Anxiety Disorders · Phlegm-Heat Internal Disturbance Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Whole Body
Pattern Overview
Phlegm-Heat Internal Disturbance is a pattern in anxiety disorders, characterized by gut-brain axis dysfunction, anxiety, chest tightness, and sticky mouth. The core pathogenesis is accumulation of Phlegm-Heat in the body, causing disturbance of the Heart spirit, anxiety, and autonomic dysfunction.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|---|
| Primary Symptoms | Anxiety, chest tightness, sticky mouth, restlessness |
| Associated Symptoms | Nausea, poor appetite, heavy head sensation, palpitations |
| Tongue and Pulse | Red tongue with yellow greasy coating, slippery and rapid pulse |
| Pathogenesis | Phlegm-Heat accumulating and disturbing the Heart spirit |
| Etiology | Poor diet, alcohol consumption, chronic stress, gut dysbiosis |
Acupuncture Point Prescription
| Point | Location | Function |
|---|---|---|
| Fenglong (ST40) | 8 cun above the lateral malleolus, 2 cun lateral to the tibial crest | Transforms Phlegm and Dampness |
| Neiguan (PC6) | 2 cun above the wrist crease, between the tendons | Relieves chest tightness and calms the spirit |
| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach; harmonizes the Stomach |
| Shenmen (HT7) | On the wrist crease, ulnar side | Source point of Heart meridian; calms the spirit |
| Yinlingquan (SP9) | Below the medial condyle of the tibia | Transforms Dampness and drains Heat |
Clinical Recommendation: Filiform needle, reducing method; may combine with cupping on Fenglong to transform Phlegm.
Herbal Formula
Base Formula: Huang Lian Wen Dan Tang (黄连温胆汤)
Composition:
Coptis (Huang Lian), Tangerine Peel (Chen Pi), Pinellia (Ban Xia), Poria (Fu Ling), Immature Bitter Orange (Zhi Shi), Bamboo Shavings (Zhu Ru), Licorice (Gan Cao)
Action: Clears Phlegm-Heat, calms the spirit, and harmonizes the Stomach.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|---|
| Severe anxiety | Add Suan Zao Ren, Bai Zi Ren to calm the spirit |
| Chest tightness | Add Ban Xia, Hou Po to transform Phlegm |
| Nausea | Add Sheng Jiang, Zhu Ru to descend rebellious Qi |
Western Mechanism Reference
Gut-brain axis dysbiosis affecting neurotransmitter metabolism, and inflammatory cytokines activating microglia. Phlegm-Heat Internal Disturbance corresponds to anxiety with gastrointestinal symptoms, where gut dysbiosis and inflammatory mediators contribute to anxiety through the gut-brain axis.
References
- Internal Medicine of TCM - Depression with Phlegm-Heat.
- DB-XJB: Huang Lian Wen Dan Tang.
- WHO. (2023). Mental health and anxiety disorders. World Health Organization.
Explore More
- Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for anxiety relief.
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