Chronic Gastritis - Liver-Stomach Qi Stagnation Pattern

Dr. Li Wei, DACM

Chronic Gastritis · Liver-Stomach Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Liver-Stomach Qi Stagnation is a common pattern in chronic gastritis, characterized by stress-induced gastric mucosal ischemia, epigastric pain, bloating, belching, and aggravation with stress. The core pathogenesis is emotional stress causing Liver Qi stagnation, which invades the Stomach, leading to Qi dysfunction, mucosal ischemia, and pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Epigastric pain, bloating, belching, worse with stress |

| Associated Symptoms | Irritability, chest tightness, frequent sighing, poor appetite |

| Tongue and Pulse | Pale red tongue with thin white coating, wiry pulse |

| Pathogenesis | Liver Qi stagnation invading the Stomach, causing Qi dysfunction |

| Etiology | Chronic stress, emotional distress, irregular eating habits |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach; harmonizes the Stomach |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver Qi |

| Neiguan (PC6) | 2 cun above the wrist crease, between the tendons | Relieves chest tightness and harmonizes the Stomach |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; regulates Qi |

| Yanglingquan (GB34) | Depression below the head of the fibula | Regulates Qi and relieves pain |

Clinical Recommendation: Filament needle, reducing method for Liver points, even method for Stomach points; combine with stress reduction techniques.

Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi Ke), Chuanxiong (Chuan Xiong), Cyperus (Xiang Fu), Tangerine Peel (Chen Pi), Licorice (Gan Cao)

Action: Soothes Liver Qi, harmonizes the Stomach, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Yan Hu Suo, Chuan Lian Zi to regulate Qi and stop pain |

| Belching | Add Chen Pi, Hou Po to regulate Qi |

| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |

| Acid reflux | Add Huang Lian, Wu Zhu Yu to harmonize the Stomach and stop reflux |

Western Mechanism Reference

Psychological stress-induced vagal activation leading to reduced gastric mucosal blood flow, mucosal barrier damage, and gastric motility dysfunction. Liver-Stomach Qi Stagnation corresponds to chronic gastritis associated with stress, where autonomic dysfunction and reduced mucosal blood flow contribute to mucosal damage and pain.

References

  1. Internal Medicine of TCM - Stomach Pain with Liver Qi Invading Stomach.

  2. DB-XJB: Chai Hu Shu Gan San.

  3. WHO. (2023). Digestive health. World Health Organization.

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