| Objective:To observe the clinical efficacy of pingwei capsule in the treatment of liver depression and spleen deficiency type ibs-d,and to provide a more scientific and sufficient clinical basis for the wide application of this prescription.16 S rDNA technology was used to compare the changes of intestinal flora structure IBS-D patients before and after medication,providing a basis for studying the mechanism of action between intestinal flora structure and TCM compound.Methods:70 patients with IBS-D who met the inclusion and exclusion criteria were randomly divided into the treatment group and the control group with 35 cases each.The control group was given bifidobacterium tetraphyllum tablets,and the treatment group was given pingwei capsules(4 capsules/time,3 times/day)for a course of 4 weeks.After one course of treatment,the clinical symptoms of traditional Chinese medicine,IBS-SSS scale,IBS-QOL scale,HAMA and hamd-17 scale were used as the efficacy evaluation indicators,and the clinical efficacy was evaluated by comparing the changes of the above scores of patients in the two groups before and after medication;Patients with qualified IBS-D were selected according to SOP,and 16 S rDNA technology and bioinformatics analysis were used to compare the changes of gut microbiota diversity,? diversity and bacterial structure of patients before and after treatment.Results: 70 cases were enrolled in the study in total,3 dropped out and were treated as shed cases.Therefore,a total of 67 cases(32 cases in the control group)were actually included in the statistical treatment.The specific results were as follows:1 There was no significant difference between the two groups in gender,age distribution and disease course before administration(P>0.05),which was comparable.2 Clinical efficacy evaluation2.1 The change of TCM Clinical syndromes:the total effective rate of the control group was 71.9%,and the total effective rate of the treatment group was90.9%.In the TCM Clinical syndromes improvement,the treatment group was significantly better than the control group(P<0.05),and the recurrence rate of the treatment group was lower than that in the control group,the difference between two groups was statistically significant(P<0.05).2.2 Comparison of TCM symptom scores: the total scores of TCM syndromes of the two groups before and after treatment were compared,and the difference was statistically significant(P<0.05);The scores of TCM syndromes in the treatment group were all decreased compared with that before treatment,while there was no significant difference between the two groups before and after treatment in terms of fatigue,and the difference of the rest before and after treatment was statistically significant(P<0.05).After treatment,there was no explicit difference between the two groups except for intestinal sagittal gas,and the others had statistically significant in the treatment(P<0.05).2.3 Comparison of ibs-sss scores: the IBS-SSS scores of the two groups before and after treatment were compared,and the difference was statistically significant(P<0.05),and the treatment group was superior to the control group,and the difference was statistically significant(P<0.05).2.4 Comparison of multi-dimensional scores in IBS-QOL scale: after treatment,there was no significant difference in two aspects of gender concept and family relationship,and the difference was not statistically significant(P>0.05).The other six dimension treatment groups were significantly better than the control group,and the difference was statistically significant(P<0.05).2.5 HAMA and hamd-17 scores: before treatment,there was no significant difference between the two groups in HAMA and hamd-17 scores,with no statistical significance(P>0.05).After treatment,the levels of HAMA and HAME-17 scores in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).3 Changes of intestinal flora: After treatment,the fecal flora richness of the two groups increased,and the species richness of the treatment group was higher than that of the control group.At the phylum level,the number of Bacteroides andactinomycetes increased and decreased in the treatment group.At the family level,the number of bacteroides,verrucosae and Prevotellaceae increased in the two groups after treatment,while the number of Streptococcus and Xanthomonas decreased significantly in the treatment group,and the number of Lactobacillus increased in the treatment group.At the generic level,the number of bacteroides,Lactobacillus and Enterococcus increased in the treatment group compared with before treatment.Conclusion:1.Pingwei capsule can significantly improve the clinical symptoms of patients with liver depression and spleen deficiency type ibs-d,has the effect of regulating emotional disorders and improving the quality of life of patients,with definite efficacy,low recurrence rate and no obvious adverse reactions.2.Pingwei capsule can regulate the structure of IBS-D intestinal flora. |
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