Clinical Observation On Treatment Of Diarrhea-predominant Irritable Bowel Syndrome By Jieyu Xingpi Decoction

ObjectiveTo observe the clinical curative effect of Jieyu Xingpi Decoction in the treatment of diarrhea-predominant irritable bowel syndrome(liver stagnation and spleen deficiency type),the improvement of anxiety and depression status of patients,the improvement of the quality of life situation,the recurrence rate and security,and to explore its possible mechanism of action,for the treatment of diarrhea-predominant irritable bowel syndrome(liver stagnation and spleen deficiency type)to provide ideas and methods,to better serve the clinic.Methods60 patients from March 2017 to September 2018 in Wuhan City Integrated Traditional Chinese and Western medicine hospital outpatient and inpatient,who diagnosed as IBS-D and diagnosed as liver stagnation and spleen deficiency based on TCM syndrome differentiation were selected in this study.They were randomly divided into treatment group and control group.There was no significant difference between the two groups in age,gender,course of disease,TCM symptom score,IBS-SSS score,IBS-QOL score,HAMA score and HAMD score,with comparability(P >0.05).Treatment group:Jieyu Xingpi Decoction was given,1 dose per day,and taken orally30 minutes after breakfast,lunch and dinner,with a dose of about150 ml each time;Control group:bifidobacterium lactobacillus triple live bacteria tablets were given,4 tablets each time,3 times a day,orally.After 8 weeks,the IBS-SSS scale,IBS-QOL scale,HAMA scale and HAMD scale were filled in again and the efficacy was evaluated.The recurrence rate was evaluated after 12 weeks.The patients in the two groups were instructed to eat regularly during the treatment period with light and digestible diet.They were advised to avoid foods high in sugar,fat and fiber,spicy,oily,sour and cold,gas producing and allergic foods.After the course of treatment,IBS-SSS scale,IBS-QOL scale,HAMA scale and HAMD scale were filled out again,and the follow-up time was 1 month later.Results1.Comparison of TCM symptom scores between the two groups:abdominal pain and diarrhea were improved in both groups(P<0.05),and the treatment group was better than the control group(P<0.05);Treatment group can significantly improve irritability,irritability,two side fullness,sodium stay,body fatigue(P>0.05),no significant effect in the control group(P>0.05).2.Comparison of the total effective rate between the two groups:2 cases were cured in the treatment group,8 cases were obviously effective,15 cases were effective,5 cases were ineffective,and the total effective rate was 83.3%;The total effective rate was 50%.The total effective rate of the two groups before and after treatment was compared(P<0.05),the total effective rate of the treatment group was significantly higher than that of the control group.3.Comparison of IBS-SSS scale score:both groups could improve the score of IBS-SSS scale for treatment(P<0.05),and the treatment group was significantly better than the control group(P<0.05).4.Comparison of IBS-QOL quality of life score:both groups could improve health anxiety and eating avoidance(P<0.05),and the treatment group was superior to the control group(P<0.05).Besides,the treatment group can also improve behavioral disorders and interpersonal relationships(P<0.05).5.Comparison of HAMA scores:anxiety status was significantly improved in the treatment group(P<0.05),no significant effect in the control group(P>0.05).6.Comparison of HAMD score:depression status was significantly improved in the treatment group(P<0.05),no significant effect in the control group(P>0.05).7.Comparison of recurrence rate:among the 25 effective patients in the treatment group,4 patients had recurrence,and the recurrence rate was 16%.Among the 18 effective patients in the control group,13 patients had recurrence,with a recurrence rate of 72.2%(P<0.05),indicating that the recurrence rate in the treatment group was significantly lower than that in the control group.8.Safety comparison:no adverse reactions occurred in the two groups,indicating that the two treatment methods were both relatively safe.ConclusionsJieyu Xingpi Decoction has a clear clinical effect in the treatment of diarrhea-predominant irritable bowel syndrome(liver stagnation and spleen deficiency type),which can improve the anxiety and depression status of patients,improve the quality of life of patients,reduce the recurrence rate,and has high safety.The mechanism of its action may be related to anti-bacterial anti-inflammatory,immune regulation,gastrointestinal motility regulation,improvement of visceral hypersensitivity,brainintestinal axis function regulation,anti-anxiety,anti-depression and so on.