PCOS - Spleen Deficiency with Phlegm-Dampness Pattern

TCM differentiation and treatment for PCOS with Spleen

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

menstruation |

Associated Symptoms

bloating |

Tongue and Pulse

coating, soft and weak pulse |

Pathogenesis

|

Etiology

constitutional Spleen deficiency |


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 |

Fenglong (ST40)

to the tibial crest | Transforms Phlegm and Dampness |

Zhongwan (RN12) 4 cun above the umbilicus

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

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.


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.