Clinical Observation On The Treatment Of Diarrhea Type Irritable Bowel Syndrome (Liver Stagnation And Spleen Deficiency Type) With Shuganjianpi Decoction

Objective To observe the clinical efficacy,improvement of TCM symptoms,change of quality of life,change of depression and anxiety,recurrence rate and safety with Shuganjianpi Decoction in treating the diarrhea type irritable bowel syndrome(liver stagnation and spleen deficiency type).To analyze the prescription characteristics of the Shuganjianpi Decoction,and to explore its mechanism,to provide the Chinese medicine basis for the treatment of the liver stagnation and spleen deficiency of the diarrhea type irritable bowel syndrome,and apply it to the clinic better.Method In this study,80 patients were elected from October 2016 to October 2017 in Hubei Provincial Traditional Chinese Medical Hospital of Professor Li Tianwang expert outpatient clinic staff,western medicine diagnosis of all the cases was diarrhea type irritable bowel syndrome and syndrome differentiation of traditional Chinese medicine was liver stagnation and spleen deficiency.According to the random grouping principle,80 patients were randomly divided into treatment group and control group,and the symptoms and signs of the patients were recorded in detail,and the IBS quality of life Scale,Hamilton Anxiety Scale and Hamilton Depression Scale were filled in before treatment.The treatment group was given Shuganjianpi Decoction.The specific prescriptions were:dangshen 10 g,poria cocos 10 g,fried atractylodes 15 g,coix seed 20 g,yam 15 g,pomegranate peel 15 g,bupleurum 10 g,citrus aurantium 10 g,fried white peony 10 g,orange peel 10 g,fangfeng 10 g,cortex albizziae 10 g,main liquorice 10 g.The herbs were decocted to 300 ml of liquids,and take the liquids in two times after the meals,one dose per day.The control group was given Trimebutine Maleate Dispersible Tablets.Taking 0.2g at a time,three times everyday,and half an hour before the meal.The two groups of patients were treated for 8 weeks,and made a return visit by two weeks,the symptoms and signs were recorded.After the end of treatment,the IBS-QOL scale,HAMD scale and HAMA scale were filled again.The follow-up time was one months.Using SPSS22.0 statistical software for data analysis,there was no statistical difference in gender,age,course of disease,TCM symptoms scores,IBS-QOL scores,HAMA scores and HAMD scores before treatment between the two groups(P > 0.05).To analyze the improvement of the clinical symptoms,the change of TCM symptom score,the change of quality of life score,the change of anxiety and depression score,and the recurrence of the two groups,and evaluate the effectiveness of the patients.Before and after the treatment,patients should be checked the electrocardiogram,blood analysis,urine analysis,fecal analysis,liver function,kidney function and other examinations to assess the safety of the treatments.Results 1.The results of the comprehensive curative effect between the two group were as follows.In the treatment group,7 cases were cured,16 cases were markedly effective,10 cases were effective and 5 cases were ineffective,the total effective rate was 86.8%.In the control group,3 cases were cured,12 cases were markedly effective,17 cases were effective and 9 cases were ineffective,the total effective rate was 77.5%.Through the rank sum test,the data showed that the comprehensive curative effect of the treatment group was significantly higher than that of the control group(P<0.05).2.The results of the change of TCM symptom scores between the two group were as follows.The two methods could reduce the scores of the diarrhea,abdominal distention,loss of appetite,and the urgency of defecation(P<0.05),and the the efficacy of treatment group was superior to the control group(P<0.05).Both methods could reduce the scores of abdominal pain(P < 0.05),and the efficacy was comparable(P>0.05).The scores of the irritability and intercostal distention could be significantly reduced in treatment group(P<0.05),but the efficacy of the control group was not obvious(P>0.05).3.The results of the change of IBS-QOL scores between the two group were as follows.The two methods could reduce the scores of health worry,dysphoria and food avoidance(P < 0.05),and the efficacy of treatment group was better than the control group(P>0.05).Both methods could reduce the scores of interference with activity(P < 0.05),and the efficacy was comparable(P>0.05).4.The results of the change of HAMA scores between the two group were as follows.The anxiety state of the treatment group was obviously improved(P<0.05),and the effect of the control group was not obvious(P>0.05).5.The results of the change of HAMD scores between the two group were as follows.The Depressive state of the treatment group was obviously improved(P<0.05),and the effect of the control group was not obvious(P>0.05).6.The recurrence rates between the two group were as follows.In the treatment group,there were 2 cases relapsed in 33 cases,and 7 cases relapsed in the control group of 31 cases.The data showed that the recurrence rate of the treatment group was significantly lower than that of the control group(P<0.05).7.The results of safety between the two group were as follows.There was no adverse reaction between the two groups,indicating that both methods had better safety.Conclusion Shugan Jianpi Decoction has significant clinical effects in treating diarrhea type irritable bowel syndrome(liver stagnation and spleen deficiency type),significantly improving the main symptoms,improving the quality of life,improving the state of depression and anxiety of patients.It is worthy of our clinical application.