Objective To explore the efficacy and clinical value of buried needle intervention based on the “Liver and Gallbladder Divergence and Convergence” theory in alleviating gastrointestinal discomfort in patients with pulmonary tuberculosis. Methods A prospective randomized controlled study design was adopted. A total of 80 patients who received anti-tuberculosis treatment and experienced gastrointestinal discomfort at Guangzhou Chest Hospital from December 2023 to December 2024 were included. They were randomly divided into an observation group and a control group according to the random number table method, with 40 cases in each group. The control group received routine tuberculosis care, while the observation group received buried needle intervention on the basis of the control group. The scores of the Gastrointestinal Symptom Rating Scale (GSRS) and the traditional Chinese medicine (TCM) syndrome scores of the two groups were compared. Result Post-intervention, both GSRS and TCM syndrome scores decreased from baseline levels, with more significant reductions observed in the observation group (all P＜0.05). Repeated measures ANOVA revealed statistically significant effects of time, group, and interaction (all P＜0.05). Conclusion Buried needle intervention based on the “Liver and Gallbladder Divergence and Convergence” theory can significantly alleviate gastrointestinal discomfort symptoms in patients with pulmonary tuberculosis, enhance their appetite and health-related quality of life, and has good safety.