Irritable Bowel Syndrome - Spleen-Kidney Yang Deficiency

TCM differentiation and treatment for irritable bowel

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

pain, cold intolerance |

Associated Symptoms

extremities, pale complexion |

Tongue and Pulse

coating, deep and weak pulse |

Pathogenesis

intestines |

Etiology

constitutional weakness |


Acupuncture Point Prescription

Point Location Function
Mingmen (GV4)

processes | Warms Kidney Yang and strengthens the body |

Shenshu (BL23) Lower back, 1.5 cun lateral to L2

point of Kidney meridian; warms Kidney Yang |

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

of Spleen meridian; strengthens Spleen Qi |

Guanyuan (RN4) 3 cun below the umbilicus

supplements Qi |

Tianshu (ST25) 2 cun lateral to the umbilicus

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

stop diarrhea |

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

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.


Explore More

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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.