---
title: "Common patterns"
url: "https://acuiq.com/wiki/theory/common-patterns"
updated: 2026-10-12
last_verified: 2026-10-12
license: CC-BY-4.0
license_url: "https://creativecommons.org/licenses/by/4.0/"
section: "theory"
basis: "Classical and modern"
audience: "Anyone"
published: "2026-10-12"
reading_minutes: 9
sources: 8
---

# Common patterns

_Qi stagnation, qi deficiency, blood deficiency, qi and blood deficiency, dampness and bi, as the WHO terminologies and ICD-11 name and describe them._

A pattern is the conclusion a practitioner of Chinese medicine draws from a patient’s findings, and a classical prescription is written against it. [Patterns, symptoms and what you can look up](/wiki/theory/patterns-and-symptoms) explains why AcuiQ’s symptom index holds pattern terms at all and what that means for a search. This page takes six terms that recur in the published prescriptions AcuiQ indexes: qi stagnation, qi deficiency, blood deficiency, qi and blood deficiency, dampness, and bi (impediment). For each it sets out how three WHO sources name and describe it.

## Where the definitions come from

The [2007 WHO standard terminology for the Western Pacific](https://iris.who.int/handle/10665/206952) defines a pattern identification as the overall analysis of clinical data to determine the location, cause and nature of a patient’s disease. It treats “pattern” and “syndrome” as interchangeable translations of one Chinese word, which is why the literature uses both. For the four qi and blood patterns on this page it gives two entries: one under mechanism of disease, saying what has gone wrong, and one under diagnostics, listing the findings that mark the pattern. The [2022 WHO terminology for traditional Chinese medicine](https://iris.who.int/handle/10665/352306) describes each pattern by its findings and then by what it often results from. Its reference list names the 2007 terminology, the ICD-11 traditional medicine chapter and Chinese textbooks such as Wang Yiqin’s _Diagnostics of Traditional Chinese Medicine_ (2006), so its descriptions draw on the textbook account.

The third source is [chapter 26 of ICD-11](https://icd.who.int/browse/2025-01/mms/en#718687701), the WHO disease classification, whose Module I covers traditional medicine conditions. A [2022 account of the chapter by Bill Reddy and Arthur Yin Fan](https://doi.org/10.1186/s12911-022-01913-7) counts 150 disorders and 196 patterns in it, and reports that a coder must first record a diagnosis from chapters 1 to 25 and may then add a pattern or disorder from chapter 26. In the 2025-01 release the pattern entries carry a code, a title and the alternative names counted as the same pattern, and no definition text, so the findings below come from the two terminologies.

## Qi stagnation and Liver qi stagnation

The 2007 terminology defines qi stagnation as impeded circulation of qi that disturbs the function of the organs and shows as distension or pain in the affected part. Its qi stagnation pattern is intermittent distension or pain in the chest, flanks, upper abdomen and abdomen, often relieved by sighing or belching. The 2022 edition describes the same pattern as distension, fullness and pain in the region below the ribs and in the abdomen that moves about and eases after sighing, belching, bowel sounds or flatus, with a wiry pulse.

Liver qi stagnation is the form tied to one organ. The 2007 terminology files it as the liver qi depression pattern and lists depression, frequent sighing, distension or moving pain below the ribs or in the lower abdomen, a string-like pulse and, in women, distending pain of the breasts and irregular menstruation. The 2022 description extends the distension, tightness or moving pain to the chest and attributes the pattern to the liver failing to keep qi flowing freely. The liver meant here is the zang-fu organ of Chinese medicine, which [The zang-fu organs](/wiki/theory/the-zang-fu-organs) distinguishes from the anatomical liver. AcuiQ indexes the term as [qi stagnation](/symptoms/qi-stagnation).

## Qi deficiency

The 2007 terminology calls qi deficiency a general term for a lack of qi that lowers the function of the organs and the body’s resistance. Its qi deficiency pattern is shortness of breath, lassitude, listlessness, spontaneous sweating, a pale tongue and a weak pulse. The 2022 edition lists shortness of breath, fatigue, lassitude, reluctance to talk, spontaneous sweating, a pale tongue and a deficient pulse, and says the pattern often results from underfunctioning of the zang-fu organs. Both editions also define narrower forms, among them qi failing to hold the blood in the vessels and qi deficiency with blood stasis. AcuiQ’s page is [qi deficiency](/symptoms/qi-deficiency).

