The Clinical Observation On The Influences Of Psychological Factors Of Inhibiting Liver And Strengthening Spleen For Treatment Of Irritable Bowel Syndrome With Diarrhea (IBS-D)

BackgroundIrritable bowel syndrome is commonly regarded as a functional intestinal disorder. In TCM theory, stagnation of liver qi and deficiency of spleen and stomach is its basic pathogenesis, harmonizing liver and spleen is the most commonly used method of treatment. Also, irritable bowel syndrome is significantly associated with emotional factors, liver controlling conveyance and dispersion plays an important role in emotion regulation, so correcting unhealthy psychological status may be the mechanism for Irritable bowel syndrome treated by the therapy of inhibiting liver and strengthening spleen.Object iveObserve and explore the relationships between the curative effects and the influences of psychological factors of inhibiting liver and strengthening spleen and invigorating spleen for el iminating dampness by a randomized study.Methods49patients with IBS-D were randomly divided into experimental group (n=30) and controlled group (n=19). The experimental group took modified Tongxie Yaofang accompanied with Frzhu Jian (drug composition:Baizhu, Cangzhu, Shaoyao, Chenpi, Zhigancao, Filling, lloupu, Ganjiang, Muxiang, Zhexie, Fangfeng, dialectical deductions), day1agent. The controlled group took Shenling Baizhu San (drug composition:Fuling, Dangshen, Zhigancao, Baizhu, Shanyao, Lianzi, Yiyiron, Jiegeng, Sharon. Baibiandou, dialectical deductions), day1agent. Treated for I month respectively. The symptoms of the patients were seared, as well as their depressiveness and anxiety by means of the irritable bowel severity system (IBS-SSS), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) before the therapy, at the end of the therapy respectively. Compare the curative effects of the two groups before and after the treatment.All data was entered and analyzed by SPSS18.0software packages.Results1. The psychological status of patients with IBS-DThe scores of SAS and SDS of patients with IBS-D were higher than the Chinese norm. Moreover, the scores of SAS and SDS of women were higher than men. The difference were statistically significant (P<0.05)The scores of SAS and SDS were higher in the patients with more severe IBS symptoms, the depressive and anxious emotions of patients with IBS-D may associate with the severity of IBS.2. The curative effectsThe score of IBS-SSS was significantly decreased at the end of the therapy in each group (P<0.05). In experimental group, the number of recovery cases was4, markedly was1, effective was17, and the effective rate was73.33%. In controlled group, the number of recovery cases was1, markedly was2, effective was12, and the effective rate was78.95%. No statistical significances were noted in the effective rate between two groups (P>0.05)3. The influences of psychological factors in two groupsThe scores of SAS and SDS were significantly decreased at the end of the therapy in two groups (P<0.05), and no statistical significances were noted in the scores of SAS and SDS between two groups before and at the end of the therapy (P>0.05). These two treatments had positive effects on improving the depressive and anxious emotions of patients both; The treatment of inhibiting liver doesn’t show special effects on improving psychological status.The scores of SAS and SDS were significantly decreased at the end of the therapy in the effective cases (P<0.05), but not in the ineffective cases. The improvement of the psychological status may associate with the curative effects, but the causality was not certain.Considering the grouping of this research and the curative effects, the similar result was found, except the differences of SDS were not significant at the end of the therapy in the effective cases of the controlled group (P=0.09)ConclusionThe curative effects were similar in experimental group and controlled group.The depressive and anxious emotions were improved at the end of the therapy in each group, but the therapy of inhibiting liver doesn’t show better effects on improving the psychological status. The results indicate that the therapy of inhibiting liver and strengthening spleen may correct unhealthy psychological status by improving the patients’symptoms; Or based on the theory "Treat Spleen to Settle Five Organs" in Traditional Chinese Medicine, the effects on improving psychological status by the treatment of invigorating spleen are similar to the treatment of dispersing stagnated liver qi.