Clinical Study On Treatment Of Diarrhea-predominant Irritable Bowel Syndrome(Syndrome Of Yang Deficiency Of Spleen And Kidney) With Wentong Zhixie Prescription

Objective:In this study,we compared the efficacy of Wentong Zhixie decoction with Sishen pill in treating diarrhea-predominant irritable bowel syndrome(IBS-D)patients with deficiency of spleen and Kidney Yang,the aim is to evaluate the safety and efficacy of Wentong Zhixie decoction in treating IBS-D,and to explore its mechanism,so as to guide clinical practice.Methods:98 cases of IBS-D(Spleen and Kidney Yang Deficiency Syndrome)were randomly divided into test group and Control Group.The Test Group was treated with Wentong Zhixie decoction,the control group was treated with Sishen Pill,both for 4weeks.The total score of TCM syndromes,symptom severity scale of irritable Bowel Syndrome(IBS-SSS),individual symptom scores and quality of life scale of irritable Bowel Syndrome(IBS-QOL)were recorded before and after treatment,the efficacy was evaluated before and after 4 weeks of treatment,the recurrence was followed up 4 weeks after discontinuation,and the safety was evaluated weekly.Results:(1)The trial included 98 patients,but the test group lost 6 patients and that control group were four,so 88 cases were observed in end.(2)Baseline comparison: There was no significant difference between the two groups in sex,age,course of disease and disease grade before treatment(p > 0.05).(3)TCM syndromes efficacy evaluation:The total effective rate of Wentong Zhixie decoction group was 90.70%,and that of Sishen pill group was 71.11%,there was a significant difference between the two groups(P<0.05),the TCM syndromes efficacy of Wentong Zhixie decoction group was better than that of Sishen pill group..(4)Evaluation of curative effect of TCM Syndrome total scores: Before treatment,there was no significant difference between the two groups(p > 0.05),but after treatment,there was significant difference(p < 0.05),the test group was significantly lower than the control group,and Wentong Zhixie decoction has obvious effect on improving the total score of TCM Syndrome.(5)IBS-SSS efficacy evaluation: Before treatment,there was no significant difference between the two groups(p > 0.05),but after treatment,there was significant difference(p< 0.05),the test group was better than the control group,and Wentong Zhixie decoction can obviously reduce the score of IBS-SSS.(6)IBS-QOL efficacy evaluation: Before treatment,there was no significant difference in the eight dimensions between the two groups(p > 0.05).After treatment,restlessness,conflict behavior,body role,health anxiety,social reaction and family relationship were all significantly higher than those of the control group(p < 0.05).However,there was no significant difference in dietary restriction and heterosexual concept dimension(p > 0.05)(7)Single symptom efficacy evaluation:After 4 weeks of treatment,there were significant differences between the two groups in the curative effects of single symptom,such as cold pain;abdominal distension;frequent defecation;loose stools;morning abdominal pain to diarrhea,diarrhea pain ease;cold body and cold limbs;weak waist and knees;lack of diet;tiredness and fatigue(P<0.05),the group of Wentong Zhixie decoction was better than the group of Sishen pill;but there was no significant difference between the two groups in the curative effect of intestinal vaginosis(P>0.05).(8)Comparison of recurrence rate after 4 weeks of discontinuation:the recurrence rate of the test group was 14.71%,the control group was 39.29%,and the difference was significant(P<0.05).(9)Safety evaluation: The safety index of the two groups were normal,and no significant side effect occurred,and the higher safety,can be used in clinical.Conclusion:Both Wentong Zhixie decoction and Sishen pill can effectively improve the symptoms of IBS-D(spleen and Kidney Yang Deficiency Syndrome)patients,and the overall effect of Wentong Zhixie decoction group is better than that of Sishen pill group,it can obviously relieve the symptoms of cold pain;abdominal distension;frequent defecation;loose stools;morning abdominal pain to diarrhea,diarrhea pain ease;cold body and cold limbs;weak waist and knees;lack of diet;tiredness and fatigue.However,there is no statistically significant difference in relieving the symptom of intestinal vaginosis.It can also effectively reduce the score of IBS-SSS and improve the quality of life of patients.The recurrence rate is lower than control group,and also does not have the serious side effect,may instruct the treatment in the clinical.