Perimenopausal depression is a major disease that currently plagues women. It has the characteristics of high incidence, low diagnosis rate, and recurrent attacks. It has attracted more and more attention from scholars at home and abroad. The disease belongs to the category of "depression syndrome", "visceral irritability" and "lily disease" in traditional Chinese medicine. Acupuncture therapy of traditional Chinese medicine has obvious advantages in the treatment of this disease. From the perspective of "kidney and brain", this paper analyzes the etiology, pathogenesis and treatment principles of the disease from three aspects: meridian, spirit and essence, so as to provide certain theoretical basis and support for acupuncture treatment and prevention of the disease.