Study On The Correlation Between Psychological Status Of Anxiety And Depression And Diarrhea Type Irritable Bowel Syndrome And The Intervention Effect Of TCM Compound Based On Gastrointestinal Dynamics

Objective:Based on the relevant parameters of gastrointestinal dynamics,the correlation between IBS-D and the state of anxiety and depression was analyzed,and the efficacy evaluation of the herbal compound JiaWeiLiChang-yin was conducted,so as to further explore the dynamic mechanism of the treatment of IBS-D by JiaWeiLiChang-yin,so as to provide theoretical basis for the diagnosis and treatment of this disease by TCM.Methods:Firstly,selecting between January 2017 and December 2018 in affiliated hospital of shandong university of TCM during the spleen and stomach disease outpatient clinic and hospital visits into the standard 219 IBS-D patients as the research object,and sign the informed consent form,through self-evaluation of Zung’s anxiety scale(SAS)and depression self rating scale(SDS)statistical IBS-D with the onset of anxiety depression,this study data adopt SPSS 24.0 software for statistical analysis.In 47 patients with only with anxiety,44 cases of patients with depression with only,97 cases of patients with anxiety and depression,31 cases of patients with anxiety depression with randomly selected from the IBS-D with anxiety group(20 cases),IBS-D with depression group(18 cases),IBS-D with anxiety depression group(20 cases),IBS-D without anxiety depression group(20 cases),the other in 20 cases of health physical examination for the normal control group,five patients signed the informed consent.Anal sphincter rest pressure(ARP),rectal rest pressure(RRP),initial rectal sensation threshold and maximum rectal tolerance threshold of the five groups were measured by anorectal pressure measurement technology,to explore the correlation between gastrointestinal dynamic parameters and anxiety and depression status of IBS-D patients.Then 60 of 108 patients with liver depression and spleen deficiency were randomly selected,according to the principle of randomized,and the average divided into TCM group and Dicetel group,30 cases in each group,TCM group give to JiaWeiLiChang-Yin treatment,Dicetel group give to Pinaverium bromide tablets treatment,each group of treatment for 4 weeks,observed and recorded in the two groups before and after treatment in patients with anorectal pressure indicators of change,at the same time to compare the two groups of patients with symptoms of TCM curative effect,observe the comparison before and after treatment of TCM symptoms integral,major and minor symptoms always score,anxiety,depression score,observe and record adverse reactions to effective cases followed up for 6 months,observe two groups of the recurrence rate.Resulis:1.According to the statistics in this study,among the included patients,97 cases(44.3%)were more than 47 cases(21.5%)with anxiety,44 cases(20.1%)with depression and 31 cases(14.1%)without anxiety and depression(P<0.05).ARP and RRP test results showed that:IBS-D without anxiety depression group,IBS-D with anxiety and IBS-D with depression group,the IBS-D with depression and anxiety group,all four groups of pressure value to different degrees higher than normal control group(P<0.05 or P<0.01),IBS-D without anxiety depression group pressure value is lower than the other three groups(P<0.05),with IBS-D anxiety group of ARP above IBS-D with depression group and IBS-D with depression and anxiety group(P<0.05),with IBS-D depression group of ARP,below IBS-D with anxiety depression group,but no difference(P>0.05),RRP value in IBS-D group with depression was lower than that in IBS-D group with anxiety and depression(P<0.05),and RRP value in IBS-D group with anxiety was higher than that in IBS-D group with anxiety and depression(P>0.05).The measurement results of the initial sensation threshold and the maximum tolerance threshold of the rectum showed that:Four groups of thresholds in patients with different degrees below the normal control group(P<0.05 or P<0.01),with IBS-D threshold above IBS-D with depression and anxiety group,IBS-D with anxiety depression group(P<0.05),IBS-D without anxiety depression group is higher than the IBS-D with anxiety depression anxiety and IBS-D group(P<0.05),with IBS-D depression group rectum initial sensory threshold value is higher than that of IBS-D is not associated with anxiety depression group,but no difference(P>0.05),The rectal maximum tolerance threshold was higher than that of the IBS-D group without anxiety and depression(P<0.05),and the initial rectal sensation threshold of the IBS-D group with anxiety and depression was higher than that of the IBS-D group with anxiety and depression(P<0.05).The rectal maximum tolerance threshold value was higher than that of the IBS-D group with anxiety and depression,but there was no difference(P>0.05).Checked by Pearson correlation,in patients with IBS-D ARP,RRP with anxiety score increases,the initial feel rectum threshold and the maximum tolerance threshold decreases with increasing anxiety score,patients with IBS-D ARP,RRP decreases with increasing depression scores,the initial sensory thresholds and the rectum rectum maximum tolerance threshold of depression score increases.2.TCM group and Dicetel group of patients in the anorectal pressure on every index were improved to different degrees(P<0.01 or P<0.05),on the reducing of ARP,rectal maximum threshold,the TCM group is superior to the Dicetel group(P<0.05),TCM group to improve the initial sensory threshold effect is superior to the rectum Dicetel group,two groups of curative effect on reducing the RRP quite(P>0.05);After treatment,the total effective rate of the two groups was 90%better than that of the Dicetel group(P<0.05).Two groups after treatment of traditional Chinese medicine in patients with primary and secondary symptoms integral aspects have different degrees of improvement(P<0.01 or P<0.05),including the improved abdominal pain to bowel bolts on the gas,and the traditional Chinese medicine between treatment group and Dicetel group(P>0.05),and in improving the defecation frequency,loss of appetite,languid,TCM group is superior to the Dicetel group(P<0.05),TCM group in improving the irritability,depression,insomnia,much dream,obviously superior to Dicetel group(P<0.01);In terms of the total score of TCM symptoms,both groups of patients showed different degrees of improvement after treatment(P<0.01 or P<0.05),and the TCM group was superior to the Dicetel group(P<0.05).The anxiety and depression status of the two patients were improved after treatment(P<0.05),and the TCM group was superior to the Dicetel group(P<0.05).There were no adverse reactions in the two groups.Long-term efficacy was observed by recurrence rate,11%in TCM group was lower than 48%in Dicetel group(P<0.05).Conclusion:1 IBS-D patients with different degrees of anxiety depression,of which at the same time with anxiety depression patients,patients with IBS-D exist the anorectal dynamics index anomalies,no correlation between anxiety and depression,the degree of abnormality of anxiety in the patients with IBS-D score was positively correlated with ARP,RRP,initial sensory thresholds and rectum and negatively correlated with maximum threshold,depression score and negatively correlated with ARP,RRP,with initial sensory thresholds and the rectum rectum maximum tolerance thresholds were positively correlated.2.TCM compound Jia WeiLiChang-Yin not only can improve clinical symptoms and the state of anxiety and depression,and in improving patients with anal rectum feel abnormal power has significant curative effect,The patients’ ARP and RRP were down-regulated,and their initial rectal sensory threshold and maximum rectal tolerance threshold were up-regulated,improve the cure rate,in recidivation has obvious advantages,the clinical curative effect,and the formulas is safe and effective in the treatment of IBS-D prescription,speculated that the mechanism may be related to improving intestinal dynamics,reduce internal sensitivity,regulating brain-gut interaction process and other related links.