Acne is a chronic inflammatory disease of hair follicle sebaceous glands, which is called "comedo" in Chinese medicine. Some medical practitioners believe that the key of comedo Zangfu syndrome differentiation is the spleen and stomach, followed by the liver, lung and kidney. The spleen and stomach is the hub of Qi movement and the basis of Qi and blood biochemistry. This article discusses the theoretical basis, etiology, pathogenesis, treatment methods and treatment methods of comedo treatment from the spleen and stomach, combined with Professor Xu Lian‘s experience in treating female comedo with the academic thought of "Middle Jiao gasification".