Exploring the Mechanism of Qibi Tiaoshen Granules in Treating Autism Spectrum Disorder Based on the “Spleen-Kidney-Brain” Axis and Mitochondrial Energy Metabolism

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder, whose pathogenesis involves the interplay of multiple factors. Qibi Tiaoshen Granules (QTSG) are a proprietary hospital preparation developed by Xi’an Hospital of Traditional Chinese Medicine Encephalopathy, based on the “three-stage, four-dimensional” rehabilitation and treatment system centered on “opening the orifices and regulating the spirit.” This formulation has shown favorable clinical efficacy in the treatment of ASD. This paper systematically reviews the traditional Chinese medicine (TCM) pathogenesis of ASD and the formula rationale of QTSG, and explores its potential molecular mechanisms from two core perspectives: the “spleen–kidney–brain” axis and mitochondrial energy metabolism. In the formula, Lujiaojiao (deer antler glue) and Renshen (ginseng) tonify the kidney and replenish essence to nourish the brain marrow; Guizhi (cinnamon twig) and Fuling (Poria) warm and activate the spleen yang to transform and generate subtle essences; and Shichangpu (sweet flag rhizome) and Yuanzhi (polygala root) resolve phlegm and open the orifices to regulate the spirit. Collectively, these ingredients exert synergistic actions of warming and tonifying the spleen and kidney, resolving phlegm and opening the orifices, and regulating the spirit to relieve blockages. At the mechanistic level, QTSG may exert its therapeutic effects by regulating the gut microbiota–gut–brain axis to improve the neuroimmune microenvironment, enhancing mitochondrial energy metabolism to ensure neuronal energy supply, and modulating neurotransmitter balance to restore synaptic plasticity. This review provides a theoretical basis for the broader clinical application of QTSG in ASD and identifies future directions for experimental research.