Clinical Study on Jiawei Lichang Decoction(加味理肠饮)in Treatment of Irritable Bowel Syndrome with Diarrhea of Liver Depression and Spleen Deficiency Type
Objective:To observe the curative efficacy of Jiawei Lichang Decoction(加味理肠饮)on irritable bowel syndrome with diarrhea(IBS-D)of liver depression and spleen deficiency type and its effects on the main symptoms,disease-related scores,and inflammatory manifestations.Methods:A total of 60 patients with IBS-D of liver depression and spleen deficiency type were divided into traditional Chinese medicine(TCM)compound group and western medicine group according to random number table method,with 30 cases in each group.The TCM compound group was treated with Jiawei Lichang Decoction,while the western medicine group was treated with Rifaximin tablets.Both groups were treated continuously for 2 weeks,and follow-up was conducted 4 weeks after treatment.The primary efficacy indicator was the effective response rate after 2 weeks of treatment(post-treatment)and after 4 weeks at the end of treatment(at follow-up),i.e.,the percentage of patients with a 30％average improvement in the most severe abdominal pain score from baseline and a 50％reduction in the number of type 6 or 7 Bristol fecal days in their bowel diary from baseline.Secondary outcome indicators included the number of loose stool days per week,mean abdominal pain score per week,IBS Symptom Severity Scale(IBS-SSS)score,IBS-specific Quality of Life Questionnaire(IBS-QOL)score,TCM symptom score,serum inflammatory factor levels,and histopathological morphology of the mucosa of the colon and ileocecal end.Results:There was no significant difference in the effective response rate between the two groups after treatment and during follow-up(P＞0.05).Compared with the pre-treatment period,patients in both groups showed a reduction in the number of loose stool days per week(P＜0.01),a decrease in average weekly abdominal pain scores(P＜0.01),and improvements in IBS-SSS,IBS-QOL,and TCM symptom scores(P＜0.01)after treatment and at follow up.After treatment,patients in both groups showed a decrease in the levels of serum IL-6,TNF-α,and SP(P＜0.01).At follow-up,the number of days of loose stools per week in the TCM compound group was less than that in the western medicine group(P=0.046),and the IBS-SSS score in the TCM compound group was better than that in the western medicine group(P＜0.01).After treatment and at follow-up,the IBS-QOL score and the TCM symptom score in the TCM compound group were better than those in the western medicine group(P＜0.01).After treatment,the serum TNF-α level in the western medicine group was lower than that in the TCM compound group(P＜0.01).At follow-up,the mucosal tissue of the colon and terminal ileum in both groups was structurally intact,neatly arranged and without inflammatory cell infiltration.Conclusions:Jiawei Lichang Decoction can relieve abdominal pain and diarrhea in patients with IBS-D of liver depression and spleen deficiency type,reduce the levels of serum inflammatory factors,and alleviate the low-grade inflammatory reaction of the intestinal mucosal tissues,with a longer-lasting effect.
Jiawei Lichang Decoctionirritable bowel syndrome with diarrhealiver depression and spleen deficiencyabdominal paininflammation
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维普
