Objective To explore the abnormality of top-down and bottom-up attention patterns in patients suffering from coronary heart disease(CHD)patients with heart-qi deficiency syndrome based on the theory of"five spirits".Methods From July 2024 to December 2024,30 CHD patients with heart-qi deficiency syndrome were recruited,and 30 subjects without CHD as the control group according to the principle of matching age,sex and years of education.Two groups of subjects were tested with top-down and bottom-up spatial cueing paradigm.Results Compared with the control group,CHD patients with heart-qi deficiency syndrome had longer valid reaction time(vRT)and lower average reaction time difference value(△RT)in top-down test(P＜0.05),and longer vSRT in bottom-up test.Correlation analysis showed that heart-qi deficiency syndrome score was positively correlated with top-down test indexes invalid reaction time(ivRT)(P＜0.05),negatively correlated with △RT(P＜0.01)and valid accurany(vAC)(P＜0.05).It was positively correlated with valid long reaction time(vLRT)(P＜0.01)and invalid long reaction time(ivLRT)(P＜0.01).Generalized linear model analysis showed that non-CHD subjects had shorter vRT(P＜0.01)and larger △ RT(P＜0.05)than CHD patients for top-down test.For bottom-up tests,non-CHD subjects had shorter vSRT than CHD patients(P＜0.05).Conclusion The change of top-down and bottom-up attention patterns in CHD patients with heart-qi deficiency syndrome provides a modern neuropsychological basis for the theory of"heart stores spirits".

Objective To analyze the core syndromes of patients with generalized anxiety disorder(GAD),explore the core pathogenesis,and offer innovative perspectives and practical strategies for the traditional Chinese medicine(TCM)diagnosis and treatment of GAD.Methods The basic information of GAD patients was collected,and depression symptoms were evaluated with Hamilton Anxiety Scale to evaluate anxiety symptoms,Hamilton Depression Scale,and the TCM psychiatric and somatic symptoms were evaluated with Traditional Chinese Medicine Symptom Observation Form.Based on the data collected from the Traditional Chinese Medicine symptom observation table,the systematic clustering method was used to cluster the symptoms with a frequency greater than 10％,determine the disease type syndrome and disease location syndrome,and form a syndrome symptom relationship table.According to this table,the traditional Chinese medicine syndrome score of each patient is calculated.The complex network analysis was carried out to evaluate core syndromes and analyze the relationships between core syndromes and psychiatric symptoms and core syndromes and other syndromes.Results A total of 517 patients with GAD were included.There were 81 symptoms with a frequency of more than 10％,including 21 psychological symptoms and 60 physical symptoms.The clustering analysis led to a total of 12 syndromes,including 6 pathological syndromes,namely yin deficiency,heat,phlegm dampness,qi stagnation,blood stasis,and qi deficiency,and 6 disease location syndromes,namely liver,spleen,kidney,gallbladder,stomach,and heart.The results of complex network analysis show that the core pathological syndrome of GAD is kidney,and the core pathological syndrome is yin deficiency.The joint analysis of pathological syndrome and pathological syndrome network suggests that yin deficiency is the core of the integrated network.The relationship between yin deficiency syndrome and various organs is in the order of kidney,spleen,gallbladder,liver,heart,and stomach.The syndrome element of yin deficiency has the highest correlation with being easily frightened,excessive thinking,indecisiveness,repetitive behavior,and groundless worry.The kidney syndrome has the highest correlation with the symptoms such as being easily scared,unfounded worry,repetitive actions,excessive rumination,and restlessness.Conclusion The core pathological pattern of GAD is kidney and the core pathological pattern is yin deficiency.Kidney yin deficiency may be the core pathogenesis of GAD.

Coronary heart disease(CHD)imposes a high disease burden in China and it is still increasing significantly.There is a two-way connection between the heart and the brain,and the premature and rapid decline of cognitive function in patients with CHD has attracted increasing interesting from researchers,but clinical professionals often pay more attention to heart-related symptoms and ignore the impact of cognitive function decline on the quality of life of patients with CHD.This article reviews the current research progresses of cognitive decline in CHD patients from the aspects of manifestation,influencing factors,pathological mechanism and intervention measures.It offers a reference for medical professionals to understand this problem more deeply.

