PCOS - Spleen Deficiency with Phlegm-Dampness Pattern

Dr. Li Wei, DACM

PCOS · Spleen Deficiency with Phlegm-Dampness Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Pelvis

Pattern Overview

Spleen Deficiency with Phlegm-Dampness is a common pattern in PCOS with metabolic syndrome, characterized by insulin resistance, obesity, anovulation, fatigue, and glucose and lipid metabolism disorder. The core pathogenesis is Spleen deficiency with Phlegm-Dampness accumulation, leading to insulin resistance, metabolic dysfunction, and chronic anovulation.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Obesity, fatigue, anovulation, irregular menstruation |

| Associated Symptoms | Sticky mouth, loose stools, heavy sensation, bloating |

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

| Pathogenesis | Spleen deficiency with Phlegm-Dampness accumulation |

| Etiology | Poor diet, overwork, sedentary lifestyle, 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 |

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

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

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

Clinical Recommendation: Filament needle, reinforcing method for Spleen points, even method for Phlegm points; 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) + Er Chen Tang (二陈汤)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Dioscorea (Shan Yao), Hyacinth Bean (Bian Dou), Coix Seed (Yi Yi Ren), Tangerine Peel (Chen Pi), Pinellia (Ban Xia), Licorice (Gan Cao)

Action: Strengthens Spleen, transforms Phlegm, and drains Dampness.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe obesity | Add Ze Xie, Che Qian Zi to promote diuresis |

| Insulin resistance | Add Huang Qi, Shan Yao to supplement Qi |

| Fatigue | Add Huang Qi to enhance Qi supplementation |

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

Western Mechanism Reference

Insulin resistance with metabolic syndrome, obesity, glucose and lipid metabolism disorder, and chronic low-grade inflammation. Spleen Deficiency with Phlegm-Dampness corresponds to PCOS with metabolic syndrome, where insulin resistance and chronic low-grade inflammation contribute to anovulation and metabolic dysfunction.

References

  1. Gynecology of TCM - PCOS with Spleen Deficiency and Phlegm-Dampness.

  2. Xiong Jibai: Spleen Deficiency with Dampness uses Shen Ling Bai Zhu San.

  3. WHO. (2023). Women’s health. World Health Organization.

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