Abstract： Objective： To observe the clinical effect of the combination use of Fu's subcutaneous needling and medical-separated umbilical moxibustion on diarrheal irritable bowel syndrome （IBS-D） of liver depression and spleen deficiency type. Methods： A total of 98 IBS-D patients of liver depression and spleen deficiency type admitted to Tengzhou Central People's Hospital from August 2023 to August 2024 were selected and divided into the control group and the trial group according to the random number table method，with 49 cases in each group. The control group was treated with basic treatment combined with Pinaverium Bromide，and the trial group was additionally treated with Fu's subcutaneous needling and medical-separated umbilical moxibustion based on the treatment in the control group. The IBS symptom scores， intestinal microecological levels， serum inflammatory marker levels [interleukin-6 （IL-6）， interleukin-8 （IL-8）， C-reactive protein （CRP）， tumor necrosis factor- α （TNF- α）] after treatment， and the incidence of complications during treatment were compared between the two groups. Results：After treatment，the total effective rate was 91.84% （45/49） in the trial group and 71.43% （35/49） in the control group， the difference being significant （P＜0.05）. After treatment，the IBS symptom scores in the two groups were decreased when compared with those before treatment （P＜0.05）， and the IBS symptom score in the trial group was lower than that in the control group（ P＜0.05）. After treatment，the levels of serum IL-6，IL-8，CRP，and TNF-α in the two groups were reduced when compared with those before treatment （P＜0.05）， and the above four levels in the trial group were lower than those in the control group （P＜0.05）. After treatment，the counts of Bifidobacterium and Lactobacillus in the two groups were elevated when compared with those before treatment （P＜0.05），and the counts of Enterococcus and Enterobacter in the two groups were reduced when compared with those before treatment （P＜0.05）；the counts of Bifidobacterium and Lactobacillus in the trial group were higher than those in the control group （P＜0.05）， and the counts of Enterococcus and Enterobacter in the trial group were lower than those in the control group （P＜0.05）. During the treatment，the incidence of complications was 8.16 %（ 4/49） in the trial group and 24.49%（ 12/49） in the control group， the difference being significant （P＜0.05）. Conclusion： The combination use of Fu's subcutaneous needling and medical-separated umbilical moxibustion can effectively alleviate the symptoms of patients with IBS-D of liver depression and spleen deficiency type， improve the intestinal microecological environment， and reduce the levels of serum inflammatory factors with great safety.