GERD/Acid Reflux - Phlegm-Qi Obstruction Pattern

Dr. Li Wei, DACM

GERD/Acid Reflux · Phlegm-Qi Obstruction Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest/Abdomen

Pattern Overview

Phlegm-Qi Obstruction is a pattern in GERD/acid reflux, characterized by esophageal motility dysfunction, globus sensation (lump in the throat), acid reflux, and chest tightness. The core pathogenesis is Phlegm and Qi obstructing the throat and chest, causing esophageal motility dysfunction and hypersensitivity.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Globus sensation, acid reflux, chest tightness, difficulty swallowing |

| Associated Symptoms | Nausea, belching, sticky phlegm, sensation of obstruction |

| Tongue and Pulse | Pale red tongue with greasy coating, slippery or wiry pulse |

| Pathogenesis | Phlegm and Qi obstructing the throat and chest |

| Etiology | Chronic stress, poor diet, emotional disturbance, phlegm 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 |

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

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

| Tiantu (RN22) | In the depression at the suprasternal fossa | Descends rebellious Qi and relieves throat obstruction |

| Danzhong (RN17) | Center of the chest, at the level of the nipples | Regulates Qi and relieves chest tightness |

Clinical Recommendation: Filiform needle, reducing method; may combine with moxibustion to transform Phlegm.

Herbal Formula

Base Formula: Ban Xia Hou Po Tang (半夏厚朴汤) + Wen Dan Tang (温胆汤)

Composition:

Pinellia (Ban Xia), Magnolia (Hou Po), Poria (Fu Ling), Perilla Leaf (Su Ye), Tangerine Peel (Chen Pi), Immature Bitter Orange (Zhi Shi), Bamboo Shavings (Zhu Ru), Licorice (Gan Cao)

Action: Transforms Phlegm, regulates Qi, and relieves obstruction.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Globus sensation | Add Zhe Bei Mu, Gua Lou to soften and transform Phlegm |

| Chest tightness | Add Zhi Ke, Jie Geng to regulate Qi and relieve distension |

| Nausea | Add Sheng Jiang, Zhu Ru to descend rebellious Qi |

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

Western Mechanism Reference

Esophageal motility dysfunction with impaired esophageal clearance, reflux retention, and esophageal hypersensitivity. Phlegm-Qi Obstruction corresponds to GERD with esophageal motility dysfunction, where impaired esophageal clearance and increased esophageal hypersensitivity contribute to reflux symptoms and globus sensation.

References

  1. Internal Medicine of TCM - Globus Hystericus with Phlegm-Qi Obstruction.

  2. DB-XJB: Wen Dan Tang.

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

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