【Abstract】 Objective To investigate the effect of Bifidobacterium triple viable tablet (Golden Bifid) combined with aerobic exercise on elderly patients with diarrhea irritable bowel syndrome (IBS d). Methods According to the method of random number table, the elderly IBS D patients who were treated in our hospital from January 2017 to October 2018 were divided into control group and observation group with 86 cases in each group. The patients in the control group were treated with bifidus aureus 2 g / time, 3 times / day for 12 weeks. The patients in the observation group took aerobic exercise on the basis of the control group, 5 times / week, for 12 weeks. The symptom score, therapeutic effect, serum substance P (SP), neuropeptide Y (NPY), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), Hamilton Depression Scale (HAMD) and anxiety scale (HAMA) were compared between the two groups. Results After 12 weeks of treatment, the abdominal pain, abdominal distention, stool characteristics, defecation frequency, HAMD and HAMA scores of the observation group were significantly lower than those of the control group (P＜0.05). The total effective rate of the observation group was 9186%, and that of the control group was 7326%. The difference between the two groups was statistically significant (center 2=21.320, P＜0.001). The level of serum NPY in the observation group was significantly higher than that in the control group, and the levels of SP, TNF-α and IL-6 were significantly lower than that in the control group (P＜0.05). Conclusion By regulating SP and NPY release and alleviating inflammatory state, Golden Bifid combined with aerobic exercise can improve the clinical symptoms, depression and anxiety of elderly IBS D patients. The therapeutic effect of Golden Bifid combined with aerobic exercise is better than that of Golden Bifid alone.