Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (5): 427-431.doi: 10.3736/jcim20100505

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Characteristics of traditional Chinese medicine syndromes in post-stroke depression

 Hui Hana,b, Li-min Wuc, Wen-ming Yanga, Mei-xia Wanga, Jing-jing Tanga, Han Wanga, Zhi-xiu Liua, Rong-zhi Liua, Ting Donga, Juan Zhanga, Bo Yanga, Ming-xiang Hana,d   

  1. a Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China
    b Department of Geriatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100029, China
    c Medical Research Center, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China
    d School of Professional and Continuing Education, University of Hong Kong, Hong Kong, China
  • Received:2009-08-31 Accepted:2010-02-20 Online:2010-05-20 Published:2010-05-15
  • Contact: Hui Han


To explore the main characteristics of syndromes in traditional Chinese medicine (TCM) in post-stroke depression (PSD) and to provide basis for treatments with TCM herbs.

According to diagnostic criteria of PSD, stroke patients and depression patients from Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine were assigned into cerebral stroke group (150 cases), depression group (151 cases) and PSD group (123 cases). Neuropsychological assessments and imaging and biochemical analyses were conducted. TCM syndrome differentiation for these diseases was performed. We also determined the characteristics of TCM syndromes of PSD, relative risk of the syndromes and their correlations with ages as well.

Scores of qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation in PSD group were significant higher than those in cerebral stroke group (P<0.05, P<0.01). In cerebral stroke group, majority of the patients displayed one syndrome, while in PSD and depression groups, the patients had three or more syndromes. Of these syndromes, the incidence rate of syndrome of liver qi depression complicated with transformation of fire due to qi stagnation or flaring of fire due to yin deficiency was high. The syndrome of liver qi depression occurred much more frequently in PSD group and depression group than in cerebral stroke group (P<0.05, P<0.01). The logistic regression analysis showed that the syndrome of qi stagnation and blood stasis had high relative risk to PSD. The syndrome of deficiency of heart and spleen was positively correlated with age in cerebral stroke group.

The main TCM syndromes of PSD and depression are qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation. The syndrome of deficiency of heart and spleen is closely related to age among the stroke patients. The syndrome of qi stagnation and blood stasis serves as an independent risk factor for PSD. The more complicated the syndromes are, the more serious depression becomes.

Key words: Cerebral stroke, Depression, Qi stagnation, Blood stasis, Liver qi depression


TCM syndrome TCM syndrome score
Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Qi stagnation and blood stasis 10.33±3.12 12.85±2.99** 11.55±2.54*△
Transformation of fire due to qi stagnation 8.73±1.69 10.65±1.75* 9.58±2.54*
Anxiety impairing spirit 8.72±1.50 8.81±2.00 8.95±1.45
Deficiency of heart and spleen 8.88±2.54 9.13±2.33 9.02±2.48
Flaring of fire due to yin deficiency 9.45±3.34 9.77±3.13 9.78±3.55
Liver qi depression 9.22±3.27 11.92±3.22** 11.63±2.79**
Stagnation of phlegm and qi 9.55±3.66 9.74±2.99 9.56±3.70


TCM syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Qi stagnation and blood stasis 43 (28.7) 63 (41.7)** 51 (41.5)**
Transformation of fire due to qi stagnation 50 (33.3) 76 (50.2)** 56 (45.5)*
Anxiety impairing spirit 13 (8.7) 30 (19.7)** 12 (9.8)
Deficiency of heart and spleen 42 (28.0) 41 (27.2) 33 (26.8)
Flaring of fire due to yin deficiency 41 (27.3) 39 (25.8) 33 (26.8)
Liver-qi depression 76 (50.7) 94 (62.3)* 75 (61.0)*
Stagnation of phlegm and qi 10 (6.7) 10 (6.6) 8 (6.5)


TCM complicated syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Single syndrome 61(40.6) 32 (21.2)* 31 (25.2)
Two syndromes 54(36.0) 60 (39.7) 40 (32.5)
Three or more syndromes 35(23.3) 59 (39.1)* 52 (42.3)*


