Chronic Abdominal Pain - Middle Jiao Deficiency-Cold Pattern
TCM differentiation and treatment for chronic abdominal
Chronic Abdominal Pain · Middle Jiao Deficiency-Cold Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Abdomen
Pattern Overview
Middle Jiao Deficiency-Cold is a chronic pattern in abdominal pain,
characterized by **chronic functional pain with autonomic dysfunction,
dull pain, fatigue, cold limbs, relief with warmth, and poor appetite**.
The core pathogenesis is Spleen-Stomach deficiency with Cold,
leading to reduced GI motility, impaired tissue nourishment, and chronic
pain.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
relief with warmth |
| Associated Symptoms |
|---|
complexion |
| Tongue and Pulse |
|---|
coating, deep and weak pulse |
| Pathogenesis | Spleen-Stomach deficiency with Cold |
|---|
| Etiology |
|---|
Spleen 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 |
| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 |
|---|
of Spleen meridian; strengthens Spleen-Qi |
| Zusanli (ST36) |
|---|
to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |
Clinical Recommendation: Filament needle, reinforcing method; heavy
moxibustion is strongly recommended to warm the Middle Jiao and tonify
Qi.
Herbal Formula
Base Formula: Xiao Jian Zhong Tang (小建中汤)
Composition:
Cinnamon Twig (Gui Zhi), White Peony (Bai Shao), Licorice (Gan Cao),
Ginger (Sheng Jiang), Jujube (Da Zao), Malt Sugar (Yi Tang), Licorice
(Gan Cao)
Action: Warms the Middle Jiao, supplements Qi, and relieves pain.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe cold pain |
|---|
|
| Fatigue | Add Huang Qi to enhance Qi supplementation |
|---|
| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |
|---|
| Loose stools |
|---|
diarrhea |
Western Mechanism Reference
Chronic functional pain with autonomic dysfunction, reduced GI motility,
and impaired tissue nourishment. Middle Jiao Deficiency-Cold corresponds
to chronic functional abdominal pain with autonomic dysfunction, where
reduced GI motility and impaired tissue nourishment contribute to
chronic pain and discomfort.
References
1. Internal Medicine of TCM - Abdominal Pain with Middle Jiao
Deficiency-Cold.
2. Xiong Jibai: Middle Jiao Deficiency-Cold uses Xiao Jian Zhong Tang.
3. WHO. (2023). Digestive health. World Health Organization.
Explore More
- Find your solution at MendGod.com –
Personalized herbal protocols and acupressure tools for digestive
health.
- Deepen your knowledge at TcmCIO.com – Full
research papers and clinical case studies on TCM digestive health.
Related TCM Patterns for Chronic Abdominal Pain
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.