Anxiety Disorders · Yin Deficiency with Fire Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Whole Body


Pattern Overview

Yin Deficiency with Fire is a common pattern in anxiety disorders, characterized by sympathetic-adrenal medullary system hyperactivity, anxiety, palpitations, insomnia, and night sweats. The core pathogenesis is insufficient Yin failing to control Yang, leading to ascendant deficiency fire, Shen (spirit) restlessness, and autonomic hyperactivity.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsAnxiety, palpitations, insomnia, night sweats
Associated SymptomsHeat in palms and soles, dry mouth, irritability, restlessness
Tongue and PulseRed tongue with little coating, thready and rapid pulse
PathogenesisYin deficiency with deficiency fire, failing to calm the spirit
EtiologyChronic stress, prolonged illness, excessive sexual activity, aging

Acupuncture Point Prescription

PointLocationFunction
Taixi (KI3)Depression between medial malleolus and Achilles tendonSource point of Kidney meridian; nourishes Kidney Yin
Shenmen (HT7)On the wrist crease, ulnar sideSource point of Heart meridian; calms the spirit
Sanyinjiao (SP6)3 cun above the medial malleolusNourishes Blood and Yin; regulates the Spleen and Kidney
Zhaohai (KI6)1 cun below the medial malleolusNourishes Yin and clears deficiency heat
Daling (PC7)Center of the wrist creaseSource point of Pericardium meridian; calms the spirit

Clinical Recommendation: Filiform needle, reinforcing method; Taixi and Zhaohai may be needled with reinforcing method to enhance Yin nourishment.


Herbal Formula

Base Formula: Tian Wang Bu Xin Dan (天王补心丹)

Composition:
Rehmannia (Sheng Di), Scrophularia (Xuan Shen), Asparagus (Tian Dong), Ophiopogon (Mai Dong), Angelica (Dang Gui), Sour Jujube Seed (Suan Zao Ren), White Peony (Bai Shao), Licorice (Gan Cao)

Action: Nourishes Yin, clears deficiency fire, and calms the spirit.

Modifications

Associated SymptomsAdditions/Subtractions
Severe insomniaAdd Suan Zao Ren, Bai Zi Ren to calm the spirit
Night sweatsAdd Mu Li, Fu Xiao Mai to stabilize the exterior
IrritabilityAdd Zhi Zi, Dan Pi to clear deficiency heat

Western Mechanism Reference

Sympathetic-adrenal medullary system hyperactivity with HPA axis negative feedback dysregulation and elevated cortisol. Yin Deficiency with Fire corresponds to anxiety with prominent autonomic symptoms, where HPA axis dysregulation and elevated cortisol contribute to hyperarousal and anxiety.


References

  1. Internal Medicine of TCM - Depression with Yin Deficiency and Fire.
  2. DB-XJB: Tian Wang Bu Xin Dan.
  3. WHO. (2023). Mental health and anxiety disorders. World Health Organization.

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