Type 2 diabetes mellitus(T2DM) is a chronic metabolic disorder characterized by hyperglycemia, with a continuously increasing prevalence in China that poses a serious threat to patients‘ health. Drawing on extensive clinical experience, Professor Zhang Ning observes that T2DM patients are often associated with spleen deficiency, liver qi stagnation, and the obstruction of stale Qi flow within the meridians. Based on principles derived from the Huangdi Neijing which advocates "treating with orchids to resolve stale Qi", Professor Zhang has developed a therapeutic approach for T2DM that focuses on regulating the spleen and soothing the liver to alleviate stale Qi. This approach aims to reduce blood glucose levels and mitigate the progression of the disease. This paper aims to explore the pathogenic evolution of Xiaoke disease from the perspective of "stagnant Qi" and elucidate Professor Zhang Ning‘s clinical experience in the diagnosis and treatment of T2DM, with the goal of providing new insights for the prevention and treatment of Xiaoke disease using traditional Chinese medicine.