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《吳醫師保健養生堂第五十講》— 腸易激綜合症之二 中醫對腸易激綜合症的看法 吳宇琛
2024年05月07日 12:13 發布 編輯:Editor

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。

Irritable Bowel Syndrome part 2 – TCM Perspective

腸易激綜合症之二 中醫對腸易激綜合症的看法

According to Traditional Chinese Medicine (TCM), IBS is a condition generally caused by Spleen and Liver disharmony, which manifests as Liver Qi stagnation and Spleen Qi deficiency. Cold in the Spleen as well as Dampness can also manifest IBS symptoms.

中醫認為,IBS多為脾肝失和所致的病癥,表現為肝鬱、脾虛,脾寒、濕邪也可出現腸易激綜合症的症狀。

 

As we mentioned in the previous episode Stress is a major factor for IBS and like in western medicine there are many different disease patterns that causes IBS and related symptoms. Overwork or excessive worry, alongside irregular eating habits or a lack of physical activity, can all weaken the spleen. Diet can trigger weakness in the stomach and spleen too. Eating lots of cold raw food introduces cold into the stomach and weakens spleen qi. Both under and overeating also weaken these organs. Eating at irregular times, missing meals, or eating late also impact spleen and stomach. Eating too much rich greasy food causes an accumulation of dampness in the intestines. Eating excessive quantities of hot foods, such as chilies, coffee, spirits, spices, fats, and meat can introduce heat and dampness as well.

正如我們在上一集中提到的,壓力是腸易激綜合症的一個主要因素,就像西醫一樣,有許多不同的疾病模式會導致腸易激綜合症和相關症狀。過度勞累或過度憂慮,加上不規律的飲食習慣或缺乏體力活動,都會削弱脾臟。飲食也會導致胃和脾虛弱,多食生冷食物,寒氣入胃,脾氣衰弱,飲食不足和過量也會削弱這些器官,飲食不規律、不吃飯、遲吃飯也會影響脾胃。吃太多油膩的食物會導致腸道濕氣積聚,吃過量的熱性食物,如辣椒、咖啡、烈酒、香料、脂肪和肉類也會帶來熱氣和濕氣。

 

The liver is associated with Anger as well as emotional well-being. It plays a vital role in ensuring the smooth flow of energy, both physically and mentally. Stress and anger directly impact the liver’s function, and factors such as alcohol, drugs, medications, or an unhealthy diet can further compromise its health. When the liver’s function is compromised, it can lead to an overflow of liver energy, figuratively “attacking” the spleen. If the spleen is already weakened, it becomes susceptible to this overflow, resulting in stress-induced symptoms due to its emotion of worry/anxiety.

肝臟與憤怒以及情緒健康有關,它在確保身體和精神上的行氣發揮著至關重要的作用。壓力和憤怒直接影響肝臟的功能,而酒精、藥物或不健康飲食等因素會進一步損害肝臟的健康。當肝臟功能受損時,就會導致肝氣溢出,可以形象地比喻為“襲”脾。如果脾臟已經虛弱,它就容易受到這種溢出的影響,由於擔心/焦慮的情緒而導致壓力誘發的症狀。

 

Stress affects the Liver Qi, which handles the smooth flow of Qi throughout the whole body; excess stress then results in Liver Qi stagnation. When the Liver Qi is stagnate it can lead to constipation and painful abdominal bloating, tightness in the chest and irritability and moodiness.

壓力會影響肝氣,肝氣負責全身氣的順暢流動;壓力過大時,就會導致肝氣鬱結。當肝氣鬱結時,會導致便秘、腹脹、胸悶、煩躁、喜怒無常。

 

The Spleen is in charge of digestion and the transformation and transportation of QI according to TCM, and when Spleen Qi is weak, it is vulnerable to Liver Qi stagnation and excess accumulation of dampness, leading to disturbances of the GI system. The major IBS symptoms such as abdominal bloating or pain, mixed or alternated constipation or loose stool, mucus in the stool, or incomplete evacuation, are all results of Liver overacting on the Spleen and Stomach.

中醫認為,脾主消化、運化,脾氣虛弱時,容易肝鬱濕盛,導致胃腸系統紊亂。腸易激綜合徵的主要症狀如腹脹或腹痛、混合性或交替性便秘或便溏、大便有粘液、大便不暢等,都是肝犯脾胃的結果。

 

Prolonged spleen weakness can also lead to phlegm dampness which blocks the flow of Qi and causes constant epigastric pain and bloating. In general if there is a Deficiency of Spleen Qi, typical symptoms include a feeling of blockage in the stomach, bloating, fatigue, lethargy, tiredness with a general feeling of heaviness in the head and body. Poor appetite, loss of sense of taste, nausea, dizziness and headaches are common too.

