with the control group,it was found that the treatment group had more obvious advantages than the control group in improving stool satisfaction,reducing life distress and reducing the total score(P<0.01),Compared with the control group,the treatment group also had more advantages in reducing the degree of abdominal pain,reducing the days of abdominal pain and relieving abdominal distension discomfort(P<0.05).(6)HAMA and HAMD scale: After treatment,HAMA and HAMD scores in 2 groups were significantly decreased compared with the relative ratio before treatment(P < 0.01),indicating that the two groups had significant efficacy in improving anxiety and depression after treatment.The comparison between groups found that whether it was HAMA or HAMM,the treatment group had a significant advantage and had a statistically significant difference(P<0.01).(7)Long-term efficacy:After 4 weeks after the end of treatment,3 of the 27 effective patients in the treatment group relapsed,with a recurrence rate of 11.11%;Among the 20 effective patients in the control group,9 relapsed,and the recurrence rate was 45.0%,and the two groups had more advantages in improving the long-term efficacy compared with the treatment group(P<0.05).(8)Safety: There were no abnormalities in the vital signs,biochemical xaminations and electrocardiogram examinations of the two groups before and fter treatment,and there were no adverse reactions,indicating that the two roups of drugs treated the disease were safe.Conclusion: Compared with the use of Bacillus subtilis enteric-coated capsules for the treatment of IBS-D patients with hepatic depression and spleen deficiency,the clinical use of Qiwei Baizhu Powder and Chaihu Shugan Powder Addition and Subtraction can more effectively alleviate the clinical symptoms of patients and improve the overall efficacy,and for patients with anxiety and depression,this formula can better improve their anxiety and depression symptoms;In terms of long-term efficacy,this side has a lower recurrence rate;No safety issues were identified during the study.In summary,the use of Qiwei Baizhu Powder and Chaihu Shugan Powder Plus and Subtraction for the treatment of IBS-D with liver depression and spleen deficiency has clinical guidance value and is worth learning and promoting. |
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