Professor Yao Naili's Experience In Treating Diarrhea-type Irritable Bowel Syndrome And Clinical Observation Of Jianpi Hegan Decoction

Aim:Study and summarize Professor Yao Naili’s academic thoughts and clinical experience in the diagnosis and treatment of diarrhea-predominant irritable bowel syndrome,i.e.,IBS-D.At the same time,evaluate the efficacy and safety of Jianpi Hegan Decoction as the basic formula with modified in the treatment of IBS-D patients with liver depression and spleen deficiency.Explore the advantages of traditional Chinese medicine in the treatment of IBS-D in order to improve the clinical efficacy.Methods:Collected the clinical records of Professor Yao Naili in treating IBS-D,and summarized the clinical experiences of Professor Yao Naili in treating IBS-D through clinical study and personal guidance given by Professor Yao Naili.Using the prospective self-control research method,60 patients with IBS-D of liver depression and spleen deficiency treated in the outpatient department of Professor Yao Naili,spleen and stomach department,Guang’anmen Hospital,Chinese Academy of traditional Chinese medicine from March 1,2019 to December 31,2019,were selected as the research object.The patients in the group were treated with Jianpi Hegan as the basic formula with modified,once adjustment every two weeks,lasting for four weeks.TCM syndrome scores were recorded before treatment,4 weeks in the treatment and 1 month following up the treatment.Quality scores of life and safety indicators were recorded before treatment,4 weeks in the treatment.SPSS 24.0 software was used for data statistics and analysis to evaluate the efficacy.Results:The experience of Professor Yao Naili in the treatment of IBS-D was summarized for the first time.In terms of etiology,Professor Yao Naili believes that the external causes lies in the invasion of external pathogens,and the internal causes lies in the weakness of the spleen and stomach,improper diet,emotional disorder,and excessive exertion;in terms of pathogenesis,he considers "weakness of spleen and stomach,disharmony of liver and spleen,accumulation of dampness and turbidity,and improper conduction" as the basic pathogenesis of IBS-D.In the diagnosis and treatment,he emphasizes to strengthen the spleen and stomach to consolidate the essence,harmonize the liver and spleen,regulate the qi mechanism and take into account the diet and emotional factors,establishing the basic treatment principle of "Tonify the spleen,regulate the air and liver".Professor Yao Naili stresses that clinical diagnosis and treatment should grasp the basic pathogenesis of the disease,combine the disease and syndrome,and treat overall,the prescription should be precise and professional,taking into consideration of multiple syndromes and be flexible as well.In this clinical study,cases of IBS-D patients were treated with Jianpi Hegan decoction with modified.Among them,4 patients fell off due to failure to take medicine as required or follow-up loss.A total of 56 patients completed this clinical observation.There were 35 males and 21 females,and the ratio of male to female was 5:3.The age distribution ranged from 30 to 39 years,with 20 cases(35.71%),followed by 13 cases(23.22%)from 18 to 29 years,and 9 cases(16.07%)from 40 to 49 years.The disease duration ranged from 1 to 5 years,with 35 cases(62.5%),followed by 6 to 10 years,with 11 cases(19.64%),and 8 cases(14.28%).After 4 weeks of treatment,according to the total score curative effect index of TCM syndromes before and after treatment,37 cases were evaluated with significant effect(66.07%),14 cases with effective effect(25.00%),5 cases with ineffective effect(8.93%),totally 51 cases were evaluated with effective effect,so the total effective rate was 91.07%.After treatment,the total score and individual score of TCM syndrome decreased,and the difference was statistically significant(P<0.01),indicating that Jianpi Hegan decoction could significantly improve the overall symptoms and signs of IBS-D patients.IBS-QOL scale was used to evaluate the life quality of the patients.The scores of all dimensions after treatment were significantly reduced,and the difference was statistically significant(P<0.01),indicating that Jianpi Hegan decoction could significantly improve the life quality of the patients.After 4 weeks of treatment,the patients were followed up for 1 month after drug withdrawal.1 case had serious relapse(1.79%),2 cases had general relapse(3.57%),2 cases had mild relapse(3.57%),51 cases had no relapse(91.07%).There were 5 cases of relapse,the total relapse rate was 8.93%.All the patients involved in this study had no adverse reactions and no abnormal safety indicators before and after treatment.Conclusion:Professor Yao Naili has his unique research and opinion on the name of disease,etiology,pathogenesis,and treatment of IBS-D.The treatment of IBS-D patients with liver depression and spleen deficiency by Jianpi Hegan decoction is effective,safe and worthy of clinical application and promotion.