Abstract： Objective： To observe the clinical effect of Jianpi Zhixie Decoction combined with Pinaverium Bromide Tablets for diarrhea-predominant irritable bowel syndrome (IBS-D) with liver constraint and spleen deficiency syndrome. Methods： A total of 96 cases IBS-D patients with liver constraint and spleen deficiency syndrome were selected as the study objects and divided into the control group and the observation group according to the random number table method，with 48 cases in each group. The control group was treated with Pinaverium Bromide Tablets， and the obsrevation group was additionally treated with Jianpi Zhixie Decoction based on the treatment of the control group. Both groups were treated for 4 weeks. Clinical effects were evaluated in the two groups. Traditional Chinese medicine syndrome scores， scores of Irritable Bowel Syndrome-Symptom Severity Scale (IBS-SSS)， serum cytokine indicators， and intestinal barrier function indicators were compared between the two groups before and after treatment. Results：The total effective rate was 93.75% in the observation group，higher than that of 79.17% in the control group (P＜0.05). After treatment， the scores of abdominal pain， abdominal distention， diarrhea， irritability and irascibility， torpid intake， distention and fullness in the rib- side， and fatigue and lack of strength in the two groups were decreased when compared with those before treatment (P＜0.05)， and each score in the observation group was lower than that in the control group (P＜0.05). After treatment，the scores of influence of IBS on life， abdominal pain frequency， abdominal pain intensity， abdominal distension， and dissatisfaction with bowel habits， as well as the total scores in the two groups were decreased when compared with those before treatment (P＜0.05)；and each score in the observation group were lower than those in the control group (P＜0.05). After treatment， the levels of serum interleukin-2 (IL-2) and interferon- γ (IFN- γ)， diamine oxidase (DAO)， D-lactic acid (D-LA)， and intestinal fatty acid binding protein (IFABP) in the two groups were decreased when compared with those before treatment (P＜ 0.05)；and the above levels in the observation group were lower than those in the control group (P＜0.05)； the levels of serum interleukin-4 (IL-4) and interleukin-10 (IL-10) in the two groups were increased when compared with those before treatment (P＜0.05)； the above two levels in the observation group were higher than those in the control group (P＜0.05). Conclusion：Jianpi Zhixie Decoction is used to treat IBS-D patients by inhibiting gastrointestinal inflammatory reactions and repairing intestinal barrier function，which can effectively relieve clinical symptoms such as abdominal pain and diarrhea， and improve the patient's daily life.