Syndrome Differentiation and Treatment of Diarrhea-Predominant Irritable Bowel Syndrome：Based on the Theory of "Zi Wu Liu Zhu （子午流注）"
10.13288/j.11-2166/r.2026.16.007
- VernacularTitle:基于“子午流注”理论辨治腹泻型肠易激综合征
- Author:
Ting ZHENG
1
;
Kaiyue HUANG
1
;
Jiayan LI
1
;
Fengyun WANG
1
;
Xudong TANG
1
;
Lin LYU
1
Author Information
1. Institute of Digestive Diseases，Xiyuan Hospital，China Academy of Chinese Medical Sciences，Beijing，100091
- Publication Type:Journal Article
- Keywords:
diarrhea-predominant irritable bowel syndrome;
Zi Wu Liu Zhu （子午流注）;
liver constraint;
spleen deficiency;
intestinal stagnation
- From:
Journal of Traditional Chinese Medicine
2026;67(16):1728-1733
- CountryChina
- Language:Chinese
-
Abstract:
Based on the theory of Zi Wu Liu Zhu （子午流注， the ebb and flow of midnight and midday） and the clinical characteristics of diarrhea-predominant irritable bowel syndrome （IBS-D） that its symptoms mainly occur during chou （丑） period （01：00—03：00）， mao （卯） period （5：00—7：00）， and si （巳） period （9：00—11：00）， this paper proposes a temporal pathogenesis chain of "liver constraint during chou period， intestinal stagnation during mao period， and spleen deficiency during si period". Within this chain， liver constraint serves as the initiating factor， and intestinal stagnation manifests as the branch， while spleen deficiency constitutes the root of the disease. Accordingly， a chronotherapeutic principle of "soothing the liver， regulating the intestines， and fortifying the spleen" is proposed， establishing a corresponding time-based syndrome differentiation and treatment system. During chou period， the treatment should focus on soothing the liver to relieve constraint and calming the mind to tranquilize the spirit， thereby blocking the mechanism of liver constraint overacting on the spleen. During mao period， the focus is regulating qi to resolve dampness and harmonizing the intestine to alleviate the branch symptoms of morning abdominal pain and diarrhea. During si period， the suggested method is fortifying the spleen and supplementing qi to drain dampness and stop diarrhea， thereby restoring the pivot of spleen-stomach transportation and transformation. These methods are complemented by strategies to optimize medication compliance， thereby providing a new chronotherapeutic approach for clinical diagnosis and treatment of IBS-D.
