References

1. 1.
   FORD A C，SPERBER A D，CORSETTI M，et al.Irritable bowel syndrome［J］.Lancet，2020，396（10263）：1675-1688.
2. 2.
   WANG Y，MA W，MEHTA R，et al.Diet and gut microbial associations in irritable bowel syndrome according to disease subtype［J］.Gut Microbes，2023，15（2）：2262130.
3. 3.
   STAUDACHER H M，BLACK C J，TEASDALE S B，et al.Irritable bowel syndrome and mental health comorbidity-approach to multidisciplinary management［J］.Nat Rev Gastroenterol Hepatol，2023，20（9）：582-596.
4. 4.
   HUANG K Y，WANG F Y，LV M，et al.Irritable bowel syndrome：Epidemiology，overlap disorders，pathophysiology and treatment［J］.World J Gastroenterol，2023，29（26）：4120-4135.
5. 5.
   LIU Y L，LIU J S.Irritable bowel syndrome in China：A review on the epidemiology，diagnosis， and management［J］.Chin Med J （Engl），2021，134（12）：1396-1401.
6. 6.
   JONES J，LEMBO A，HEIDELBAUGH J，et al.Management of irritable bowel syndrome with diarrhea： Focus on eluxadoline［J］.Curr Med Res Opin，2021，37（4）：567-578.
7. 7.
   HOU Q，HUANG Y，ZHU S，et al.MiR-144 increases intestinal permeability in IBS-D rats by targeting OCLN and ZO1［J］.Cell Physiol Biochem，2017，44（6）：2256-2268.
8. 8.
   WEN Y D，LI B S，WANG Y G，et al.Clinical practice guideline of TCM for common digestive system diseases： Irritable bowel syndrome（Edition for primary physician）［J］. Chin J Tradit Chin Med Pharm，2020，35（7）：3518-3523.
9. 9.
   SAVARINO E，ZINGONE F，BARBERIO B，et al.Functional bowel disorders with diarrhoea：Clinical guidelines of the United European gastroenterology and european society for neurogastroenterology and motility［J］.United Eur Gastroenterol J，2022，10（6）：556-584.
10. 10.
    HOLTMANN G，SHAH A，MORRISON M.Pathophysiology of functional gastrointestinal disorders：A holistic overview［J］.Dig Dis，2017，35（Suppl 1）：5-13.
11. 11.
    EIJSBOUTS C，ZHENG T，KENNEDY N A，et al.Genome-wide analysis of 53，400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders［J］.Nat Genet，2021，53（11）：1543-1552.
12. 12.
    SPERBER A D，BANGDIWALA S I，DROSSMAN D A，et al.Worldwide prevalence and burden of functional gastrointestinal disorders，results of rome foundation global study［J］.Gastroenterology，2021，160（1）：99-114.
13. 13.
    BRENNER D M，DOMÍNGUEZ-MUÑOZ J E.Differential diagnosis of chronic diarrhea：An algorithm to distinguish irritable bowel syndrome with diarrhea from other organic gastrointestinal diseases，with special focus on exocrine pancreatic insufficiency［J］.J Clin Gastroenterol，2023，57（7）：663-670.
14. 14.
    BOSMAN M，WEERTS Z，SNIJKERS J，et al.The socioeconomic impact of irritable bowel syndrome：An analysis of direct and indirect health care costs［J］.Clin Gastroenterol Hepatol，2023，21（10）：2660-2669.
15. 15.
    WU H，ZHAN K，RAO K，et al.Comparison of five diarrhea-predominant irritable bowel syndrome （IBS-D） rat models in the brain-gut-microbiota axis［J］.Biomed Pharmacother，2022，149：112811.
16. 16.
    KANG P，WANG A Z.Microbiota-gut-brain axis：The mediator of exercise and brain health［J］.Psychoradiology，2024，4：kkae007.
17. 17.
    RUTSCH A，KANTSJO J B，RONCHI F.The gut-brain axis：How microbiota and host inflammasome influence brain physiology and pathology［J］.Front Immunol，2020，11：604179.
18. 18.
    GOMAA E Z.Human gut microbiota/microbiome in health and diseases：A review［J］.Antonie Van Leeuwenhoek，2020，113（12）：2019-2040.
19. 19.
    MARGOLIS K G，CRYAN J F，MAYER E A.The microbiota-gut-brain axis：From motility to mood［J］.Gastroenterology，2021，160（5）：1486-1501.
20. 20.
