Investigation On Syndrome Regularity And Clinical Characteristics Of Diarrhea - Predominant Irritable

Objective:Irritable bowel syndrome (IBS)is one of the common clinical functional disorders. The main syndromes are abdominal pain, abdominal distension with bowel habits and change of character of stool, at present there is no standard of TCM Syndrome type, the etiology and pathogenesis is still not very clear, most think that is closely related to emotional and mental disorders, hope to investigate the clinical features of diarrhea-predominant irritable bowel syndrome through the perspective of Chinese medicine, observe the similarities and unique performance, to further understand the relevance of emotion and life habits and disease.Methods:The first part of the study of retrieval Chinese CKNI, VIP journal net, Wanfang database included modern research literature about IBS-D in recent fifteen years, through strict selection and extraction of IBS-D TCM syndrome type, syndrome, syndrome elements from the IBS-D, finally summarizes the regularity of TCM syndrome.The second part is clinical study, in this study the "Twelfth Five-Year" national project for the support, the patients were diagnosed with diarrhea-predominant irritable bowel syndrome enrolled into this study. All IBS-D patients were divided into three kinds of syndromes, respectively, stagnation of liver-QI with deficiency of the spleen type, damp abundance due to splenic asthenia type, asdthenic splenonephro-yang type, which by the above deputy chief physician to determine the type of syndrome. Take the way of questionnaire, analysis of patient’s age, sex, course of disease, etiology, and clinical features, etc., to explore the TCM syndrome type and its distribution.Results:The first part of 65 papers of the 13 kinds of TCM syndrome type, most often the 5 kinds of TCM syndrome type frequency and percentage in order for the stagnation of liver-QI with deficiency of the spleen syndrome in 62 times accounted for 95.4%; followed by asdthenic splenonephro-yang syndrome in 47 times accounted for 72.3%; 42 of deficiency of spleen and stomach type accounted for 64.6%; syndrome of accumulated dampness-heat 21 times, accounting for 32.3; the splenasthenic fluid-retention syndrome in 15 times accounted for 23.1%.The second part summarizes the results of the following four points:1.This study collected 33 cases of diarrhea-predominant irritable bowel syndrome patients, including male 24, male:female ratio was 2.67:1. Mean age was 40.8 years. Mean disease duration 5.08 years.2. The distribution of stagnation of liver-QI with deficiency of the spleen type, proportion of up to 16 cases, accounting for 49%; 9 cases of asdthenic splenonephro-yang type, accounted for 27%; 8 cases of splenasthenic fluid-retention type, accounting for 24%.3. Defecation, patients with symptoms of diarrhea, but also with the change of character of stool, defecation urgency accounted for 81.8%; defecation is not clean accounted for 75.8%, there are occasional patients showed normal stool or constipation.4. The clinical features of IBS-D patients showed abdominal distension, accounted for 78.8%; stomach accounted for 69.7%; abdominal pain accounted for 63.6%; anxious or nervous 63.6%; sleep disorders accounted for 81.8%; easy fatigue accounted for 78.8%.Conclusion:1. According to TCM syndrome type of IBS-D, the incidence of disease closely related with liver, spleen and kidney.2. TCM syndrome type of IBS-D of liver stagnation and spleen deficiency type, followed by spleen kidney yang deficiency, in addition to abdominal distension, abdominal pain, accompanied by emotional tension, easy to get angry, sigh, pharyngeal foreign body sensation, dry mouth, bitter taste in the mouth, eat less, anorexia, nausea and other symptoms.3. Patients with IBS-D is closely related to the psychic factors, when the mood disorders, mental stress and other psychological disorders, the digestive system may appear obvious dysfunction; IBS-D can also lead to insomnia, sleep disorder.4.The diarrhea, abdominal distension, abdominal pain, fatigue, insomnia, nervous, anxiety for diarrhea-predominant irritable bowel syndrome clinical features in common.