Analysis of pattern identification and treatment of anxiety disorder based on the "yin fire" theory

Based on the "yin fire" theory of LI Dongyuan, this article systematically discusses the pathogenesis and treatment method for anxiety disorder outlined by traditional Chinese medicine (TCM). The study posits that although anxiety disorder has traditionally been ascribed to the heart and liver in terms of pattern identification and treatment, its essential pathogenesis is intrinsically linked to dysfunction of the spleen and stomach. From the viewpoint of "yin fire" theory, the pathogenesis of anxiety disorder can be summarized as spleen and stomach deficiency as the root, and upward disturbance of "yin fire" as the manifestation. The spleen and stomach are the acquired foundation of the human body and the source of the production and transformation of qi and blood. The spleen and stomach ascend lucidity and descend turbidity and regulate and mediate the qi movement of the whole body. Impairment of the spleen and stomach caused by improper diet, physical overstrain, excessive mental contemplation, and other internal damage factors will lead to the failure of clear yang to ascend and turbid yin to descend, as well as the sinking of the middle qi into the lower energizer. Consequently, the "yin fire" is the lower energizer and loses its restraint, takes advantage of the deficiency to ascend and disturb the earth position, resulting in disharmony between qi and fire, upward disturbance of "yin fire", and eventually manifesting as a series of anxiety-related symptoms including restlessness, easy fatigability, palpitations, and insomnia. In terms of treatment, this paper emphasizes the basic therapeutic principle of tonifying qi and ascending yang, regulate qi movement, mildly purging floating fire. It advocates taking Buzhong Yiqi Decoction as the primary prescription, supplemented with a small amount of heat-clearing medicinal, and attaches great importance to nourishing and astringing yin, so as to restore the transportation and transformation function of the middle energizer and harmonize qi and fire. Based on the traditional therapeutic strategy for treating the heart and liver, this paper expands a new perspective for the diagnosis and treatment of anxiety by treating it from the spleen and stomach, which holds certain theoretical significance and practical reference value for the clinical diagnosis and treatment of anxiety disorder with spleen-stomach deficiency pattern.