The cause of irritable bowel syndrome is not well understood and may be related to genetics, gastrointestinal hormones, gastrointestinal reflexes, emotions, etc. It is characterized clinically by diarrhea or constipation and abdominal pain, and is a difficult disease to treat. Chinese medicine has a better effect on it, and the effectiveness of the treatment depends on the choice of treatment and prescription. For example, there are many kinds of antidiarrheal drugs, but the sexual taste and efficacy vary greatly, so the treatment of diarrhea is not a random pile of antidiarrheal drugs. The most appropriate drugs should be selected for use, and further division of similar drugs should be made.
The following is a classification of several treatment methods and drugs for irritable bowel syndrome, combined with our own experience.
1.Realization method
Irritable bowel syndrome often manifests the phenomenon of liver qi stagnation, irregular Qi flow in the internal organs, and Qi stagnation. All types of irritable bowel syndrome can be treated with qi management drugs. Qi-regulating drugs can be subdivided into
1.1 Diversion of liver and Qi, which is the main treatment method. The drugs are Yu Jin, Xiang Shu, Yuan Hu, Chuan Neem and Jiang Huang. The addition of these drugs to the prescription can adjust the balance of the internal organs, relieve tension and improve the therapeutic effect.
1.2 To strengthen the spleen and regulate qi, the drugs include mucuna pruriens, chenpi, foxglove and sand. These drugs can move Qi and eliminate stagnation, strengthen the spleen and open the stomach, and are commonly used in prescriptions.
1.3 Regulating qi and relieving pain. There are more drugs with this effect, and some of the first two types of drugs also have this effect. Commonly used drugs include Mu Xiang, Tai Wu Yao, Xiang Xiang Shen, Buddha’s Hand, Neem, Yuan Hu, and Jiang Huang. Each qi medicine has multiple functions, and the most suitable one should be chosen for the patient in the clinical evidence. In addition, there are hot and cold elements in qi medicine, so care should be taken when selecting the medicine.
2.Clear heat and detoxification method
This is a familiar common treatment method, which is applicable to patients with irritable bowel syndrome with heat evidence. Commonly used herbal medicines include: Baidian, Qinpi, Huanglian, Huangbai, Scutellaria, forsythia, Thornybush, Phyllanthus, Pueraria, Amaranthus, and Andrographis. You can choose one to three kinds of medicine per dose, not too many and not too much. Whitehead, Qin Pi and Huang Lian can have toxic side effects when used in large doses and should be noted.
3.Antidiarrheal method
It is mainly for irritable bowel syndrome with diarrhea as the main cause. There are many herbal medicines that can directly stop diarrhea, so the type of evidence should be identified and not mixed. They can be subdivided according to their medicinal properties as follows
3.1 Clearing heat and detoxifying diarrhea, drugs such as Pueraria lobata and Amaranthus. It is used for patients with heat toxicity diarrhea.
3.2 Strengthening the spleen to stop diarrhea, drugs such as Huai Shan, lotus seeds, gravy seeds, coix seeds. It is used for patients with obvious signs of spleen deficiency.
3.3 To stop diarrhea by astringency, the drugs include Wu Wei Zi, Chebulo Zi, Wu Mei Zi, Jin Zhen Zi, Red Stone Resin, Wu Bei Zi, and Pomegranate Peel. They are mostly sour medicines and can be used for all types of diarrhea. According to the number of times of diarrhea, 1 to 3 flavors of medicine can be chosen for each dose.
3.4 Warming the middle and stopping diarrhea, the drugs are nutmeg, bone flesh. Mainly used for deficiency-cold type diarrhea, not for those with obvious heat symptoms. These rules and drugs must be correctly selected in clinical practice, the use of the wrong will affect the anti-diarrheal effect.
4.Laxative method
It is mainly used for irritable bowel syndrome with constipation as the main cause. The purpose of laxative can be divided into the dull down and slow down. If the dry stool is knotted for several days, the abdominal fullness and abdominal real is more serious, can be used in a short period of time under the precipitous, laxative stagnation. However, the treatment of constipation in irritable bowel syndrome mostly uses slow down, mainly to regulate the internal organs. Laxatives can be subdivided into
4.1 heat-clearing laxative, drugs such as rhubarb, mannitol, senna, comfrey, raw earth, used for dryness, heat obvious. Slow down each optional 1 to 2 flavors, the dose should not be too large. If the constipation is very constipated and the heat is heavy, 5-10 grams of rhubarb can be used for the latter, or add mannitol and senna leaves; for those who are slow, 5-8 grams of rhubarb can be used without the latter. Raw earth and comfrey are heat-clearing and moistening medicines, laxative effect is weak, can be used as appropriate.
4.2 laxative, drugs are fire marijuana, Yu Li Ren, peach kernel, almond, grass cassia. These drugs are more calm and can be used for all types of constipation.
4.3 Warming the kidneys and laxative, drugs include Cistanches, lockjaw. Used for constipation patients with spleen and kidney Yang deficiency, also used for cold-type constipation. These drugs are warm and hot in nature and should not be used for those with obvious heat symptoms.
4.4 Lowering the Qi and relaxing the bowels, drugs include Lycopodium, Su Zi, Citrus aurantium. These drugs have a wide range of use and can be used in various prescriptions.
5. Tonic method
Deficiency is often seen in the course of the disease, with spleen deficiency being the most common. The main method of tonification is also to nourish the spleen and stomach. Commonly used drugs include Radix et Rhizoma Ginseng, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Poria, which have a certain effect on the softness and hardness of the stool. In addition, the qi, blood and kidney yin and yang are also commonly used in the treatment of the disease, the corresponding drugs have been familiar to people, and will not repeat.
6.Lifting method
It is mainly used for those with Qi deficiency and prolonged diarrhea. Commonly used drugs are Huang Qi, Sheng Ma, Chai Hu. It is not recommended for those with dry stools.
7.Anti-allergic method
Anti-allergy is a Western medical term, the method has a special effect on irritable bowel syndrome. Some patients with irritable bowel syndrome are related to allergies. Adding some herbs with anti-allergic effect can change the allergic constitution and promote the elimination of symptoms. Commonly used drugs are Wu Mei Zi, Wu Wei Zi and Che Chee Chee, plus Huang Qi, Fang Feng, Bai Zhu and Jing Zuo for the anti-allergy formula. Anti-allergic drugs are mostly acid-accepting products, and those with dry stools should use them together with laxative drugs if needed.
The above are the common treatments for irritable bowel syndrome, which treatment should be used in clinical legislation and prescription depending on the condition. The most commonly used combinations of treatment methods are
(1) diarrhea: dredge liver and Qi + clear heat and detoxification + antidiarrheal + analgesic + anti-allergic, may add discretionary tonic, discretionary ascending, discretionary hemostatic.
(2) constipation: dredging the liver and Qi + clearing heat and detoxification + laxative + analgesic + anti-allergic, with the addition of blood circulation and tonicity as appropriate.