Objective: To evaluate the overall efficacy of rTMS in the treatment of irritable bowel syndrome and to explore the central mechanism of rTMS for IBS.

Methods: 1. Clinical efficacy evaluation of TMS for chronic visceral pain in IBS patients The 200 IBS patients who meet the recruitment criteria for the clinical study will be randomized into 100 patients in rTMS and Western medicine group. Corresponding treatment was given for 1 week, rTMS group received 1 Hz/s, 20 min for 1 week; Western medicine group received pivinonium tablets orally, 50 mg three times a day for 1 week. Clinical assessment included symptoms, stool traits, mood, and sleep. 2. Study on the central mechanism of using fMRI to treat chronic visceral pain in IBS patients Forty cases each were included in the IBS-eligible patient group and the healthy control group, and repeated transcranial magnetic stimulation treatment was given to the patient group for 1 week, and the patient group underwent the assessment of clinical observational indexes (IBS-SSS, SAS, SDS, and AIS) before and after the treatment and the acquisition of functional magnetic resonance data. In the healthy control group, clinical observation indexes (SAS, SDS, AIS) were evaluated before enrollment, and functional magnetic resonance data were collected after enrollment.

Conclusion: 1. The clinical efficacy of rTMS for IBS is superior to that of the western drug pivoxyl bromide tablets. 2. Targeted brain areas of rTMS treatment: there was a positive correlation between the change in ALFF values of mPFC and the improvement in abdominal pain level score before and after treatment.