    SIKANDER A，RANA S V，SINHA S K，et al.Association of serotonin transporter promoter polymorphism （5-HTTLPR） with orocecal transit time in irritable bowel syndrome［J］.Indian J Gastroenterol，2022，41（6）：610-617.
21. 21.
    ZHANG Y，ZHANG H，ZHANG W，et al.LncRNA XIST modulates 5-hydroxytrytophan-induced visceral hypersensitivity by epigenetic silencing of the SERT gene in mice with diarrhea-predominant IBS［J］.Cell Signal，2020，73：109674.
22. 22.
    RASKOV H，BURCHARTH J，POMMERGAARD H C，et al.Irritable bowel syndrome，the microbiota and the gut-brain axis［J］.Gut Microbes，2016，7（5）：365-383.
23. 23.
    THIJSSEN A Y，MUJAGIC Z，JONKERS D M，et al.Alterations in serotonin metabolism in the irritable bowel syndrome［J］.Aliment Pharmacol Ther，2016，43（2）：272-282.
24. 24.
    HAGSÄTER S M，LISINSKI A，ERIKSSON E.5-HT（6） receptor antagonism reduces defecation in rat：A potential treatment strategy for irritable bowel syndrome with diarrhea［J］.Eur J Pharmacol，2019，864：172718.
25. 25.
    DONG W Z，LI Z S，ZOU D W，et al.The changes of mucosal mast cells and substance P in patients with irritable bowel syndrome［J］.Chin J Intern Med，2003，42（9）：611-614.
26. 26.
    YANG L H，LIU Q.Expression of 5-HT， IL-18，and CGRP in patients with diarrheal irritable bowel syndrome and their correlation with symptom severity and visceral sensitivity［J］.Int J Digestive Dis，2022，42（3）：179-184.
27. 27.
    SALVO-ROMERO E，MARTÍNEZ C，LOBO B，et al.Overexpression of corticotropin-releasing factor in intestinal mucosal eosinophils is associated with clinical severity in diarrhea-predominant irritable bowel syndrome［J］.Sci Rep，2020，10（1）：20706.
28. 28.
    GUILARTE M，VICARIO M，MARTÍNEZ C，et al.Peripheral corticotropin-releasing factor triggers jejunal mast cell activation and abdominal pain in patients with diarrhea-predominant irritable bowel syndrome［J］.Am J Gastroenterol，2020，115（12）：2047-2059.
29. 29.
    TAN X，PEI W，XIE C，et al.Tongxie anchang decoction relieves visceral hypersensitivity in diarrhea-predominant irritable bowel syndrome rats by regulating the NGF/TrkA signaling pathway［J］.Evid Based Complement Alternat Med，2021，2021：6679348.
30. 30.
    ZHEN Z，XIA L，YOU H，et al.An integrated gut microbiota and network pharmacology study on Fuzi-Lizhong pill for treating diarrhea-predominant irritable bowel syndrome［J］. Front Pharmacol，2021，12：746923.
31. 31.
    DISTRUTTI E，MONALDI L，RICCI P，et al.Gut microbiota role in irritable bowel syndrome：New therapeutic strategies［J］.World J Gastroenterol，2016，22（7）：2219-2241.
32. 32.
    CHEN W，LIAO L，HUANG Z，et al.Patchouli alcohol improved diarrhea-predominant irritable bowel syndrome by regulating excitatory neurotransmission in the myenteric plexus of rats［J］.Front Pharmacol，2022，13：943119.
33. 33.
    CHEN W，LIAO L，HUANG Z，et al.Corrigendum：Patchouli alcohol improved diarrhea-predominant irritable bowel syndrome by regulating excitatory neurotransmission in the myenteric plexus of rats［J］.Front Pharmacol，2024，15：1394753.
34. 34.
    YU L，HUANG C，YANG W，et al.Aqueous cinnamon extract ameliorates bowel dysfunction and enteric 5-HT synthesis in IBS rats［J］.Front Pharmacol，2022，13：1010484.
35. 35.
    SUN Y N，FU M Z.Effects of total glucosides of paeony on 5-HT signal pathway in diarrhea predominant-irritable bowel syndrome［J］.Western J Tradit Chin Med，2023，36（6）：14-18.
36. 36.
    LIU X S，WEI H Y，SHI L L，et al.Effects of Alhagi sparsifolia Shap extract on water metabolism and gastrointestinal hormone levels in rats with diarrhea-predominant of irritable bowel syndrome［J］.Chin J New Drug Clin Remedies，2019，38（3）：169-173.
