Psycho-cardiological disease refers to a clinical syndrome involving the coexistence of cardiovascular diseases and psychological disorders. It maintains a consistently high prevalence and seriously affects patients’ quality of life as well as long-term prognosis. Treatments with Western medicine present limitations including risks of drug interactions and a shortage of psychological intervention resources. Huanglian Wendan Decoction (黄连温胆汤, HLWDT), derived from Liu Yin Tiao Bian of the Qing dynasty, has the effects of clearing heat and resolving phlegm, regulating the stomach and benefiting the gallbladder, and tranquilizing the mind. It conforms to the core pathogenesis of psycho-cardiological disease: phlegm-heat disturbing the heart. By systematically reviewing mechanistic studies on HLWDT against psycho-cardiological disease in recent years, this paper summarizes the active components of HLWDT and its mechanisms in preventing and treating psycho-cardiological disease. It is found that this prescription exerts effects through multiple pathways, such as ameliorating immune inflammatory responses, regulating neurotransmitter metabolism, upregulating the expression of brain-derived neurotrophic factor, alleviating oxidative stress injury, and inhibiting hyperactivity of the hypothalamic-pituitary-adrenal axis, thus illustrating its advantages in multi-component and multi-target improvement of related psycho-cardiological diseases including coronary heart disease, arrhythmia, heart failure and hypertension. This provides a reference for the clinical promotion and in-depth research of HLWDT in treatment of psycho-cardiological disease.
NING Bo, JIA Wenting, LYU Chenqu, LUO Cheng, LEI Yuxuan, GE Teng, YANG Liangbin, ZOU Rongjun, ZHAO Mingjun, FAN Xiaoping.
Mechanism and clinical research progress of Huanglian Wendan Decoction in treatment of psycho-cardiological disease[J].
Chinese Traditional and Herbal Drugs,
2026
, 57
(13)
: 5287
-5297
.
DOI: 10.7501/j.issn.0253-2670.2026.13.029
中华医学会心身医学分会, 中国康复医学会心血管病预防与康复专委会, 丁荣晶, 等. 双心门诊建设规范中国专家共识 [J]. 中国全科医学, 2024, 27(3): 253-261. 刘梅颜, 陆林. 心理心脏病学 [M]. 北京: 人民卫生出版社, 2024: 199. 余国龙, 邓云龙. 心血管疾病患者心理障碍的识别与治疗 [J]. 中国全科医学, 2018, 21(22): 2750-2754. Chen R, Liu Y Y, Yang S C, et al. The prevalence, recognition, and treatment of depression and anxiety symptoms among Chinese cardiovascular outpatients [J]. Sci Rep, 2025, 15: 36798. Zhang L J, Bao Y P, Tao S H, et al. The association between cardiovascular drugs and depression/anxiety in patients with cardiovascular disease: A Meta-analysis [J]. Pharmacol Res, 2022, 175: 106024. Wells A, Reeves D, Heal C, et al. Metacognitive therapy self-help for anxiety-depression: Single-blind randomized feasibility trial in cardiovascular disease [J]. Health Psychol, 2022, 41(5): 366-377. Wang Z Z, Lu H Y, Li Y D, et al. Exploring the correlation between cardiovascular adverse events and