GERD/Acid Reflux - Spleen-Stomach Deficiency with Cold Pattern

Dr. Li Wei, DACM

GERD/Acid Reflux · Spleen-Stomach Deficiency with Cold Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest/Abdomen

Pattern Overview

Spleen-Stomach Deficiency with Cold is a common pattern in GERD/acid reflux, characterized by decreased GI motility, acid reflux, cold epigastric pain, poor appetite, and loose stools. The core pathogenesis is Spleen and Stomach Yang deficiency failing to warm and transform food, leading to delayed gastric emptying and acid reflux.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Acid reflux, cold epigastric pain, poor appetite, loose stools |

| Associated Symptoms | Relief with warmth, fatigue, cold extremities, bloating |

| Tongue and Pulse | Pale and swollen tongue with white coating, deep and weak pulse |

| Pathogenesis | Spleen-Stomach Yang deficiency failing to warm and transform |

| Etiology | Irregular eating habits, cold food intake, chronic illness, overwork |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen Qi |

| Weishu (BL21) | Lower back, 1.5 cun lateral to T12 | Back-Shu point of Stomach meridian; harmonizes the Stomach |

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

| Guanyuan (RN4) | 3 cun below the umbilicus | Warms Yang and supplements Qi |

Clinical Recommendation: Filiform needle, reinforcing method; heavy moxibustion is strongly recommended to warm the Spleen and Stomach.

Herbal Formula

Base Formula: Li Zhong Tang (理中汤) + Xiang Sha Liu Jun Zi Tang (香砂六君子汤)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Dried Ginger (Gan Jiang), Poria (Fu Ling), Pinellia (Ban Xia), Amomum (Sha Ren), Aucklandia (Mu Xiang), Licorice (Gan Cao)

Action: Warms the Spleen and Stomach, strengthens Qi, and harmonizes the Stomach.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe cold pain | Add Fu Zi, Rou Gui to warm Yang and disperse Cold |

| Loose stools | Add Shan Yao, Yi Yi Ren to strengthen Spleen and stop diarrhea |

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

| Fatigue | Add Huang Qi to enhance Qi supplementation |

Western Mechanism Reference

Decreased GI motility causing delayed gastric emptying, increased intragastric pressure, and decreased LES tone. Spleen-Stomach Deficiency with Cold corresponds to GERD with hypomotility, where delayed gastric emptying and decreased LES tone contribute to acid reflux.

References

  1. Internal Medicine of TCM - Acid Reflux with Spleen-Stomach Deficiency Cold.

  2. DB-XJB: Li Zhong Tang, Xiang Sha Liu Jun Zi Tang.

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

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