GERD/Acid Reflux - Spleen-Stomach Deficiency with Cold Pattern

TCM differentiation and treatment for GERD/acid reflux

GERD/Acid Reflux · Spleen-Stomach Deficiency with Cold Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest/Abdomen


Pattern Overview

Spleen-Stomach Deficiency with Cold is a common pattern in GERD/acid

reflux, characterized by **decreased GI motility, acid reflux, cold

epigastric pain, poor appetite, and loose stools**. The core

pathogenesis is **Spleen and Stomach Yang deficiency failing to warm and

transform food**, leading to delayed gastric emptying and acid reflux.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

appetite, loose stools |

Associated Symptoms

extremities, bloating |

Tongue and Pulse

deep and weak pulse |

Pathogenesis

transform |

Etiology

illness, overwork |


Acupuncture Point Prescription

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

Stomach; harmonizes the Stomach |

Pishu (BL20) Lower back, 1.5 cun lateral to T11

of Spleen meridian; strengthens Spleen Qi |

Weishu (BL21) Lower back, 1.5 cun lateral to T12

point of Stomach meridian; harmonizes the Stomach |

Zusanli (ST36)

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

Guanyuan (RN4) 3 cun below the umbilicus

supplements Qi |

Clinical Recommendation: Filiform needle, reinforcing method; heavy

moxibustion is strongly recommended to warm the Spleen and Stomach.


Herbal Formula

Base Formula: Li Zhong Tang (理中汤) + Xiang Sha Liu Jun Zi Tang

(香砂六君子汤)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Dried Ginger (Gan Jiang),

Poria (Fu Ling), Pinellia (Ban Xia), Amomum (Sha Ren), Aucklandia (Mu

Xiang), Licorice (Gan Cao)

Action: Warms the Spleen and Stomach, strengthens Qi, and harmonizes

the Stomach.

Modifications

Associated Symptoms Additions/Subtractions
Severe cold pain Add Fu Zi, Rou Gui to warm Yang and disperse Cold
Loose stools

diarrhea |

Bloating Add Hou Po, Zhi Ke to regulate Qi and relieve distension
Fatigue Add Huang Qi to enhance Qi supplementation

Western Mechanism Reference

Decreased GI motility causing delayed gastric emptying, increased

intragastric pressure, and decreased LES tone. Spleen-Stomach Deficiency

with Cold corresponds to GERD with hypomotility, where delayed gastric

emptying and decreased LES tone contribute to acid reflux.


References

1. Internal Medicine of TCM - Acid Reflux with Spleen-Stomach Deficiency

Cold.

2. DB-XJB: Li Zhong Tang, Xiang Sha Liu Jun Zi 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.