antidepressant use: A retrospective pharmacovigilance analysis based on the FDA adverse event reporting system database [J]. J Affect Disord, 2024, 367: 96-108. Kwek S Q, Yeo T M, et al. Effectiveness of therapist-supported Internet-based cognitive behavioural therapy interventions on depression, anxiety and quality of life among patients with cardiovascular disease: A systematic review and Meta-analysis [J]. Eur J Cardiovasc Nurs, 2025, 24(6): 860-870. 徐宁阳, 周春桐, 马原, 等. 中医辨证治疗双心疾病的新探索 [J]. 中华中医药杂志, 2023, 38(3): 948-952. 颜晓睿, 隋国媛, 吕美君, 等. 黄连温胆汤文献分析研究 [J]. 时珍国医国药, 2019, 30(8): 2015-2017. 赵海滨, 李东方. 双心疾病的中医药治疗研究思考及理论范式探析 [J]. 中医学报, 2025, 40(6): 1131-1138. 朱爽, 刘文娜, 李新龙, 等. 黄连温胆汤研究热点和前沿可视化分析 [J]. 中国中医药信息杂志, 2023, 30(3): 20-24. Tian C X, Li M Y, Shuai X X, et al. Berberine plays a cardioprotective role by inhibiting macrophage Wnt5a/β-catenin pathway in the myocardium of mice after myocardial infarction [J]. Phytother Res, 2023, 37(1): 50-61. 孙亚南, 刘敏, 王琪, 等. 小檗碱抗抑郁的研究进展 [J]. 药学学报, 2018, 53(12): 2006-2011. 谢博欢, 李雁, 常艳宾, 等.“陈皮-半夏”治疗稳定型心绞痛的作用机制研究 [J]. 中医药临床杂志, 2023, 35(5): 946-952. 黄曼婷. 柚皮素通过P2Y12受体信号通路抑制血小板活性和动脉血栓形成 [D]. 广州: 广州中医药大学, 2017. 吴婉婉, 魏科东, 丁芮, 等. 基于网络药理学与体外实验探讨茯苓酸治疗心肌纤维化的作用机制 [J]. 海南医学院学报, 2024, 30(10): 747-761. 苏鸿凯, 许二平, 张明远, 等. 茯苓及含茯苓复方治疗抑郁症研究进展 [J]. 中医学报, 2026, 41(2): 314-321. 王嘉惠. 基于数据挖掘和网络药理学研究中医药治疗痰热型失眠的用药规律及机制 [D]. 南宁: 广西中医药大学, 2024. 丁原全, 李瑞海. 甘草、生姜和大枣配伍前后18种氨基酸含量变化及其机制初探 [J]. 中国药师, 2020, 23(2): 370-372. Bruckbauer A, Banerjee J, Cao Q, et al. Erratum: Leucine-nicotinic acid synergy stimulates AMPK/SIRT1 signaling and regulates lipid metabolism and lifespan in Caenorhabditis elegans, and hyperlipidemia and atherosclerosis in mice [J]. Am J Cardiovasc Dis, 2017, 7(4): 97. 崔入元, 任琼迪, 朱明军. 氨基酸代谢紊乱在冠心病发生发展中的作用机制及临床意义 [J]. 南京医科大学学报 (自然科学版), 2026, 46(5): 725-738. 蒲莲莲, 刘漫, 杨颖, 等. 基于网络药理学和实验验证的甘麦大枣汤抗抑郁的物质基础及作用机制研究 [J]. 中医药临床杂志, 2023, 35(7): 1347-1358. 杨敏. 基于网络药理学与分子对接术探讨黄连温胆汤治疗痰热互结型高血压病合并焦虑的作用机制 [D]. 南宁: 广西中医药大学, 2024. 潘姿钢, 陈品良, 吴辉, 等. 从免疫炎症调控探讨益气活血疏肝法治疗双心疾病的作用机制 [J]. 中医杂志, 2023, 64(12): 1211-1217. Ong H T, Chen J H. Mental stress, atheroma, myocardial ischaemia and injury: The link is inflammation [J]. Gen Psychiatry, 2023, 36(6): e101282. 沈瑞环. 代谢、行为、社会心理危险因素与心血管疾病以及死亡风险的相关性研究 [D]. 北京: 中国医学科学院, 2024. 马迪. 冠心病合并焦虑心胆郁热证的炎性特征及柴胡加龙骨牡蛎汤的机制研究 [D]. 北京: 北京中医药大学, 2023. Gouweleeuw L, Wajant H, Maier O, et al. Effects of selective TNFR1 inhibition or TNFR2 stimulation, compared to non-selective TNF inhibition, on (neuro)inflammation and behavior after myocardial infarction in male mice [J]. Brain Behav Immun, 2021, 93: 156-171. 杨金果, 鞠建庆, 汤献文, 等. 黄连温胆汤调控NLRP3炎症小体抗动脉粥样硬化机制 [J]. 