Clinical efficacy of Xifeng Huashi and its effect on mental status in patients with diarrheal irritable bowel

BACKGROUND Diarrheal irritable bowel syndrome (IBS-D) is a functional gastrointestinal disorder characterized by abdominal pain accompanied by recurrent diarrhea that significantly impacts the quality of life and mental health of patients. AIM To investigate the clinical efficacy of Xifeng Huashi and its effects on the mental status of patients diagnosed with IBS-D. METHODS Data from 128 patients with IBS-D treated at the Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine between June 2023 and May 2024 were divided into control and research groups, with 64 patients in each group. The control group received conventional treatment with Western medicine alone, whereas the research group was prescribed Xifeng Huashi. Differences in specific indices between the two groups were observed and compared using relevant assessment tools. RESULTS The research group showed a higher total effective rate (92.19% vs 76.56%; P = 0.027) and lower traditional Chinese medicine symptom score (5.07 ± 3.11 vs 7.38 ± 3.68; P < 0.001) than the control group. Post-treatment, the research group exhibited significantly lower levels of pro-inflammatory cytokines (tumor necrosis factor-α: 18.80 ± 4.02 ng/L vs 21.09 ± 4.10 ng/L, P = 0.002; interleukin-6:14.84 ± 4.06 ng/L vs 19.80 ± 4.42 ng/L, P < 0.001) and higher levels of the anti-inflammatory cytokine interleukin-10 (48.53 ± 5.02 ng/L vs 46.06 ± 4.94 ng/L, P = 0.006). Moreover, markers of intestinal mucosal barrier function (diamine oxidase: 6.53 ± 2.35 ng/mL vs 7.66 ± 2.40 ng/mL, P = 0.008; D-lactate: 0.18 ± 0.04 mmol/L vs 0.20 ± 0.06 mmol/L, P = 0.004; lipopolysaccharides: 44.77 ± 8.16 pg/mL vs 48.20 ± 8.15 pg/mL, P = 0.019) were significantly improved in the research group. In addition, Self-rating Anxiety Scale (37.33 ± 5.73 vs 39.59 ± 6.36; P = 0.036) and Self-rating Depression Scale scores (34.77 ± 6.71 vs 38.06 ± 6.52; P = 0.006) were lower in the research group. The recurrence rate was significantly lower in the research group than in the control group (18.64% vs 40.82%, P = 0.001). CONCLUSION Xifeng Huashi is effective for the treatment of IBS-D and manifests advantages in improving clinical symptoms and mental status, as well as reducing the short-term relapse rate.