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.

Mental Health – Spleen and Anxiety 1

心理健康-脾脏和焦虑（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.

感到焦虑是每个人每天都会发生的正常情绪体验，这可能是由于工作或其他因素里轻度的压力造成的，可能是对某件事情担心焦虑情绪的一种结果，也可能是一种诱因。当焦虑的感觉没有消失，或者这种感觉与情况不成比例时，就会成为一种主要的心理健康问题，也就是焦虑症。

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.

焦虑症是澳大利亚最常见的心理健康疾病之一，四分之一的澳大利亚人在一生中的某个时刻都会遭受焦虑的困扰，它可以分为几类。

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.

最常见的类型被称为广泛性焦虑症或GAD，这可能是由于对健康、工作或财务状况等日常问题过度、无法控制的担忧所致。

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.

惊恐症是有规律的惊恐发作，这是突然的强烈的恐惧，担心更多的攻击和避免可能发生惊恐发作的情况。

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

对某些事物的特定恐惧症、强迫症和创伤后应激障碍都是其他常见的焦虑症。

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.

焦虑症的症状包括惊恐发作、呼吸短促、头晕、心悸、失眠、胃部翻腾、颤抖和过度口渴、肌肉紧张和疲劳等等。

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.

对抗和减少焦虑的一些方法是通过冥想和放松技巧、正念、认知治疗和咨询。与抑郁症等其他常见心理健康问题类似，也经常使用药物治疗和互助支持小组。

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.

就像西医一样，中医认为焦虑有多种不同的种类和原因。它可以由气虚、血虚、阴虚、血瘀、肝气瘀滞、心神失和、痰湿蕴结等引起。在这个话题中，我们无法涵盖焦虑症的所有不同类型，但我将只关注一种模式，并再次探讨一些基本原理，例如脏腑系统。

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.

在中医中，我们的器官分为五脏（心、肝、脾、肺、肾）和六腑（胆、胃、大肠、小肠、膀胱和三焦）。五行理论解释了脏腑系统如何相互关联，以及一个器官的功能和健康如何通过五行循环的生成和限制作用影响其他脏腑。当这个循环出现问题时，可能会导致器官系统功能障碍，从而导致外邪和疾病。之所以有必要再次提及这一点，是因为中医认为焦虑与脾脏密切相关，我们将重点讨论湿的概念。

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.

湿气是影响身体的外邪之一，在高湿度的环境中很常见。经常处于潮湿的天气，体内会产生湿气，从而影响脾的功能，正如我们前面提到的，脾的主要作用是运化水谷精微到脏腑，化为气血，为人体四肢提供能量，属土主神。

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个主要功能，首先，脾主体内水、营养物质的运输和代谢，胃是与其配对的脏腑，将食物消化成各种成分，这些成分被运输到脾脏，然后分配到身体的其他部位。水液上行至肺，以生成气，而身体各部位产生的多余水份和代谢废物，则下行至肾，排出体外。湿盛或病理性湿称为痰湿或水肿，是由于消化不良、营养不良或代谢综合征导致脾功能失调的结果。

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.

从西方医学的角度来看，脾脏在消化方面并没有真正发挥重要作用，而是产生白细胞和抗体来抵抗感染，但在一些关于糯米的研究中，糯米是增强脾功能的食疗中的常见成分，发现它通过增加可能患有脾脏功能障碍的人的唾液淀粉酶水平来改善消化。另一项研究表明，在湿气重的情况下，水通道蛋白（一种常见于肺、消化系统和肾脏的水通道蛋白）过度表达，这表明脾的功能可能与这些系统在调节体内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，脾主调节气血运行。脾的功能是使血管内的血液沿着正确的方向流动，然后将气输送到全身。因此，皮下瘀伤和出血，例如与血尿和月经出血过多相关的病症，是由脾功能失调引起的。在西医中，预防内部瘀伤是血液的一种功能，通过调节血液凝固和毛细血管通透性来防止红细胞渗漏到微细血管外空间。研究表明，脾脏功能障碍的患者普遍表现出血小板形态异常，导致其聚集和释放凝血因子的能力下降。研究发现，脾功能障碍患者的血小板寿命较短，导致出血的可能性较高。脾功能不全的患者还发现毛细血管脆性增加，因此更容易发生毛细血管破裂，导致内部瘀伤。

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.

就营养代谢和运输以及血液循环的功能而言，脾表现为维持骨骼肌正常功能的重要决定因素。这是因为血液中营养物质向骨骼肌的运输是由脾控制的，实验观察证实了这一点，即脾功能障碍小鼠的伸肌结构和功能均显著恶化，并且由于骨骼肌中无氧糖酵解，脾功能障碍患者的血乳酸水平较高。这些观察结果可以很好地解释为什么脾功能障碍患者常见疲劳和肌肉疼痛。

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，脾与免疫功能有关。中医理论认为，脾的功能良好，就不会受到“外邪”的影响。脾属土，被认为是五行的中心。脾的功能好了，其他脏的功能也就正常了。许多研究的结果已经确定了脾脏和免疫系统之间的功能关系。脾功能不全的2型糖尿病患者存在明显的免疫功能障碍，苍术可改善脾功能不全患者的免疫功能，保护和修复受损的粘膜组织。

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。）