[Theoretical construction and treatment strategies for geriatric anxiety from perspective of "deficiency, stagnation, and turbidity"].

Geriatric anxiety, a major public health challenge in an aging society, often co-exists with multiple chronic physical diseases, resulting in a complex clinical problem of mind-body comorbidity. Its pathological understanding and treatment strategies require systematic elucidation. Based on the holistic view of unity of body and spirit in TCM and the physiological characteristics of "decline of all five viscera" in the elderly, this study proposed a pathological framework centered on "deficiency, stagnation and turbidity" for geriatric anxiety, and systematically elaborates on its dynamic evolution. Within this framework, "deficiency" constitutes the fundamental pathogenesis, arising from functional decline of the five viscera, particularly the deficiency of the kidney, heart, and liver, leading to insufficient nourishment of the spirit. "Stagnation" serves as the pivotal link in disease progression, characterized primarily by impaired Qi movement, which may further result in blood stasis and act as a critical mediator of mutual impairment between the body and the spirit. "Turbidity" represents the lingering manifestation of the disease, mainly involving the accumulation of pathological products such as phlegm and fire that disturb the spirit, causing the conditions to persist. These three factors interact with one another and are mutually causal, constituting a characteristic pathological pattern of geriatric anxiety described as "deficiency leading to stagnation, stagnation generating turbidity, and turbidity further damaging vital Qi". This explains its clinical features of deficiency in origin with excess in manifestation, symptom complexity, and chronicity. Based on this understanding, the fundamental therapeutic principles are established as tonifying deficiency to consolidate the root, relieving stagnation to unblock the pivot, and resolving turbidity to calm the spirit. In clinical practice, Liuwei Dihuang Decoction, Xiaoyao Powder, and Wendan Decoction serve as the principal prescriptions with syndrome-based modifications, aiming to harmonize multiple viscera, regulate both Qi and blood, and address integrated treatment of both body and spirit. This framework provides a systematic theoretical basis and practical reference for syndrome differentiation and treatment of geriatric anxiety in TCM.