Objective To explore the distribution patterns of traditional Chinese medicine(TCM)syndromes in patients with metabolic syndrome caused by antipsychotic drugs.Methods A standardized TCM syndrome survey was performed to collect diagnostic information from 160 patients diagnosed with metabolic syndrome due to antipsychotic drug use.Subsequent frequency analysis,cluster analysis,and Bayesian network analysis were carried out.The syndrome pattern distribution was ultimately determined through relevant literatures and expert opinions.Results Five TCM syndromes were identified through frequency,cluster,and Bayesian network analyses.The most common syndrome was qi deficiency with phlegm-dampness(30％),followed by spleen deficiency with phlegm-Heat(23.75％),qi and yin deficiency Pattern(21.88％),yin deficiency with damp-heat(17.50％),and stomach fire hyperactivity pattern(6.88％).Conclusion The pathogenesis of antipsychotics-induced metabolic syndrome involves a complex interplay of deficiency and excess factors.The primary disease is mainly located at the spleen and stomach,with involvement of the liver,kidney,and heart.Pathogenic factors include qi deficiency,yin deficiency,dampness,heat,pathogenic fire,and phlegm.

Objective To evaluate the efficacy and safety of Qingre Jiedu recipe in the treatment of bipolar depression.Methods A randomized,double-blind,Chinese medicine and western medicine placebo control design was used in this study.Totally 80 subjects with bipolar depression and fiery internal depression that met the enrollment criteria,were divided into the experimental group(EG,40 cases of western medicine simulation tablets+Chinese medicine formula granules)and the control group(CG,40 cases of western medicine+Chinese medicine placebo)according to a 1∶1 ratio at last,7 cases dropped out after enrollment,EG 36 cases,CG 37 cases.TCM Heat Internal Depression Syndrome(TCMHIDS),Hamilton Depression Scale-24 Item(HAMD-24),Hamilton Anxiety Scale(HAMA),Hypomania Checklist-33(HCL-33),Young Manic Rating Scale(YMRS)and Treatment Emergent Symptom Scale(TESS)scores were assessed at baseline and at the 2nd,4th and 8th week after treatment.Important signs and adverse events were recorded.Blood routine,hepatic and renal function,urine routine and electrocardiogram were performed during the screening period and the 8th week after treatment.For the patients who dropped out of the examination program,the examination item are identical to those at week 8.The primary outcome measure was the change in HAMD score from baseline to 8th week.Secondary outcome evaluation indicators included the changes of TCMHIDS,HAMA,HCL-33 and YMRS scores from baseline to 8th week.Results The scores of the HAMD-24 between EG and CG decreased significantly compared with the baseline at different time-point,and the difference was statistically significant(P＜0.01).However,the scores of the EG on the HAMD-24 decreased more significantly compared with the CG at the 4th and 8th week,and this difference was statistically significant(P＜0.01).The TCMHIDS and HAMD scores between two groups decreased compared with the baseline at different time-point,and this difference was statistically significant(P＜0.01).However,the TCMHIDS and HAMD scores of the EG decreased more significantly ot the 4th and 8th week,compared with the CG,and this difference was statistically significant(P＜0.01).Both YMRS and HCL-33 scores decreased more significantly between two groups at different time-point,compared with the baseline,and this differences was statistically significant,but there was no difference between two groups.Conclusion TCM Qingre Jiedu recipe could effectively relieve depression and anxiety mood of bipolar depression,with more advantages than western medicine.In addition,it showed a certain effect on hypomania or manic-related symptoms of bipolar disorder,No risk of turning to hypomania or manic,better safety and less adverse reactions were observed.

Objective To explore the attentional network function in sub-healthy individuals with spleen qi deficiency syndrome.Methods Twenty-seven individuals in the sub-healthy spleen qi deficiency syndrome group were recruited from September 2022 to August 2024 in communities and colleges.Twenty-five healthy controls were also recruited according to the principle of matching age,gender,and years of education components.Attention network tests were performed on subjects in both groups.Results Compared with the control group,the executive control network function value of the spleen qi deficiency syndrome group was significantly decreased(P=0.012).The differences in correct rate,overall reaction time,alert network and orientation network between the two groups were not statistically significant(P＞0.05).The results of correlation analysis showed a significant negative correlation between Health Evaluating Questionnaire H20 V2009 scores and executive control network efficiency of the subjects in the spleen qi deficiency syndrome(P＜0.001),and a positive correlation between the spleen qi deficiency syndrome score and executive control network efficiency(P=0.038).Conclusions Abnormal changes in the executive control of attention in sub-healthy subjects with spleen qi deficiency syndrome were closely related to the severity of the symptoms of spleen qi deficiency,which provided further scientific evidence for the cognitive psychological connotation of the theory of"spleen stores Yi".