TCM syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
<60 years ≥60 years <60 years ≥60 years <60 years ≥60 years
Qi stagnation and blood stasis 8.95±1.35 8.48±2.45 9.69±1.88 10.66±2.76 10.45±3.02 9.76±2.46
Transformation of fire due to qi stagnation 11.55±2.44 11.27±2.97 11.48±2.87 11.77±3.35 11.35±2.21 11.29±2.97
Anxiety impairing spirit 10.77±2.00 10.17±1.98 9.91±2.20 10.15±1.95 10.35±3.12 10.37±2.52
Deficiency of heart and spleen 10.16±2.73 12.24±3.50▲▲ 11.37±2.80 11.45±2.94 12.24±3.50 11.06±3.05
Flaring of fire due to yin deficiency 9.59±3.10 9.54±3.11 10.14±2.05 9.78±2.00 9.35±3.44 10.05±3.17
Liver-qi depression 10.54±2.95 10.07±2.60 10.13±2.56 10.58±2.45 9.62±1.95 9.80±2.43
Stagnation of phlegm and qi 8.89±1.87 9.02±2.00 9.48±2.78 9.08±2.37 9.82±2.03 9.25±2.35
[1] Feigin VL, Lawes CM, Bennett DA, Anderson CS . Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century[J]. Lancet Neurol, 2003,2(1):43-53
doi: 10.1016/S1474-4422(03)00266-7
[2] Lipsey JR, Robinson RG, Pearlson GD, Rao K, Price TR . Nortriptyline treatment of post-stroke depression: a double-blind study[J]. Lancet, 1984,1(8372):297-300
[3] Sinyor D, Amato P, Kaloupek DG, Becker R, Goldenberg M, Coopersmith H . Post-stroke depression: relationships to functional impairment, coping strategies, and rehabilitation outcome[J]. Stroke, 1986,17(6):1102-1107
doi: 10.1161/01.STR.17.6.1102
[4] Andersen G, Vestergaard K, Riis J, Lauritzen L . Incidence of post-stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale[J]. Acta Psychiatr Scand, 1994,90(3):190-195
doi: 10.1111/acp.1994.90.issue-3
[5] Whyte EM, Mulsant BH . Post-stroke depression: epidemiology, pathophysiology, and biological treatment[J]. Biol Psychiatry, 2002,52(3):253-264
doi: 10.1016/S0006-3223(02)01424-5
[6] Carod-Artal FJ . Post-stroke depression(Ⅰ). Epidemiology, diagnostic criteria and risk factors[J]. Rev Neurol, 2006,42(3):169-175
[7] Andersen G, Vestergaard K, Ingemann-Nielsen M, Lauritzen L . Risk factors for post-stroke depression[J]. Acta Psychiatr Scand, 1995,92(3):193-198
doi: 10.1111/acp.1995.92.issue-3
[8] Burvill P, Johnson G, Jamrozik K, Anderson C, Stewart-Wynne E . Risk factors for post-stroke depression[J]. Int J Geriatr Psychiatry, 1997,12(2):219-226
doi: 10.1002/(ISSN)1099-1166
[9] Bush BA . Major life events as risk factors for post-stroke depression[J]. Brain Inj, 1999,13(2):131-137
doi: 10.1080/026990599121791
[10] Robinson RG, Kubos KL, Starr LB, Rao K, Price TR . Mood disorders in stroke patients. Importance of location of lesion[J]. Brain, 1984,107(Pt 1):81-93
doi: 10.1093/brain/107.1.81
[11] The Fourth National Conference in Cerebrovascular Diseases of Chinese Medical Assosciation. Scoring criteria of clinical neurological function defect in patients with stroke(1995)[J]. Zhonghua Shen Jing Ke Za Zhi, 1996,29(2):379-381
中华医学会第四次全国脑血管病学术会议. 脑卒中患者临床神经功能缺损程度评分标准(1995)[J]. 中华神经科杂志, 1996,29(2):379-381
[12] Wang YY, Li DL. Internal medicine of traditional Chinese medicine today(Ⅲ)[M]. Beijing: People's Medical Publishing House, 1997: 56-57
王永炎, 栗德林 . 今日中医内科学(下册)[M]. 北京: 人民卫生出版社, 1997: 56-57
[13] Liu ZY, Li C . Study progress of post-stroke depression syndromes[J]. Hua Bei Mei Tan Yi Xue Yuan Xue Bao, 2008,10(3):330-332
柳真裕, 李春 . 脑卒中后抑郁的研究进展[J]. 华北煤炭医学院学报, 2008,10(3):330-332
[1] Bosch Peggy, van den Noort Maurits, Yeo Sujung, Lim Sabina, Coenen Anton, van Luijtelaar Gilles. The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 2015, 13(6): 380-390.
[2] Sheng Wei, Jin-liang Hou, Yu-bin Chao, Xi-yang Du, Shao-bo Zong . Analysis on content of serum monoamine neurotransmitters in macaques with anger-in-induced premenstrual syndrome and liver-qi depression syndrome. Journal of Chinese Integrative Medicine, 2012, 10(8): 925-931.
[3] Ze-long Dai, Hui Chen, Xiao-ying Wu . Relationship between cytochrome P450 2C19*17 genotype distribution platelet aggregation and bleeding risk in patients with blood stasis syndrome of coronary artery disease treated with clopidogrel. Journal of Chinese Integrative Medicine, 2012, 10(6): 647-654.
[4] Chun Li, Yong Wang, Yu-lin Ouyang , Wen-jing Chuo , Qi Qiu , Shu-zhen Guo, Wei Wang. Effects of a compound Chinese herbal medicine Yixin Jiedu Formula on haemodynamic in rats with heart failure of qi-deficiency and blood stasis syndrome. Journal of Chinese Integrative Medicine, 2012, 10(5): 577-583.
[5] Li Xiao-hong, Li Jing-jing, Liu Yue-yun, Chen Jia-xu. Central neurobiological mechanism of liver depression and spleen deficiency syndrome based on chronic stress: a review. Journal of Chinese Integrative Medicine, 2012, 10(1): 1-6.
[6] Sui Yue Hu, Su E Wang, Chun Hu Zhang. Relationship between symptom stratification and syndrome differentiation of traditional Chinese medicine for depressive episode. Journal of Chinese Integrative Medicine, 2011, 9(9): 933-936.
[7] Yong Wang, Shu-zhen Guo, Chun Li, Jian-xin Chen, Wen-jing Chuo, Fang Dong, Wei Wang, Ying-feng Wang. Analysis of plasma metabonomics of mini-swines with qi deficiency and blood stasis syndrome due to chronic myocardial ischemia. Journal of Chinese Integrative Medicine, 2011, 9(2): 158-164.
[8] Jian-peng Du, Da-zhuo Shi , Tian-chang Li, Hao Xu, Hao Chen. Correlation between blood stasis syndrome and pathological characteristics of coronary artery in patients with coronary heart disease. Journal of Chinese Integrative Medicine, 2010, 8(9): 848-852.
[9] Xuan Liu , Qing-qi Wang. Professor Wang Qingqi's experience in treating senile diseases based on the theory of blood stasis. Journal of Chinese Integrative Medicine, 2010, 8(5): 486-488.
[10] Li-juan Xiu, Pin-kang Wei, Hui-ming Lin, Bin Pang. Effects of Xiaotan Jieyu Recipe on behaviors of tumor-bearing rats with chronic mild stress and the mechanism. Journal of Chinese Integrative Medicine, 2010, 8(2): 138-144.
[11] Xin-jun Wang, Ling-ling Wang . A mechanism of endogenous opioid peptides for rapid onset of acupuncture effect in treatment of depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1014-1017.
[12] Tao Wang , Feng Qin. Effects of Chinese herbal medicine Xiaoyao Powder on monoamine neurotransmitters in hippocampus of rats with postpartum depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1075-1079.
[13] Rui Wu , Wen-wen Xiong, Yi-ping Jiang, Guo-xian Li. Changes of eye signs in chronic hepatitis B patients with blood stasis syndrome. Journal of Chinese Integrative Medicine, 2010, 8(1): 46-48.
[14] Bin Li , Rong Xu, Fu-lun Li, Ke-qin Zhao, Ming Zhang, Zheng-cheng Xu. Study of syndrome differentiation factor of gouty arthritis with blood stasis syndrome based on connection number. Journal of Chinese Integrative Medicine, 2009, 7(8): 724-727.
[15] Mei Xue , Ke-ji Chen, Hui-jun Yin. Relationship between polymorphism of platelet membrane glycoprotein Ⅲa and coronary heart disease with blood-stasis syndrome in Chinese Han population. Journal of Chinese Integrative Medicine, 2009, 7(4): 325-329.
Full text



