Observation The Effect Of Trimebutin Maleate Combined With Addition And Subtraction Of Shengyang Yiwei Decoction Treatment For Irritable Bowel Syndrome

[Objective]Observe the clinical effeciacy of the conbination of Trimebutine Maleate and addition and subtraction of Shengyang Yiwei decoction on irritable bowel syndrome with diarrhea (IBS-D) and explore the mechanism of Rise Yangyi bowel soup from both theoretic and clinical aspects.[Motheds]1. Select92patients with irritable bowel syndrome with diarrhea (IBS-D) from Digestive synstem department in HuBei Province Hospital of trandinational Chinese medicine during1year and half from2010-3to2011-9. According to the sequential of out or in hospital, they have been devided into2groups by using the table of random numbers:48in treatment group and44in control group,all cases have been confirmde no obvious abnormal by colonoscopy, more than3times negative results by stool routine test and cultivate examination, normal blood routine test, urine routine test and erythrocyte sedimentation rate results, corresponding with the Rome Ⅲ criteria. And there is no significant difference between two groups on sex, age, the duration of mortality (P>0.05), of no statistics significance.2. Management:The control group was supplied with Trimebutine Maleate(brand name:Trimebutine Maleate Dispersible Tablets) before the meal,200mg thice daily orally; the treatment group was added addition and subtraction of Shengyang Yiwei decoction on the foundation of the control group, the basic prescription are:Astragalus20g, bupleurul15g,dangshen15g, radices sileris10g, white paeony root10g, dried tangerine or orange peel10g, Poria cocos15g, white atractylodes rhizome15g, Coptis chinensis6g, corydalis tuber10g, fructus evodiae10g, myrobalan lOg, elecampane lOg, Radix Glycyrrhizae Preparata6g.a dose Shuijianbi day1, morning and evening hours service.The total therapeutic duration for both groups is4weeks,during this period,both groups withdrawal other drugs, the supplied diets are rich in proteins and vitamine, and of low fat. At the same time, avoid to consume cold spicy and stimulative fatty food. Observe the clinical effieciacy, and focus on the general condition, physical examination, blood routine, urine routine, stool routine, hepatic function and renal function,as well as the possible adverse event.3.Statistics analysis:All data was analyzed by SPSS16. OSignif icant difference was determined when P value was less than0.05(two-tailed). For enumeration data, the Chi-Square test was performed; Measurement data,the t-test; ranked data, Ridit analyse.[Result]1. the treatment group:10patients have reached clinical control,14patients appearant effect,17patients availability,7 patients nullity, the total effective rate reaches to85.42%; the control group:5patients have reached clinical control,11patients appearant effect,13patients availability,15patients nullity, the total effective rate is only65.90%, the two groups have significant difference (P<0.05), the treatment group is much better than the control group.2. The two groups have significant difference on the total score after treatment (P<0.01), the treatment group has a significant elevation on the total score, the comparation has statistical significance.3. The improvement on symptomes such as abdominal pain, diarrhea, abdominal bloating, the urgent defecacy, depression, the two groups have stctistics significance, the treatment group has remarkable effecacy.4. The treatment group are much better than the control group in the decrease in the rate of recurrence and the improvement in the quality of life,the comparability is of significant statistical difference.(P<0.05)[Conclusion]The present study indicated that in IBS patients, the efficacy of A add-on B combination therapy is better than B mono-therapy in terms of amelioration of clinical symptoms, improving of effective rate and decreasing of relapse rate.The mechanism of its effectiveness may not be sole. The prescription is conformed with Chinese medicine theory well, it can regulating mood and enhanced bowel function, however, it is combined Tonic with Diarrhea,also adjustment cool with hot pi Decoction rigorous, full-square principle of liver qi stagnation The potential effect may be as follows:1. regulate the movement of the gastrointestinal tract, by easing the muscular spasm;2. Anti-inflammatory effect, by protection of gastric mucosa and enhancing the defense fuction of the mucosa;3. Sedative effect, by relieving the mental pressure of the patients;4. Modulate the immune system of the patients, thus enhance the physical fitness.In general, Addition And Subtract ion of Shengyang Yi we i decoction and Trimebutine Maleate combination therapy had significant effect on IBS, deserving further study and promotion.