吴宇琛

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.

吴宇琛，澳洲政府注册中医师、针灸师，五龙岗大学心理学学士、悉尼科技大学中医系学士，擅长用传统针灸理伤手法和中药治疗各种新旧损伤痛症，特别采用中医中药和现代心理学、营养学相结合调理治疗各种慢性病和亚健康。

Mental Health – Spleen and Anxiety 2

心理健康-脾脏和焦虑（二）

In TCM the Spleen has slightly different functions than in Western medicine as mentioned previous. It governs transportation and transformation of energy and Qi, it controls the muscles and four limbs, the Spleen house the Yi or “thoughts”, it manages the blood and controls Upright Qi but from our previous episode I also covered on how through modern research, some of these functions that was only from TCM theory may have some connection to Western understanding of the Spleens role in other previously non-related functions.

中医中的脾与西医中的功能略有不同，就像前面提到过的，脾主运化气血，主肌肉和四肢，脾主意或“意念”，主统血，但在我们上一部分里，我们还介绍了如何通过现代研究，一些仅来自中医理论的功能可能与西方对脾脏在其他先前不相关功能中的理解有一定联系。

The Spleen is responsible for transforming food and drinks into sources the body needs, Qi and Blood, and transporting them to where they need to be in the body. Qi and Blood are vital to all the functions the body needs to carry out; when the transformation and transportation function is working properly, the Qi is strong, digestion is smooth and the muscles and limbs of the body get the nutrients they need transported to them. When the Spleen Qi is weak, the muscles and four limbs will not receive adequate nourishment and they will become weak, tired and not function as effectively.

脾负责将食物和饮料转化为人体所需的气和血，并将它们输送到体内需要的地方。气和血对于身体的所有功能都至关重要。当运化功能正常时，则气盛，消化顺畅，全身肌肉、四肢可以得到所需的营养输送。脾气虚弱，肌肉四肢得不到充分的滋养，就会出现无力、疲倦、功能不全的情况。

The Spleen is directly linked to our capacity for thinking and concentration. The ability we have to concentrate well, think clearly, have mental clarity, form intentions and decisions is very dependent on the strength of the Spleen Qi. All organs in Chinese Medicine have an emotion attached to them and the emotion of the Spleen is worry. This is twofold; excessive worrying damages the Spleen, however a deficient Spleen can also weaken the mind and make us more susceptible to emotions such as worry. Many people often see a link in their own bodies between digestion and bowel movements and their state of mind, in particular when worrying or having anxious thoughts.

脾脏与我们的思考和集中能力直接相关。我们能否集中注意力、思维清晰、头脑清晰、形成意图和决策，很大程度上取决于脾气的强弱。中医认为五脏六腑都有情，脾的情就是忧。这是双重的；过度忧虑伤脾，但脾虚也会削弱心志，使我们更容易受到忧虑等情绪的影响。许多人经常看到自己身体的消化和排泄与他们的精神状态之间存在联系，特别是在担心或有焦虑想法时。

The Spleen is responsible for making and manufacturing the blood and the Spleen Qi keeps the blood within the vessels (veins and arteries). When Spleen Qi is weak a person will usually bruise easily and may have problems with bleeding.

脾负责生成和制造血液，脾气将血液保持在血管（静脉和动脉）内。当脾气虚弱时，人通常会容易瘀伤，并可能出现出血问题。

Spleens Qi also helps to hold the organs upright and in place. When the Spleen is weak we see prolapse of organs often including the Uterus, Bladder, Stomach or Vagina as well as things such as haemorrhoids.

脾气还有助于保持器官的直立且在正确的位置。当脾虚时，我们会看到器官脱垂，包括子宫、膀胱、胃或阴道，以及痔疮等疾病。

In summary, when the Spleen Qi is weak it will results in lethargy and lassitude; the appetite may also be poor, digestion sluggish and stools may be loose and watery and anxiety symptoms.

总结来讲就是，脾气虚弱，就会出现嗜睡、倦怠；食欲也可能不佳、消化迟缓、大便松软、水样和焦虑症状。

Both Spleen and anxiety belong to the Earth, giving rise to a TCM theory stating that “Anxiety impairs Spleen”. According to TCM, over-focusing or over-thinking on one subject will lead to anxiety, with resultant dysfunction in the transport of water and nutrients around the body and the stagnation of Qi, indicative of a poorly functioning of the Spleen. Prolonged anxiety can worsen the functions of other Zang, which is consistent with the inter-functional relationship among various Zang. Interestingly, anger can be used to alleviate anxiety. Anger belongs to Wood, which restricts the Earth according to the Five Element theory. Thus, by inducing a state of rage, the effects of anger can effectively alleviate a state of anxiety. Although such psychotherapy is theoretically sound, little is currently known about the scientific basis of such treatment.

