The Clinical Efficacy Of Gegen Qinlian Modified Prescription On IBS-D Of Damp-heat Syndrome And Effect On Intestinal Flora

ObjectiveThis research aims to observe the clinical effect of Gegen Qinlian modified Prescription on diarrhea Predominant irritable bowel syndrome(IBS)of damp heat syndrome,and analyze its effect on intestinal flora by metagenomics method,so as to explain the mechanism of Qingre Lishi formula.Methods1.In this study,Patients with IBS-D of damp-heat syndrome were randomly divided into treatment group and control group.The treatment group was treated with Gegen Qinlian modified Prescription,and the control group was treated with Bifidobacterium triple viable capsules for 4 weeks.The therapeutic effects were observed before treatment,2 weeks after treatment and 4 weeks after treatment.The indexes included IBS-SSS,IBS-QOL and TCM symptom score.2.The fecal samples of 10 healthy volunteers and IBS-D Patients with damp heat syndrome before and after treatment were collected.The structure and diversity of intestinal flora were analyzed by metagenomics technology.The difference of intestinal flora between healthy volunteers and IBS-D Patients with damp heat syndrome was compared;the structure of intestinal flora before and after treatment was observed,and the effect of Gegen Qinlian modified formula on intestinal flora was analyzed.ResultsA total of 24 Patients were enrolled in this study,2 cases were dropped,and 22 Patients were finally enrolled,11 cases in the treatment group and 11 cases in the control group.There was no significant difference between the two groups in demographic baseline data such as gender,age or course of disease,or in curative baseline data such as severity of disease,TCM symptom score and quality of life score.1.The IBS-SSS total score of the two groups after treatment was significantly lower than that before treatment(P<0.05),indicating that the condition of the two groups were improved after treatment.After treatment,the difference was statistically significant(P<0.05),indicating that the treatment group was better than the control group in improving the severity of the disease.2.In terms of TCM symptom improvement,after treatment,the total symptom scores of the two groups were significantly lower than those before treatment(P<0.05),indicating that the two groups can significantly improve TCM symptoms.There was no significant difference between the two groups after 2 weeks of treatment(P>0.05);after 4 weeks of treatment,the total score of symptoms in the treatment group was significantly lower than that in the control group(P<0.05),indicating that the effect of relieving TCM symptoms in the treatment group was better than that in the control group.The results of single TCM symptom scores showed that after 2 weeks of treatment,the differences were statistically significant(P<0.05),except for dry mouth and hot liver hilum(P<0.05);after 4 weeks of treatment,the TCM symptom scores were lower than before treatment,the difference was statistically significant(P<0.05),indicating that after full course of treatment,the TCM symptoms in the treatment group could be significantly improved.After treatment,the TCM symPtom scores of the control group were significantly reduced(P<0.05),except for bitter mouth.After treatment,the improvement of halitosis and Portal burning heat in the treatment group was significantly better than that in the control group(P<0.05),indicating that the effect of the treatment group as the classic Prescription of clearing heat and removing dampness on improving damp heat syndrome was better than that in the control group,and the effect of other symptoms was similar.3.In terms of clinical efficacy,after treatment,the total effective rate of the treatment group was 100%,and the total effective rate of the control group was 90.90%,the treatment group was higher than the control group,the difference was statistically significant(P<0.05),indicating that the treatment group was better than the control group.4.In terms of improvement of quality of life,after treatment,the total IBS-QOL scores of the two groups decreased compared with those before treatment,and the difference was statistically significant(P<0.05),indicating that the two groups can significantly improve the quality of life after treatment,but the improvement degree between the two groups was roughly the same,and the difference was not statistically significant(P>0.05).5.Intestinal microflora:①the distribution of intestinal microflora in healthy group was significantly different from that in damp heat group,and the diversity of intestinal microflora in healthy group was higher than that in damp heat syndrome ibs-d.At the Phylum level,Bacteroides,Firmicutes and Proteus were the main Phylum in the two groups.However,compared with the healthy group,the abundance of Firmicutes and Proteus decreased and Bacteroides increased in the damp heat syndrome group.At the genus level,Bacteroides and Prevotella were the dominant bacteria in the two groups.Before treatment,the abundance of Bacteroides and Parabacilli was relatively increased,while the abundance of Prevotella and Escherichia Proteus was relatively decreased.②Compared with the control group,the species and diversity of intestinal flora in the two groups increased after treatment.At the Phylum level,the abundance of Proteus decreased and actinomycetes increased in the treatment group,while the Proportion of Proteus decreased in the control group.At the genus level,the abundance of Bacteroides and Prevotella in the treatment group decreased,while that of Prevotella increased.In the control group,the abundance of Prevotella and broughteria increased,while the abundance of Bacteroides,megamonas and Parabacilli decreased.③Analyzed by KEGG database and LEfSe method,Preliminary results showed that both the healthy group and the damp-heat syndrome IBS-D have characteristic metabolic Pathways.Conclusion1.Gegen Qinlian modified prescription and Bifidobacterium triple viable capsule have curative effect on diarrhea Predominant irritable bowel syndrome of damp heat syndrome,and Gegen Qinlian modified formula can improve damp heat related symptoms more effectively than Probiotics.2.Compared with healthy People,the abundance and species diversity of intestinal flora in IBS-D Patients with damp heat syndrome are decreased,and the difference of flora structure may lead to the occurrence of diseases.3.Gegen Qinlian Jiawei Prescription may Play a role by improving the structure of intestinal flora and increasing the abundance and diversity of flora.