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《吳醫師保健養生堂第四十四講》 — 心理健康-脾臟和焦慮(一)吳宇琛
2024年03月26日 13:05 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.

Mental Health – Spleen and Anxiety 1

心理健康-脾臟和焦慮(一)

Feeling anxious is a normal emotional experience that happens to everyone day to day. This can be caused from moderate amounts of stress due to work or other commitments. It is can be a result from worrying about things and can actually be a motivator. It’s when the feeling of anxiousness doesn’t go away or the feeling is not proportionate with the situation which then can become a major mental health issue which is called anxiety.

感到焦慮是每個人每天都會發生的正常情緒體驗,這可能是由於工作或其他因素里輕度的壓力造成的,可能是對某件事情擔心焦慮情緒的一種結果,也可能是一種誘因。當焦慮的感覺沒有消失,或者這種感覺與情況不成比例時,就會成為一種主要的心理健康問題,也就是焦慮症。

 

Anxiety is one of the most common mental health conditions in Australia and 1 in 4 Australians will suffer from it at some point in there lives. It can be separated into a few categories.

焦慮症是澳大利亞最常見的心理健康疾病之一,四分之一的澳大利亞人在一生中的某個時刻都會遭受焦慮的困擾,它可以分為幾類。

 

The most common type is known as General Anxiety Disorder or GAD. This can be due to excessive, uncontrollable worry about everyday issues such as health, work or finances.

最常見的類型被稱為廣泛性焦慮症或GAD,這可能是由於對健康、工作或財務狀況等日常問題過度、無法控制的擔憂所致。

 

Panic disorder is regular panic attacks, which are sudden intense episodes of fear, worry about more attacks and avoiding situations where panic attacks may happen.

驚恐症是有規律的驚恐發作,這是突然的強烈的恐懼,擔心更多的攻擊和避免可能發生驚恐發作的情況。

 

Specific phobias to certain things, OCD and PTSD are all other common anxiety disorders.

對某些事物的特定恐懼症、強迫症和創傷後應激障礙都是其他常見的焦慮症。

 

Symptoms of anxiety include panic attacks, shortness of breath, dizziness, heart palpitation, insomnia, churning stomach, trembling and excessive thirst, muscle tension and fatigue just to name a new.

焦慮症的症狀包括驚恐發作、呼吸短促、頭暈、心悸、失眠、胃部翻騰、顫抖和過度口渴、肌肉緊張和疲勞等等。

 

Some of the ways to combat and reduce anxiety is through mediation and relaxation techniques, mindfulness, cognitive therapy and counselling. Similar to other common mental health issues such as depression, medication and support groups are often used as well.

對抗和減少焦慮的一些方法是通過冥想和放鬆技巧、正念、認知治療和咨詢。與抑鬱症等其他常見心理健康問題類似,也經常使用藥物治療和互助支持小組。

 

Like in western medicine, there are multiple different patterns and causes of anxiety. It can be caused by Qi deficiency, blood deficiency, Yin deficiency, blood stasis, Liver Qi stasis, Heart Shen disharmony and phlegm dampness accumulation etc. For this topic we won’t be able to cover all the different patterns of anxiety disorders but I will focus on just one pattern and will once again refer back to some basic principles such as Zangfu system.

就像西醫一樣,中醫認為焦慮有多種不同的種類和原因。它可以由氣虛、血虛、陰虛、血瘀、肝氣瘀滯、心神失和、痰濕蘊結等引起。在這個話題中,我們無法涵蓋焦慮症的所有不同類型,但我將只關註一種模式,並再次探討一些基本原理,例如臟腑系統。

 

In TCM our organs are categorised as five Zang organs (Heart, Liver, Spleen, Lung and Kidneys) and six Fu organs (Gall bladder, Stomach, Large intestine, Small Intestine, Bladder and San Jiao). These organise are further characterised by the 5 elements. The 5 elements theory explains how the organ systems are interrelated to each other and how the function and health of 1 organ can affect the rest through a generating and restricting action through the 5 element cycle. When there is issue with this cycle, it can lead to dysfunction of the organ system resulting in external evils and those patterns of illness. The reason why it is necessary to mention this again is because in TCM anxiety is closely related to the Spleen organ and we will be focusing on the concept of dampness.

在中醫中,我們的器官分為五臟(心、肝、脾、肺、腎)和六腑(膽、胃、大腸、小腸、膀胱和三焦)。五行理論解釋了臟腑系統如何相互關聯,以及一個器官的功能和健康如何通過五行循環的生成和限制作用影響其他臟腑。當這個循環出現問題時,可能會導致器官系統功能障礙,從而導致外邪和疾病。之所以有必要再次提及這一點,是因為中醫認為焦慮與脾臟密切相關,我們將重點討論濕的概念。

 

Dampness is one of the external evils that can affect the body that is common in environments that are high in humidity. Constant exposure to humid weather will induce dampness in the body which will upset the function of the Spleen and as we have mentioned previously the Spleen’s main role is the transform and transport food essence to the organs for become Qi and Blood and to provide energy to the four limbs. Its element is Earth and its emotion is worry or overthinking.

濕氣是影響身體的外邪之一,在高濕度的環境中很常見。經常處於潮濕的天氣,體內會產生濕氣,從而影響脾的功能,正如我們前面提到的,脾的主要作用是運化水谷精微到臟腑,化為氣血,為人體四肢提供能量,屬土主神。

 

The Spleen has 3 main functions. Firstly, the Spleen controls the transportation and metabolism of water and nutrients in the body. The Stomach, which is its paired Fu organ, digests food into various components, which are transported to the Spleen for distribution to the rest of the body. Water will be transported upward to the Lung for the generation of Qi, and excessive water and metabolic wastes produced by different regions of the body are transported downward to the Kidney to be passed out. Excess or pathological dampness is referred to as phlegm dampness or oedema which is a result of Spleen dysfunction which can be caused by indigestion or malnutrition or metabolic syndrome.

