Diarrhea-predominant irritable bowel syndrome (IBS-D) is the most common subtype of irritable bowel syndrome (IBS).The main causes of IBS-D include gastrointestinal inflammation,increased visceral sensitivity,abnormal brain-gut axis,intestinal microecological disorder,and intestinal barrier damage.There are key factors that trigger IBS-D in these pathological processes.Therefore,the key signaling pathways and key signaling factors of the pathogenesis of IBS-D can be sought as biological targets for the treatment of IBS-D,and the purpose of preventing and treating IBS-D can be achieved by inhibiting or regulating these biological targets.Studies have shown that traditional Chinese medicine (TCM) is a safe and effective way to intervene in the treatment of IBS-D.Both single TCM and TCM compound have been shown to have regulatory effects on multiple key pathways and key signaling factors in the pathogenesis of IBS-D.This article reviews the research progress of biological targets related to traditional Chinese medicine in the treatment of the pathogenesis of IBS-D,so as to provide ideas for the exploration of the mechanism of action of drugs for IBS-D and the development of new drugs.