Objective To characterize working memory performance in patients with chronic fatigue syndrome(CFS)and spleen-deficiency syndrome and to examine its associations with clinical symptoms by Sternberg working memory task(SWMT).Methods 31 CFS patients meeting both CDC-1994 criteria and consensus criteria for spleen-deficiency pattern were recruited from outpatient clinics and universities from September 2022 and June 2025.31 healthy controls were also recruited based on age,sex,and education.All subjects completed the SWMT.Group differences were analyzed.Within the CFS cohort,reaction time(RT)was correlated with scores on the checklist individual strength(CIS),36-item short-form health survey(sf-36),and fatigue scale-14(FS-14).Mediation was examined.Results RT lengthened with increasing memory load in both groups.CFS patients displayed slower RTs than controls in the baseline and 6-digit set(P<0.05).The 3-digit RT difference,though not significant(P>0.05),yielded a medium effect size(r=0.36).Accuracy did not differ between two groups.Among CFS patients,3-digit RT correlated positively with CIS total and the 4 sub-scale scores.6-digit RT correlated with the SF-36 health-transition dimension(r=0.396,P=0.027).CIS and FS-14 scores directly impaired SF-36 social functioning without working-memory mediating.Conclusion CFS patients with spleen-deficiency exhibit slowed processing speed rather than capacity loss.The close link between working-memory slowing and fatigue suggests a distinct neural basis.These results support the traditional concept"the spleen stores Yi"and integrate TCM pattern differentiation with modern cognitive neuroscience in CFS.

The theory of Five Spirit-Organs in TCM originates from the"five Zang-organs storing spirit"in"Huangdi Neijing",constructing a regulatory system for mental activities centered on the unity of form and spirit,which includes the heart storing spirit,liver storing soul,spleen storing intention,lung storing corporeal soul,and kidney storing will.By connecting mental activities with the functions of the five Zang-organs through the symbolic thinking of the Five Elements,this theory provides a systematic framework for the qualitative and positional diagnosis of mental symptoms,and its research holds theoretical and clinical significance for breaking through the bottlenecks in the diagnosis and treatment of mental diseases in TCM.This review summarized the multi-dimensional research progress on the scientific connotation of the theory,finding that psychological studies have confirmed the correlation between dysfunction of the five Zang-organs and psychological abnormalities such as attention disorders.Neurobiological research has provided neuroscientific evidence for the"Zang-spirit-brain"mapping via imaging and neurotransmitter detection.And clinical practice has shown the unique advantage of"simultaneous regulation of form and spirit"in the management of mental diseases(anxiety,depression,etc.)and organic diseases complicated with mental symptoms based on the differentiation of five spirit-organs.Current research faces controversies and bottlenecks such as the integration of TCM and Western medicine theories,requiring future construction of a modern interpretive system through interdisciplinary technologies to promote the standardization and internationalization of the theory.

Bidirectional communication between the heart and brain has been well documented,and their respective electrophysiological activities are not independent but rather exhibit a measurable degree of coupling.The traditional Chinese medicine(TCM)doctrine of"heart storing the spirit"posits that the heart governs all vital activities and that the heart and brain are functionally interdependent and mutually reinforcing.This paper systematically reviews current methodological approaches for investigating cardio-electroencephalographic coupling,summarizes empirical findings that elucidate human physiological and pathological mechanisms through this coupling framework,and integrates TCM-based perspectives on heart-brain interactions.Finally,prospects for applying emerging cardio-electroencephalographic techniques is outline to advance research on the"heart storing the spirit"theory.

Objective To explore their inter-relationship,cognitive performance and cardio-electroencephalographic coupling in coronary heart disease(CHD)patients with heart-qi deficiency pattern were characterized.Methods Thirty CHD patients who met the diagnostic criteria for heart-qi deficiency were enrolled.Thirty healthy volunteers without heart-qi deficiency or CHD served as controls.Cognitive function was assessed with the repeatable battery for the assessment of neuropsychological status(RBANS).Simultaneous resting-state electrocardiogram and electroencephalogram were recorded,and the strength of heart-brain coupling was quantified by calculating the maximal information coefficient(MIC)between heart-rate variability(HRV)and EEG signals.Results Compared with controls,heart-qi deficiency CHD patients showed lower RBANS total scores and reduced performance in immediate memory,visuospatial/constructional ability,and attention.Significant between-group differences in HRV-EEG MIC values were observed at several channels(P<0.05).In patients,the MIC values for HRV-Beta(channel FC1)and HRV-Delta(channel F2)were positively correlated with RBANS total score(P<0.05).Conclusion CHD patients with heart-qi deficiency exhibit impaired cognition and altered cardio-electroencephalographic coupling.These findings suggest that heart-brain interactions may contribute to the pathophysiological mechanisms underlying cognitive decline in this population.