Abstract：Objective：To observe the clinical effect of modified Chaihu Guizhi Ganjiang tang combined with thunder-fire moxibustion on patients with irritable bowel syndrome with diarrhea(IBS-D) with Shaoyang Taiyin of cold，heat and diarrhea syndrome. Methods： A total of 60 patients with IBS- D with Shaoyang Taiyin of cold， heat and diarrhea syndrome were selected and randomly divided into the treatment group and the control group，30 cases in each group. The treatment group was treated with modified Chaihu Guizhi Ganjiang tang combined with thunder-fire moxibustion，and the control group was treated with trimebutin maleate tablets combined with bifidobacterium triple viable capsules. The scores of stool characteristics， degree of abdominal pain and distension， and defecation frequency were compared between the two groups. The overall gastrointestinal symptoms and effect in the two groups were counted. The recurrence rate in the two groups was counted after follow-up for two months. Results：After treatment，the scores of stool characteristics，degree of abdominal pain and distension， and defecation frequency were decreased(P＜0.05)； the above three scores in the treatment group were lower than those in the control group(P＜0.05). The total effective rate was 96.7% (29/30) in the treatment group and 73.3%(22/30) in the control group；the total effective rate in the treatment group was higher than that in the control group(P＜0.05). The recurrence rate in the treatment group was 0(0/29)，significantly lower than that of 13.64%(3/22) in the control group，the difference being significant(P＜0.05). Conclusion：The therapy of modified Chaihu Guizhi Ganjiang tang combined with thunder- fire moxibustion has better clinical effect than the treatment of trimebutin maleate tablets combined with bifidobacterium triple viable capsules in treating IBS- D patients with Shaoyang Taiyin of cold， heat and diarrhea syndrome，which has great advantages in improving patients' symptoms and reducing recurrence rate.