脾有3個主要功能,首先,脾主體內水、營養物質的運輸和代謝,胃是與其配對的臟腑,將食物消化成各種成分,這些成分被運輸到脾臟,然後分配到身體的其他部位。水液上行至肺,以生成氣,而身體各部位產生的多餘水份和代謝廢物,則下行至腎,排出體外。濕盛或病理性濕稱為痰濕或水腫,是由於消化不良、營養不良或代謝綜合徵導致脾功能失調的結果。

 

From a western medical perspective the Spleen doesn’t really play a big role in digestion but rather it produces white blood cells and antibodies to fight infection but in some studies on glutinous rice, which is a common ingredient in food therapy for strengthening Spleen function, found that it improves digestion by increasing the levels of salivary amylase in someone who may have Spleen dysfunction. Another study suggests that in cases where the patient has a lot of dampness, there is an over-expression of aquaporin, a water channel protein commonly found in the lungs, digestive system and kidney, suggesting that the function of the Spleen may be related to the functioning of these systems in regulating water content in the body.

從西方醫學的角度來看,脾臟在消化方面並沒有真正發揮重要作用,而是產生白細胞和抗體來抵抗感染,但在一些關於糯米的研究中,糯米是增強脾功能的食療中的常見成分,發現它通過增加可能患有脾臟功能障礙的人的唾液澱粉酶水平來改善消化。另一項研究表明,在濕氣重的情況下,水通道蛋白(一種常見於肺、消化系統和腎臟的水通道蛋白)過度表達,這表明脾的功能可能與這些系統在調節體內水分含量方面的功能。

 

Secondly, the Spleen regulates the circulation of blood. Spleen functions to enable the flow of blood within blood vessels in the right direction and then deliver Qi throughout the body. Thus, sub-cutaneous bruising and haemorrhage, such as conditions associated with haematuria and excessive menstrual bleeding, are caused by Spleen malfunctioning. In western medicine, the prevention of internal bruising is a function of the blood, through the regulation of blood clotting and capillary permeability, with the latter preventing the leakage of red blood cells into the extracellular space. Research has shown that patients with Spleen dysfunction generally show an abnormal morphology of blood platelets, leading to a decrease in their ability to aggregate and release clotting factors. Thrombocytes in Spleen dysfunction patients have been found to exhibit a shorter lifespan, resulting in a higher likelihood of haemorrhage. Spleen dysfunction patients were also found to have an increased capillary fragility, such that that they are more prone to capillary rupture, leading to internal bruising.

其次,脾主調節氣血運行。脾的功能是使血管內的血液沿著正確的方向流動,然後將氣輸送到全身。因此,皮下瘀傷和出血,例如與血尿和月經出血過多相關的病癥,是由脾功能失調引起的。在西醫中,預防內部瘀傷是血液的一種功能,通過調節血液凝固和毛細血管通透性來防止紅細胞滲漏到微細血管外空間。研究表明,脾臟功能障礙的患者普遍表現出血小板形態異常,導致其聚集和釋放凝血因子的能力下降。研究發現,脾功能障礙患者的血小板壽命較短,導致出血的可能性較高。脾功能不全的患者還發現毛細血管脆性增加,因此更容易發生毛細血管破裂,導致內部瘀傷。

 

In connection with the functions of nutrient metabolism and transport as well blood circulation, the Spleen appears to be an important determinant for the maintenance of proper functioning of skeletal muscle. This is because the transport of nutrients in blood to skeletal muscle is controlled by the Spleen. This is corroborated by the experimental observations that both the configuration and function of extensor muscle were significantly deteriorated in mice with Spleen dysfunction, and that Spleen dysfunction patients have higher blood lactate levels, as a result of anaerobic glycolysis in skeletal muscles. These observations may well explain why tiredness and muscle pain are commonly observed in patients with Spleen dysfunction.

就營養代謝和運輸以及血液循環的功能而言,脾表現為維持骨骼肌正常功能的重要決定因素。這是因為血液中營養物質向骨骼肌的運輸是由脾控制的,實驗觀察證實了這一點,即脾功能障礙小鼠的伸肌結構和功能均顯著惡化,並且由於骨骼肌中無氧糖酵解,脾功能障礙患者的血乳酸水平較高。這些觀察結果可以很好地解釋為什麼脾功能障礙患者常見疲勞和肌肉疼痛。

 

Thirdly, the Spleen is related to immune function. TCM theory states that one will not be influenced by “external evils” if the Spleen is functioning optimally. The Spleen, being endowed with the Earth nature, is thought to be the center of other elements. If the Spleen functions well, other Zang will also function properly. Results from a number of studies have established the functional relationship between the Spleen and the immune system. Patients with Type 2 Diabetes Mellitus with Spleen dysfunction showed an obvious immune dysfunction and administering Cang Zhu has been found to improve the immune function of the subjects with Spleen dysfunction as well as protect and repair damaged mucosal tissues.

第三,脾與免疫功能有關。中醫理論認為,脾的功能良好,就不會受到“外邪”的影響。脾屬土,被認為是五行的中心。脾的功能好了,其他臟的功能也就正常了。許多研究的結果已經確定了脾臟和免疫系統之間的功能關系。脾功能不全的2型糖尿病患者存在明顯的免疫功能障礙,蒼術可改善脾功能不全患者的免疫功能,保護和修復受損的粘膜組織。

 

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。)