Clinical Observation On Treatment Of Diarrhea-Predominant Irritable Bowel Syndrome (Spleen And Stomach Weakness Type) With Modified Yigong Decoction

ObjectiveTo observe the clinical efficacy of modified YiGong Decoction in the treatment of diarrhea-predominant irritable bowel syndrome(D-IBS)(spleen and stomach weakness type),and to analyze its safety,clinical efficacy and long term recurrence rate,so as to provide clinical basis for the treatment of D-IBS with traditional Chinese medicine.MethodsFrom July 2016 to September 2018,70 patients with D-IBS(spleen-stomach weakness type)were divided into observation group(35 cases)and control group(35 cases)according to the method of random digital table.By the end of the experimental observation,a total of 8 cases had fallen off.Finally,30 cases of observation group and 32 cases of control group were completed.The observation group was given modified Yi Gong Decoction,the basic formula and dosage:Jiao Sanxian(Jiaoshan Hawthorn,fried Shenqu,fried malt)10g,Taizishen 20 g,Licorice 6g,Poria cocos 10 g,Bergamot 6g,tangerine peel 6g,fried Baizhu 10 g,Fangfeng 10 g.Method:Take one decoction a day,200 ml each time,drink it half an hour later after breakfast and dinner.The control group was given the classical gastrointestinal spasmolytic agent Pinaverium Bromide Tablets(Dicetel)50mg orally,three times a day.The course of treatment was 8 weeks,followed up for 6 months.Statistical analysis was used to compare the two groups of patients(observation group modified Yi Gong Decoction,control group Pinaverium Bromide Tablets)before treatment,gender,age,course of disease,disease classification,TCM symptom score,and compare the two groups of patients after treatment,disease classification,disease efficacy,syndrome efficacy,TCM symptom score,adverse events,long-term recurrence rate.Results1.Before treatment,there was no significant difference in general data(gender,age,course of disease)and disease classification between the two groups(P > 0.05),which was comparable.2.After treatment,the effective rate of the two groups was 90%in the observation group and 71.88% in the control group,with statistical difference(P < 0.05);after treatment,the effective rate of the observation group was 93.33% and the effective rate of the control group was 75%,with statistical difference(P<0.05).It is suggested that modified Yi Gong Decoction is superior to Pinaverium Bromide Tablets in improving disease and symptoms in the treatment of D-IBS.3.Before treatment,there was no significant difference in the scores of TCM symptoms between the two groups(P>0.05),which was comparable.After treatment,there was no significant improvement in intestinal ringing and incomplete defecation in the observation group compared with before treatment(P > 0.05);fecal characteristics,frequency of defecation,urgency of defecation,abdominal pain,postprandial abdominal distention,food intake,fatigue,laziness and mood were all improved compared with before treatment(P < 0.05).The control group had no significant improvement in bowel sounding,fecal incompleteness,food intake,fatigue,laziness and mood(P > 0.05);fecal characteristics,defecation frequency,defecation urgency,abdominal pain and postprandial abdominal distension were improved compared with those before treatment(P < 0.05).There was no significant difference in the improvement of bowel sounding and incomplete defecation between the observation group and the control group(P> 0.05).The improvement of fecal characteristics,frequency of defecation,urgency of defecation,abdominal pain,postprandial abdominal distention,food intake,fatigue,laziness and mood in the observation group was better than that in the control group(P<0.05).4.Following up for 6 months,the recurrence rate of observation group was 6.67%,and the recurrence rate of control group was 18.75%.The difference was statistically significant(P < 0.05).The recurrence rate of Pinaverium Bromide Tablets group was higher than the recurrence rate of modified Yi Gong Decoction group.5.During the study,there were no adverse events in the observation group.In the control group,abdominal pain was aggravated in one patient and slight skin rash in the forechest occurred in one patient.After symptomatic treatment,the study continued.ConclusionBoth modified Yi Gong Decoction and Pinaverium Bromide Tablets can improve the clinical symptoms of D-IBS,but modified Yi Gong Decoction is superior to Pinaverium Bromide Tablets in improving defecation urgency,postprandial abdominal distension,food intake,fatigue,laziness and mood.In addition,modified Yi Gong Decoction has no adverse events,high safety and low long-term recurrence rate,which is worthy of clinical application.