Gout - Spleen Deficiency with Dampness Pattern

Dr. Li Wei, DACM

Gout · Spleen Deficiency with Dampness Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Joints

Pattern Overview

Spleen Deficiency with Dampness is a chronic pattern in gout, characterized by impaired renal uric acid excretion, hyperuricemia, fatigue, edema, and obesity. The core pathogenesis is Spleen deficiency failing to transform and transport, leading to Dampness accumulation, impaired uric acid excretion, and hyperuricemia.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fatigue, edema, obesity, hyperuricemia |

| Associated Symptoms | Poor appetite, loose stools, heavy sensation, bloating |

| Tongue and Pulse | Pale and swollen tongue with white greasy coating, soft and weak pulse |

| Pathogenesis | Spleen deficiency causing Dampness accumulation and impaired uric acid excretion |

| Etiology | Poor diet, overwork, chronic illness, constitutional Spleen deficiency |

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 |

| Yinlingquan (SP9) | Below the medial condyle of the tibia | Transforms Dampness and promotes diuresis |

| Fenglong (ST40) | 8 cun above the lateral malleolus, 2 cun lateral to the tibial crest | Transforms Phlegm and Dampness |

| Taibai (SP3) | Medial foot, behind the base of the 1st metatarsal | Source point of Spleen meridian; strengthens Spleen Qi |

Clinical Recommendation: Filament needle, reinforcing method; moxibustion may be applied to Pishu and Zusanli to warm and tonify Spleen Qi.

Herbal Formula

Base Formula: Shen Ling Bai Zhu San (参苓白术散) + Si Miao San (四妙散)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Dioscorea (Shan Yao), Hyacinth Bean (Bian Dou), Coix Seed (Yi Yi Ren), Atractylodes (Cang Zhu), Phellodendron (Huang Bai), Achyranthes (Niu Xi)

Action: Strengthens Spleen, drains Dampness, and promotes uric acid excretion.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| High uric acid | Add Tu Fu Ling, Ku Shen to promote uric acid excretion |

| Edema | Add Ze Xie, Che Qian Zi to promote diuresis |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

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

Western Mechanism Reference

Impaired renal uric acid excretion causing elevated serum uric acid, metabolic syndrome, and hyperuricemia. Spleen Deficiency with Dampness corresponds to gout with metabolic syndrome, where impaired renal uric acid excretion and metabolic dysfunction contribute to hyperuricemia.

References

  1. Internal Medicine of TCM - Bi Syndrome with Spleen Deficiency and Dampness.

  2. DB-XJB: Shen Ling Bai Zhu San.

  3. WHO. (2023). Gout fact sheet. World Health Organization.

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