Chronic Abdominal Pain - Cold Obstruction Pattern

TCM differentiation and treatment for chronic abdominal

Chronic Abdominal Pain · Cold Obstruction Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen


Pattern Overview

Cold Obstruction is a common pattern in chronic abdominal pain,

characterized by **visceral hypersensitivity with cold-induced smooth

muscle spasm, cold pain, abdominal cramps, relief with warmth, and cold

extremities. The core pathogenesis is invasion of Cold-Dampness into

the Spleen and Stomach**, causing cold-induced smooth muscle spasm, Qi

stagnation, and visceral hypersensitivity.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

warmth |

Associated Symptoms

appetite, preference for warm drinks |

Tongue and Pulse

tense pulse |

Pathogenesis Cold-Dampness invading the Spleen and Stomach
Etiology

Spleen-Stomach deficiency |


Acupuncture Point Prescription

Point Location Function
Zhongwan (RN12) 4 cun above the umbilicus

Stomach; harmonizes the Stomach |

Qihai (RN6) 1.5 cun below the umbilicus

the lower abdomen |

Zusanli (ST36)

to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |

Taibai (SP3)
Source point of Spleen meridian; strengthens Spleen-Qi

Clinical Recommendation: Filament needle, reinforcing method; heavy

moxibustion is strongly recommended to warm the meridians and disperse

Cold.


Herbal Formula

Base Formula: Liang Fu Wan (良附丸) + Zheng Qi Tian Xiang San

(正气天香散)

Composition:

Cyperus (Xiang Fu), Alpinia (Gao Liang Jiang), Lindera (Wu Yao),

Tangerine Peel (Chen Pi), Angelica (Dang Gui), Licorice (Gan Cao)

Action: Disperses Cold, warms the Stomach, and relieves pain.

Modifications

Associated Symptoms Additions/Subtractions
Severe cold pain Add Fu Zi, Gui Zhi to warm Yang and disperse Cold
Abdominal cramps Add Bai Shao, Gan Cao to relax muscles
Loose stools

diarrhea |

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

Western Mechanism Reference

Visceral hypersensitivity with cold-induced smooth muscle spasm,

increased visceral afferent sensitivity, and autonomic dysfunction. Cold

Obstruction corresponds to chronic abdominal pain with cold sensitivity,

where cold-induced smooth muscle spasm and visceral hypersensitivity

contribute to abdominal cramps and pain.


References

1. Internal Medicine of TCM - Abdominal Pain with Cold Obstruction.

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


Explore More

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Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.