Chronic Abdominal Pain - Cold Obstruction Pattern
Dr. Li Wei, DACM
Chronic Abdominal Pain · Cold Obstruction Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Abdomen
Pattern Overview
Cold Obstruction is a common pattern in chronic abdominal pain, characterized by visceral hypersensitivity with cold-induced smooth muscle spasm, cold pain, abdominal cramps, relief with warmth, and cold extremities. The core pathogenesis is invasion of Cold-Dampness into the Spleen and Stomach, causing cold-induced smooth muscle spasm, Qi stagnation, and visceral hypersensitivity.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
| :— | :— |
| Primary Symptoms | Cold pain in the abdomen, cramps, relief with warmth |
| Associated Symptoms | Cold extremities, loose stools, poor appetite, preference for warm drinks |
| Tongue and Pulse | Pale tongue with thin white coating, deep and tense pulse |
| Pathogenesis | Cold-Dampness invading the Spleen and Stomach |
| Etiology | Cold food intake, exposure to cold, constitutional Spleen-Stomach deficiency |
Acupuncture Point Prescription
| Point | Location | Function |
| :— | :— | :— |
| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach; harmonizes the Stomach |
| Qihai (RN6) | 1.5 cun below the umbilicus | Tonifies Qi and warms the lower abdomen |
| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |
| Taibai (SP3) | Medial foot, behind the base of the 1st metatarsal | Source point of Spleen meridian; strengthens Spleen-Qi |
Clinical Recommendation: Filament needle, reinforcing method; heavy moxibustion is strongly recommended to warm the meridians and disperse Cold.
Herbal Formula
Base Formula: Liang Fu Wan (良附丸) + Zheng Qi Tian Xiang San (正气天香散)
Composition:
Cyperus (Xiang Fu), Alpinia (Gao Liang Jiang), Lindera (Wu Yao), Tangerine Peel (Chen Pi), Angelica (Dang Gui), Licorice (Gan Cao)
Action: Disperses Cold, warms the Stomach, and relieves pain.
Modifications
| Associated Symptoms | Additions/Subtractions |
| :— | :— |
| Severe cold pain | Add Fu Zi, Gui Zhi to warm Yang and disperse Cold |
| Abdominal cramps | Add Bai Shao, Gan Cao to relax muscles |
| Loose stools | Add Gan Jiang, Rou Gui to warm the Spleen and stop diarrhea |
| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |
Western Mechanism Reference
Visceral hypersensitivity with cold-induced smooth muscle spasm, increased visceral afferent sensitivity, and autonomic dysfunction. Cold Obstruction corresponds to chronic abdominal pain with cold sensitivity, where cold-induced smooth muscle spasm and visceral hypersensitivity contribute to abdominal cramps and pain.
References
Internal Medicine of TCM - Abdominal Pain with Cold Obstruction.
WHO. (2023). Digestive health. World Health Organization.
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