Objective: To observe the efficacy and safety of Jieyu Anchang Tongxie Formula combined with Pinaverium bromide in the treatment of liver - depression and spleen - deficiency syndrome of irritable bowel syndrome with predominant diarrheal (IBS - D).Methods: A total of 112 IBS - D patients with liver - depression and spleen- deficiency treated in Shanghai Fifth People's Hospital from August 2022 to September 2023 were chosen and randomly separated into the observation group (n = 56, Jieyu Anchang Tongxie formula + Pinaverium bromide, 4 weeks) and control group (n=56, Pinaverium bromide, 4 weeks). 8 - week follow - up was arranged after the end to observe the sustained effect. The clinical efficacy, IBS symptom severity questionnaire (IBS - SSS), rectal sensitivity [anal canal resting pressure (ARP), anal maximum contraction pressure (AMCP) , rectal resting pressure (RRP), abdominal pain threshold, defecation threshold], serum vasoactive intestinal peptide (VIP), neurotransmitter [5 - serotonin (5- HT), Neuropeptide Y (NPY), calcitonin gene - related peptide (CGRP)], the number of intestinal flora, quality of life (IBS - QOL), self - rating anxiety scale (SAS) and self - rating depression scale (SDS) were compared between the two groups. The adverse reactions were recorded.Results: The observation group had higher effective rate (92.86%vs 78.57%) (P <0.05); IBS - SSS scores in the observation group were lower than those in the control group at 4 weeks and 8 weeks after treatment (P < 0.05) ; After treatment, ARP, abdominal pain threshold and defecation threshold in the observation group were higher than those in the control group (P <0.05), while the levels of VIP, 5- HT, and CGRP were lower, the levels of NPY were higher, and Lactobacillus acidophilus and bifidobacterium were also higher (P <0.05) ; The observation group had lower IBS - QOL scores, SAS scores and SDS scores (P < 0.05). Th incidence of adverse reactions was similar in the two groups (7.14% and 3.57%, P > 0.05). Conclusions: Jieyu Anchang Tongxie Formula combined with Pinaverium bromide has good efficacy in the treatment of IBS - D, which can significantly improve symptoms, reduce the release of serum VIP, neurotransmitter and inflammatory factors, maintain intestinal mucosal barrier and rectal sensitivity, regulate intestinal flora and negative emotions, and improve patients' quality of life with good safety.

Jieyu Anchang Tongxie Formula  /  Pinaverium bromide  /  Irritable bowel syndrome with predominant diarrhea  /  Liver depression and spleen deficiency syndrome