ICD-11 SF70 (Spleen qi deficiency pattern, TM1): A Coding and Interoperability Dossier

Bottom line: SF70 is a morbidity-only pattern code in Module 1 of the ICD-11 traditional-medicine chapter, sitting under "Spleen system patterns (TM1)" and requiring dual coding with a biomedical diagnosis.

Field	Value	Source tier
Linearization code	SF70	A
Official English title	Spleen qi deficiency pattern (TM1)	A
WHO official Chinese title	脾气虚证（TM1） — the core term also aligns with national standard GB/T 16751.2	A (WHO 2026-01 Chinese browser)
Chapter / module	Chapter 26, Traditional Medicine Conditions — Module 1 (TM1)	A
Parent block	Spleen system patterns (TM1)	A
Foundation entity ID	1687720868 (verified in the WHO 2026-01 browser entity view)	A (WHO official)
Foundation URI	http://id.who.int/icd/entity/1687720868	A (WHO official)
Release	2026-01	A
Query date	2026-07-12	—
Coding purpose	Supplementary morbidity reporting, service utilisation, research	A
Mortality applicability	No — the chapter is morbidity-only	A
Dual coding	Required — a Chapter 01–25 diagnosis is combined with the TM1 code	A
WHO index terms	Spleen qi deficiency pattern (TM1); Spleen qi depletion pattern (TM1); Spleen qi insecurity pattern (TM1)	A (WHO 2026-01 browser)
Version status	No entity-level change found across the public releases checked (see §5)	—

The Foundation entity ID, English and Chinese titles, and all three English index terms were verified in the live WHO ICD-11 2026-01 browser on 2026-07-12. The Find-A-Code page is retained only as an auxiliary mirror.

Bottom line: SF70 is a classification category — not a disease, symptom, laboratory value, or mechanism.

For the general reader: think of SF70 as a shared serial number. Different clinics and languages used to write "spleen qi deficiency" in many ways; the number lets those records line up for counting. The number itself does not diagnose a person, choose a treatment, or prove any therapy works.

Professional note. Terminology work distinguishes six kinds of object; SF70 is only the first:

• Classification category — what SF70 is: a label built for statistics and interoperability.
• Clinical diagnosis — a judgement about an individual; SF70 is not this.
• Traditional pattern — the concept SF70 identifies: a functional state organised under traditional theory.
• Symptom cluster — fatigue, poor appetite, loose stool may co-occur, but co-occurrence is not the definition.
• Biomedical disease — SF70 has no official equivalence to any Western disease.
• Pathophysiological mechanism — only research hypotheses exist; nothing is confirmed.

Evidence and limits. Collapsing "category" into "diagnosis" or "disease" is the most consequential misuse of a TM code in both analytics and public communication.

Bottom line: in both English and Chinese, the organ word ("spleen"/"脾") denotes a functional system, not the anatomical organ; a literal reading misleads.

Word formation. "Spleen qi deficiency pattern" combines a functional system (spleen), a traditional concept (qi), a state (deficiency) and the object type (pattern); the trailing "(TM1)" marks Module 1. The word "spleen" here is a conventional rendering of a traditional physiological system responsible in TCM theory for transformation, transport and holding the blood — it is not the immune/filtering organ of anatomy.

Three kinds of name. Readers must distinguish (a) the WHO official title, (b) national standard terminology (in China, GB/T 16751.2, "脾气虚证"), and (c) an editorial/interpretive translation on a website. They may coincide but are not the same kind of authority; cite the status you rely on.

Regional scope (CJK). Module 1 concepts originate in Chinese medicine but also have long histories in Japanese Kampo, Korean traditional medicine, and Vietnamese traditional medicine. The same English title may carry different scope and diagnostic rules across these systems, so a shared label does not guarantee identical meaning.

Chinese-only source materials. Some primary references — national terminology standards, pharmacopoeia monographs, and product labelling — exist chiefly in Chinese. English readers should treat any English rendering of those as a working translation unless an official English version is cited.

Bottom line: the historical concept "spleen qi deficiency" and today’s ICD entity SF70 are different objects and must be described in separate layers.

A. Traditional conceptual history (near-synonym / precursor layer)

Expressions locating illness at the "spleen(-stomach)" with "qi insufficiency" have long existed in classical texts and modern TCM textbooks, as a near-synonym or precursor to the present pattern. This page makes no unverified "first attested in text X" claim, since cross-edition verification of classical sources is specialist work; absent that, it states only that the concept has a long history.

