| Background:Irritable bowel syndrome(IBS)is the most common digestive system disease in functional gastrointestinal disorders(FGIDs).The pathogenesis of IBS has not been fully elucidated.There is no thoroughly effective treatment for IBS.Studies have shown that dietary intervention would improve symptoms of IBS;the current guidelines make it clear that high dietary fiber foods may be effective in IBS with constipation(IBS-C),but which is detrimental to abdominal pain and diarrhea.Few studies have reported the relationship between high dietary fiber foods and IBS with diarrhea(IBS-D),which have reported that insoluble fibers can aggravate some of the symptoms of IBS patients.This study used the idea of combining traditional Chinese medicine and western medicine and used "diet section" point of view,observed the improvement of clinical symptoms and the points of TCM syndrome score scale after dietary fiber intervention.Objective:To study TCM syndromes typing of IBS-D under the guidance of traditional Chinese medicine theory and to observe the scores of traditional Chinese medicine syndrome score scale after dietary fiber intervention.To investigate the patient's awareness of dietary fiber,to explore the symptoms and quality of life of IBS-D after dietary fiber intervention.Methods:The patients were randomly divided into intervention group and control group.The two groups of patients were all educated with dietary knowledge.The intervention group also educated with dietary fiber knowledge and then took low fiber diet,the control group followed the general diet rule.Surveying the patients by questionnaires with IBS-SSS,dietary fiber table,hospital anxiety and depression self-rating scale(HAD),irritable bowel syndrome quality of life scale(IBS-QOL),traditional Chinese medicine syndrome score scale.Compared the patients before and after intervention.Results:(1):According to the IBS-SSS score,78.69%of patients were moderate IBS-D,21.31%were severe IBS-D,after intervention,73.77%of IBS-D patients were mild and below.After treatment,the improvement of the total score of IBS-SSS in the intervention group was better than that in the control group.:intervention group(130.66±51.30)VS control group(163.28±55.62).(2):According to IBS-SSS,the overall effective rate was 83.61%.Intervention group(93.75%)VS control group(72.41%).The overall effective rate of intervention group was higher compared with control group.According to the IBS-SSS abdominal distension and abdominal pain score,abdominal pain and abdominal distension of intervention group were significantly improved compared with the control group.(3):91.80%of the patients considered that there was a relationship between food and IBS.food temperature(cold food)accounted for 70.49%,food seasoning(spicy)accounted for 59.02%,milkaccounted for 45.90%,fruits(watermelon and pear)accounted for 27.87%,drinks(coffee and wine)accounted for 24.59%,meat and eggs(shrimp,crab and shellfish)accounted for 23.23%,vegetables(pepper,fungus,bamboo shoots)accounted for 22.95%;Food is one of the important factors that aggravate the symptoms of irritable bowel syndrome.(4):Although 88.52%of patients admitted that dietary fiber is not the more the better,81.97%of patients do not actually know dietary fiber,83.61%of patients do not know the relationship between dietary fiber and IBS-D symptoms.After intervention,81.25%of the patients in the intervention group knew a little dietary fiber food,18.75%of the patients were fully aware of dietary fiber food;90.63%of the patients thought that dietary fiber was associated with IBS-D,78.13%of patients believed that dietary fiber foods aggravated IBS-D symptoms.(5):Among all of patients in group,there were 37.70%IBS-D patients with significant anxiety and/or depression,anxiety combined with depression accounted for 3.28%,anxiety or depression accounted for 34.43%of patients.(6):In the quality of life,IBS-D patients have outstanding performance in the Food avoidance,Dysphoria,Interference with activity,Health worry.Six dimensions' scores were lower after intervention,Food avoidance dimension after treatment have increased.But there was no significant difference between the two groups,indicating that simple dietary fiber intervention had less impact on the quality of life of patients.(7):According to TCM Syndrome typing IBS-D can be divided into 4 types,Spleen deficiency and dampness(27.4%),Liver-depression and Spleen-deficiency Syndrome(27.40%),Syndrome of dampness-heat of spleen and stomach(20.55%),Syndrome of yang deficiency of spleen and kidney(12.33%),The total score of TCM syndromes in both groups was improved,intervention group(5.19 ± 2.96)VS control group(6.41±3.09).There was no significant difference between two groups.Dietary fiber intervention had no obvious effect in the improvement of TCM syndromes. |
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