中醫背後的科學及其功效

吳宇琛

SUM WU

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吳宇琛，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，擅長用傳統針灸理傷手法和中藥治療各種新舊損傷痛症，特別採用中醫中藥和現代心理學、營養學相結合調理治療各種慢性病和亞健康。

中醫背後的科學及其功效

吳宇琛

Sum Wu

I’ve recently had a discussion with a friend about TCM and in medicine in general. They are not involved with the health field but they share their view of what it is like to be sick and the question of whether they should seek treatment is a question that they weigh up quite often. This friend is a firm believer in medicine but find that they often question the necessity of taking medicine all the time or what they perceive as over prescription of medication.

我最近和朋友討論了中醫和一般醫學。他們不涉及健康領域，但他們對生病的感覺有共同的看法，而是否應該尋求治療的問題是他們經常權衡的問題。這位朋友是醫學的堅定信徒，但發現他們經常質疑一直服藥的必要性或他們認為的過度處方藥物。

One of their arguments was that western medicine considers a common cold as untreatable and will resolve itself in about 7 days if you do nothing about it, then in these situations, medical intervention is not necessary. In some cases, this may be true. The common cold may very well resolve itself within 7-10 days in a relatively health or young individual because their immune system is strong enough to fight it off but often you would find that this is not always the case and a common cold can easily develop into a more serious illness if left unchecked. It is also a bit funny when western medicine says there is no cure for common cold but there are a plethora of drugs for alleviating the symptoms.

他們的論點之一是，西醫認為普通感冒是無法治癒的，如果不採取任何措施，7天左右就會自行痊癒，那麼在這種情況下就不需要醫療干預。在某些情况下，這可能是真的。對於相對健康或年輕的人來說，普通感冒可能會在7-10天內自行痊癒，因為他們的免疫系統足够强大，可以抵抗感冒，但您通常會發現情况並非總是如此，很容易患上普通感冒如果不加以控制，可能會發展成更嚴重的疾病。有趣的是，西醫說普通感冒無法治癒，但緩解症狀的藥物卻有很多。

In TCM, we consider the common cold as an attack by external factors such as wind, heat and cold etc. these factors change the presenting symptoms and we use herbal medicine or acupuncture to reduces this symptom to make the recovery a smoother journey. In some cases, the symptoms may be much more severe so we will need to use herbs to stop it from getting worse or to repair the body afterwards such as when someone that is recovery from a prolonged respiratory illness, we may use herbs to support this recovery by strengthening and clearing the lungs. Tthen the question asked is “if modern science and medicine says there’s no cure for common cold and it will resolve itself it 7-10 days then where is there proof taking any medicine helps at all?” Usually in these scenarios it may come down to anecdotal evidence and other scientific research behind what makes medicines work.

在中醫中，我們認為普通感冒是由於風、熱、寒等外界因素的侵襲，這些因素改變了症狀，我們使用草藥或針灸來減輕這種症狀，使康復過程更加順利。在某些情况下，症狀可能會更加嚴重，因此我們需要使用草藥來封锁病情惡化或事後修復身體，例如當某人從長期呼吸道疾病中恢復過來時，我們可能會使用草藥來支持這種情況通過加强和清理肺部來恢復。那麼問題來了：“如果現代科學和醫學說普通感冒無法治癒，7-10天后就會自行痊癒，那麼有什麼證據證明服用任何藥物有幫助呢？”通常在這些情况下，可能會歸結為藥物發揮作用背後的軼事證據和其他科學研究。

One of the main counter points of TCM is whether there is scientific evidence to support the usage or in cases where scientific research has been conducted, the question could be, is it scientific enough and can it withstand scrutiny?

中醫的主要對立點之一是是否有科學證據支持其使用，或者在進行科學研究的情况下，問題可能是，它是否足够科學並且經得起審查？

One of the common arguments we as younger practitioners hear often is if complementary medicine works then it would just be considered medicine. While there is merit to this argument it also neglects what differentiates TCM with other therapies in the first place.