37. 37.
    ZHANG S，TIAN D，XIA Z，et al.Chang-Kang-Fang alleviates diarrhea predominant irritable bowel syndrome （IBS-D） through inhibiting TLR4/NF-κB/NLRP3 pathway［J］.J Ethnopharmacol，2024，330：118236.
38. 38.
    SUN J，ZHANG M，LIU W，et al.Evaluation of the effectiveness and mechanism of action of the Chang-Kang-Fang formula combined with bifid triple viable capsules on diarrhea-predominant irritable bowel syndrome［J］.Front Microbiol，2023，14：1160783.
39. 39.
    REN J，FAN X Y，FANG Z W，et al.Effect of Changkang formula on MC in rats with IBS-D［J］.Inf Tradit Chin Med， 2020，37（3）：35-39.
40. 40.
    WANG Y H，LI Y C，LIU Y L，et al.Effect of Jianpi Huashi granule on tyrosine hydroxylase，monoamine oxidase and serotonin transporter expression in brain of rats with diarrheapredominant irritable bowel syndrome［J］.Chin J Exp Tradit Med Form，2018，24（11）：133-138.
41. 41.
    GUO L X，QIN T T，GAO J，et al.Study on the regulative effect of Shenbei Guchang capsule on the brain-gut bacteria axis in the treatment of diarrhea-predominant irritable bowel syndrome［J］.J Chin Med Mater，2022，45（10）：2502-2506.
42. 42.
    WEI Y，FAN Y，HUANG S，et al.Baizhu shaoyao decoction restores the intestinal barrier and brain-gut axis balance to alleviate diarrhea-predominant irritable bowel syndrome via FoxO1/FoxO3a［J］.Phytomedicine，2024，122：155163.
43. 43.
    WANG G，CUI L W，LIU X N，et al.Regulation of 5-HT-RhoA/ROCK2 pathway by Xingpi capsule intervenes mechanism of spleen deficiency and diarrhea in rats with irritable bowel syndrome［J］.Chin J Exp Tradit Med Form，2024，doi：.
44. 44.
    GUO Y，LU Q，YANG X J，et al.Efficacy of Shu-yi-ning-chang decoction on IBS-D：Modulating Nr4a3 pathway to reduce visceral hypersensitivity［J］.PLoS One，2024，19（4）：e0299376.
45. 45.
    WEI X X， YI M N， DENG N，et al.Effect of Sishen pills on expression of 5-HT signaling pathway in rats with diarrhea irritable bowel syndrome［J］.J Emerg Tradit Chin Med，2024，33（2）：215-218.
46. 46.
    FU Y L，QIN Y，LIU H L，et al.Analysis on clinical effect of Xifeng Huashi formula in treatment of diarrhea-predominant irritable bowel syndrome［J］.Chin Commun Doct，2023，40（34）：52-54.
47. 47.
    BI J H，YANG Y，YANG Y T，et al.Effect of Shengyang Yiwei decoction on 5-HT content of hypothalamus and colon in rats with IBS-D［J］.Acta Chin Med Pharmacol，2022，50（6）：40-44.
48. 48.
    LUO Q H，SHI G Y，GAO Y，et al.Effect of Huosha oral liquid on intestinal motility in rats with diarrhea predominant irritable bowel syndrome［J］.Fujian J Tradit Chin Med， 2021，52（8）：32-34.
49. 49.
    WANG H Y，WANG Y.Therapeutic effects of liver and spleen simultaneous treatment on diarrhea-type irritable bowel syndrome and its effects on the peripheral blood 5-HT，NPY and CGRP［J］.Hebei Med J，2020，42（17）：2658-2660.
50. 50.
    HU Y，ZHNEG Y L，MEI Q X，et al.Effect of Tongxieyaofang wall-broken decoction pieces on brain-gut peptide in rats with diarrhea-predominant irritable bowel syndrome［J］.J Chin Med Mater， 2020，43（7）：1726-1731.
51. 51.
    HUANG L X，ZHU C Y，KUANG S M.Effect of Tongxie Anpi decoction on 5-HT in rats with diarrhea irritable bowel syndrome［J］.Acta Chin Med， 2020，35（5）：1034-1039.
52. 52.
    ZHANG P，REN P P，MAO L F，et al.Based on CGRP，VIP and SP，the effect of Pingwei capsule on brain-gut peptide in IBS-D rats with liver-Qi stagnation and spleen deficiency was studied［J］.Lishizhen Med Mater Med Res，2023，34（7）：1552-1555.
