Chronic Fatigue Syndrome - Spleen-Qi Deficiency Pattern

TCM differentiation and treatment for chronic fatigue

Chronic Fatigue Syndrome · Spleen-Qi Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Whole Body


Pattern Overview

Spleen-Qi Deficiency is a core pattern in chronic fatigue syndrome,

characterized by **mitochondrial energy dysfunction, fatigue, poor

appetite, loose stools, and weakness**. The core pathogenesis is

insufficient Spleen Qi failing to generate adequate Qi and Blood,

leading to reduced energy production, muscle weakness, and systemic

fatigue.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

stools |

Associated Symptoms

bloating, drowsiness after meals |

Tongue and Pulse

white coating, thready and weak pulse |

Pathogenesis

Qi and Blood |

Etiology

habits |


Acupuncture Point Prescription

Point Location Function
Pishu (BL20) Lower back, 1.5 cun lateral to T11

of Spleen meridian; strengthens Spleen Qi |

Zusanli (ST36)

to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi and

Blood |

Zhongwan (RN12) 4 cun above the umbilicus

Stomach meridian; harmonizes the Stomach |

Baihui (GV20)

anterior hairline | Lifts Qi and treats fatigue and dizziness |

Qihai (RN6) 1.5 cun below the umbilicus

strengthens the body's foundation |

Clinical Recommendation: Filiform needle, reinforcing method;

moxibustion may be added to warm and tonify Qi.


Herbal Formula

Base Formula: Bu Zhong Yi Qi Tang (补中益气汤)

Composition:

Astragalus (Huang Qi), Ginseng (Ren Shen), Atractylodes (Bai Zhu),

Licorice (Gan Cao), Angelica (Dang Gui), Tangerine Peel (Chen Pi),

Cimicifuga (Sheng Ma), Bupleurum (Chai Hu)

Action: Strengthens Spleen, supplements Qi, and lifts Yang.

Modifications

Associated Symptoms Additions/Subtractions
Severe fatigue Increase Huang Qi dosage
Poor appetite

Stomach |

Loose stools

diarrhea |

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

Western Mechanism Reference

Mitochondrial energy dysfunction with reduced ATP production and

decreased skeletal muscle oxidative capacity. Spleen-Qi Deficiency

corresponds to chronic fatigue with energy deficits, where impaired

mitochondrial function and reduced nutrient assimilation contribute to

persistent fatigue.


References

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

2. DB-TCMJB: Spleen-Qi Deficiency.

3. DB-XJB: Bu Zhong Yi Qi Tang.

4. 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.