【Case 03】Diarrhea-predominant Irritable Bowel Syndrome (IBS-D)

📋 Basic Information

• Medical Record No.: SS-2025-NK-003

• Patient: Mr. Lukas, German, Male, 38 years old, Software Engineer

• Treatment Duration: 8 weeks

Diagnostic Information

• Chief Complaint: Recurrent abdominal pain and diarrhea for 3 years, worsening with emotional stress.

• History of Present Illness: The patient developed abdominal pain and diarrhea 3 years ago due to high-pressure work and irregular schedule, with 3-5 daily loose mucoid stools. Pain worsened before defecation and relieved after bowel movement, triggered by stress or cold food. External colonoscopy showed no organic lesions. Previous pinaverium bromide and probiotics showed inconsistent efficacy. In recent 6 months, diarrhea worsened to 4-6 times daily with lower abdominal distension, borborygmus and poor appetite.

• Western Diagnosis: Diarrhea-predominant irritable bowel syndrome (IBS-D)

• TCM Diagnosis: Diarrhea disorder (Liver stagnation and spleen deficiency)

💊 Comprehensive Treatment Plan

1. TCM Conservative Treatment

• Visceral Tuina + Abdominal Moxibustion: Twice weekly, 30min/session, massage on Tianshu, Guanyuan, Ganshu, Pishu, plus ginger-partition moxibustion on Shenque.

• Acupuncture: 3 times weekly, combined reinforcing-reducing method on Tianshu, Shangjuxu, Sanyinjiao, Taichong, Pishu, Zusanli, 25min retention.

2. Physical Therapy

• Warm Medium-frequency Electrotherapy: Once daily, 20min/session, lower abdominal placement to improve intestinal smooth muscle function.

3. Rehabilitation Training

• Mindfulness-based Stress Reduction + Gut Sensory Training: Once daily, 20min, to reduce intestinal hypersensitivity.

4. TCM Herbal Decoction

• Formula: Modified Tongxie Yaofang + Shenling Baizhu Powder

• Ingredients: Atractylodis Macrocephalae Rhizoma (stir-fried) 12g, Paeoniae Radix Alba 15g, Citri Reticulatae Pericarpium 10g, Saposhnikoviae Radix 6g, Codonopsis Radix 15g, Poria 15g, Dioscoreae Rhizoma (stir-fried) 20g, Nelumbinis Semen 12g, Coicis Semen (stir-fried) 20g, Aucklandiae Radix (roasted) 6g, Lablab Semen Album (stir-fried) 12g, Glycyrrhizae Radix 6g.

• Usage: 1 dose/day for 8 weeks.

📊 Quantitative Comparison

✅ Efficacy Evaluation