作為年輕的中醫，我們經常聽到的常見論點之一是，如果補充醫學有效，那麼它就只能被視為藥物。雖然這一論點有其道理，但它也忽略了中醫與其他療法的區別。

Consider this, in place such as China, Hong Kong, Japan and Korea there is a strong presence of TCM alongside with western medicine and especially in China it is common to be prescribed a combination of herbal medicine along with western pharmaceuticals in a lot of cases. In Australia there is a clear distinction between a western doctor and a TCM doctor but western medicine is just referred to as medicine here. While in China, for example, this distinction can be a bit blurred. Of course, there are doctors that are only TCM practitioners and work in a private clinic but you will also find a lot of doctors in hospitals and outside of them that do both. When I was doing my intern studies in Chengdu, we often see Doctors at the teaching hospital prescribe a combination of “western” pharmaceutical drugs as well as a more traditional prescription of herbs but also sometimes patent medicine that is made from a combination.

考慮到這一點，在中國、香港、日本和韓國等地，中醫與西藥並存，特別是在中國，在很多情况下，草藥與西藥的組合是很常見的。在澳大利亞，西醫和中醫之間有明顯的區別，但西醫在這裡僅被稱為醫學。例如，在中國，這種區別可能有點模糊。當然，有些醫生只是中醫執業者，在私人診所工作，但你也會發現很多醫院內外的醫生兩者兼而有之。當我在成都實習時，我們經常看到教學醫院的醫生開出“西藥”的組合以及更傳統的草藥處方，有時也開出組合而成的成藥。

This brings me to another point that is often used to support the usage of TCM and add validity to its efficacy.

這讓我想到了另一個經常被用來支持中醫使用並新增其功效有效性的觀點。

From a scientific point of view, drugs work because they contain chemicals that work on the body on a molecular level or it has the function to alter the body’s natural processes chemically. An example of this is Panadol. Everyone has heard of Panadol and most likely used it for treating fever or pain. Panadol is paracetamol which basically works as an analgesic and antipyretic. When there is pain in the body paracetamol blocks the chemical messengers in the brain and in case of fever it does so by affecting the area of the brain that regulates temperature. So this is an example of how a drug works chemically. Interestingly, the mechanism of why it works isn’t actually very well understood and there is ongoing debate of its intended and off label uses.

從科學的角度來看，藥物之所以有效，是因為它們含有在分子水准上對人體起作用的化學物質，或者具有以化學管道改變人體自然過程的功能。一個例子是必理痛（Panadol）。每個人都聽說過Panadol，並且很可能用它來治療發燒或疼痛。Panadol是撲熱息痛，主要起到鎮痛和解熱作用。當身體疼痛時，撲熱息痛會阻斷大腦中的化學信使，而在發燒時，它會影響大腦調節溫度的區域。這是藥物如何發揮化學作用的一個例子。有趣的是，它的作用機制實際上並沒有得到很好的理解，並且對其預期用途和標籤外用途的爭論仍在繼續。

Then what about herbs? If you remember from the episodes I did last year about the 5-element theory and the relationship between yin and yang and the different channels and Zangfu theories then you remember that in TCM we need to consider each individuals nature as well as the signs and symptoms presented and formulate a herbal treatment based on yin and yang, the 5 elements and the nature of the herbs.

那麼草藥呢？如果你還記得我去年講的五行理論、陰陽之間的關係以及不同經絡和臟腑理論，那麼你會記得在中醫中我們需要考慮每個人的性質以及體征和症狀提出並製定基於陰陽、五種元素和草藥性質的草藥治療。

Then someone might ask how do we make it scientific? There has been many attempts to force TCM into a western medical framework and the result is usually more of a mess than good results. And this is a field which I do not feel like I have much to offer for now but if we consider an herbal ingredient individually then we can start to find some answers.

那麼有人可能會問我們如何讓它變得科學呢？人們曾多次嘗試將中醫納入西方醫學框架，但結果通常是一團糟而不是好的結果。我覺得這個領域現時還沒有什麼可以提供的，但如果我們單獨考慮一種草藥成分，那麼我們就可以開始找到一些答案。

Like all things in the world, everything is made up of a combination of chemicals. Our body is giant bag of chemicals. The human body comprise of between 50-75% water. It’s commonly referred to as about 70% just for ease of argument. Water’s chemical structure is H2O which is 2 hydrogen atoms and 1 oxygen atom. These are molecules.