53. 53.
    REN P P，WANG M L，ZHAO L，et al.Effect of Pingwei capsule on cerebral enteric peptide in irritable bowel syndrome rats with liver stagnation and spleen deficiency［J］.West China J Pharmaceut Sci，2021，36（3）：262-267.
54. 54.
    LAI J M，CHEN C Y，HE S Y，et al.Effect of Huosha oral liquid on serum levels of SP and NO in patients with diarrhea-predominant irritable bowel syndrome of spleen deficiency and damp blockage［J］.Fujian J Tradit Chin Med，2021，52（6）：54-55.
55. 55.
    TAN H L，XU Y，XIAO L，et al.Clinical study on Qilian Jiechangning decoction for treatment of diarrhea-predominant irritable bowel syndrome with spleen deficiency and damp heat syndrome［J］.Chin J Inf Tradit Chin Med，2021，28（2）：92-96.
56. 56.
    WANG J W，LIU J W，LIU Y M.Clinical effect of Shenling Sini decoction combined with probiotics on diarrhea-predominant irritable bowel syndrome［J］.Chin Tradit Patent Med，2021，43（6）：1679-1681.
57. 57.
    LI S Q，HU Y L，SU C X，et al.Sishenwan ameliorates visceral sensitivity in rat model of diarrhea-predominant irritable bowel syndrome （spleen-kidney Yang deficiency） by regulating p38 MAPK/JNK/TRPV1 pathway［J］.Chin J Exp Tradit Med Form，2024，30（21）：10-18.
58. 58.
    TANG X D.The invention relates to a traditional Chinese medicine composition for treating diarrhea-type irritable bowel syndrome and a preparation method thereof［P］.Beijing，Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine，2020-11-04.
59. 59.
    MA X X，LV L，YANG B，et al.Effect of Chang'an Ⅰ formula on visceral hypersensitivity of IBS-D model rats with Gan depression Pi deficiency syndrome［J］.Chin J Int Tradit West Med，2021，41（3）：343-349.
60. 60.
    WENG W A，LI H H.Clinical study on Shugan Jianpi decoction combined with Trimebutine Maleate capsules for diarrhea-predominant irritable bowel syndrome［J］.New Chin Med，2024，56（11）：54-57.
61. 61.
    XU B W，XU H F，CHEN C.Effects of addition and reduction of Shenling Baishu powder on serum gastrointestinal hormone levels in patients with diarrheal irritable bowel syndrome with spleen deficiency and dampness［J］.Lab Med Clin，2024，21（4）：530-532.
62. 62.
    WANG K C，LI H.Effects of Xifeng Huashi recipe on diarrheal irritable bowel syndrome in rats and its mechanism［J］.Acta Chin Med，2022，37（10）：2191-2197.
63. 63.
    ZHANG Y X，ZAHNG N，ZHENG C H.Effect of Sini Danggui recipe on VIP，SS and MOT contents of D-IBS patients［J］.Liaoning J Tradit Chin Med，2015，42（11）：2146-2148.
64. 64.
    LIANG J，CHEN Q，ZHANG X.Changes of gastrointestinal hormones in diarrhea predominant irritable bowel syndrome treated by Tongxie Sishen decoction and its clinical significance［J］.World J Tradit Chin Med，2020，15（1）：71-75.
65. 65.
    LIAO L M，ZOU L，LI K W，et al.Moxibustion ameliorates visceral hypersensitivity by regulating hypothalamus-spinal cord-colon axis in rats with irritable bowel syndrome with diarrhea［J］.Acupunct Res，2024，49（1）：47-56.
66. 66.
    HOU Y J，WANG K，JIANG H L，et al.Study on the mechanism of electroacupuncture repairing intestinal barrier via regulating mast cell in rats with diarrhea-predominant irritable bowel syndrome［J］.Acupunct Res，2023，48（3）：281-286.
67. 67.
    TANG H Y，CHEN X Q，WANG H，et al.Acupuncture relieves the visceral pain of diarrhea-predominant irritable bowel syndrome rats by regulating P2X4 expression［J］.Am J Transl Res，2022，14（8）：5563-5573.
68. 68.
    LI X L，CAI J Z，LIN Y，et al.Study on acupuncture therapy in regulating gut microbiota and promoting intestinal tight junction in IBS-D rats［J］.J Guangzhou Univ Tradit Chin Med，2019，36（7）：1022-1028.
69. 69.
