Articles

Irritable Bowel Syndrome (IBS)

Related Health Condition

Not available

Introduction

Irritable bowel syndrome (IBS) is a common gastrointestinal dysfunction. Its clinical symptoms include abdominal pain, diarrhea, intestinal gurgling, changes in bowel movement habits, and accompanying disturbances of the autonomous nervous system, such as palpitation, insomnia, restlessness, etc. In traditional Chinese medicine, it belongs to the categories of diarrhea, abdominal pain, and sun-shi (lienteric diarrhea).

Etiology/Pathogenesis

Chen, et al. believe that IBS is mainly caused by impaired spleen and stomach functions due to emotional upsets or improper diet, or by chronic spleen and stomach deficiencies coupled with the attack of exogenous pathogens. The pathological process is often affected by the qi and blood-regulating functions of the liver and the gallbladder. The disease is mainly located at the liver, spleen, and large intestine, but not entirely independent of the heart and the kidney. Although the condition's symptoms primarily involve the spleen and the stomach, the root cause lies with the liver. Due to the liver's failure to maintain normal qi functions, the spleen's transportation ability is compromised, leading to diarrhea. Likewise, the liver's failure to promote harmonious qi activities sets the stage for abdominal pain. (1)

Primary Treatments with Chinese Medicinal Herbs

Tong Xie Yao Fang

Ingredients: Chao Bai Zhu (processed White Atractylodes), Chao Bai Shao (processed White Peony Root), Chao Chen Pi (processed Citrus), Fang Feng (Siler)

Clinical Application:
Deng treated 49 cases of irritable bowel syndrome with a modification of this formula. The modified formula consisted of Bai Zhu, Bai Shao, Chen Pi, Fang Feng, Fu Ling, Yi Yi Ren, and Gan Cao. One dose of the formula in water decoction was administered three times a day before meals, and one unit of treatment called for three doses. The results: after 1-6 units of treatment, 37 cases significantly improved, 11 improved, and 1 did not respond to the treatment, with a total effective rate of 97.2%. (2)

Similarly, Liu used a modification of this formula in treating 32 cases of IBS. Here the formula was modified to include Chen Pi, Fo Shou, Bai Shao, Bai Zhu, Fang Feng, Mu Xiang, and Gan Cao. One dose of the formula was administered daily, and one unit of treatment called for seven doses. The results: after two consecutive units of treatment, 19 cases were resolved, 11 improved, and 2 did not respond to the treatment, with a total effective rate of 93.75%. (3)

Other Treatments with Chinese Medicinal Herbs

Yi Chang Jian

Chen, et al. treated 30 cases of IBS with a formula called Yi Chang Jian (intestine-invigorating formula). The formula consisted of Chen Pi, Ban Xia, Hou Pu, Chao Bai Zhu, Fu Ling, Su Gen, Bai Shao, Sha Ren, Gan Cao, and Jiao San Xian. Modifications were made to suit individual patients' symptoms. One dose of the formula in water decoction was administered daily. A comparison group of 30 cases was treated with Shu Te (50mg each time, three times a day). One unit of treatment was 4 weeks for both groups. The results: of the treatment group, 7 cases significantly improved, 19 improved, and 4 did not respond to the treatment, with a total effective rate of 86.7%; of the comparison group, the corresponding number were 4, 20, 6, and 80%. (4)

Shu Gan Jian Pi Qing Chang Tang

Yan, et al. treated 39 cases of IBS with a formula called Shu Gan Jian Pi Qing Chang Tang (liver-soothing, spleen-invigorating, and intestine-cleansing formula). The formula consisted of Huang Qi, Bai Zhu, Fu Ling, Chai Hu, Zhi Ke, Chi Shao, Bai Shao, and Xiang Fu, E Zhu, Gou Teng, He Huan Pi, Huang Qin, Tie Xian Cai, and Gan Cao. One dose of the formula in water decoction was administered daily, and one unit of treatment lasted 30 days. The results: after one unit of treatment, of the treatment group, 14 cases significantly improved, 21 improved, 4 did not respond to the treatment; the corresponding numbers for the comparison group were 3, 15, and 13. The difference between the two groups was significant (P

Qin Shao Tang

Qiu, et al. treated 36 cases of IBS with a modification of the formula Qin Shao Tang (scutellaria and peony combination). The modified formula consisted of Huang Qin, Bai Shao, Huang Lian, Gan Cao, Mu Xiang, Zhi Shi, Xing Ren, Hou Pu, Chen Pi, Hua Shi, and Dang Gui. Further modifications were made to suit individual patients' symptoms. One dose of the formula in water decoction was administered daily, and seven days constituted one unit of treatment. The results: after 1-2 units of treatment, 29 cases were recovered, 5 significantly improved, 2 improved, with a total effective rate of 100%. (5)