中国老年学杂志, 2022, 42(19): 4729-4733. Jia K K, Ding H, Yu H W, et al. Huanglian-Wendan Decoction inhibits NF-κB/NLRP3 inflammasome activation in liver and brain of rats exposed to chronic unpredictable mild stress [J]. Mediat Inflamm, 2018, 2018: 3093516. Hoyer D. Targeting the 5-HT system: Potential side effects [J]. Neuropharmacology, 2020, 179: 108233. Jiang C J, Chen Y, Sun T. From the gut to the brain, mechanisms and clinical applications of γ-aminobutyric acid (GABA) on the treatment of anxiety and insomnia [J]. Front Neurosci, 2025, 19: 1570173. Warnke K, Brandt J, Jörgens S, et al. Association of 5-HTTLPR/rs25531 with depressive symptoms in patients with coronary heart disease: A prospective study [J]. J Affect Disord, 2020, 277: 531-539. 李亮, 王珠强, 胡莹, 等. 基于神经递质和5-HT1A/ Gαi/o/cAMP信号通路研究黄连温胆汤对失眠大鼠的治疗作用及机制 [J]. 中药新药与临床药理, 2023, 34(5): 591-598. 胡莹, 李亮, 戴卫波, 等. 黄连温胆汤对氯苯丙氨酸致失眠小鼠的睡眠改善及γ-氨基丁酸能系统通路递质含量及受体表达的影响 [J]. 中药新药与临床药理, 2022, 33(8): 1009-1016. Ning B, Ge T, Wu Y Q, et al. Role of brain-derived neurotrophic factor in anxiety or depression after percutaneous coronary intervention [J]. Mol Neurobiol, 2024, 61(5): 2921-2937. Huang F, Duan J H, Liu W, et al. BDNF mediates the heart-brain axis: Implications for cardiovascular diseases and mental disorders [J]. Eur Arch Psychiatry Clin Neurosci, 2026, 276(1): 135-149. 宁博, 罗成, 葛腾, 等. 基于脑源性神经营养因子探讨“畅络调神”论治双心疾病的理论内涵及病理机制 [J]. 中国实验方剂学杂志, 2024, 30(14): 240-248. 田梦萱, 宁博, 赵明君, 等. 从脑源性神经营养因子探讨冠心病合并焦虑抑郁中医治疗机制 [J]. 陕西中医, 2024, 45(11): 1533-1537. Liu W, Huang K, Wu Y S, et al. The predictive value of mBDNF for major adverse cardiovascular events in stable coronary artery disease patients with depressive symptoms: A single-center, 5-year follow-up study [J]. Neurobiol Dis, 2024, 199: 106608. 桑贤港, 韩宇博, 邹国良, 等. 黄连温胆汤加减对冠心病伴焦虑、抑郁状态患者治疗效果及血清炎症反应及脑源性神经营养因子、核转录因子-κB、5-羟色胺、P物质水平的影响 [J]. 世界中西医结合杂志, 2022, 17(3): 566-570. 冯敏瑶, 罗冬强, 潘梓珊, 等. 黄连温胆汤治疗经皮冠状动脉介入术后合并焦虑抑郁状态疗效观察 [J]. 广州中医药大学学报, 2023, 40(12): 3006-3012. 田真真, 徐义勇, 朱金华, 等. 温胆汤含药血清对CREB mRNA沉默海马神经元细胞凋亡及BDNF/ TrkB/CREB信号通路的影响 [J]. 中国实验方剂学杂志, 2020, 26(22): 1-6. 高源, 朱金华, 张媛, 等. 温胆汤对精神分裂症模型大鼠海马组织BDNF、CaMKII表达的影响 [J]. 中药药理与临床, 2021, 37(4): 8-12. 韩慧莹, 刘寨华, 曹洪欣. 基于氧化应激和生物信息学探讨温阳益心调神法治疗冠心病抑郁症的作用机理 [J]. 中国中医基础医学杂志, 2024, 30(6): 1025-1036. Sutkowy P, Modrzejewska M, Porzych M, et al. The current state of knowledge regarding the genetic predisposition to sports and its health implications in the context of the redox balance, especially antioxidant capacity [J]. Int J Mol Sci, 2024, 25(13): 6915. Jiang H, Zhou Y W, Nabavi S M, et al. Mechanisms of oxidized LDL-mediated endothelial dysfunction and its consequences for the development of atherosclerosis [J]. Front Cardiovasc Med, 2022, 9: 925923. 王琳, 杨怀莉, 兰建军. 冠心病PCI术后合并睡眠障碍患者氧化应激水平的变化及其危险因素分析 [J]. 临床和实验医学杂志, 2024, 23(8): 823-826. Qiu T T, Jiang Z M, Chen X C, et al. Comorbidity of anxiety and hypertension: Common risk factors and potential mechanisms [J]. Int J Hypertens, 2023, 2023(1): 9619388. 王琪, 吴限, 刘丰, 等. 黄连温胆汤通过PI3K/Akt通路对缺氧复氧诱导心肌细胞损伤作用机制 [J]. 陕西中医, 2023, 44(7): 859-863. 张鑫俊, 肖志强, 鲁佳, 等. 基于调控SIRT3/PGC-1α通路干预能量代谢探讨温胆汤防治心肌缺血机制 [J]. 