脾与忧同属土，故中医有“忧伤脾”的理论。中医认为，过度专注或过度思考某一件事会导致焦虑，从而导致全身水和营养的输送功能障碍以及气滞，这表明脾的功能不佳。长期的焦虑会使其他脏的功能恶化，这与各脏腑之间的功能关系是一致的。而有趣的是，愤怒可以用来缓解焦虑。愤怒属于木，根据五行理论，木克制土。因此，通过诱发愤怒状态，愤怒的影响可以有效缓解焦虑状态。尽管这种心理治疗在理论上是合理的，但目前人们对这种治疗的科学基础知之甚少。

It is worth noting the difference between stress and anxiety. Stress can be defined as a short-term psychological pressure when only limited resources are available to finish a task, whereas anxiety can be defined as a long-term worry about something uncertain in the future. Yet, a prolonged state of stress can also lead to anxiety. Studies have shown that General Anxiety Disorder (GAD) can be characterized by an asymmetrical expression of the Sympathetic Nervous System (SNS) and the Hypothalamic-Pituitary-Adrenal (HPA) axis. Based on this observation, it can be deduced that the influence of anxiety on Spleen function is likely mediated by both nervous and endocrine factors. The SNS, a component of the autonomic nervous system, serves to inhibit digestive functions (including peristalsis) and the enteric nervous system, an intrinsic nervous system in the digestive process. The HPA axis regulates a series of endocrine glands, wherein the hypothalamus secretes Corticotropin Releasing Hormone (CRH) that stimulates the pituitary gland to secrete adrenocorticotropic hormone (ACTH), and ACTH in turn stimulates the secretion of cortisol from the adrenal cortex.

值得注意的是压力和焦虑之间的区别。压力可以定义为只有有限的资源可以完成任务时的短期心理压力，而焦虑可以定义为对未来不确定事物的长期担忧。然而，长期的压力状态也会导致焦虑。研究表明，广泛性焦虑症（GAD）的特征是交感神经系统（SNS）和下丘脑-垂体-肾上腺（HPA）轴的不对称表达。根据这一观察，可以推断焦虑对脾功能的影响可能是由神经和内分泌因素共同介导的。 交感神经系统是自主神经系统的组成部分，用于抑制消化功能（包括蠕动）和肠神经系统（消化过程中的内在神经系统）。下丘脑-垂体-肾上腺轴调节一系列内分泌腺，其中下丘脑分泌促肾上腺皮质激素释放激素（CRH），刺激垂体分泌促肾上腺皮质激素（ACTH），促肾上腺皮质激素又刺激肾上腺皮质分泌皮质醇。

Cortisol primarily activates gluconeogenesis and the metabolism of fat, protein and carbohydrate in cells. However, cortisol sometimes referred to as a stress hormone, has been found to be strongly associated with anxiety. The overproduction of cortisol under conditions of anxiety leads to immunosuppression, a symptom of Spleen dysfunction in TCM.

皮质醇主要激活细胞中的糖异生和脂肪、蛋白质和碳水化合物的代谢。然而，皮质醇有时被称为应激激素，已被发现与焦虑密切相关。焦虑状态下皮质醇的过度产生会导致免疫抑制，这是中医脾功能障碍的症状。

Another example that can tie the theory of Spleen dysfunction in TCM closely with stress and anxiety and digestive issues is Irritable Bowel Syndrome. It common knowledge that Irritable Bowel Syndrome (IBS) was closely associated with anxiety and it is one of the number one triggers.

另一个将中医脾功能失调理论与压力、焦虑和消化问题紧密联系起来的例子是肠易激综合症。众所周知，肠易激综合症（IBS）与焦虑密切相关，是第一大诱因之一。

This may be explained by the over-stimulation or under-stimulation of the digestive system by the SNS, leading to contradicting IBS symptoms such as constipation and diarrhoea. A study also shows that stressors can disrupt the function of GI microbiota by inducing a neural response, which increases the risk of mucosal infection and inflammation. Stress on the GI mucosal immune system can lead to the translocation of pathogenic microbes from the GI tract to the interior of the body, with the resultant infection and the associated inflammatory response. Severe and sustained anxiety can induce peptic ulceration. Symptoms of peptic ulcer, including digestive discomfort and bleeding along the digestive tract, can be related with Spleen dysfunction, in which the Spleen fails to sustain the function of the digestive system and regulate the circulation of blood.

这可能是由于交感神经系统对消化系统的过度刺激或刺激不足，导致便秘和腹泻等矛盾的肠易激综合症症状。一项研究还表明，压力源可以通过诱导神经反应来破坏胃肠道微生物群的功能，从而增加粘膜感染和炎症的风险。胃肠道粘膜免疫系统的压力可能导致病原微生物从胃肠道转移到身体内部，从而导致感染和相关的炎症反应。严重且持续的焦虑可诱发消化性溃疡。消化性溃疡的症状，包括消化道不适和消化道出血，可能与脾脏功能失调有关，脾脏不能维持消化系统的功能和调节血液循环。

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.

中医认为，焦虑是由于脏腑功能失衡而产生的，脏腑功能失衡的不同组合会导致不同的症状。然而，正如五行理论所说，土作为五行的中心，最终会受到其他元素不平衡的阻碍。因此，治疗不同类型的焦虑症，主要以健脾为主。归脾汤是治疗焦虑症的常用方剂，不仅能改善焦虑症引起的脾虚症状，还能直接缓解焦虑症。从中医理论来看，归脾汤调动郁气，养神于心，被认为是情志之主。由于焦虑在病理上与气滞有关，气畅则可以缓解焦虑。

如有疑问想咨询吴宇琛中医师，可以在微信或whatsapp搜索0404836368，加吴宇琛中医师微信或whatsapp，也可以发短信或致电0404836368作语音留言，吴宇琛中医师有空就会回复。

（吴宇琛中医师，澳洲政府注册中医师、针灸师，五龙岗大学心理学学士、悉尼科技大学中医系学士，悉尼好思维松轩药行主治中医师，本文仅供参考，具体诊疗应咨询专业人士。）