Anxiety Disorders - Heart-Spleen Deficiency Pattern

Dr. Li Wei, DACM

Anxiety Disorders · Heart-Spleen Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Heart-Spleen Deficiency is a common pattern in anxiety disorders, characterized by chronic stress exhaustion, anxiety, fatigue, poor sleep, and poor memory. The core pathogenesis is prolonged stress and overthinking consuming Heart Blood and Spleen Qi, leading to Shen (spirit) restlessness, anxiety, and systemic fatigue.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Anxiety, fatigue, poor sleep, palpitations |

| Associated Symptoms | Pale complexion, poor appetite, loose stools, dizziness |

| Tongue and Pulse | Pale tongue with thin white coating, thready and weak pulse |

| Pathogenesis | Heart Blood and Spleen Qi deficiency due to chronic stress |

| Etiology | Chronic stress, excessive thinking, poor nutrition, overwork |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Shenmen (HT7) | On the wrist crease, ulnar side | Source point of Heart meridian; calms the spirit |

| Xinshu (BL15) | Lower back, 1.5 cun lateral to T5 | Back-Shu point of Heart meridian; nourishes Heart Blood |

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen Qi |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi and Blood |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin; regulates the Spleen and Kidney |

Clinical Recommendation: Filiform needle, reinforcing method; moxibustion may be applied to Pishu and Zusanli to warm and tonify Qi and Blood.

Herbal Formula

Base Formula: Gui Pi Tang (归脾汤)

Composition:

Astragalus (Huang Qi), Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Sour Jujube Seed (Suan Zao Ren), Longan (Long Yan Rou), Angelica (Dang Gui), Polygala (Yuan Zhi), Licorice (Gan Cao)

Action: Nourishes Heart Blood, strengthens Spleen Qi, and calms the spirit.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe fatigue | Add Huang Qi to enhance Qi supplementation |

| Poor sleep | Add Suan Zao Ren, Ye Jiao Teng to calm the spirit |

| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |

Western Mechanism Reference

Chronic stress exhaustion state, reduced 5-HT synthesis (tryptophan depletion), and autonomic dysfunction. Heart-Spleen Deficiency corresponds to anxiety with significant fatigue and cognitive symptoms, where chronic stress and tryptophan depletion contribute to reduced serotonin synthesis and autonomic dysfunction.

References

  1. Internal Medicine of TCM - Depression with Heart-Spleen Deficiency.

  2. DB-XJB: Gui Pi Tang.

  3. WHO. (2023). Mental health and anxiety disorders. World Health Organization.

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