Cluster Headache - Phlegm-Turbidity Obscuring the Orifices Pattern

Dr. Li Wei, DACM

Cluster Headache · Phlegm-Turbidity Obscuring the Orifices Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Phlegm-Turbidity Obscuring the Orifices is a pattern in cluster headache, characterized by hypothalamic rhythm dysregulation, melatonin secretion disorder, heavy head sensation, nausea, and chest tightness. The core pathogenesis is Phlegm-Turbidity accumulating in the head, causing hypothalamic rhythm dysregulation and headache.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Heavy head sensation, dull pain, nausea, chest tightness |

| Associated Symptoms | Vomiting of phlegm-saliva, poor appetite, heavy sensation, dizziness |

| Tongue and Pulse | Pale and swollen tongue with white greasy coating, slippery pulse |

| Pathogenesis | Phlegm-Turbidity obstructing the clear orifices |

| Etiology | Poor diet, Spleen deficiency, Phlegm-Dampness constitution |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Fenglong (ST40) | 8 cun above the lateral malleolus, 2 cun lateral to the tibial crest | Transforms Phlegm and Dampness |

| Touwei (ST8) | On the head, 0.5 cun above the anterior hairline, 4.5 cun lateral to the midline | Clears the head and relieves headache |

| Zhongwan (RN12) | 4 cun above the umbilicus | Harmonizes the Stomach and transforms Phlegm |

| Yinlingquan (SP9) | Below the medial condyle of the tibia | Transforms Dampness and promotes diuresis |

| Baihui (GV20) | On the midline of the head, 5 cun posterior to the anterior hairline | Lifts Yang and clears the head |

Clinical Recommendation: Filament needle, even method; moxibustion may be added to strengthen the Spleen and transform Phlegm.

Herbal Formula

Base Formula: Ban Xia Bai Zhu Tian Ma Tang (半夏白术天麻汤)

Composition:

Pinellia (Fa Ban Xia), Atractylodes (Bai Zhu), Gastrodia (Tian Ma), Poria (Fu Ling), Tangerine Peel (Ju Hong), Licorice (Gan Cao), Ginger (Sheng Jiang), Jujube (Da Zao)

Action: Transforms Phlegm, clears the head, and stops dizziness.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Heavy head sensation | Add Yi Yi Ren, Ze Xie to promote diuresis and transform turbidity |

| Nausea | Add Xuan Fu Hua, Dai Zhe Shi to descend rebellious Qi |

| Chest tightness | Add Zhi Ke, Hou Po to regulate Qi and relieve distension |

| Dizziness | Add Gou Teng, Shi Jue Ming to calm Liver Wind |

Western Mechanism Reference

Hypothalamic rhythm dysregulation with melatonin secretion disorder and histamine metabolism abnormality. Phlegm-Turbidity Obscuring the Orifices corresponds to cluster headache with rhythm disturbance, where hypothalamic dysregulation and melatonin secretion disorder contribute to headache pattern.

References

  1. Internal Medicine of TCM - Headache with Phlegm-Turbidity.

  2. Xiong Jibai: Phlegm-Dampness uses Er Chen Tang with Tian Ma.

  3. WHO. (2023). Headache disorders. World Health Organization.

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