Chronic Fatigue Syndrome - Liver Qi Stagnation Pattern

Dr. Li Wei, DACM

Chronic Fatigue Syndrome · Liver Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Liver Qi Stagnation is a common pattern in chronic fatigue syndrome, characterized by chronic stress-induced fatigue, HPA axis and autonomic dysfunction, and 5-HT/DA neurotransmitter imbalance. The core pathogenesis is chronic psychological stress causing Liver Qi stagnation, leading to Qi obstruction, systemic fatigue, and mood disturbance.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, depression, irritability, chest tightness, frequent sighing |

| Associated Symptoms | Insomnia, poor appetite, hypochondriac fullness, premenstrual tension |

| Tongue and Pulse | Pale red tongue with thin white coating, wiry pulse |

| Pathogenesis | Chronic stress causing Liver Qi stagnation and Qi obstruction |

| Etiology | Chronic stress, emotional distress, overwork |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver Qi |

| Ganshu (BL18) | Lower back, 1.5 cun lateral to T9 | Back-Shu point of Liver meridian; regulates Liver Qi |

| Qimen (LR14) | On the chest, 4 cun lateral to the midline, below the nipple | Front-Mu point of Liver meridian; treats Qi stagnation |

| Neiguan (PC6) | 2 cun above the wrist crease, between the tendons | Relieves chest tightness and regulates Qi |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Regulates Qi and Blood; harmonizes the Liver and Spleen |

Clinical Recommendation: Filiform needle, reducing method; combine with stress reduction techniques and counseling.

Herbal Formula

Base Formula: Xiao Yao San (逍遥散)

Composition:

Bupleurum (Chai Hu), Angelica (Dang Gui), White Peony (Bai Shao), Atractylodes (Bai Zhu), Poria (Fu Ling), Licorice (Gan Cao), Mint (Bo He)

Action: Soothes Liver Qi, nourishes Blood, strengthens Spleen, and relieves depression.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Pronounced depression | Add Yu Jin, He Huan Pi to relieve depression |

| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |

| Chest tightness | Add Zhi Ke, Xiang Fu to regulate Qi |

| Irritability | Add Zhi Zi, Dan Pi to clear Heat |

Western Mechanism Reference

Chronic stress-induced HPA axis and autonomic dysfunction, with 5-HT/DA neurotransmitter imbalance. Liver Qi Stagnation corresponds to chronic fatigue with significant affective symptoms, where chronic stress and HPA axis dysregulation contribute to fatigue and mood disturbance.

References

  1. Internal Medicine of TCM - Depression with Liver Qi Stagnation.

  2. DB-TCMJB: Liver Qi Stagnation.

  3. WHO. (2023). Chronic fatigue syndrome fact sheet. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for fatigue relief.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM fatigue management.