Tension Headache - Qi-Blood Deficiency Pattern

Dr. Li Wei, DACM

Tension Headache · Qi-Blood Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Qi-Blood Deficiency is a chronic pattern in tension headache, characterized by chronic fatigue with hyperalgesia, reduced cerebral perfusion, low 5-HT function, and decreased pain modulation. The core pathogenesis is Qi-Blood deficiency failing to nourish the head, leading to reduced cerebral perfusion, hyperalgesia, and chronic headache.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Dull headache, worsened by fatigue, pale complexion, dizziness |

| Associated Symptoms | Shortness of breath, palpitations, poor sleep, cold limbs |

| Tongue and Pulse | Pale tongue with thin white coating, thready and weak pulse |

| Pathogenesis | Qi-Blood deficiency failing to nourish the head |

| Etiology | Chronic illness, poor nutrition, overwork, postpartum weakness |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

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

| Qihai (RN6) | 1.5 cun below the umbilicus | Tonifies Qi and strengthens the body |

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

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin; regulates the Spleen and Kidney |

Clinical Recommendation: Filament needle, reinforcing method; moxibustion may be applied to Zusanli and Qihai to warm and tonify Qi and Blood.

Herbal Formula

Base Formula: Ba Zhen Tang (八珍汤) or Bu Zhong Yi Qi Tang (补中益气汤)

Composition:

Ginseng (Ren Shen), Astragalus (Huang Qi), Atractylodes (Bai Zhu), Poria (Fu Ling), Angelica (Dang Gui), White Peony (Bai Shao), Chuanxiong (Chuan Xiong), Rehmannia (Shu Di), Cimicifuga (Sheng Ma), Bupleurum (Chai Hu), Licorice (Gan Cao)

Action: Supplements Qi and Blood, lifts Yang, and nourishes the head.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe fatigue | Add Huang Qi to enhance Qi supplementation |

| Dizziness | Add Tian Ma, Gou Teng to calm Liver Wind |

| Poor sleep | Add Suan Zao Ren, Yuan Zhi to calm the spirit |

| Cold limbs | Add Gui Zhi, Sheng Jiang to warm the meridians |

Western Mechanism Reference

Chronic fatigue with hyperalgesia, reduced cerebral perfusion, low 5-HT function, and decreased pain modulation. Qi-Blood Deficiency corresponds to chronic tension headache with fatigue and hyperalgesia, where reduced cerebral perfusion and low 5-HT function contribute to decreased pain modulation and persistent headache.

References

  1. Internal Medicine of TCM - Headache with Qi-Blood Deficiency.

  2. Zang-Fu Pattern Differentiation: Qi Deficiency + Blood Deficiency.

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

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