Irritable bowel syndrome with diarrhea (IBS-D) is one of the subtypes of irritable bowel syndrome (IBS), which is a common gastrointestinal disease characterized by disorder of brain-gut axis interaction. Clinical manifestations encompass abdominal distension, abdominal pain, as well as alterations in defecation pattern and frequency. IBS exhibits a protracted duration and frequent relapses, significantly compromising the overall well-being and psychological state of the majority of patients. At present, it is believed that the disease has a variety of pathogenic factors and a complex pathological mechanism. The current clinical guidelines for the diagnosis and management of IBS primarily focus on symptomatic relief, while traditional Chinese medicine offers distinctive advantages in IBS addressing. This article reviews the traditional Chinese medicine and western medicine in the treatment of IBS-D, encompassing both pharmacological and non-pharmacological interventions. The aim is to provide valuable insights for clinicians seeking evidence-based approaches for treating this condition.

Li Yuanhui, Liu Jianping. Research Progress of Chinese and Western Medicine Treatment for Diarrheal Irritable Bowel Syndrome. International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 12: 63-68. https://doi.org/10.25236/IJFM.2023.051209.

[1] Lacy Brian E, Pimentel Mark, Brenner Darren M, et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome [J]. The American journal of gastroenterology, 2020, 116(1):17-44. 

[2] Brian E. Lacy, Fermín Mearin, Lin Chang, et al. Bowel Disorders [J]. Gastroenterology, 2016, 150(6):1393-1407. e5.

[3] Barbara G, Cremon C, Bellini M, et al. Italian guidelines for the management of irritable bowel syndrome [J]. Digestive and Liver Disease, 2023, 55(2):187-207.

[4] Ami D. Sperber, Shrikant I. Bangdiwala, Douglas A. Drossman, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study [J]. Gastroenterology, 2020, 160(1):99-114. e3.

[5] Study Group of Functional Gastrointestinal Disorders, Study Group of Gastrointestinal Motility, Chinese Society of Gastroenterology, Chinese Medical Association. Chinese expert consensus of irritable bowel syndrome in 2020 [J]. Chinese Journal of Digestion, 2020, 40(12):803-818.

[6] Li Heyuan, Chen Weigang, Xiong Aqin, et al. The therapeutic mechanism of Tongxie decoction for diarrhea-predominant irritable bowel syndrome based on VIP-cAMPPKA-AQP8 pathway [J]. Modern Medicine Journal of China, 2022, 24(8):1-5.

[7] Priya Oka, Heather Parr, Brigida Barberio, et al. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis [J]. The Lancet Gastroenterology & Hepatology, 2020, 5(10):908-917.

[8] Longstreth George F, Thompson W Grant, Chey William D, et al. Functional bowel disorders [J]. Gastroenterology, 2006, 130(5):1480-1491.

[9] Black Christopher J, Ford Alexander C. Global burden of irritable bowel syndrome: trends, predictions and risk factors [J]. Nature reviews. Gastroenterology & hepatology, 2020, 17(8):473-486.

[10] Xing Yu, Guo Liang, Xie Chaoju, et al. Etiology, Pathogenesis and Visceral Treatment of Diarrhea-predominant Irritable Bowel Syndrome [J]. Journal of Liaoning University of Traditional Chinese Medicine, 2023, 25(10):110-113.

[11] Lin Yangjin, Zheng Layang, Xu Jianhong, et al. Research on the Correlation of Traditional Chinese Medicine Syndromes and Traditional Chinese Medicine Constitution Classification of Patient with Diarrhea Irritable Bowel Syndrome [J]. Chinese Medicine Modern Distance Education of China, 2021, 19(1):61-63.

[12] Guo Hong, Jiang Tao, Wang Jingliang, et al. The effect of food intolerance on diarrhea-predominant irritable bowel syndrome [J]. Tianjin Medical Journal, 2011, 39(10):957-958.

[13] Wan Qi, Zhang Jing, Nie Yuting, et al. Application of Tong Xiaolin’s theory of “zang-fu rheumatism” in diseases of dingjiao nervoussystem [J]. Jilin Journal of Chinese Medicine, 2021, 41(3):339-343.

[14] Zang Tingting, TianYaozhou. Research progress of dietary intervention of diarrhea-predominant irritable bowel syndrome in traditional Chinese and western medicine [J]. Medical Innovation of China, 2015, 12(28):143-145.

[15] Black CJ, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis [J]. Gut, 2022, 71(6):1117-1126.

[16] Chen Limin, Tao Qi, Niu Conghui, et al. Basic and Clinical Research Progress of Tongxie Yaofang in The Treatment of Diarrhea Irritable Bowel Syndrome [J]. Journal of Practical Traditional Chinese Internal Medicine, 2023, 37(7):108-111.