B. Modern standardisation history (verifiable timeline)

• ICD-11’s traditional-medicine chapter builds on earlier standardisation, including WHO standard acupoint nomenclature and the International Classification of Traditional Medicine (ICTM) project, which harmonised disorders and patterns into a web-based system.
• 2019: the 72nd World Health Assembly adopted ICD-11, including Chapter 26.
• 1 January 2022: ICD-11 with Module 1 (East-Asian systems) took effect; Chapter 26 is a supplementary, morbidity-only chapter enabling optional dual coding of traditional-medicine concepts alongside conventional diagnoses.
• February 2025: Module 2 (TM2 — Ayurveda, Siddha, Unani) was added; it is irrelevant to SF70, which is Module 1. TM2 content must not be substituted here.

C. Current ontology position

• ICD-11 Foundation: SF70 maps to Foundation entity 1687720868, verified in the WHO 2026-01 English and Chinese browsers (see Table 1).
• ICD-11 MMS (linearization): SF70 appears in the supplementary TM1 chapter.
• SNOMED CT / UMLS / MeSH / LOINC: in the public sources checked, no official equivalence mapping to SF70 was verified. Lexical similarity is not a mapping.

Evidence and limits. "WHO international classification", "WHO terminology standard", "national standard", "textbook definition", "society consensus" and "website translation" are six different tiers of authority; conflating them manufactures false consistency.

Bottom line: across the public releases checked, no entity-level change to SF70 (code / parent / title) was verifiable — but the annual update cycle means you must always record the release you used.

Release	Code	Title	Hierarchy / definition change	Source	Conclusion
2022 in force	SF70	Spleen qi deficiency pattern (TM1)	Module 1 came into effect	A / literature	Established
2024-01	SF70	same	No entity-level change found	A (WHO browser)	Stable
2025-01	SF70	same	Annual update; no SF70 change; TM2 module added (unrelated)	A (WHO)	Stable
2026-01 (used here)	SF70	same	No entity-level change found	A (WHO) / mirror	Stable

Hierarchy. SF70 sits within the block "Spleen system patterns (TM1)". Neighbouring pattern codes in the same block include SF71 (spleen qi sinking), SF76 (spleen yin deficiency) and SF77 (spleen yang deficiency), per the current WHO hierarchy. Adjacent codes are for orientation only and are not used to infer SF70’s definition.

No publicly verifiable entity-level change was found between the versions checked.

Implementation status. A WHO standard and a country’s implementation are different things. Whether Chapter 26 is used, which release is adopted, and who may assign a pattern all depend on national and local rules; this page does not state a mandatory recording requirement for any jurisdiction.

Bottom line: SF70 has no official equivalence to the anatomical spleen, to any Western disease, symptom, lab value, molecular mechanism, formula, patent medicine, or Western drug.

Object often equated	Actual relation	Why not equivalent	Cautious overlap	Tier
Anatomical spleen	Not equivalent	The traditional "spleen" is a functional system, not the immune/filtering organ	Digestive-function topics may co-occur but do not map	E
Functional dyspepsia, chronic gastritis, etc.	Not equivalent; clinical overlap only	Different criteria, inclusions/exclusions, and assessors	Studies often record "disease + pattern"; that is a dual-coding illustration, not a mapping	D
Fatigue / poor appetite / loose stool	Not equivalent	Symptoms are manifestations, not the definition, and are non-specific	Symptom clusters can feed research pattern criteria	D
A lab or endoscopy finding	Not diagnostically equivalent	No finding is established as a diagnostic criterion for SF70	May be explored as a research correlate	D
A molecular mechanism	Research hypothesis	Association is not causation; samples small, criteria non-uniform	Discussable as a hypothesis	D
Sijunzi Tang and similar formulas	Not defined by the code	ICD codes do not prescribe formulas	Historical/terminological association only (§10)	E
A Chinese patent medicine	Not a product the code maps to	The code points to no specific product	Pattern wording may appear in the label indication text	B
A Western drug	Not a treatment "for" this TM code	Drug indications target Western diseases, not patterns	May treat a co-existing Western disease (§10)	B

Similar term ≠ formal mapping · Overlapping symptoms ≠ same disease · Research association ≠ diagnostic criterion · Mechanistic hypothesis ≠ clinical proof · Pattern code ≠ drug indication · WHO inclusion ≠ efficacy or safety endorsement.

Bottom line: a TM1 code is a supplementary dimension attached to a biomedical primary diagnosis; it never replaces the primary code.