## Blood deficiency

The 2007 terminology defines blood deficiency as a lack of blood that fails to nourish the organs, tissues and channels. Its blood deficiency pattern is a pale or sallow complexion, pale lips and nails, dizziness, dimmed vision, palpitations, numbness of the limbs and a fine pulse. The 2022 description adds a pale tongue, dream-disturbed sleep and, in women, scanty pale menstruation with a delayed period or none. In Chinese medicine “blood” is a concept with functions of its own rather than the fluid a blood test measures, a difference [Qi, blood and body fluids](/wiki/theory/qi-blood-and-body-fluids) sets out. AcuiQ’s page is [blood deficiency](/symptoms/blood-deficiency).

## Qi and blood deficiency

The 2007 terminology calls it a dual deficiency of qi and blood and defines it as the two deficiencies present together. Its pattern combines their findings: listlessness, lack of strength, shortness of breath, a pale or sallow complexion, dizziness, dimmed vision, pale lips and nails, palpitations, insomnia, a pale tongue and a weak pulse. The 2022 entry, the qi and blood deficiency pattern, lists nearly the same findings and adds reluctance to talk.

## Dampness and damp-heat

Dampness is first a cause of disease, one of the six excesses that [Causes of disease](/wiki/theory/causes-of-disease) covers. The 2007 terminology characterises it by turbidity, heaviness, stickiness and downward flow, and by the way it impedes the movement of qi. It also defines internal dampness, produced inside the body when deficient spleen and kidney yang fail to transform fluids. Its dampness pattern covers both origins and is marked by physical fatigue, heavy limbs, a heavy head, poor appetite, abdominal distension, loose stools, a slippery, slimy tongue coating and a soggy pulse.

Damp-heat is dampness combined with heat. The 2007 terminology says its findings depend on where it lodges: jaundice in the liver and gallbladder, vaginal discharge when it pours downward, diarrhoea in the intestines. The 2022 description of the general damp heat pattern is an inhibited body fever, body heaviness, discomfort in the stomach, thirst with little wish to drink, scanty yellow urine, loose stools with a feeling of incomplete evacuation, a red tongue with a yellow, greasy coating and a slippery, rapid pulse. AcuiQ’s page is [damp](/symptoms/damp).

## Bi syndrome (impediment)

The WHO sources class bi as a disease or disorder rather than a pattern. The 2007 terminology defines impediment disease as a group of diseases caused by wind, cold, dampness or heat invading the channels, involving the muscles, sinews, bones and joints, and showing as local pain, soreness, heaviness or heat and even swelling, stiffness and deformity of the joints. The 2022 edition calls the group bi-impediment disorders and lists “bi-impediment disease/pattern” among its synonyms. Both editions divide it by pathogen:

- **Moving or wind impediment:** joint pain that migrates; the 2022 edition includes muscle pain.
- **Painful or cold impediment:** severe joint pain made worse by cold; the 2022 edition adds that the pain is fixed and that warmth relieves it.
- **Fixed or dampness impediment:** joint pain in a fixed place; the 2022 edition adds soreness and sometimes swelling.
- **Heat impediment:** joint pain of sudden onset with local redness, swelling and heat; the 2022 edition adds that cold relieves it.

The 2007 terminology also names forms of bi by the tissue or organ involved, among them bone, flesh, vessel, heart and intestinal impediment. AcuiQ’s page is [bi syndrome](/symptoms/bi-syndrome).

## The same patterns in ICD-11

| Pattern | ICD-11 entry | Code |
| --- | --- | --- |
| Qi stagnation | Qi stagnation pattern, also indexed as qi depression pattern | SE91 |
| Liver qi stagnation | Liver qi stagnation pattern, also indexed as liver depression and qi stagnation pattern | SF57 |
| Qi deficiency | Qi deficiency pattern, including qi decrease pattern | SE90 |
| Blood deficiency | Blood deficiency pattern | SF00 |
| Qi and blood deficiency | No general entry; dual deficiency of heart qi and blood pattern | SF62 |
| Dampness | Dampness factor pattern, under environmental factor patterns | SE82 |
| Damp-heat | No general entry; located forms such as bladder dampness-heat pattern | SF9G |
| Bi syndrome | Joint impediment disorders: cold, wind and dampness impediment disorder | SC50, SC51, SC52 |

The chapter sorts the six differently from the terminologies. It places qi and blood patterns under body constituents, dampness under environmental factors, and bi under disorders of bones, joints and muscles. Its damp-heat entries name a place, among them the bladder, the large intestine, the uterus and the liver and gallbladder, and its joint impediment group has no heat impediment code.

