Irritable Bowel Syndrome - Spleen-Kidney Yang Deficiency Pattern

Dr. Li Wei, DACM

Irritable Bowel Syndrome · Spleen-Kidney Yang Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Spleen-Kidney Yang Deficiency is a severe deficiency pattern in IBS, characterized by autonomic dysfunction, diarrhea at dawn, abdominal pain, and cold intolerance. The core pathogenesis is Spleen and Kidney Yang deficiency failing to warm and transform the intestines, leading to abnormal colonic transit, impaired fluid absorption, and chronic diarrhea.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Diarrhea at dawn (early morning), abdominal pain, cold intolerance |

| Associated Symptoms | Frequent urination, fatigue, cold extremities, pale complexion |

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

| Pathogenesis | Spleen-Kidney Yang deficiency failing to warm the intestines |

| Etiology | Aging, chronic illness, overwork, cold food intake, constitutional weakness |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Mingmen (GV4) | On the midline, between L2 and L3 spinous processes | Warms Kidney Yang and strengthens the body |

| Shenshu (BL23) | Lower back, 1.5 cun lateral to L2 | Back-Shu point of Kidney meridian; warms Kidney Yang |

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

| Guanyuan (RN4) | 3 cun below the umbilicus | Warms Yang and supplements Qi |

| Tianshu (ST25) | 2 cun lateral to the umbilicus | Front-Mu point of Large Intestine; regulates bowel function |

Clinical Recommendation: Filiform needle, reinforcing method; heavy moxibustion is strongly recommended to warm Spleen and Kidney Yang.

Herbal Formula

Base Formula: Fu Zi Li Zhong Tang (附子理中汤) + Si Shen Wan (四神丸)

Composition:

Aconite (Fu Zi), Dried Ginger (Gan Jiang), Ginseng (Ren Shen), Atractylodes (Bai Zhu), Psoralea (Bu Gu Zhi), Nutmeg (Rou Dou Kou), Evodia (Wu Zhu Yu), Schisandra (Wu Wei Zi), Licorice (Gan Cao)

Action: Warms Spleen and Kidney Yang, stops diarrhea, and strengthens the intestines.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Dawn diarrhea | Add Bu Gu Zhi, Rou Dou Kou to warm the Kidneys and stop diarrhea |

| Severe cold intolerance | Add Ba Ji Tian, Yin Yang Huo to warm Yang |

| Frequent urination | Add Yi Zhi Ren, Sang Piao Xiao to astringe the Kidneys |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

Western Mechanism Reference

Intestinal autonomic dysregulation causing abnormal colonic transit time, fluid malabsorption, and decreased intestinal motility. Spleen-Kidney Yang Deficiency corresponds to IBS with autonomic dysfunction, where reduced intestinal autonomic regulation and impaired fluid absorption contribute to chronic diarrhea.

References

  1. Internal Medicine of TCM - Diarrhea with Kidney Yang Deficiency.

  2. DB-XJB: Li Zhong Tang.

  3. WHO. (2023). Digestive health. World Health Organization.

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