Bloating/Abdominal Distension · Spleen-Stomach Deficiency Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Abdomen


Pattern Overview

Spleen-Stomach Deficiency is a common pattern in bloating/abdominal distension, characterized by digestive enzyme insufficiency, abdominal distension, poor appetite, fatigue, and loose stools. The core pathogenesis is Spleen Qi deficiency failing to transform and transport, leading to incomplete digestion, gas accumulation, and bloating.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsAbdominal distension, poor appetite, fatigue, loose stools
Associated SymptomsBloating after meals, pale complexion, cold limbs, weakness
Tongue and PulsePale tongue with thin white coating, thready and weak pulse
PathogenesisSpleen Qi deficiency failing to transform and transport
EtiologyIrregular eating habits, overwork, chronic illness, poor nutrition

Acupuncture Point Prescription

PointLocationFunction
Zhongwan (RN12)4 cun above the umbilicusFront-Mu point of Stomach; harmonizes the Stomach
Pishu (BL20)Lower back, 1.5 cun lateral to T11Back-Shu point of Spleen meridian; strengthens Spleen Qi
Zusanli (ST36)3 cun below the patella, 1 finger-width lateral to the tibial crestStrengthens Spleen and Stomach; tonifies Qi
Gongsun (SP4)Medial foot, below the base of the 1st metatarsalLuo-connecting point of Spleen; harmonizes the Stomach
Taibai (SP3)Medial foot, behind the base of the 1st metatarsalSource point of Spleen meridian; strengthens Spleen Qi

Clinical Recommendation: Filament needle, reinforcing method; moxibustion may be applied to Pishu and Zusanli to warm and tonify Spleen Qi.


Herbal Formula

Base Formula: Xiang Sha Liu Jun Zi Tang (香砂六君子汤)

Composition:
Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Licorice (Gan Cao), Tangerine Peel (Chen Pi), Pinellia (Ban Xia), Amomum (Sha Ren), Aucklandia (Mu Xiang)

Action: Strengthens Spleen, harmonizes Stomach, and transforms Phlegm.

Modifications

Associated SymptomsAdditions/Subtractions
Severe distensionAdd Hou Po, Zhi Ke to regulate Qi and relieve distension
FatigueAdd Huang Qi to enhance Qi supplementation
Loose stoolsAdd Shan Yao, Yi Yi Ren to strengthen Spleen and stop diarrhea
Cold limbsAdd Gui Zhi, Sheng Jiang to warm the meridians

Western Mechanism Reference

Digestive enzyme insufficiency causing incomplete food digestion, altered intestinal osmotic pressure, and increased gas production. Spleen-Stomach Deficiency corresponds to bloating with malabsorption, where reduced digestive capacity and increased intestinal fermentation contribute to gas accumulation.


References

  1. Internal Medicine of TCM - Fullness with Spleen-Stomach Deficiency.
  2. DB-XJB: Xiang Sha Liu Jun Zi Tang.
  3. WHO. (2023). Digestive health. World Health Organization.

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