Irritable Bowel Syndrome - Liver Depression with Spleen
TCM differentiation and treatment for irritable bowel
Irritable Bowel Syndrome · Liver Depression with Spleen Deficiency
Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Abdomen
Pattern Overview
Liver Depression with Spleen Deficiency is the most common pattern in
irritable bowel syndrome (IBS), characterized by **gut-brain axis
dysregulation, abdominal pain triggered by stress, alternating diarrhea
and constipation, and bloating. The core pathogenesis is emotional
stress causing Liver Qi depression**, which overacts on the Spleen,
leading to visceral hypersensitivity and abnormal gut motility.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
alternating diarrhea/constipation |
| Associated Symptoms |
|---|
tightness, poor appetite |
| Tongue and Pulse |
|---|
pulse |
| Pathogenesis |
|---|
Qi dysfunction |
| Etiology |
|---|
habits |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Taichong (LR3) |
|---|
metatarsals | Source point of Liver meridian; soothes Liver Qi |
| Tianshu (ST25) | 2 cun lateral to the umbilicus |
|---|
of Large Intestine; regulates bowel function |
| Zusanli (ST36) |
|---|
to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |
| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 |
|---|
of Spleen meridian; strengthens Spleen Qi |
| Sanyinjiao (SP6) | 3 cun above the medial malleolus |
|---|
and Blood; harmonizes Liver and Spleen |
Clinical Recommendation: Filiform needle, reducing method for Liver
points, reinforcing method for Spleen points; combine with stress
reduction techniques.
Herbal Formula
Base Formula: Chai Shao Liu Jun Zi Tang (柴芍六君子汤) + Tong Xie
Yao Fang (痛泻要方)
Composition:
Bupleurum (Chai Hu), White Peony (Bai Shao), Ginseng (Ren Shen),
Atractylodes (Bai Zhu), Poria (Fu Ling), Tangerine Peel (Chen Pi),
Saposhnikovia (Fang Feng), Licorice (Gan Cao)
Action: Soothes Liver Qi, strengthens Spleen Qi, stops diarrhea, and
relieves pain.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe abdominal pain |
|---|
and stop pain |
| Diarrhea-predominant |
|---|
and stop diarrhea |
| Constipation-predominant |
|---|
promote bowel movement |
| Bloating |
|---|
|
Western Mechanism Reference
Gut-brain axis dysregulation causing visceral hypersensitivity, abnormal
gut motility, and CRH-induced intestinal movement. Liver Depression with
Spleen Deficiency corresponds to IBS associated with stress, where HPA
axis activation and CRH release contribute to visceral hypersensitivity
and abnormal gut motility.
References
1. Internal Medicine of TCM - Diarrhea with Liver Overacting on Spleen.
2. DB-XJB: Chai Shao Liu Jun Zi Tang.
3. Lembo, A., et al. (2016). Acupuncture for IBS. *American Journal of
Gastroenterology*, 111(8), 1145-1153.
4. WHO. (2023). Digestive health. World Health Organization.
Explore More
- Find your solution at MendGod.com –
Personalized herbal protocols and acupressure tools for digestive
health.
- Deepen your knowledge at TcmCIO.com – Full
research papers and clinical case studies on TCM digestive health.
Related TCM Patterns for Irritable Bowel Syndrome
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.