就像世界上的所有事物一樣，一切都是由化學物質的組合而成。我們的身體是一個巨大的化學物質袋。人體由50-75%的水組成。為了便於論證，通常將其稱為70%左右。 水的化學結構是H2O，由2個氫原子和1個氧原子組成。這些是分子。

So how does this help with TCM to be more scientific? I think most of the time when someone thinks about a natural remedy such as herbal medicine, they might not consider the chemical composition of the ingredients. Here are some examples of some herbs with known chemical functions.

那麼這如何幫助中醫變得更加科學呢？我認為大多數時候，當人們想到草藥等自然療法時，他們可能不會考慮成分的化學成分。以下是一些具有已知化學功能的草藥的例子。

Willow bark contains the precursor chemical salicylate that is used to make aspirin. And it has been used throughout ancient history as a treatment for fever, pain and inflammation.

柳樹皮含有用於製造阿司匹林的化學前體水楊酸鹽。在整個古代歷史中，它一直被用來治療發燒、疼痛和炎症。

Foxglove which contains a chemical called Digoxin, which is highly toxic, is used in heart related illnesses such as heart failure.

毛地黃含有一種名為地高辛的化學物質，具有劇毒，用於治療心力衰竭等與心臟相關的疾病。

Ma Huang is a well-known herb that is used for stopping coughing and other lung related issues. Its active ingredient is ephedrine. A synthetic version called pseudoephedrine is widely used in OTC cold remedies such as Sudafed.

麻黃是一種眾所周知的草藥，用於止咳和其他肺部相關問題。其活性成分是麻黃堿。 一種稱為偽麻黃堿的合成版本廣泛用於非處方感冒藥，例如Sudafed。

Huang Bai is used a lot for clearing out damp heat in the body which can cause skin conditions as well as ulcers and lower jiao diseases. One of its key components is Berberine and there is currently quite a bit of research into what it can do. Berberine has been used for mouth ulcers, lowering cholesterol and is suggested to lower blood sugar levels in diabetic patients. Research is still inconclusive on this one right now as with a lot of other herbs.

黃柏被廣泛用於清除體內的濕熱，濕熱會導致皮膚病以及潰瘍和下焦疾病。它的關鍵成分之一是小檗堿，現時對其作用進行了大量研究。小檗堿已用於治療口腔潰瘍、降低膽固醇，並被建議用於降低糖尿病患者的血糖水准。與許多其他草藥一樣，現時對這種草藥的研究還沒有定論。

While to some researchers this helps further the validity and usage of herbs as a therapy, but it only reflects 1 aspect of what makes TCM so wonderful. An herbal formula is not just a combination of herbs with active chemicals that work on a molecular level but it is also the combination of certain herbs together that produce an effect or herbs that need to be processed first to draw out its health benefits or to eliminate its toxicity. Why does 2 people suffering from the cold might react differently to the same medicine? These are question that we also need to consider as TCM practitioners and there is a saying, no 2 patients are the same. We prescribe based on what we see and how we interpret the signs and symptoms to tailor an individual treatment best for the patient.

雖然對一些研究人員來說，這有助於進一步提高草藥作為治療方法的有效性和用途，但這僅反映了中醫如此美妙的一個方面。草藥配方不僅是草藥與在分子水准上起作用的活性化學物質的組合，而且還是某些產生效果的草藥的組合，或者需要首先加工以發揮其健康益處或消除副作用或毒性的草藥的組合。為什麼兩個感冒的人對同一種藥的反應可能不同？這些都是我們作為中醫從業者也需要考慮的問題，有句話說，沒有兩個病人是相同的。我們根據所看到的情况以及我們如何解釋體征和症狀來開處方，以製定最適合患者的個體化治療方案。

如有疑問想咨詢吳宇琛中醫師，可以在微信或whatsapp搜索0404836368，加吳宇琛中醫師微信或whatsapp，也可以發簡訊或致電0404836368作語音留言，吳宇琛中醫師有空就會回復。

吳宇琛中醫師，澳大利亞政府注册中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，悉尼好思維松軒藥行主治中醫師，澳大利亞中醫骨傷專科學院副院長，本文僅供參考，具體診療應諮詢專業人士。