Chronic Fatigue Syndrome - Spleen-Qi Deficiency Pattern

Dr. Li Wei, DACM

Chronic Fatigue Syndrome · Spleen-Qi Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Spleen-Qi Deficiency is a core pattern in chronic fatigue syndrome, characterized by mitochondrial energy dysfunction, fatigue, poor appetite, loose stools, and weakness. The core pathogenesis is insufficient Spleen Qi failing to generate adequate Qi and Blood, leading to reduced energy production, muscle weakness, and systemic fatigue.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, muscle aches, poor appetite, loose stools |

| Associated Symptoms | Pale complexion, shortness of breath, bloating, drowsiness after meals |

| Tongue and Pulse | Pale and swollen tongue with teeth marks, thin white coating, thready and weak pulse |

| Pathogenesis | Spleen Qi deficiency failing to produce sufficient Qi and Blood |

| Etiology | Poor diet, overwork, chronic illness, irregular eating habits |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen Qi |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi and Blood |

| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach meridian; harmonizes the Stomach |

| Baihui (GV20) | On the midline of the head, 5 cun posterior to the anterior hairline | Lifts Qi and treats fatigue and dizziness |

| Qihai (RN6) | 1.5 cun below the umbilicus | Tonifies Qi and strengthens the body’s foundation |

Clinical Recommendation: Filiform needle, reinforcing method; moxibustion may be added to warm and tonify Qi.

Herbal Formula

Base Formula: Bu Zhong Yi Qi Tang (补中益气汤)

Composition:

Astragalus (Huang Qi), Ginseng (Ren Shen), Atractylodes (Bai Zhu), Licorice (Gan Cao), Angelica (Dang Gui), Tangerine Peel (Chen Pi), Cimicifuga (Sheng Ma), Bupleurum (Chai Hu)

Action: Strengthens Spleen, supplements Qi, and lifts Yang.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe fatigue | Increase Huang Qi dosage |

| Poor appetite | Add Sha Ren, Mu Xiang to regulate Qi and harmonize the Stomach |

| Loose stools | Add Shan Yao, Yi Yi Ren to strengthen Spleen and stop diarrhea |

| Cold limbs | Add Gui Zhi, Sheng Jiang to warm the meridians |

Western Mechanism Reference

Mitochondrial energy dysfunction with reduced ATP production and decreased skeletal muscle oxidative capacity. Spleen-Qi Deficiency corresponds to chronic fatigue with energy deficits, where impaired mitochondrial function and reduced nutrient assimilation contribute to persistent fatigue.

References

  1. Internal Medicine of TCM - Fatigue with Qi Deficiency.

  2. DB-TCMJB: Spleen-Qi Deficiency.

  3. DB-XJB: Bu Zhong Yi Qi Tang.

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

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