## How often practitioners agree on these patterns

[The four examinations](/wiki/theory/the-four-examinations) reports the systematic review and the studies that measured whether practitioners examining the same patient reach the same pattern. A few studies looked at the patterns on this page by name.

A [2014 study by Birkeflet and colleagues](https://doi.org/10.1136/acupmed-2013-010473) gave eight acupuncturists written case histories of the same 25 women, 10 of them infertile, and each made a pattern diagnosis independently. Agreement on patterns was poor (kappa below 0.20, where 0 is chance agreement and 1 is perfect), and the authors found that symptoms, frequent and infrequent alike, were used inconsistently to diagnose Liver qi stagnation. A [2013 study by Suzanne Grant and colleagues at the University of Western Sydney](https://doi.org/10.1155/2013/710892) had two practitioners assess 27 people with prediabetes using a structured instrument. They agreed on the primary pattern for 70% of participants (kappa 0.56). Secondary patterns, mainly damp, damp-heat, Liver qi stagnation and blood stagnation, could not be compared statistically because each participant could receive several, and the two agreed on both primary and secondary patterns for 41%.

Two studies measured agreement after the practitioners trained together. In a [2008 study by Zhang and colleagues at the University of Maryland](https://doi.org/10.1089/acm.2007.0712), three practitioners who had trained together on agreed diagnostic criteria examined 42 people with rheumatoid arthritis, and each pair agreed on 73% of diagnoses on average. In a [2009 study by Mist and colleagues in Arizona and Oregon](https://doi.org/10.1089/acm.2008.0488), ten practitioners assessing people with temporomandibular joint disorder raised their inter-rater correlation from 0.11 to 0.62 through questionnaire-based diagnosis and repeated calibration, with the greatest agreement on primary and more severe diagnoses.

## What a pattern term on AcuiQ records

A pattern term on an AcuiQ symptom page records that a published prescription or a point’s indication list used it. AcuiQ does not differentiate patterns and cannot say whether the patients in a study would have received the same pattern from another practitioner, or which of the definitions above the authors applied.

### Sources

1. WHO Regional Office for the Western Pacific, WHO international standard terminologies on traditional medicine in the Western Pacific Region, 2007 — https://iris.who.int/handle/10665/206952
2. World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 — https://iris.who.int/handle/10665/352306
3. World Health Organization, ICD-11 for Mortality and Morbidity Statistics, release 2025-01, chapter 26: Supplementary chapter traditional medicine conditions — https://icd.who.int/browse/2025-01/mms/en#718687701
4. Reddy B, Fan AY, Incorporation of complementary and traditional medicine in ICD-11, BMC Medical Informatics and Decision Making 2022 — https://doi.org/10.1186/s12911-022-01913-7
5. Birkeflet O, Laake P, Vøllestad NK, Poor multi-rater reliability in TCM pattern diagnoses and variation in the use of symptoms to obtain a diagnosis, Acupuncture in Medicine 2014 — https://doi.org/10.1136/acupmed-2013-010473
6. Grant SJ, Schnyer RN, Chang DH, Fahey P, Bensoussan A, Interrater reliability of Chinese medicine diagnosis in people with prediabetes, Evidence-Based Complementary and Alternative Medicine 2013 — https://doi.org/10.1155/2013/710892
7. Zhang GG, Singh B, Lee W, Handwerger B, Lao L, Berman B, Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training, Journal of Alternative and Complementary Medicine 2008 — https://doi.org/10.1089/acm.2007.0712
8. Mist S, Ritenbaugh C, Aickin M, Effects of questionnaire-based diagnosis and training on inter-rater reliability among practitioners of traditional Chinese medicine, Journal of Alternative and Complementary Medicine 2009 — https://doi.org/10.1089/acm.2008.0488