[17] Guo Junxiong, Ma Li, Kang Wanrong, et al. Effect of Tongxie Yaofang on p38 MAPK Pathway Associated Protein and Its Target Gene Expression in Colon Tissues of D-IBS Rats with Liver-stagnation and Spleen-deficiency [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020, 26(4):1-8.

[18] Hou Qiuke, Huang Yongquan, Zhu Zhaoyang, et al. Tong-Xie-Yao-Fang improves intestinal permeability in diarrhoea-predominant irritable bowel syndrome rats by inhibiting the NF-κB and notch signalling pathways [J]. BMC complementary and alternative medicine, 2019, 19(1):337.

[19] Zhao Xingjie, Li Junxiang, Yun Yifei, et al. Study on the Mechanism of Regulating the Immune Balance of Th17/Treg Cells in Mice with Irritable Bowel Syndrome by Tongxie Anchang Decoction [J]. Journal of Emergency in Traditional Chinese Medicine, 2022, 31(12):2092-2096+2101.

[20] Huang Jianfeng, Chen Zhaoyuan, He Shunyong, et al. Modified Tong Xie yao Fang for IBS - D (the liver and qi stagnation and the striking deficiency type) in patients with colonic mucosa of VIP, the effects of CGRP [J]. Xinjiang Journal of Traditional Chinese Medicine, 2022, 40(3):11-14.

[21] Liang Jin, Chen Qian, Zhang Xuan. Changes of Gastrointestinal Hormones in Diarrhea Predominant Irritable Bowel Syndrome Treated by Tongxie Sishen Decoction and Its Clinical Significance [J]. World Chinese Medicine. 2020; 15(1):71-75+80.

[22] Huang Liuxiang, Kuang Simin, Zhu Chuyue. Effects of Tongxie Anpi Decoction on Intestinal Flora of Rats with Diarrhea-Type Irritable Bowel Syndrome [J]. Guiding Journal of Traditional Chinese Medicine and Pharmacy, 2020, 26(9):1-6.

[23] Du Jiaxue, Liu Shaoneng. Network Pharmacology of Windbreak in the Treatment of Irritable Bowel Syndrome [J]. Journal of Shenyang Pharmaceutical University, 2021, 38(4):415-423.

[24] Sihao Gu, Ling Li, Hai Huang, et al. Antitumor, Antiviral, and Anti-Inflammatory Efficacy of Essential Oils from Atractylodes macrocephala Koidz. Produced with Different Processing Methods [J]. Molecules, 2019, 24(16):2956.

[25] Ma Xiaoling, Shi Leiling, Liu Xuesong, et al. Effects of Alhagi sparsifolia extract on abdominal myoelectric activity and serum nitric oxide level in rats with diarrhea-predominant irritable bowel syndrome [J]. Pharmacology and Clinics of Chinese Materia Medica, 2018, 34(5):78-81.

[26] Zhou Tianran, Huang Jingjing, Ju Xin, et al. Pharmacodynamics Study of Pogostemonis Herba Formula Granules on IBS-D Rats [J]. Journal of Chinese Medicinal Materials, 2018, 41(1):180-183.

[27] Liu Lianghao, Jiang Zhibin, Yu Haiyang, et al. Research progress in mechanisms underlying attenuation of irritable bowel syndrome by berbrine [J]. Chinese Journal of Pathophysiology, 2022, 38(5): 944-948.

[28] Li Lei, Cui Herong, Li Tong, et al. Synergistic Effect of Berberine-Based Chinese Medicine Assembled Nanostructures on Diarrhea-Predominant Irritable Bowel Syndrome In Vivo [J]. Frontiers in pharmacology, 2020, 11:1210-1210.

[29] Liu Tao, Wu Mengling, Deng Guoyan, et al. Linderae Radix water extract treats diarrhea-predominant irritable bowel syndrome in rats: a serum metabolomics study [J]. China Journal of Chinese Materia Medica, 2023, 48(19):5356-5364.

[30] Sun Yanning, Fu Meizhu. Effects of Total Glucosides of Paeony on 5-HT Signal Pathway in Diarrhea Predominant-Irritable Bowel Syndrome [J]. Western Journal of Traditional Chinese Medicine, 2023, 36(6):14-18.

[31] Liao Zhengyi, Long Nianbao, Ge Lai’an. Research on External Therapy of Traditional Chinese Medicine in the Treatment of Diarrhea-predominant Irritable Bowel Syndrome [J]. Chinese Medicine Modern Distance Education of China, 2023, 21(22):183-186.

[32] Chen Biwei, Chen Shaozong, Fang Jianqiao, et al. Research progress and problems of neurobiological mechanisms of acupuncture underlying improvement of irritable bowel syndrome [J]. Acupuncture Research, 2021, 46(10):885-892.