[Effect of jianpi tiaogan wenshen recipe in treating diarrhea-predominant irritable bowel syndrome].

OBJECTIVE: To verify the efficacy of Jianpi Tiaogan Wenshen Recipe (JTWR) in treating diarrhea-predominant irritable bowel syndrome (IBS-D) and to analyze its therapeutic mechanism through observing the effect of JTWR on clinical symptoms and rectal sensibility in patients. METHODS: With a prospective, randomized controlled trial adopted, 80 patients with IBS-D were assigned randomly equally and to two groups. The treatment group was treated with JTWR, and the control group was treated with pinaverium bromide tablet (PVB), all for four weeks. Patients' symptoms, such as abdominal discomfort, pain, and distension; frequency of defecation; appearance of stool; and occurrence of tenesmus were recorded before and after treatment by scoring, and the rectal sensitivity was detected as well. Patients with therapeutic effect of cured and markly effective were followed up four weeks after withdrawal of medication. RESULTS: Three cases in the treatment group and four cases in the control group were dropped. Except the appearing of mucus stool, no statistically significant difference was shown between the two group in all other symptoms, either at before or after treatment; but the end point scores of individual symptoms between pre- and post-treatment were different statistically in both groups (P<0.05). Per-protocol population set (PPS) analysis on comprehensive effect showed that the total effective rate and the cure rate in the treatment group was 81.1% (30/37) and 24.3% (9/37), and those in the control group, 80.6% (29/36) and 19.4% (7/36) respectively; while the full analysis set (FAS) showed a result of 80.0% (32/40) and 22.5% (9/40) vs 77.5% (31/40) and 17.5% (7/40) respectively, all with insignificant difference between groups (P>0.05). Follow-up study showed that relapse or aggravation of disease occurred in four cases in the treatment group and 12 in the control group respectively, showing significant difference between groups (P<0.01). Rectal sensitivity examination showed that the rectal thresholds of sensation, defecation, and maximum tolerable volume were improved in both groups after treatment (P<0.05), but showed no significant difference between groups (P>0.05). CONCLUSIONS: JTWR is effective in treating IBS-D, with the effect better than PVB in improving mucus stool, also in the remote effect. Its therapeutic mechanism is possibly by way of adjusting the sensitivity of rectum.

[Effects of Changjishu soft elastic capsule in treatment of diarrhea-predominant irritable bowel patients with liver-qi stagnation and spleen deficiency syndrome: a randomized double-blinded controlled trial].

OBJECTIVE: To evaluate the efficacy and safety of Changjishu soft elastic capsule, a new Chinese herbal medicine for smoothing liver, invigorating spleen and regulating qi activity, on diarrhea-predominant irritable bowel syndrome (D-IBS) patients with liver-qi stagnation and spleen deficiency syndrome. METHODS: A randomized, double-blinded, and positive control method was adopted. One hundred and four cases of D-IBS conforming to the inclusive criteria were randomly divided into treatment group (78 cases) and control group (26 cases). Patients in the treatment group were treated with Changjishu soft elastic capsule, four capsules once daily and three times a day. Patients in the control group were treated with glutamine compound enteric capsule, three capsules once daily and three times a day. After 21-day treatment, the efficacy of Changjishu soft elastic capsule was evaluated by the changes of single symptom such as abdominal pain or discomfort, defecation frequency, and stool characteristics. The safety of Changjishu elastic capsule was assessed by laboratory data and adverse events. RESULTS: Abdominal pain or discomfort scores at days 7, 14, 21 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Defecation frequency score at day 14 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Stool characteristics score and the declined score at day 21 in the treatment group significantly decreased as compared with those of the control group (P < 0.05). Rugitus scores and the declined scores at days 14 and 21 significantly decreased as compared with the control group (P < 0.05). The total response rates in the treatment and control groups were 71.62% and 40.91%, and the recovery rates were 20.27% and 13.64%, respectively. There existed significant differences between the two groups in therapeutic effect (P < 0.01). The therapeutic effect of Changjishu elastic capsule was better than that of glutamine compound enteric capsule. Side effects and adverse events were not found in the two groups. CONCLUSION: Changjishu soft elastic capsule is effective and safe for treatment of D-IBS patients with liver-qi stagnation and spleen deficiency syndrome.