[1] Yi-ting He, Qing-lin Zha, Jian-ping Yu, Yong Tan, Cheng Lu, Ai-ping Lv. Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 32-36
[2] Jun Cai, Hua Wang, Sheng Zhou, Bin Wu, Hua-rong Song, Zheng-rong Xuan. Effect of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation: A randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(1): 37-40
[3] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Wei Zhang, Xiang-feng Lu, Xiao-mei Zhang, Jian-jun Wu, Liang-duo Jiang. A rat model of pulmonary fibrosis induced by infusing bleomycin quickly through tracheal intubation. Journal of Chinese Integrative Medicine, 2008, 6(1): 60-67
[6] Xi Lin, Jian-ping Liu. Tai chi for treating rheumatoid arthritis. Journal of Chinese Integrative Medicine, 2008, 6(1): 82
[7] Guo-hong Yuan, Xiao-jing Pang, He-chao Ma. Synergic effects of Danggui Buxue Decoction in reducing toxicity of cytoxan in tumor-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 83-88
[8] Li Zhou, Hong-xing Zhang, Ling-guang Liu, Wen-jun Wan. Effect of electro-acupuncture at Fenglong (GV 16) on nitric oxide and endothelin in rats with hyperlipidemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 89-92
[9] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. Guiding principles of clinical research on mild cognitive impairment (protocol). Journal of Chinese Integrative Medicine, 2008, 6(1): 9-14
[10] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97