Research On The Regulation And Characteristic Of Syndrome Differentiation In Irritable Bowel Syndrome Based On Gastrointestinal Disease Syndrome Differentiation Theory Of Shanghan Zabing Lun

Objective:To seek the regulation of syndrome differentiation in irritable bowel syndrome (IBS), which based on Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases), to standardize the pattern of syndrome differentiation of Traditional Chinese Medicine (TCM) in IBS, and to partly unveil its pathogenesis based on the theory of visceral manifestation.Methods:The articles from ancient to modern time which associate to IBS were arranged systematically to seek the theoretical basis of the TCM treatment of IBS. The clauses related to IBS in Shanghan Zabing Lun were analyzed and synthesized to explore the regulation of syndrome differentiation using mathematical statistics. Clinical documents about IBS in modern time were collected to carry out the study of syndrome including the extraction of the syndrome elements using mathematical statistics. During the process, we continuously focused on the influence of "liver’s failure of controlling dispersion" and emotional factors on IBS so as to identigy the relatively accurate role that liver controlling dispersion plays in the course of IBS.Results:1.There are many detailed contents about IBS in ancient articles, which provide a solid theoretical foundation for the diagnosis and treatment of the disease. Being a major emotional inducement, the depression of liver attracted many doctors’attention2. Opinions on the etiology and pathogenesis of IBS among modern scholars differ very much, but these ideas gradually tend to unify in recent years with many considering liver and spleen disharmony as the core of pathogenesis and large intestine as the location of disease.3. Certain regularity of the syndrome differentiation on IBS is presented in Shanghan Zabing Lun. As for the types of disease, the clauses and prescriptions about diarrhea-predominant IBS are more common than constipation-predominant IBS; as for the symptoms, asthenia cold syndromes are the main syndromes such as spleen Qi deficiency, spleen yang deficiency and kidney yang deficiency. The influence of emotional factors and liver’s failure of controlling dispersiong on IBS is not mentioned but the frequent use of Minor Bupleurum Decoction may indicate that liver qi stagnation is an inducement of IBS.4. Study of syndrome elements and related modern literature in IBS produces the following results:Diarrhea-predominant IBS are more common than constipation-predominant IBS clinically. The locations of disease are liver and spleen and the main syndrome elements are qi deficiency and qi stagnation while the most common syndromes are spleen deficiency caused by liver depression, liver Qi stagnation and simultanious qi deficiency of spleen and stomach. Liver’s failure of controlling dispersio should be seen as a commonly encountered, potential inducement during the course of IBS.Conclusions:The locations of disease related to IBS are liver, spleen and kidney and the main syndromes are spleen qi deficiency, spleen yang deficiency, liver qi stagnation and kidney yang deficiency. Diarrhea-predominant IBS has a higher incidence than constipation-predominant IBS and it’s paroxysmal with liver’s failure of controlling dispersion as the main inducement.