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 DimensionManifestations
Primary SymptomsAnxiety, fatigue, poor sleep, palpitations
Associated SymptomsPale complexion, poor appetite, loose stools, dizziness
Tongue and PulsePale tongue with thin white coating, thready and weak pulse
PathogenesisHeart Blood and Spleen Qi deficiency due to chronic stress
EtiologyChronic stress, excessive thinking, poor nutrition, overwork

Acupuncture Point Prescription

PointLocationFunction
Shenmen (HT7)On the wrist crease, ulnar sideSource point of Heart meridian; calms the spirit
Xinshu (BL15)Lower back, 1.5 cun lateral to T5Back-Shu point of Heart meridian; nourishes Heart Blood
Pishu (BL20)Lower back, 1.5 cun lateral to T11Back-Shu point of Spleen meridian; strengthens Spleen Qi
Zusanli (ST36)3 cun below the patella, 1 finger-width lateral to the tibial crestStrengthens Spleen and Stomach; tonifies Qi and Blood
Sanyinjiao (SP6)3 cun above the medial malleolusNourishes 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 SymptomsAdditions/Subtractions
Severe fatigueAdd Huang Qi to enhance Qi supplementation
Poor sleepAdd Suan Zao Ren, Ye Jiao Teng to calm the spirit
Poor appetiteAdd 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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