2025年03月25日 12:10 發布
編輯：Editor
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。
The Four levels theory
The Four Levels theory was developed during the Qing Dynasty by Ye Tian Shi in his book “Discussion on Warm Diseases”.
衛氣營血辨證是清代葉天士在《溫病論》一書中發展起來的。
While the Six Stages Theory is mostly about diagnosing and treating diseases caused by External Cold, the Four Levels describes the treatment of virulent diseases caused by External Heat.
六經辯證主要用於診斷和治療由外寒引起的疾病，而衛氣營血辨證則描述了由外熱引起的惡性疾病的治療。
Historically it represented a major milestone in Chinese Medicine theory. For almost 15 centuries beforehand, the thinking had been that diseases of external origin were all caused by Wind-Cold, even if they transformed into Heat internally. Introducing the concept of diseases caused by Wind-Heat allowed TCM doctors more accurate track viral disease progression.
從歷史上看，這是中醫理論的一個重要里程碑。在此之前的近15個世紀中，人們一直認為外因疾病都是由風寒引起的，即使它們在內部轉化為熱。引入風熱疾病的概念使中醫師能够更準確地追蹤病毒性疾病的進展。
This theory deals with Warm Diseases. Such diseases share a few characteristics:
此理論涉及溫病。此類疾病具有以下幾個特點：
All Warm Diseases are caused by invasion of Wind-Heat but not every invasion of Wind-Heat causes a Warm Disease. They really need to have the characteristics above to be considered one.
溫病皆由風熱侵襲而致，但並非每個風熱侵襲都會導致溫病。只有具備上述特徵才可視為溫病。
In Western medicine, examples include influenza, measles, chicken pox, mononucleosis, mumps, SARS, COVID-19, meningitis, encephalitis, whooping cough or scarlet fever.
在西醫中，例子包括流感、麻疹、水痘、單核細胞增多症、腮腺炎、非典、新冠肺炎、腦膜炎、腦炎、百日咳或猩紅熱。
The theory describes what happens as the invasion progresses deeper within the body, through four levels of invasion, one at the Exterior of the body and three within the body’s Interior.
該理論描述了當病邪在體內不斷深入時發生的情况，病邪通過四個入侵層次進行侵襲，一個層次在身體外部，另外三個層次在身體內部。
The four levels（衛氣營血四個層次）
Defensive Qi level (衛分, Wei Fen)
Generally this stage represents the early stages of febrile and infectious diseases. At this stage the disease in still in the Exterior of the body.
一般此階段為熱病、傳染病的初期，病邪尚在體外。
It comprises four different patterns according to the nature of the pathogenic factor:
根據致病因素的性質，它包括四種不同的模式：
Of these four, Wind-Heat is by far the most common one.
在這四種病證中，風熱病是最常見的。
This is your body’s army of immune cells springing into action, from a western perspective. At least 200 years before western medicine would begin studying the immune response in great detail, TCM already establishes a theory on immune response with this first level.
從西方人的角度來看，這是人體免疫細胞大軍開始行動。至少在西方醫學開始詳細研究免疫反應的200年前，中醫就已經從這一層面建立了免疫反應理論。
The type of Qi energy known as “Wei” protects you from nasty microbes and foreign invaders, i.e. pathogens. You can think of Wei as a security guard at a gate, keeping all the unwanted people out. Wei energy is superficial; it’s not deep and intrinsic in the Zang Fu organs. Wei instead circulates outside the meridians, close to the skin and musculo-skeletal system. Yang by nature, Wei provides warmth and regulates perspiration.
被稱為“衛”的氣能保護您免受有害微生物和外來入侵者（即病原體）的侵害。您可以將“衛”視為門口的警衛，將所有不受歡迎的人拒之門外。 衛能是膚淺的，它並不深藏於臟腑器官中。衛在經絡外遊走，靠近皮膚和肌肉骨骼系統。衛本質上是陽，可提供溫暖並調節排汗。
But sometimes, a security guard can be overcome by an out of control group. And such is the nature with Wei. If one organ is weak (as a result of lack of exercise, stress, poor diet, etc.) Wei Qi energy weakens and becomes vulnerable to an invasion of a cold.
但有時，一個警衛會被一群失控的人打敗。這就是衛的本質。如果一個器官虛弱（由於缺乏運動、壓力、飲食不良等），衛氣能量就會减弱，容易受到感冒的侵襲。
And usually the first signs of a viral illness is respiratory discomfort. These symptoms typically occurs because Wei energy directly affects the Lung meridian. That’s why a wind-heat invasion when Wei is compromised typically manifests with Lung disharmony.
通常病毒性疾病的首發症狀是呼吸不適。這些症狀通常是因為衛氣直接影響肺經而發生的。這就是為什麼衛氣受損時風熱侵襲通常表現為肺失調。
A healthy person will be able to expel the wind-invasion out of the body rather quickly. But if the pathogen is significantly stronger than a person’s Wei Qi, then invasion will intensify, leading to the next level.
健康的人，風邪能較快地排出體外。但如果病邪比人的衛氣强很多，則侵襲會加劇，進入下一個階段。
Some symptoms of this early immune response of TCM theory include, in addition to fever: chills; headache, sore throat, yellow phlegm, sinus problems, nasal congestion, no sweating, etc. To treat a patient during the Defensive stage, a TCM practitioner will perform specific acupuncture points and perhaps dispense herbs that expel wind-heat from the body.
中醫理論認為，這種早期免疫反應的一些症狀除了發燒外，還包括：發冷、頭痛、喉嚨痛、黃痰、鼻竇問題、鼻塞、不出汗等。為了在防禦階段治療患者，中醫師將進行特定的穴位針灸，並可能使用草藥來驅除體內的風熱。
Qi level (氣分, Qi Fen)
This level is similar to the Yang Ming stage in the Six Stages theory.
