Objective: Evaluate clinical study of Jiawei Yigan Powder in treating patients of diarrhea predominant irritable bowel syndrome (IBS-D) with anxiety and depression. Methods: IBS-D patients with anxiety and depression who were included in the diagnostic criteria were randomly divided into a treatment group with 33 cases (Jiawei Yigan Powder) and a control group with 30 cases (pinaverium bromide tablet). Evaluation through symptom score, anxiety and depression score, the quality of life (IBS-QOL), efficacy evaluation, adverse symptoms scale. Results: The overall efficiency of the treatment group was 87.88%, which was significantly higher than the control group (66.67%), and the difference was statistically significant (P<0.05). Symptoms scores, anxiety and depression scores and IBS-QOL improved in both groups. The treatment group was significantly superior to the control group in terms of main symptoms (abdominal pain or abdominal discomfort, irritability), secondary symptoms (discomfort of rib, poor appetite), IBS-QOL (irritability, conflicting behavior, health concerns, social responses). Conclusion: The clinical effect of Jiawei Yigan Powder in treating patients of diarrhea predominant irritable bowel syndrome with anxiety and depression was remarkable, and there was no adverse reaction, it was worth clinical promotion.