Sheng Yang Yi Wei Tang

Weng treated 78 cases of IBS with a formula called Sheng Yang Yi Wei Tang (spleen yang-elevating and stomach-invigorating formula). The formula consisted of Huang Qi, Dang Shen, Ban Xia, Zhi Gan Cao, Bai Zhu, Bai Shao, Chen Pi, Fu Ling, Fang Feng, Qiang Huo, Du Huo, Chai Hu, Ze Xie, Huang Lian, Sheng Jiang, and Da Zao. Modifications were made to suit individual patients' symptoms. One dose of the formula in water decoction was administered daily. One unit of treatment lasted 15 days, and a three-day break was instituted between units of treatment. The results: after two units of treatment, 47 cases significantly improved, 23 improved, 8 did not respond to the treatment, with a total effective rate of 89.7%. (6)

Acupunture & Acupressure

Acupuncture Treatment
Cao treated 58 cases of IBS by pricking the acupoint Shenque (Ren 8) with red-hot needles. The procedure: Three-edged pricking needles were heated on an alcohol burner; when the needles were red-hot, they were used to prick the acupoint Shenque. Each session called for pricking the acupoint twice, and the treatment was repeated every other day. Seven sessions constituted one unit of treatment, and a three-day break was instituted between units of treatment. The results: 46 cases (79.31%) were recovered, 6 (10.34%) significantly improved, 4 (6.90%) improved, and 2 (3.45%) did not respond to the treatment, with a total effective rate of 96.55%. (7)

Xue treated 14 cases of IBS with a combination of acupuncture and massage. The procedure was as follows: Acupuncture treatment was applied daily at the acupoints Zusanli (St 36) and Sanyinjiao (Sp 6) by the lifting-thrusting-twisting-twirling method, with the needles retained for 20 minutes after insertion. Six sessions constituted one unit of treatment. In addition, with the patient lying on their back and the knees bent, massage was applied at the acupoints Zhongwan (Ren 12), Qihai (Ren 6), and Guanyuan (Ren 4) by pushing and kneading maneuvers, at the bilateral acupoint Tianshu (St 25) by progressively more forceful thumbing, and around the navel by palm-rubbing; then, with the patient sitting upright, massage was applied at the acupoints Pishu (B 20), Dachangshu (B 25), Shenshu (B 23), and Mingmen (Du 4) by pushing and pressing. Each daily massage session lasted 20 minutes. The results: after 1-3 units of treatment, all 14 cases were recovered. A follow-up on 10 patients conducted 2-5 years after the treatment found no relapses in six patients. (8)

Massage
Xu treated 68 cases of IBS with a combination of massage and herbal therapy. The acupoints Hegu (LI 4) and Guanyuan (Ren 4) received massage treatment three times a day, one hour before a meal: the acupoint Hegu was first pressed with a thumb for about half a minute to initiate the treatment, and then kneaded 100 times clockwise; the acupoint Guanyuan was first pressed with a thumb to initiate the treatment, and then gently palm-kneaded 50 times clockwise, and 50 times counter-clockwise. The herbal therapy used a formula called Bu Pi Fang (spleen-invigorating decoction), which consisted of Dang Shen, Fu Ling, Bai Zhu, Rou Dou Kou, Bai Shao, Shan Yao, Wu Zhu Yu, and Zhi Gan Cao. One dose of the formula in water decoction was administered daily at three takings just before the massage sessions. One unit of treatment lasted ten days. A comparison group of 84 cases was treated with various Western medications (e.g., vitamin B, diazepam, etc.) The results: of the treatment group, 36 cases were recovered, 27 improved, and 5 did not respond to the treatment, with a total effective rate of 92.6%; in comparison, the corresponding numbers for the comparison group were 11, 32, 41, and 51.2%, respectively. (9)

Other Treatments
Lu treated 48 cases of IBS with auricular pressure and millimeter wave therapies. The procedure of the auricular pressure therapy: three times a day, each time for a duration of five minutes, a vicaria seed was pressed against the acupoint Shenmen and points related to the liver, spleen, and kidney, to gain a feeling of warmth, swelling, and slight pain; the bilateral points were alternated in receiving the treatment, and 10 sessions constituted one unit of treatment. The procedure of the millimeter wave therapy: once a day, each of the acupoints Daheng and Qihai were treated with millimeter wave for 10 minutes; ten sessions constituted one unit of treatment. The results: 34 cases were recovered, 7 significantly improved, 5 improved, and 2 did not respond to the treatment, with a total effective rate of 95.8%. (10)

References

  1. Chen Zhen, et al. Hebei Journal of TCM. 1997;19(2):46-48.
  2. Deng Sheng Li. Sichuan Journal of TCM. 1999;17(1):32.
  3. Liu Hui Hua. Guangxi Journal of Traditional Chinese Medicine. 1999;22(2):18.
  4. Chen Ming, et al. Beijing Journal of TCM. 1999;18(4):27-28.
  5. Qiu Ming Shan, et al. Fujian Journal of Chinese Medicine. 1999;30(6):36.
  6. Weng Qi Xi. Fujian Journal of Chinese Medicine. 1999;30(5):8.
  7. Cao Wei Min. China Journal of Acupuncture. 1996;16(11):11.
  8. Xue Ling. Journal of Acupuncture Clinical Application. 1998;14(7):25-26.
  9. Xu Xue Jun. Journal of Folk Chinese Medical Treatment. 1999;7(9):33-34.
  10. Lu Ya Kang. China Journal of Acupuncture. 1999;19(2):75-76.