Tension Headache - Phlegm-Turbidity Obscuring the Orifices Pattern

Dr. Li Wei, DACM

Tension 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 tension headache, characterized by heavy head sensation, cervical proprioceptive abnormalities, vestibular dysfunction, nausea, and chest tightness. The core pathogenesis is Phlegm-Turbidity accumulating in the head, causing cervical proprioceptive abnormalities, vestibular dysfunction, and headache.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Heavy head sensation (like being wrapped), dull headache, nausea |

| Associated Symptoms | Chest tightness, vomiting of phlegm-saliva, poor appetite, 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, sedentary lifestyle |

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 |

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

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

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 |

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

Western Mechanism Reference

Heavy head sensation with cervical proprioceptive abnormalities, vestibular dysfunction, and vertebrobasilar insufficiency. Phlegm-Turbidity Obscuring the Orifices corresponds to tension headache with cervicogenic symptoms, where cervical proprioceptive abnormalities and vestibular dysfunction contribute to heavy head sensation and dizziness.

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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