Coronary atherosclerotic heart disease(CHD) complicated by anxiety/depression is commonly referred to in clinical practice as “psychocardiological disease”，aligning with the modern Chinese medical paradigm of the biopsychosocial model.Current research suggests that the hypothalamic-pituitary-adrenal(HPA) axis may serve as a potential pathogenic mechanism and therapeutic target in CHD accompanied by anxiety/depression.Based on the theory of collateral disease，this research group has proposed the therapeutic principle of “unblocking collaterals to calm the mind” for the treatment of psychocardiological disease，with promising clinical outcomes.Syndrome differentiation and treatment of CHD accompanied by anxiety/depression from “obstructed collaterals and restless mind” suggests that “obstructed collaterals” may lead to inflammatory responses and oxidative stress injury in CHD patients，thereby affecting the HPA axis and resulting in anxiety or depression.Meanwhile，“restless mind” manifests in platelet activation and aggregation and gut microbiota dysbiosis，both of which contribute to symptoms of anxiety and depression and are closely associated with HPA axis hyperactivity，which in turn exacerbates CHD.The HPA axis is thus considered a key potential therapeutic target for CHD accompanied by anxiety/depression，which helps regulate inflammatory mediators，reduce oxidative damage，promote platelet activation，and stabilize gut microbiota，offering neuroprotective and cardioprotective benefits.Therefore，this paper elaborates on the theoretical connotation of the collateral disease concept of “unblocking collaterals and calming the mind” in the treatment of CHD with anxiety/depression from the perspective of HPA axis regulation，providing a novel insight into syndrome differentiation and treatment in TCM for CHD with anxiety/depression