Evolution of fire-qi-spirit pathogenesis and strategies of prevention and treatment for post-stroke depression

Post-stroke depression, a common complication after stroke, severely affects the physical and mental rehabilitation of patients. Currently, the treatment of depression after stroke has limitations, such as limited efficacy and numerous adverse reactions. Preventing and treating depression after stroke have specific effects; however, the optimal intervention timing and duration remain unclear. Based on the principle of preventive treatment of diseases and the theory that "excessive fire consumes qi" (Huangdi Neijing), this article explores the influence of the stroke etiology and pathogenesis on secondary depression. The article proposes the pathogenesis of post-stroke depression as "wind and fire interacting-excessive fire consuming qi-spirit decline and qi depression," where fire is the pathological cause, qi is the fundamental pathogenesis, and spirit is the disease manifestation. The disease can be prevented after the occurrence of stroke, but treatment should occur before "excessive fire consumes qi." Clearing fire, preserving the body′ s normal functions, and reducing fire to protect qi and prevent depression are advisable. After "excessive fire consumes qi," which results in spirit decline and qi depression, dispersing stagnated liver qi for relieving qi stagnation, nourishing the spirit, and relieving depression to treat it are recommended. This article elaborates on the pathogenesis of post-stroke depression as " fire-qi-spirit, "based on the theory of" excessive fire consumes qi" and "preventing disease from exacerbating." This study proposes reducing fire to protect qi and nourishing the spirit to relieve depression to prevent and treat post-stroke depression, with the aim of providing a novel theoretical basis and practical guidance for preventing and treating post-stroke depression in traditional Chinese medicine.