Chronic Fatigue Syndrome - Qi-Blood Deficiency Pattern

Dr. Li Wei, DACM

Chronic Fatigue Syndrome · Qi-Blood Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body

Pattern Overview

Qi-Blood Deficiency is a chronic pattern in chronic fatigue syndrome, characterized by anemia or subclinical anemia, fatigue, pale complexion, poor sleep, and impaired immune function. The core pathogenesis is insufficient Qi and Blood to nourish the body, leading to reduced energy production, poor tissue perfusion, and systemic fatigue.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, pale complexion, shortness of breath, palpitations |

| Associated Symptoms | Poor sleep, dizziness, cold limbs, poor appetite |

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

| Pathogenesis | Qi-Blood deficiency failing to nourish the body |

| Etiology | Chronic illness, poor nutrition, blood loss, overwork |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

| Xuehai (SP10) | On the medial thigh, 2 cun above the patella | Nourishes Blood and invigorates circulation |

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

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin |

| Xinshu (BL15) | Lower back, 1.5 cun lateral to T5 | Back-Shu point of Heart meridian; calms the spirit and nourishes Blood |

Clinical Recommendation: Filiform needle, reinforcing method; moxibustion may be applied to Zusanli and Sanyinjiao to warm and tonify Qi and Blood.

Herbal Formula

Base Formula: Ba Zhen Tang (八珍汤) or Gui Pi Tang (归脾汤)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Licorice (Gan Cao), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), White Peony (Bai Shao), Rehmannia (Shu Di) — or with Astragalus, Sour Jujube Seed, Longan, Polygala for Gui Pi Tang

Action: Supplements Qi and Blood, strengthens the Spleen and Heart.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe fatigue | Add Huang Qi to enhance Qi supplementation |

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

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

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

Western Mechanism Reference

Anemia or subclinical anemia with reduced oxygen-carrying capacity, protein-energy malnutrition, and immune dysfunction. Qi-Blood Deficiency corresponds to chronic fatigue with anemia and nutritional deficits, where reduced tissue oxygenation and impaired immune function contribute to persistent fatigue.

References

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

  2. DB-XJB: Gui Pi Tang.

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

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