長期脾虛,痰濕阻滯,氣機運行不暢,就會出現胃脘疼痛、腹脹的情況。一般來說,脾氣虛的典型症狀包括胃部不適、腹脹、乏力、嗜睡、疲倦,並伴有頭部和身體沉重的感覺。食欲不振、味覺喪失、惡心、頭暈和頭痛也很常見。

 

Spleen and Kidney Yang deficiency pattern IBS will experience more abdominal cramping, loose stools, and urgency to defecate. This type of condition is worse when one eats cold or raw foods. People with spleen and kidney yang deficiency can experience cold hands and feet and feel generally cold.

脾腎陽虛型腸易激綜合症會出現腹部絞痛、便溏、便急等症狀,當一個人吃冷的或生的食物時,這種情況會更嚴重。脾腎陽虛的人會出現手腳冰涼、全身冰冷的情況。

 

Damp-Heat in the large intestine will manifest as abdominal pain and diarrhoea with a sense of urgency as key symptoms. The diarrhoea is commonly yellow and explosive with a strong odour and a sensation of burning. In addition, there may be a feeling of heaviness of the body and stuffiness in the chest.

大腸濕熱則以腹痛、泄瀉、尿急感為主要症狀,腹瀉通常是黃色的、爆炸性的,有強烈的氣味和燒灼感。另外,可能還會有身體沉重、胸悶的感覺。

 

Clinical studies have also shown Chinese herbs to improve the effectiveness of IBS treatments. For example, Fuling (Poria) and Shanyao (Rhizoma Dioscoreae) can relieve diarrhoea. Baizhu (Rhizoma Atractylodis Macrocephalae) is well known for its regulating and dual effect on the gastrointestinal tract: it treats diarrhoea at low doses and constipation at high doses. With this dual effect, it is the ideal herb for relieving the major IBS symptom of alternating diarrhoea and constipation. Since stress and emotions such as anxiety and depressive moods can trigger IBS, herbal formulas tailored to calm the mind and body as well as smooth Liver Qi are commonly used as well.

臨床研究還表明中草藥可以提高腸易激綜合症的治療效果,例如茯苓、山藥可以止瀉。白術以其對胃腸道的調節和雙重作用而聞名:低劑量治療腹瀉,高劑量治療便秘。憑借這種雙重功效,它是緩解腹瀉和便秘交替的腸易激綜合症主要症狀的理想中藥。由於壓力和情緒(例如焦慮和抑鬱情緒)會引發腸易激綜合症,因此通常會使用旨在平靜身心以及疏通肝氣的中藥配方。

 

In TCM, it is believed that anxiety arises from an imbalance of Zang functions, wherein different combinations of functional imbalances among Zang result in various symptoms. Yet, as the Five Element theory goes, Earth, which is considered as the center of the five elements, will eventually be hindered by the imbalance of other elements. Thus, the treatment of different types of anxiety is primarily focused on invigorating the function of the Spleen. Gui Pi Tang, which is a commonly used formulation in treating anxiety, not only ameliorates the symptoms of Spleen dysfunction caused by anxiety, but also directly alleviates anxiety. From the perspective of TCM theory, Gui Pi Tang mobilizes the stagnant Qi and nourishes shen in the Heart, which is thought to be the master of emotion. As anxiety is pathologically- related to the stagnation of Qi, a smooth flow of Qi will ease anxiety. Another formula that is commonly prescribed is Shen Ling Bai Zhu San. It is used for stopping diarrhoea by Strengthening Spleen Qi and resolves dampness and contains.

中醫認為,焦慮是由於臟腑功能失衡而產生的,臟腑功能失衡的不同組合會導致不同的症狀。然而,正如五行理論所說,土作為五行的中心,最終會受到其他元素不平衡的阻礙。因此,治療不同類型的焦慮症,主要以健脾為主。歸脾湯是治療焦慮症的常用方劑,不僅能改善焦慮症引起的脾虛症狀,還能直接緩解焦慮症。從中醫理論來看,歸脾湯調動鬱氣,養神於心,被認為是情志之主。由於焦慮在病理上與氣滯有關,氣暢則可以緩解焦慮。另一種常用的處方是參苓白術散,用於健脾利濕止瀉。

 

An important point for IBS patients to keep an eye on is the diet. Patients should avoid gas-producing foods such as onions, beans, cabbage, milk etc. Other foods containing lactose may also induce symptom flare-ups in some people. It is important to remove spicy and acidic foods from diet as they over-stimulate the lining of the intestine.

IBS患者需要注意的一個重要點是飲食。患者應避免產氣食物,如洋蔥、豆類、捲心菜、牛奶等。其他含有乳糖的食物也可能會導致某些人出現症狀,從飲食中去除辛辣和酸性食物非常重要,因為它們會過度刺激腸道內壁。

 

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,也可以發短信或致電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,悉尼好思维松轩药行主治中医师,本文僅供參考,具體診療應諮詢專業人士。)