Exploring the theoretical insights of modified Huanglian Wendan Decoction in treating psycho-cardiological disease from the perspective of "Changluo Tiaoshen"

Psycho-cardiological disease, also known as psychological heart disease, is a common comorbidity in clinical cardiology at present. The current treatment is challenged by complex symptoms, high recurrence rate, and obvious side effects of Western medical intervention. Traditional Chinese medicine (TCM) has unique advantages in "simultaneous treatment of the heart and mind". Under the guidance of the collateral disease theory and the theory of mental disorders, our team has summarized the principle of "Changluo Tiaoshen". We hold that the core pathogenesis of psycho-cardiological disease is phlegm-heat blocking collaterals and disturbing the heart-spirit. Huanglian Wendan Decoction is based on the methods of clearing heat and resolving phlegm, calming the mind and tranquilizing the spirit. Modified Huanglian Wendan Decoction is applied to different combinations of Psycho-cardiological Diseases, such as chest obstruction with depression syndrome, true heart pain with zangzao syndrome, palpitations with insomnia, heart failure with dian syndrome, and vertigo with depression syndrome. Remarkable therapeutic effects are achieved by adopting the syndrome differentiation and modification ideas of resolving phlegm, unblocking collaterals and relieving depression; clearing heat, unblocking collaterals and nourishing yin; eliminating phlegm, unblocking collaterals and calming the heart; purging turbidity, unblocking collaterals and removing phlegm; clearing phlegm, unblocking collaterals and regulating the liver respectively. This article elaborates on the syndrome differentiation characteristics of the application of modified Huanglian Wendan Decoction in treating psycho-cardiological diseases from the aspects of TCM theory construction, exploration of pathogenesis and treatment methods, and discussion of clinical ideas, aiming to provide references for the prevention and treatment of psycho-cardiological diseases with TCM.