中国实验方剂学杂志, 2025, 31(2): 1-8. Meng F C, Wu Z F, Yin Z Q, et al. Coptidis rhizoma and its main bioactive components: Recent advances in chemical investigation, quality evaluation and pharmacological activity [J]. Chin Med, 2018, 13(1): 13. Remok F, Saidi S, Gourich A A, et al. Phenolic content, antioxidant, antibacterial, antihyperglycemic, and α-amylase inhibitory activities of aqueous extract of Salvia lavandulifolia Vahl [J]. Pharmaceuticals, 2023, 16(3): 395. Feng L S, Wang Y M, Liu H, et al. Hyperactivity in the hypothalamic-pituitary-adrenal axis: An invisible killer for anxiety and/or depression in coronary artherosclerotic heart disease [J]. J Integr Neurosci, 2024, 23(12): 222. Hage Z, Madeira M M, Koliatsis D, et al. Convergence of endothelial dysfunction, inflammation and glucocorticoid resistance in depression-related cardiovascular diseases [J]. BMC Immunol, 2024, 25(1): 61. 冯兰栓, 王一鸣, 宁博, 等. 基于下丘脑-垂体-肾上腺轴探讨络病理论辨治冠心病合并焦虑抑郁 [J]. 世界中医药, 2025, 20(6): 984-988. 王丹枫, 刘福明, 司徒秋顺, 等. 黄连温胆汤对缓慢性心律失常伴抑郁患者血脂代谢及HPA功能的影响 [J]. 临床和实验医学杂志, 2025, 24(5): 449-453. 文玥. 冠心病伴抑郁的中医证素分布规律及相关分析[D]. 南京: 南京中医药大学, 2020. Castillo-González J, Ruiz J L, Serrano-Martínez I, et al. Cortistatin deficiency reveals a dysfunctional brain endothelium with impaired gene pathways, exacerbated immune activation, and disrupted barrier integrity [J]. J Neuroinflammation, 2023, 20(1): 226. 董新禹, 邹国良, 韩宇博, 等. 加味黄连温胆汤对代谢综合征慢性炎症和血管内皮功能的影响 [J]. 中国实验方剂学杂志, 2025, 31(23): 138-145. Liu W N, Wang S T, Gu H Y, et al. Heart rate variability, a potential assessment tool for identifying anxiety, depression, and sleep disorders in elderly individuals [J]. Front Psychiatry, 2025, 16: 1485183. Zhou L P, Zhang Y Z, Cao G, et al. Wireless self-powered optogenetic system for long-term cardiac neuromodulation to improve post-MI cardiac remodeling and malignant arrhythmia [J]. Adv Sci, 2023, 10(9): 2205551. 谢冰昕, 吴欣芳, 冯硕, 等. 黄连温胆汤加减治疗痰热内扰型冠心病稳定型心绞痛合并慢性失眠的疗效观察 [J]. 天津中医药, 2024, 41(12): 1504-1509. 陆洁, 周诗颖, 段丽君, 等. 黄连温胆汤结合耳穴压丸对冠心病合并失眠病人心率变异性、褪黑素水平的影响 [J]. 中西医结合心脑血管病杂志, 2023, 21(12): 2254-2257. 顾晶, 王巍, 周琦. 清心化痰法治疗痰热扰心型房颤伴失眠患者的疗效观察 [J]. 河北医药, 2020, 42(12): 1877-1879. 王亚利. 黄连温胆汤对室性早搏痰火扰心证患者生存质量的影响研究 [D]. 济南: 山东中医药大学, 2018. 蔡雪林. 黄连温胆汤加减预防阵发性房颤射频消融术后 (痰火扰心证) 再复发的临床观察 [D]. 成都: 成都中医药大学, 2022. 郑宏. 黄连温胆汤治疗心衰的临床应用与思考 [J]. 北京中医药, 2012, 31(3): 185-186. 程曼曼, 张晓勇, 彭冬梅, 等. 黄连温胆汤加减治疗慢性心力衰竭痰瘀互结证伴焦虑抑郁患者的疗效观察 [J]. 长春中医药大学学报, 2025, 41(9): 1024-1028. 刘璟霞. 黄连温胆汤加味联合曲美他嗪治疗缺血性心肌病慢性心力衰竭的疗效观察 [J]. 临床急诊杂志, 2015, 16(7): 540-542. 巫祖强, 周慧萍, 邹军, 等. 黄连温胆汤加减方治疗痰热内扰型高血压病合并睡眠障碍患者有效性与安全性研究 [J]. 广州中医药大学学报, 2024, 41(9): 2319-2325. 关凤华. 黄连温胆汤对血压合并睡眠障碍患者临床症状及血清5-HT、P物质水平的影响 [J]. 中华中医药学刊, 2018, 36(4): 923-926. 赵娜, 刘莉, 高晶. 加味黄连温胆汤联合体外反搏对高血压病患者临床疗效及自主神经功能的影响 [J]. 辽宁中医杂志, 2022, 49(5): 87-90. 李佳奇, 刘莉, 韩宇博, 等. 加味黄连温胆汤治疗H型高血压痰瘀互结证患者临床疗效及对LVMI的影响 [J]. 天津中医药, 2023, 40(1): 14-19. 仝允军, 吴小伟. 加服黄连温胆汤加减治疗心脏神经官能症53例 [J]. 广西中医药, 2010, 33(4): 38. 冯亚男. 理气化痰祛瘀法治疗高脂血症 (痰瘀互结型) 合并焦虑状态的临床观察 [D]. 济南: 山东中医药大学, 2023. 胡敏. 加味黄连温胆汤治疗失眠伴抑郁的临床观察 [D]. 南京: 南京中医药大学, 2020.