    ZHANG Z H，LIU Y T，GU L，et al.Effects of electroacupuncture stimulation of "Tianshu"（ST25） and "Zusanli"（ST36） on IBS-D rats based on 5-HT［J］.J Hunan Univ Chin Med，2023，43（12）：2264-2271.
70. 70.
    LIN X D，WANG L L，HUANG X Y，et al.Clinical observation on curative effect of herbs-partition moxibustion at Shenque acupoint in treatment of IBS-D and effects on serum 5-HT，IL-10［J］.Chin J Tradit Med Sci Technol，2022，29（3）：356-359.
71. 71.
    LIU H R，LI J，LU M，et al.Effects of Shugan Jianpi acupuncture on intestinal flora and serum 5-HT，NPY and CGRP in patients with diarrhea irritable bowel syndrome with liver depression and spleen deficiency syndrome［J］.Progress Mod Biomed，2022，22（2）：259-263.
72. 72.
    CAO J N，LIU X，LIU T，et al.Effect of moxibustion on colon 5-HT and 5-HT3R in diarrhea predominant irritable bowel syndrome rats［J］.J Hunan Univ Chin Med，2021，41（10）：1493-1497.
73. 73.
    LI D，LI J，WU S.Effect of electroacupuncture at "Zusanli（ST36）"，"Neiguan（PC6）" and "Taichong（LR3）" on inflammatory factors，5-HT and SIgA concentrations in rats with diarrhea irritable bowel syndrome［J］.Liaoning J Tradit Chin Med，2021，48（8）：238-241.
74. 74.
    CHEN Q，ZHOU Y，ZHANG M，et al.Efficacy observation of acupuncture combined with salt-partitioned moxibustion for IBS-D of spleen deficiency pattern［J］.Shanghai J Acupunct Moxib，2021，40（4）：400-405.
75. 75.
    LI W F，CHEN B W，CHEN S Z.Effect of acupuncture on colonic slow wave and serum cAMP，cGMP，SP in rats with diarrhea-predominant irritable bowel syndrome［J］.Lishizhen Med Mater Med Res，2023，34（5）：1261-1264.
76. 76.
    ZHOU X L，WANG H，LI J，et al.Effects of "Biao-ben acupoints compatibility" acupuncture on heart rate variability and colonic substance P in IBS-D rats［J］.Lishizhen Med Mater Med Res，2023，34（3）：739-743.
77. 77.
    SI Y C，REN C C，LI Q Q，et al.Effect on NPY and PAR4 in brain-cerebral neuropeptide of diarrhea-predominant irritable bowel syndrome （D-IBS） by acupuncture［J］.Lishizhen Med Mater Med Res，2020，31（7）：1782-1785.
78. 78.
    WANG K，HOU Y J，WAMG L，et al.Mechanisms of Peitu Yimu acupuncture in repairing intestinal mucosal barrier by regulating CRF/CRFR1 pathway in diarrhea-predominant irritable bowel syndrome rats［J］.Acupunct Res，2024，49（5）：472-479.
79. 79.
    LIAO L M，ZHOU L，LI K W，et al.Moxibustion ameliorates visceral hypersensitivity by regulating hypothalamus-spinal cord-colon axis in rats with irritable bowel syndrome with diarrhea［J］.Acupunct Res，2024，49（1）：47-56.
80. 80.
    ZHOU Z，YANG X F，YU H M，et al.Effect of acupuncture on the expression of neuropeptides and related inflammatory factors in rats with diarrhea-predominant irritable bowel syndrome［J］.Acupunct Res，2023，48（11）：1142-1150.
81. 81.
    HOU Y J，WANG K，JIANG H L，et al.Study on the mechanism of electroacupuncture repairing intestinal barrier via regulating mast cell in rats with diarrhea-predominant irritable bowel syndrome［J］.Acupunct Res，2023，48（3）：281-286.
82. 82.
    LIU Y，XU P D，YANG M，et al.Therapeutic observation of acupuncture-moxibustion for diarrhea-dominant irritable bowel syndrome of liver depression and spleen deficiency pattern［J］.Shanghai J Acupunct Moxibustion，2021，40（11）：1305-1311.
83. 83.
    Functional Gastrointestinal Diseases Collaboration Group，Gastroenterology Society of Chinese Medical Association，Gastrointestinal Motility Group，Gastroenterology Society of Chinese Medical Association.Expert consensus opinions on irritable bowel syndrome in China in 2020［J］.Chin J Digestion，2020，40（12）：803-818.