Clinical study of acupuncture in the treatment of diarrhea-predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome)

OBJECTIVE: To treat diarrhea-predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome) with acupuncture and, by observing its clinical efficacy and the change in traditional Chinese medicine (TCM) syndrome scores, to evaluate the clinical efficacy and long-term effect of acupuncture in the treatment of diarrhea-predominant irritable bowel syndrome. METHODS: 64 patients with irritable bowel syndrome of the liver depression and spleen deficiency syndrome were randomly divided into a treatment group and a control group, 32 cases each. 2 cases in the acupuncture group and 2 cases in the control group dropped out due to loss to follow-up, leaving 60 cases in the statistical analysis. There were no significant differences between the two groups in age, sex, disease duration or total TCM symptom score before treatment, so they were comparable (P>0.05). The acupuncture group received acupuncture at Tianshu, Shangjuxu, Guanyuan, Zusanli and Taichong; the control group took Dicetel tablets orally, 1 tablet each time, 3 times/d. In both groups 3 weeks constituted 1 course, and efficacy was assessed after 1 course. The clinical efficacy, the changes in primary and secondary TCM syndrome scores before and after treatment, and the changes of each indicator at 3-week and 6-week follow-up were observed in both groups. RESULTS: Comparing primary and secondary TCM syndrome scores before and after treatment, diarrhea, abdominal pain, chest and hypochondriac distension, depression or irritability, epigastric and abdominal fullness, poor appetite, mucus in stool, borborygmus and flatus, belching, and lassitude improved in both groups after treatment (P<0.05). After 3 weeks of treatment, for primary TCM syndrome scores, the treatment group was superior to the control group for diarrhea and abdominal pain (P<0.05), and similar for chest and hypochondriac distension (P>0.05); for secondary TCM syndrome scores, the treatment group was superior for depression or irritability and borborygmus and flatus (P<0.05), and similar for epigastric and abdominal fullness, poor appetite, mucus in stool, belching and lassitude (P>0.05). After 6 weeks, for primary TCM syndrome scores, the treatment group was superior to the control group for diarrhea, abdominal pain and chest and hypochondriac distension (P<0.05); for secondary TCM syndrome scores, the treatment group was superior for depression or irritability, borborygmus and flatus, epigastric and abdominal fullness, poor appetite, mucus in stool, belching and lassitude (P<0.05). CONCLUSIONS: 1 Acupuncture is an ideal method for treating diarrhea-predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome); most primary symptoms improve faster, and improvement is more marked in diarrhea, abdominal pain, chest and hypochondriac distension, depression or irritability, epigastric and abdominal fullness, poor appetite, mucus in stool, borborygmus and flatus, belching and lassitude. 2 The therapeutic effect of acupuncture in diarrhea-predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome) is lasting, with a clear long-term effect. 3 Acupuncture is an effective method for treating diarrhea-predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome) and is worth promoting in clinical practice.