Abstract： Coronary atherosclerotic heart disease complicated by anxiety and depression is a highly prevalent clinical condition that severely affects prognosis and quality of life of patients. This article，based on the "heart-braingut" axis theory and integrating the traditional Chinese medicine （TCM） theories of visceral manifestation， qi， and blood，focuses on the "deficiency in the origin" characterized by deficiency of heart and spleen and the "excess in the superficiality" characterized by the intermingling of phlegm，blood stasis，and depression. Deficiency in the origin and excess in the superficiality interact to form a vicious cycle of "disease leading to depression and depression aggravating disease" through the "heart-brain-gut" axis. Treatment emphasizes the simultaneous treatment of the heart and spleen， aiming to invigorate the spleen and nourish the heart to strengthen the root，and to dispel stasis and resolve phlegm to treat the branch manifestations. This approach seeks to achieve functional coordination of the "heart-brain-gut" axis by regulating intestinal microbiota，neurotransmitters，and the free flow of qi and blood，thereby providing a theoretical basis and new insights for the clinical prevention and treatment of the "psycho-cardiological diseases."