The rule. The ICD-11 Reference Guide directs those coding TM concepts to first record an ICD-11 diagnosis from Chapters 01–25, then combine it with a TM1 pattern or disorder from Chapter 26. Pattern identification should be done by a qualified traditional-medicine practitioner; coding neither changes nor replaces the biomedical pathway.

Fit-for-purpose uses. Aggregating pattern distributions across institutions, service-utilisation and quality monitoring, comparability of research data, and reducing free-text synonym noise.

Not fit for. Diagnosis, choosing prescriptions or doses, proving efficacy, turning a pattern into a biomedical entity, or public self-diagnosis.

Three educational vignettes (not individual medical advice)

1. Correct dual coding. An adult receives a biomedical diagnosis of functional dyspepsia (primary code from the relevant ICD-11 chapter); at a site that has enabled Chapter 26, a qualified practitioner records SF70 as a parallel dimension. Both codes coexist and answer different questions.
2. Improper substitution. Recording SF70 but omitting the biomedical primary diagnosis loses comparable disease information — a misuse. A TM code cannot carry the diagnosis alone.
3. Ambiguous NLP extraction. Natural-language processing "finds" an SF70 in legacy notes but cannot confirm whether it reflects prospective pattern assessment or an incidental text mention. Such records must be flagged for provenance and never pooled with clinician-assigned patterns in one variable.

Bottom line: mixing "clinician-assigned", "legacy import" and "NLP-inferred" in a single variable makes one SF70 carry data of completely different origin; separate them by field.

Group	Fields
Classification anchor	ICD release, code, official title, Foundation URI, language
Coding context	coding date, coding context, practitioner/source
Ascertainment	ascertainment method (prospective / imported / NLP-inferred), diagnostic criteria used, confidence
Parallel medical info	biomedical diagnosis (primary code), TM disorder, TM pattern
Temporality / provenance	prospective/retrospective, clinician-assigned/NLP-inferred/imported, source document
Local / mapping	local terminology, mapping relation
Governance	reviewer, last reviewed

Why it matters. A prospectively assessed SF70 is a study object; an imported SF70 may be only a text artefact; an NLP-inferred SF70 carries algorithmic error. Their evidentiary value differs, and any prevalence, association, or effect analysis built on an unlayered SF70 can be contaminated by source heterogeneity.

Bottom line: informatics, metabolomic, network-pharmacology and interventional work around "spleen (qi) deficiency" exists, but non-uniform pattern criteria, small single-centre samples, and label leakage mean it cannot support "SF70 has a diagnostic biomarker" or "therapy X works for SF70".

Direction	Representative work	Main finding	Key limitation	What can be concluded
Informatics / ICD-11 coding	Reddy & Fan, 2022 (BMC Med Inform Decis Mak)	Maps the 150 disorders and 196 patterns of Chapter 26 and the dual-coding mechanism, with "disease + pattern" pairing examples	Pairings are illustrative, not official equivalences	Explains how dual coding works; establishes no SF70↔disease mapping
Metabolomic association	IBD metabolomics, 2022 (PMC9270137)	Coded a spleen-deficiency group as SF70 under study-defined criteria; compared differential metabolites vs damp-heat and controls	n=15/group, single-centre, self-defined criteria, exploratory	Suggests possible group differences; not a diagnostic basis for SF70
Network pharmacology	SQD network pharmacology, 2020 (DOI 10.1155/2020/2974268)	Explores a putative biological basis and disease–pattern–herb relationships	Computation/literature driven; no prospective clinical validation	Provides a hypothesis framework, not clinical proof
Interventional trial	Hou Gu Mi Xi multicentre RCT protocol, 2019 (DOI 10.1186/s13063-019-3429-x; NCT03019042)	Uses a spleen-qi-deficiency symptom scale as the primary outcome for a dietary TCM formula	Protocol; outcome is a pattern symptom score, not SF70 itself	An intervention study on the "pattern", not on the "SF70 code"
Pathophysiology (older)	Yin GY et al., Chin Med J 2004/2005 (PMID 15361303, 15788127)	Examines a pathophysiological basis for "spleen" classification in chronic gastritis	Older; criteria not aligned with ICD-11	Pattern-level exploration on non-SF70 criteria

Dedicated methodology issues

• Inter-rater reliability: practitioners may disagree whether a given patient is "spleen qi deficient"; agreement studies are a prerequisite for treating the pattern as a reliable data entity.
• External validity: associations and models from single-centre samples may not generalise.
• Cultural/regional variation: CJK systems differ in the scope and rules of same-named patterns; cross-regional pooling needs care.
• Label leakage and small-sample multiplicity: omics studies with many variables and few subjects readily generate false-positive associations.
• Pattern-definition drift: each paper’s "spleen deficiency" criteria differ from one another and from ICD-11’s SF70; a study’s pattern label is not a WHO ICD code.

