Chronic Fatigue Syndrome - Liver Qi Stagnation Pattern

TCM differentiation and treatment for chronic fatigue

Chronic Fatigue Syndrome · Liver Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body


Pattern Overview

Liver Qi Stagnation is a common pattern in chronic fatigue syndrome,

characterized by **chronic stress-induced fatigue, HPA axis and

autonomic dysfunction, and 5-HT/DA neurotransmitter imbalance**. The

core pathogenesis is **chronic psychological stress causing Liver Qi

stagnation**, leading to Qi obstruction, systemic fatigue, and mood

disturbance.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

tightness, frequent sighing |

Associated Symptoms

fullness, premenstrual tension |

Tongue and Pulse

pulse |

Pathogenesis

obstruction |

Etiology Chronic stress, emotional distress, overwork

Acupuncture Point Prescription

Point Location Function
Taichong (LR3)

metatarsals | Source point of Liver meridian; soothes Liver Qi |

Ganshu (BL18) Lower back, 1.5 cun lateral to T9

of Liver meridian; regulates Liver Qi |

Qimen (LR14)

the nipple | Front-Mu point of Liver meridian; treats Qi stagnation |

Neiguan (PC6)
Relieves chest tightness and regulates Qi
Sanyinjiao (SP6) 3 cun above the medial malleolus

and Blood; harmonizes the Liver and Spleen |

Clinical Recommendation: Filiform needle, reducing method; combine

with stress reduction techniques and counseling.


Herbal Formula

Base Formula: Xiao Yao San (逍遥散)

Composition:

Bupleurum (Chai Hu), Angelica (Dang Gui), White Peony (Bai Shao),

Atractylodes (Bai Zhu), Poria (Fu Ling), Licorice (Gan Cao), Mint (Bo

He)

Action: Soothes Liver Qi, nourishes Blood, strengthens Spleen, and

relieves depression.

Modifications

Associated Symptoms Additions/Subtractions
Pronounced depression Add Yu Jin, He Huan Pi to relieve depression
Insomnia Add Suan Zao Ren, Yuan Zhi to calm the spirit
Chest tightness Add Zhi Ke, Xiang Fu to regulate Qi
Irritability Add Zhi Zi, Dan Pi to clear Heat

Western Mechanism Reference

Chronic stress-induced HPA axis and autonomic dysfunction, with 5-HT/DA

neurotransmitter imbalance. Liver Qi Stagnation corresponds to chronic

fatigue with significant affective symptoms, where chronic stress and

HPA axis dysregulation contribute to fatigue and mood disturbance.


References

1. Internal Medicine of TCM - Depression with Liver Qi Stagnation.

2. DB-TCMJB: Liver Qi Stagnation.

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

Organization.


Explore More

Personalized herbal protocols and acupressure tools for fatigue relief.

research papers and clinical case studies on TCM fatigue management.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.