Tension Headache · Qi-Blood Deficiency Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Head


Pattern Overview

Qi-Blood Deficiency is a chronic pattern in tension headache, characterized by chronic fatigue with hyperalgesia, reduced cerebral perfusion, low 5-HT function, and decreased pain modulation. The core pathogenesis is Qi-Blood deficiency failing to nourish the head, leading to reduced cerebral perfusion, hyperalgesia, and chronic headache.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsDull headache, worsened by fatigue, pale complexion, dizziness
Associated SymptomsShortness of breath, palpitations, poor sleep, cold limbs
Tongue and PulsePale tongue with thin white coating, thready and weak pulse
PathogenesisQi-Blood deficiency failing to nourish the head
EtiologyChronic illness, poor nutrition, overwork, postpartum weakness

Acupuncture Point Prescription

PointLocationFunction
Zusanli (ST36)3 cun below the patella, 1 finger-width lateral to the tibial crestStrengthens Spleen and Stomach; tonifies Qi and Blood
Pishu (BL20)Lower back, 1.5 cun lateral to T11Back-Shu point of Spleen meridian; strengthens Spleen-Qi
Qihai (RN6)1.5 cun below the umbilicusTonifies Qi and strengthens the body
Baihui (GV20)On the midline of the head, 5 cun posterior to the anterior hairlineLifts Qi and clears the head
Sanyinjiao (SP6)3 cun above the medial malleolusNourishes Blood and Yin; regulates the Spleen and Kidney

Clinical Recommendation: Filament needle, reinforcing method; moxibustion may be applied to Zusanli and Qihai to warm and tonify Qi and Blood.


Herbal Formula

Base Formula: Ba Zhen Tang (八珍汤) or Bu Zhong Yi Qi Tang (补中益气汤)

Composition:
Ginseng (Ren Shen), Astragalus (Huang Qi), Atractylodes (Bai Zhu), Poria (Fu Ling), Angelica (Dang Gui), White Peony (Bai Shao), Chuanxiong (Chuan Xiong), Rehmannia (Shu Di), Cimicifuga (Sheng Ma), Bupleurum (Chai Hu), Licorice (Gan Cao)

Action: Supplements Qi and Blood, lifts Yang, and nourishes the head.

Modifications

Associated SymptomsAdditions/Subtractions
Severe fatigueAdd Huang Qi to enhance Qi supplementation
DizzinessAdd Tian Ma, Gou Teng to calm Liver Wind
Poor sleepAdd Suan Zao Ren, Yuan Zhi to calm the spirit
Cold limbsAdd Gui Zhi, Sheng Jiang to warm the meridians

Western Mechanism Reference

Chronic fatigue with hyperalgesia, reduced cerebral perfusion, low 5-HT function, and decreased pain modulation. Qi-Blood Deficiency corresponds to chronic tension headache with fatigue and hyperalgesia, where reduced cerebral perfusion and low 5-HT function contribute to decreased pain modulation and persistent headache.


References

  1. Internal Medicine of TCM - Headache with Qi-Blood Deficiency.
  2. Zang-Fu Pattern Differentiation: Qi Deficiency + Blood Deficiency.
  3. WHO. (2023). Headache disorders. World Health Organization.

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