此層面與六經辨證中的陽明階段相似。
It is the first Interior level reached by the disease and as such the most superficial one. While the disease has progressed, this level is never life threatening.
這是疾病到達的第一個內部層面，因此也是最表層的。儘管疾病已經惡化，但這個層面絕不會危及生命。
The general symptoms at this level include high fever, thirst, a feeling of heat and mental restlessness.
這一級別的一般症狀包括高燒，口渴，發熱和精神不安。
If Wei isn’t strong enough to neutralize the pathogen, the next level of wind-heat invasion occurs. This is called “Qi” level. The pathogen now enters the interior of the body. This is why you want a healthy immune system. You can suffer the most symptoms during this state. Not only can you suffer the most symptoms, but also the most severe ones.
如果衛氣不够强，無法中和病原體，就會發生下一階段的風熱侵襲。這稱為氣分。病原體現在進入體內。這就是為什麼你需要一個健康的免疫系統。在這個狀態下，你可能會出現最多的症狀。你不僅會出現最多的症狀，而且症狀也會最嚴重。
If left without treatment, the pathogen during this Qi Level can cook the internal organs! In TCM, the euphemistic way to say this is “internal heat excess.”
如果不加以治療，這個 “氣”層面中的病原體會燒壞內臟！在中醫中，委婉的說法是“內熱上炎”。
You may not be aware that you have a hidden pathogen (think of the herpes virus, or shingles). Or you may have a very weak immune system (perhaps from the hidden pathogen). In these two scenarios, the Defensive stage may not occur, causing a panic in the immune system and causing the illness to progress into this level.
您可能沒有意識到自己有隱藏的病原體（想想皰疹病毒或帶狀皰疹）。或者您的免疫系統可能非常脆弱（可能是因為隱藏的病原體）。在這兩種情况下，防禦階段可能不會發生，導致免疫系統恐慌，並導致疾病發展到這個階段。
In the Qi stage, there is further compromise of the Lungs. Other organ systems are also being challenged during this stage, including the Large Intestine and Lungs. Some common symptoms, which are more serious in nature than the Wei stage are: a higher fever; profuse sweating, insatiable thirst for very cold beverages, painful cough, gastrointestinal problems, etc.
在“氣”的階段，肺臟會進一步受損。其他器官系統也在這個階段受到挑戰，包括大腸和肺臟。一些常見症狀比“衛”階段更嚴重，包括：發燒、大量出汗、極度渴求冷飲、咳嗽疼痛、胃腸道問題等。
Nutritive Qi level (營分, Ying Fen)
This represents an acute stage of the disease and urgent care may be necessaryAt this level, the Heat is deeper within the body and has begun to injure the Yin and obstruct the Mind, causing delirium and even coma.
這代表疾病處於急性階段，可能需要緊急護理。在這個階段，熱在體內較深，已開始損傷陰液、阻礙心智，導致譫妄甚至昏迷。
There are two patterns at the Nutritive Qi level:
營分有兩種模式：
If a pathogen advances to this level, your mental functions and vitality may be compromised. In TCM terminology, Ying level adversely affects your Shen. If the heart is the seat of the spirit, there’s a good reason why this stage affects mostly your Heart organ system. At this point your Yin energy is on life support. What started out as heat invasion has now robbed your interior of virtually any remaining heat. You are now heat deficient.
如果病原體發展到這個階段，您的精神功能和活力可能會受到損害。在中醫術語中，陰氣會對神產生不利影響。如果心臟是精神的所在，那麼這個階段主要影響心臟器官系統是有充分理由的。此時，您的陰氣處於生命維持狀態。最初的熱氣侵襲現在已經奪走了您體內幾乎所有剩餘的熱量。您現在處於熱氣不足的狀態。
It is possible that if left untreated, the pathogen completely overtakes your interior; the body’s Shen is totally depleted, possibly resulting in coma. This stage is serious, obviously. In this stage, blood flow and blood manufacturing is severely weakened.
如果不加以治療，病原體可能會完全佔據你的內臟；身體的神會完全耗盡，可能會導致昏迷。這個階段顯然很嚴重。在這個階段，血液流動和血液製造能力嚴重减弱。
Blood level (血分, Xue Fen)
This stage involves severe damage to Essence and Blood, so that in addition to severe high fever and coma, there are symptoms of bleeding such as epistaxis and hematuria. Macules on the skin are also a definite sign that Heat has reached the Blood level.
此期精血受損嚴重，除有高熱昏迷外，還有鼻出血、尿血等出血症狀。皮膚出現斑疹也是熱入血分的明顯表現。
Some of the patterns at this stage include
此階段的一些模式包括
Now the pathogen enters into the Blood. In TCM theory, this is the deepest layer of Qi. TCM theory also considers the Liver the storage vessel of blood. And because Kidneys interconnect with the Liver, water balance and retention is severely compromised. Internal bleeding may manifest during this last stage of wind-heat related disease. Because blood flow and the nature of the blood is damaged, the Heart becomes damaged as well. The Heart and Blood are, in a manner of speaking, on fire, exhaustively trying to do their best to defeat the pathogen, but at this point, it’s a futile effort.
現在病原體進入血液。在中醫理論中，這是氣的最深層。中醫理論還認為肝臟是血液的儲存容器。由於腎臟與肝臟相連，水分平衡和滯留受到嚴重損害。在風熱相關疾病的最後階段，可能會出現內出血。由於血流和血液性質受損，心臟也會受損。可以說，心臟和血液都在燃燒，竭盡全力擊敗病原體，但此時，這是徒勞的。
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。）
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