Known / unknown / disputed / not inferable. Known: SF70 is a stable label requiring dual coding. Unknown: whether a diagnostic biomarker exists. Disputed: the degree of biological reification and diagnostic reliability of the pattern. Not inferable: no efficacy or causal claim follows from the association studies above.

This ICD-11 TM code does not define a corresponding formula or drug, so this page builds no fixed "code → medicine" table. The notes below are historical and terminological indexing only and are not treatment, formula, or medication recommendations.

10.1 Historical formula (tier E, retrospective/terminological)

Sijunzi Tang ("Four Gentlemen Decoction") is recorded in the Song-dynasty Taiping Huimin Heji Ju Fang (volume 3), whose text describes use for "qi vacuity of construction and defence… reduced appetite, borborygmus, diarrhoea, and vomiting", with a four-ingredient composition. It is often cited when discussing "spleen-stomach qi deficiency" wording. This is a historical/terminological association with the concept — not a treatment defined or mandated by the SF70 code, and the two form no official correspondence.

10.2 Chinese patent medicines (source boundary, tier B)

Some patent-medicine labels and Chinese Pharmacopoeia monographs use "spleen-stomach qi deficiency" wording in their indications. That indication language is about a product’s applicable-pattern text; it does not mean the product maps to the SF70 classification code. Consistent with the site’s editorial red lines, this page names no brands, gives no purchasing direction, and builds no code–product table; consult current pharmacopoeia and official labelling for product facts.

10.3 Herbs and chemical constituents (strict layering)

For the herbs in Sijunzi Tang, review articles (e.g. Chinese Traditional and Herbal Drugs 2016;47(5):837-843) report that the decoction can contain saponins (e.g. ginsenosides), flavonoids (largely from liquorice), polysaccharides, and atractylenolides. Distinguish: prescription herb ≠ pharmacopoeial marker ≠ identified constituent ≠ in-vitro active constituent ≠ constituent reaching human exposure ≠ clinically proven active ingredient. "A constituent is detectable" does not mean "that constituent produces a clinical effect." Most of these remain at the chemical-identification and in-vitro/animal level, still distant from clinical conclusions.

10.4 Western drugs (no correspondence built)

A Western drug belongs only in three contexts: treating a patient’s co-existing Western disease, a potential interaction with a herbal product, or a research comparator. No "corresponding Western drug" is established for SF70. A prokinetic, for instance, targets the indication of functional dyspepsia (a biomedical diagnosis), not the "spleen qi deficiency" pattern; mapping a drug indication onto a TM pattern is a category error.

Bottom line: because SF70 maps to no fixed medicine, this page lists no specific interaction table and states only the layering principle.

Any concrete safety or interaction judgement should concern a specific herb or product, not a pattern, and should be graded: regulatory label confirmed > clinical case / pharmacovigilance signal > clinical pharmacokinetic study > in-vitro CYP/transporter study > theoretical inference. An in-vitro CYP inhibition result alone does not establish a clinical interaction. For product-specific questions, rely on current pharmacopoeia, official labelling and pharmacovigilance sources, and consult a qualified professional.

Bottom line: in the public sources checked, "no established mapping" holds between SF70 and mainstream biomedical terminologies.

Target system / object	Relation label	Note
ICD-11 Foundation ↔ MMS (SF70)	official (base ↔ linearization of one entity)	Foundation entity and its MMS code
National standard GB/T 16751.2 "脾气虚证"	exact lexical alignment	The WHO Chinese title and national-standard core term align, while remaining distinct sources
Western diseases (e.g. functional dyspepsia)	research-only / historical association	Illustrative pairings in the literature, not official equivalences
SNOMED CT / UMLS / MeSH / LOINC	no established mapping	No official equivalence verified here

Where there is no official basis, this page avoids "corresponds to", "equivalent to", or "is".

Bottom line: classifying a pattern improves data visibility but also raises reification, regional-difference, reliability and misreading tensions; competing views should be presented without manufacturing consensus.

• Reification risk: assigning a stable code can make a pattern look like a well-bounded, diagnosable biomedical entity, when its diagnosis still depends heavily on assessor and criteria.
• Standardisation vs regional tradition: a single international code aids counting but can flatten scope differences between Chinese, Japanese and Korean systems.
• Diagnostic reliability: inter-rater agreement is central to trusting the pattern as a data variable, and current evidence is limited.
• Statistical value ≠ efficacy evidence: being countable and researchable is a different conclusion from a therapy being proven effective.
• Research-label heterogeneity: study-defined pattern criteria differ from one another and from SF70.
• Public misreading: "WHO inclusion" is frequently misreported as "WHO endorses efficacy", which needs ongoing correction.

