GERD/Acid Reflux - Phlegm-Qi Obstruction Pattern

TCM differentiation and treatment for GERD/acid reflux

GERD/Acid Reflux · Phlegm-Qi Obstruction Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest/Abdomen


Pattern Overview

Phlegm-Qi Obstruction is a pattern in GERD/acid reflux, characterized by

**esophageal motility dysfunction, globus sensation (lump in the

throat), acid reflux, and chest tightness**. The core pathogenesis is

Phlegm and Qi obstructing the throat and chest, causing esophageal

motility dysfunction and hypersensitivity.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

difficulty swallowing |

Associated Symptoms

of obstruction |

Tongue and Pulse

or wiry pulse |

Pathogenesis Phlegm and Qi obstructing the throat and chest
Etiology

phlegm constitution |


Acupuncture Point Prescription

Point Location Function
Fenglong (ST40)

to the tibial crest | Transforms Phlegm and Dampness |

Neiguan (PC6)
Relieves chest tightness and regulates Qi
Zhongwan (RN12) 4 cun above the umbilicus

Stomach; harmonizes the Stomach |

Tiantu (RN22) In the depression at the suprasternal fossa

Descends rebellious Qi and relieves throat obstruction |

Danzhong (RN17)
Regulates Qi and relieves chest tightness

Clinical Recommendation: Filiform needle, reducing method; may

combine with moxibustion to transform Phlegm.


Herbal Formula

Base Formula: Ban Xia Hou Po Tang (半夏厚朴汤) + Wen Dan Tang

(温胆汤)

Composition:

Pinellia (Ban Xia), Magnolia (Hou Po), Poria (Fu Ling), Perilla Leaf (Su

Ye), Tangerine Peel (Chen Pi), Immature Bitter Orange (Zhi Shi), Bamboo

Shavings (Zhu Ru), Licorice (Gan Cao)

Action: Transforms Phlegm, regulates Qi, and relieves obstruction.

Modifications

Associated Symptoms Additions/Subtractions
Globus sensation

Phlegm |

Chest tightness

distension |

Nausea Add Sheng Jiang, Zhu Ru to descend rebellious Qi
Acid reflux

stop reflux |


Western Mechanism Reference

Esophageal motility dysfunction with impaired esophageal clearance,

reflux retention, and esophageal hypersensitivity. Phlegm-Qi Obstruction

corresponds to GERD with esophageal motility dysfunction, where impaired

esophageal clearance and increased esophageal hypersensitivity

contribute to reflux symptoms and globus sensation.


References

1. Internal Medicine of TCM - Globus Hystericus with Phlegm-Qi

Obstruction.

2. DB-XJB: Wen Dan Tang.

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


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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.