Pathogenesis of Chronic Heart Failure with Anxiety and Depression and Therapeutic Mechanisms of Bupleuri Radix-based Formulas from Theory of Qi Movement in Lesser Yang

TAN Duoting ,  

LIAN Kun ,  

LIANG Hao ,  

MENG Lichong ,  

HU Zhixi ,  

摘要

Chronic heart failure (CHF), as the terminal stage of various cardiovascular diseases, is characterized by a prolonged clinical course and recurrent exacerbations. The coexistence of CHF with anxiety and depression falls under the category of psycho-cardiological diseases. Studies have demonstrated that anxiety and depression are closely associated with adverse outcomes including elevated risks of cardiovascular events and increased mortality in CHF patients. The complex pathogenesis poses challenges to modern medical treatments, which often face limited efficacy and concurrent side effects. According to the theory of Qi movement in lesser Yang in traditional Chinese medicine (TCM), this paper elucidates that obstructed Qi movement in lesser Yang—manifested as Qi transformation disorder, dysregulated fluid metabolism, and abnormal distribution of ministerial fire-serves as a critical pathological basis for CHF with anxiety and depression. Bupleuri Radix-based Formulas, such as Xiao Chaihu Tang, Chaihu Guizhi Tang, and Chaihu Jia Longgu Muli Tang, aim to harmonize lesser Yang to restore the Qi transformation, activate Yang to promote water excretion, and redistribute ministerial fire, thus effectively alleviating pathological states such as Qi stagnation, blood stasis, water retention, and phlegm-fire disturbing the heart in CHF patients with anxiety and depression. Consequently, they mitigate symptoms of this psycho-cardiological disease. Mechanism studies have revealed that Bupleuri Radix-based formulas exhibit multi-target effects, including modulation of neurotransmitters, suppression of inflammatory responses, regulation of lipid metabolism, protection of cardiomyocytes, and improvement of the endothelial function. By interpreting the TCM pathogenesis of CHF with anxiety and depression from the theory of Qi movement in lesser Yang, this paper delves into the therapeutic principles and mechanisms of Bupleuri Radix-based formulas, providing a theoretical foundation for optimizing TCM diagnosis and treatment strategies for psycho-cardiological diseases.

关键词

Qi movement in lesser Yang;psycho-cardiological disease;chronic heart failure;state of anxiety and depression;Bupleuri Radix-based formulas

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