The Effect And Mechanism Of Xu’s Yigan-fupi Decoction In Treatment Of Diarrhea-Predominant Irritable Bowel Syndrome With Liver Depression And Spleen Deficiency

Objective:To observe the clinical efficacy of Professor Xu’s yigan-fupi Decoction in treating IBS-D patients who with liver depression and spleen deficiency,and to observe its effect on serum corticotropin-releasing factor(CRF),D-lactate(D-LA),diamine oxidase(DAO),interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and discuss the possible mechanism of action.Methods:1.Sixty liver depression and spleen deficiency type IBS-D patients who visited outpatient and inpatients of general medicine and digestive endoscopy of Jiangsu Provincial Hospital of Chinese Medicine during May 2020 to December 2020.They were randomly divided into treatment group and control group,and 30 cases in each group.The treatment group was given Xu’s yigan-fupi Decoction,one dose daily,200ml decoction,twice a day,taken one hour after breakfast and dinner;the control group was given bifidobacterium sanlian capsule,620mg once and 2 times daily,taken half an hour after breakfast and dinner,pinaverium bromide talets 5mg once and 3 times daily,taken half an hour after breakfast and dinner.The treatment course of both groups is 4 weeks.Clinical symptoms and quality of life were evaluated before and after treatment in both groups.2.10 cases of the treatment group and the control group were randomly selected.Enzyme-linked immunosorbent assay was used to detect the Serum levels of CRF,D-LA,DAO,IL-1 β,IL-6 and TNF-α.SPSS 25.0 software was used for statistical analysis of all data.Results:1.Comparison of comprehensive efficacy:The total effective rate of the treatment group was 96.67%,and the control group was 83.33%.The difference between the two groups was statistically significant(P<0.05),indicating that the effect of yigan-fupi Decoction was better than Western medicine.2.IBS-SSS score comparison:The individual scores and total scores of the two groups were compared within the group,which was statistically significant(P<0.01);the individual scores and total scores between the two groups after treatment were compared with significant statistical significance(P<0.01).It shows that both Yigan Fupi Decoction and western medicine can effectively alleviate various symptoms,but Yigan Fupi Decoction is better than western medicine in alleviating the condition.3.Comparison of TCM syndrome scores:The comparison of the individual TCM syndrome scores and total scores of the two groups before and after treatment showed significant statistical significance(P<0.01);In terms of abdominal pain,abdominal discomfort,diarrhea,abdominal distension,emotion,loss of appetite,fatigue,feeling of excrement,there was statistical significance(P<0.05);in terms of stool frequency and bowel swelling(P>0.05),Yigan Fupi Decoction had the same effect as western medicine.In general,both yigan-fupi Decoction and Western medicine can effectively relieve the TCM symptoms of patients with IBS-D,but yigan-fupi Decoction is better than western medicine4.Comparison of Bristol fecal scores:Comparison between the two groups of scores(P<0.01),indicating that Yigan Fupi Decoction and western medicine can improve the patient’s stool properties.After treatment,the scores of the two groups were not statistically significant(P>0.05),indicating that Yigan Fupi Decoction has the same effect as western medicine.5.Comparison of HAD-A and HAD-D:The comparison of HAD-A and HAD-D scores within the group(P<0.05)shows that Yigan Fupi Decoction and western medicine can improve the anxiety and depression of patients.The comparison of HAD-A and HAD-D scores between the two groups after treatment(P<0.05 or P<0.01),suggesting that Yigan Fupi Decoction is better than western medicine.6.Serum CRF,D-LA,DAO,IL-1β,IL-6,TNF-α:The comparison of the serum index levels of within the group,P<0.05,which is statistically significant;The comparison of serum index levels between the two groups after treatment,P<0.05,which was statistically significant.It shows that both Yigan Fupi Decoction and western medicine can reduce the levels of various serum indexes,but Yigan Fupi Decoction is better than western medicine.7.Adverse reactions occurred in both the treatment group and the control group.Conclusion:1.Xu’s Yigan Fupi Decoction can effectively improve the clinical symptoms,quality of life and mental state of IB S-D patients.2.Xu’s Yigan-Fupi Decoction can decrease the contents of serum CRF,D-LA,DAO,IL-1β,IL-6,TNF-α.Regulation of brain-intestine axis,improvement of intestinal barrier function,and reduction of low-grade intestinal mucosal inflammation may be one of the mechanisms of Yigan-Fupi Decoction in the treatment of IBS-D.