Experience And Academic Thought Of Professor Wang Changhong In Treating Diarrhea-Predominant Irritable Bowel Syndrome

The theoretical study of etiopathogenisis and pathogenesis on diarrheapredominant irritable bowel syndrom(D-IBS):This article discuss the etiopathogenisis and pathogenesis of D-IBS from three directions:Traditional Chinese medicine,Western medicine and professor wang-changhong's.Professor Wang considered that D-IBS had the intimate relationship with liver,spleen and kidney and regard that weakness of the spleen and stomach is the foundation of pathopoiesis,hepatosplenic disorder is the key point of pathogenesis,asthenia of both the spleen and kidney is the important pathogenesis evolution.Academic thought of professor wang-changhong in treating D-IBS: Professor wang had accumulated experience of treatment on D-IBS.Invigorate the spleen and coordinating liver,invigorate the spleen and deprive the evil wetness,warming the kidney and firm the foundation and regulating the functions of Liver,Spleen and Kidney at the same time were important means of professor wang treating D-IBS.Professor Wang likes to use the method of regulating the functions of Liver,Spleen and Kidney at the same time best clinically.Professor Wang always following the rule of medication on D-IBS as follows:warming and clearing hot Simultaneously;to deprive the evil wetness,the method of warm should be administered,but should not warm too much;promoting blood flow and dissipate phlegm should be apply if the course last long time,and so on.The clinical study of jianpitiaoganwenshenfangon D-IBS:We verify the efficacy of jianpitiaoganwenshenfang(JTW) on D-IBS with the researching of clinical,and analysis the treatment mechanism of JTWS on D-IBS with observating the influence of JTW on rectal sensitivity.A prospective,randomized controlled trial was conducted.80 patients were divided into 2 groups randomly. Treatment group(n=40) took the JTW,control group(n=40) took pinaverium bromide tablet.The therapeutic course for both groups was 4 weeks.Items should be observed or detected as follows:(1) observe and record the symptom of D-IBS at pretherapy,the 14^th day and the 28^th day;(2)detect the rectum sensitivity at before and after treatment;(3)survey the quality of life by SF-36 and IBS-QOL at before and after treatment.After drug withdrawal 4 weeks,followed up the patients that cured and excellence.Improving of symptom:There no statistical significance between two group on scores of abdominal pain or abdominal discomfort,abdominal distention and defecation urgency at 14^th day and 28^th day. The difference on score of degression at 14^th day and 28^th day hadn't statistical significance;there no statistical significance between two group on scores of frequency of defecation and character of defecation at 14^th day and 28^th day.PPS analysis showed that the difference of score of degression at 28^th day had the statistical significance(P＜0.05),treatment group was better than control group;the difference of the score of mucus stool at 28^th day had the statistical significance( P＜0.05) too,treatment group was better than control group.The scores of every symptom of end point were different from of baseline statistically,therapeutic effect of synthetic:FAS analysis showed that the total effective rates of the treatment group and the controlled group were 80.00%and 77.50%respectively (P＞0.05).PPS analysis showed that they were 81.08%and 80.56%respectively (P＞0.05).No significant difference between two groups was detected.Protective efficacy:he patients that cured and excellence were followed up after drug withdrawal.There were 4 cases and 12 cases recidivating or aggravation in treatment group and control group respectively.There is significant difference on recurrence rates between two group(P＜0.05).quality of life:SF-36:the accumulated points on bodily pain,general health,vitality,social functioning and mental health increased significantly in treatment group after treatment(P＜0.05) .treatment group is better than control group on improving bodily pain,mental health and social functioning(P＜0.05)。IBS-QOL:the accumulated points on dysphoria,food avoidance,health worry,social reaction and relationship increased significantly in treatment group after treatment(P＜0.05).treatment group is better than control group on improving dysphoria and relationship( P＜0.05).JTW is effective in treating D-IBS and better than pinaverium bromide tablet on improving frequency and character of stool,mucus stool.Its prostective efficacy is better than pinaverium bromide tablet too.Meanwhile,it can improve patients' quality of life.The mechanism of treatment is adjusting the sensitivity of intestines.JTW is worth investigating and generalization.