Clinical Observation Of Chaihu Guizhi Ganjiang Decoction In The Treatment Of IBS-D Patients With Liver Depression And Spleen Deficiency And Its Effect On Plasma GLP-1

Objective:To observe the clinical efficacy of Chaihu Guizhi Ganjiang Decoction in the treatment of irritable bowel syndrome(IBS-D)of liver depression and spleen deficiency type,and to evaluate the clinical efficacy and possible targets of Chaihu Guizhi Ganjiang Decoction in the treatment of diarrhea type IBS by comparing the efficacy,symptom score,plasma GLP-1content,mental status and other related indicators.Methods: Methods 60 patients with IBS-D were randomly divided into treatment group and control group.Among them,in the process of treatment,1patient in the treatment group fell off,2 patients in the control group fell off,29 patients in the treatment group and 28 patients in the control group.The treatment group was treated with Chaihu Guizhi Ganjiang decoction,and the control group was treated with pinaverium bromide tablets.The treatment cycle was 4 weeks.The clinical efficacy,TCM symptom score,IBS-SSS score,anxiety and Depression Scale(SAS,SDS),plasma GLP-1 content,recurrence rate and safety of the two groups before and after treatment were observed and compared,and the clinical efficacy and possible targets of Chaihu Guizhi Ganjiang Decoction in the treatment of liver depression and spleen deficiency type IBS-D were evaluated.Results:(1)overall efficacy comparison: the total effective rate of the treatment group was 89.70%,and that of the control group was 71.40%,and the treatment group was better(P<0.05).(2)TCMsymptom total score: before treatment,there was no significant difference in TCM symptom total score between the two groups(P>0.05).After treatment,the total symptom scores of the two groups were significantly lower than those before treatment(P<0.01).After treatment,the total symptom score of the treatment group was lower than that of the control group,the difference was statistically significant(P<0.05).(3)Before treatment,there was no significant difference between the two groups(P > 0.05).TCM single symptom score comparison:after treatment,the symptom scores of the treatment group were improved compared with those before treatment(P<0.05),the control group was improved in the main symptoms of abdominal pain,diarrhea and secondary abdominal distension compared with those before treatment(P<0.05),but there was no significant effect on the secondary symptoms of irritability,loss of appetite and mental fatigue(P>0.05);after treatment,the comparison between the two groups showed that in the main symptoms of abdominal pain,diarrhea and secondary symptoms of abdominal distension There was no significant difference in abdominal pain,diarrhea and secondary abdominal distension between the two groups(P>0.05),but the treatment group was better than the control group in the treatment of secondary irritability,loss of appetite and mental fatigue(P< 0.05).(4)IBS-SSS score comparison: there was no significant difference between the two groups before treatment(P>0.05).After treatment,the IBS-SSS score of the two groups decreased(P<0.05),and the IBS-SSS score of the treatment group was significantly lower than that of the control group(P<0.01).(5)Mental state comparison:before treatment,there was no significant difference in SAS and SDS scores of anxiety between the two groups(P>0.05).After treatment,SAS and SDS scores of anxiety and depression in the two groups were significantly lower than before(P<0.01),and the curative effect of the treatment group was significantly better than that of the control group(P<0.01).(6)Comparison of plasma GLP-1 content:before treatment,there was no significant difference in plasma GLP-1 content between the two groups(P>0.05).After treatment,the level of plasma GLP-1 in the control group was higher than before(P<0.05),and the level of plasma GLP-1 in the treatment group was significantly higher than before(P<0.01);after treatment,the level of plasma GLP-1 in the treatment group was higher than that in the control group(P<0.05).(7)Comparison of recurrence rate: after treatment,follow-up survey was conducted according to the requirements.In the treatment group,23 patients were effectively followed up,of which 2 cases recurred,the recurrence rate was 8.7%;in the control group,21 patients were effectively followed up,of which 9 cases recurred,the recurrence rate was 42.9%,the recurrence rate of the treatment group was lower than that of the control group.(P<0.05)(8)Safety:all patients had no adverse drug reactions during the treatment time and follow-up.Conclusion:Chaihu Guizhi Ganjiang decoction can improve the clinical symptoms,anxiety and depression of IBS-D patients,reduce the recurrence rate and increase the level of GLP-1 in patients.The curative effect of Chaihu Guizhi Gan Jiang Tang is better than tramest maleate capsule in the above aspects.