Research Progress of Traditional Chinese Medicine and Western Medicine on Treatment of Post-stroke Depression by Blood-activating and Depression-relieving Chinese Medicine

Abstract

Post-stroke depression (PSD), as the most common mood disorder following cerebrovascular events, is characterized by high incidence, significantly impacts patient prognosis, and increases the risk of stroke recurrence. Based on Traditional Chinese Medicine (TCM) theory, this article systematically explores the core pathogenesis of PSD, “interconnected stagnation and depression,” identifying “blood stasis obstructing collaterals” as the fundamental cause and “qi stagnation” as the secondary manifestation. These two factors interact causally, forming a vicious cycle and giving rise to complex syndromes such as phlegm-stasis interconnection. Consequently, the blood-activating and depression-relieving method is proposed as the fundamental therapeutic approach for PSD, with its advantage lying in simultaneously addressing both “stasis” and “depression” to break the pathological cycle. The article further reviews the research progress of four representative blood-activating and depression-relieving herbs: Curcuma (Zanthoxylum) root, Albizia (Albizia) bark, Rose (Rosa) flower, and Salvia (Salvia) root. From historical herbal records to modern pharmacological studies, it elucidates their modern scientific mechanisms: the “blood-activating” effects through anti-platelet aggregation, microcirculation improvement, and neuroinflammation inhibition, as well as the “depression-relieving” effects via modulation of monoamine neurotransmitters and brain-derived neurotrophic factors. Finally, the synergistic relationship between blood-activating and depression-relieving therapies is discussed. The conclusion suggests that the blood-activating and depression-relieving method not only intervenes at the root of PSD’s pathological progression but also promises more durable therapeutic outcomes. Its “blood-activating” effect aligns with secondary prevention strategies for cerebrovascular events, holding significant clinical implications for breaking the “stroke-depression-restroke” vicious cycle and achieving dual physical and mental rehabilitation.