Foundation

ICD-11’s multidimensional concept layer where entities carry stable IDs and URIs.

Linearization

A one-dimensional, statistics-ready list derived from the Foundation, e.g. the MMS.

Stem code

A code usable on its own; SF70 appears as a stem code in the MMS.

Postcoordination

Refining a stem code with extension codes.

Dual coding

Recording a biomedical primary diagnosis together with a TM pattern/disorder.

Morbidity

Statistics about illness and encounters; the supplementary chapter is morbidity-only.

Pattern

A functional-state category grouping signs and symptoms under traditional theory.

Disorder

A relatively distinct traditional illness category — a different level from a pattern.

Mapping

A formally confirmed correspondence between two terminologies.

Provenance

The record of how, by whom and in what context a code was created.

Ascertainment

Whether a pattern was prospectively assessed, imported, or NLP-inferred.

Biomarker

An objectively measurable indicator tied to a state; SF70 has no accepted diagnostic biomarker.

Chemical constituent

A compound detected/identified in a herb, not necessarily clinically active.

Marker compound

A representative constituent used for pharmacopoeial identification or assay.

Active ingredient

A constituent proven to produce a clinical effect; a "detected constituent" cannot be called this.

Source tiers: A = normative/official definition, B = drug & regulatory, C = high-level evidence, D = primary research, E = history & terminology.

Tier A — official / normative primary sources

1. WHO. ICD-11 for Mortality and Morbidity Statistics (MMS), release 2026-01. icd.who.int/browse/2026-01/mms/en (queried 2026-07-12).
2. WHO. ICD-11 Reference Guide. icdcdn.who.int
3. WHO. Traditional medicine classifications — FAQ. who.int
4. WHO. 2025 update to ICD-11 (TM2 module note). who.int/news
5. SF70 auxiliary entity mirror (the Foundation ID was subsequently verified in the WHO 2026-01 browser). Find-A-Code, code-1687720868. findacode.com
6. National standard of China GB/T 16751.2, Clinical terminology of TCM — syndromes/patterns (basis for the Chinese term).

Tier C/D — peer-reviewed research

7. Reddy B, Fan AY. Incorporation of complementary and traditional medicine in ICD-11. BMC Med Inform Decis Mak. 2022;22:53. DOI: 10.1186/s12911-022-01913-7.
8. ICD-11 and data gaps in traditional medicine (Chapter 26 dual-coding review). PMC12578526.
9. Development of the traditional medicine classification Module 1 in ICD-11. ScienceDirect S2225411026000106 (2026).
10. Metabolomics of IBD and damp-heat syndrome (spleen deficiency coded SF70). PMC9270137.
11. Wang X, et al. Network pharmacology of spleen qi deficiency syndrome. 2020. DOI: 10.1155/2020/2974268.
12. Zhou X, et al. Hou Gu Mi Xi multicentre RCT protocol (spleen qi deficiency). Trials. 2019. DOI: 10.1186/s13063-019-3429-x; registration NCT03019042.
13. Yin GY, et al. Pathophysiologic basis of 'spleen' deficiency classification in chronic gastritis. Chin Med J (Engl). 2005;118(6):468-73. PMID: 15788127.
14. Yin GY, et al. Pathological basis of spleen deficiency classification in chronic gastritis. Chin Med J (Engl). 2004;117(8):1246-52. PMID: 15361303.

Tier E — history and terminology

15. Taiping Huimin Heji Ju Fang, vol. 3, "Sijunzi Tang" (Song-dynasty official formulary; source and indication text of the formula).
16. Ji Y-F, Wang R-J, Li X-B. Research progress on chemical constituents and pharmacological effects of Sijunzi Decoction. Chinese Traditional and Herbal Drugs. 2016;47(5):837-843.

Version record

• ICD query date: 2026-07-12; WHO release used: 2026-01.
• Pharmacopoeia/terminology reference: current Chinese Pharmacopoeia; GB/T 16751.2 (constituents and terminology).
• Literature cut-off: 2026-07-12.
• Change log: first published 2026-07-04; on 2026-07-12 fully rewritten to the professional-depth standard (added the field table, version table, non-equivalence matrix, evidence map, minimum dataset, glossary and tiered references, and moved the body to single-source rendering).