"I know it's not good for me, but I can't get out of these dinners." It is a sentence that comes up often, said with a note of defensiveness — as though a lecture is coming.

It isn't. What a practitioner needs is the real version, not the tidy one. This article is about what gets asked and why those details are useful, set out as 5 things.

I. First: the consultation is not there to correct your life

Worth establishing up front, because it directly affects how much you say.

Asking how much you drink, what time you sleep and whether you smoke is not an assessment of your character. It is putting those things into the overall picture. Report half of it and the judgement rests on half the evidence.

Within the TCM framework, routine and diet are treated as part of the overall state. How TCM understands them belongs to the theoretical framework of the organ systems and qi — a different kind of explanation from medical research on alcohol and sleep deprivation. The two should not be conflated.

II. The 5 things a practitioner asks about

• Frequency and the actual amount — how many nights a week, roughly how much, what kind of drink.
• Timing — what time it starts, what time it ends, what time you are up the next day.
• What happens alongside — smoking, what you eat late, any hangover or stomach remedies.
• The next day — headache, reflux, palpitations, how tired and how long until you are back to normal.
• Existing diagnoses and medication — screening reports, medication for chronic conditions, liver function results.

That fifth matters especially. For anyone entertaining regularly, liver function and metabolic markers belong to the medical side — keep to the schedule your doctor sets.

III. What is worth spelling out

This table deliberately does not say how much is too much or what time to sleep. Those depend on the individual and should come from the practitioner or doctor who assesses you.

IV. See a doctor first in these situations

• Vomiting blood, or black stools — call 999 now, or go to the nearest emergency department
• Yellowing of the skin or the whites of the eyes — see a doctor promptly
• Persistent upper abdominal pain, or tenderness under the right ribs
• Chest pain or palpitations with breathlessness or a cold sweat — call 999 now, or go to the nearest emergency department
• Blackouts, loss of awareness, or injury while drinking
• Shaking, sweating, racing heart or severe mood swings when you stop drinking — tell your doctor
• You find it hard to cut down — this is not a matter of willpower. Talk to your doctor; there is professional support for it
• Abnormal liver function or metabolic results — follow your doctor's diagnosis and treatment

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

V. Fitting it into life in Malaysia

• The timing of mamak suppers. What time and what you eat beats "often".
• Raya, Chinese New Year, the company dinner. Those concentrated stretches differ from your normal pattern — describe them separately.
• Riding or driving the next morning. Never drive after drinking. That is a safety matter, not a wellness one — use e-hailing.
• Catching up on sleep at weekends. Five hours on weekdays and ten at weekends: the gap itself is information.
• Your company health screening report. Liver function, lipids, glucose — keep it and mention it.

On tiredness: always tired. On sleep: how TCM assesses poor sleep.

In closing

✅ Worth remembering:

1. The consultation is not there to correct your life — plain answers make the judgement possible.
2. A practitioner asks about frequency and amount, timing, what happens alongside, the next day, and existing diagnoses and medication.
3. Specific numbers and times beat descriptions of severity.
4. Vomiting blood, black stools, yellowing skin, chest pain or palpitations — seek medical attention immediately.
5. If cutting down is hard, talk to your doctor — there is professional support for it.

❌ Better not to:

1. Under-report drinking and hours to make it sound better.
2. Drive or ride after drinking — that is a safety matter.
3. Take hangover or liver products of unclear origin long-term on your own.

👉 If you would like to set out your lifestyle alongside how you have been feeling, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you; if anything in section IV applies, see a doctor first.

Reviewed by Ms. Tan Wan Yuet, a TCM practitioner registered with Malaysia's Traditional and Complementary Medicine Council under the T&CM Act 2016, practising in internal medicine, pain management and acupuncture.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，我知道这样不好，可是应酬推不掉。」这是不少读者常说的一句话，说出口时带着一点防卫——好像预期接下来会被念一顿。

不会。医师需要的是真实情况，不是理想版本。这篇讲的是问诊时医师会了解哪些事，以及为什么这些细节有用，整理成 5 件事。

一、先分清楚：问诊不是来纠正您的生活

这一点值得先说清楚，因为它直接影响您愿意说多少。

医师问喝多少、几点睡、抽不抽烟，目的不是评价，而是把这些放进整体的判断里。少讲一半，判断就少了一半的依据。

在中医的理论框架里，作息与饮食被视为整体状态的一部分。至于中医怎么理解这些，属于脏腑与气血的理论框架，与现代医学对酒精与睡眠剥夺的研究不是同一回事，两者不应混为一谈。

二、医师会了解的 5 件事

• 频率与实际的量：一周几次、每次大概喝多少、什么酒。
• 时间：几点开始、几点结束、隔天几点起。
• 同时发生的事：有没有抽烟、宵夜吃什么、有没有服用解酒或胃药。
• 隔天的状态：头痛、反酸、心悸、疲倦到什么程度、多久恢复。
• 已有的诊断与用药：体检报告、慢性病用药、肝功能的检查结果。

第五项特别重要。长期应酬的人，肝功能与代谢指标的追踪属于西医的范围，请按医生的安排定期检查。

三、一张表看懂：值得说明的具体资讯

这张表刻意不写「喝多少算多」或「几点睡才好」。这些属于需要依个别情况判断的建议，应由为您评估的医师或医生说明。

四、这些情况请先就医

• 呕血，或解黑便——请立刻拨打 999，或前往最近的急诊部
• 皮肤或眼白发黄——请尽快就医
• 上腹持续疼痛，或右上腹压痛
• 胸痛、心悸伴随气促或冒冷汗——请立刻拨打 999，或前往最近的急诊部
• 喝酒后曾经断片、意识不清，或曾因此受伤
• 停止饮酒后出现手抖、冒汗、心跳加快或情绪剧烈波动——请务必让医生知道
• 您觉得难以减少饮酒量——这不是意志力的问题，请与医生谈；这是有专业协助的范围
• 肝功能或代谢指标异常——请以医生的诊断与治疗为主

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

五、大马生活里怎么安排

• mamak 宵夜的时间：几点吃、吃什么，比「常常吃」有用得多。
• 开斋节、农历新年、公司年会：这些集中的时段和平常不一样，值得分开说明。
• 隔天还要骑摩托或开车：酒后不驾驶，这是安全问题，不是调理问题。有需要请用 e-hailing。
• 周末补眠：平日五小时、周末十小时，这个落差本身就是问诊要了解的资讯。
• 公司体检报告：肝功能、血脂、血糖——报告留着，问诊时一并说明。

关于疲倦的问诊内容，可参考：一直觉得累。关于睡眠，可参考：睡不好，中医会怎么评估。

结语

✅ 记住这几点：

1. 问诊不是来纠正您的生活——如实说，判断才有依据。
2. 医师会了解频率与量、时间、同时发生的事、隔天的状态、已有诊断与用药。
3. 说具体的数字与时段，比形容程度有用。
4. 呕血、黑便、皮肤发黄、胸痛心悸——立刻就医。
5. 觉得难以减少饮酒，请与医生谈，这是有专业协助的范围。

❌ 不要这样做：

1. 不要为了「讲得好听」而少报饮酒量与作息。
2. 不要酒后驾驶或骑摩托——这是安全问题。
3. 不要自行长期服用来源不明的解酒或护肝产品。

👉 如果您想把生活型态与身体状况一起说给医师听，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估；若有第四节列出的情况，请先就医。

本文由 陈奂仴 医师 撰稿审阅。陈奂仴 医师依 2016 年 T&CM 法令于马来西亚传统与辅助医药理事会注册执业，专长为内科、疼痛管理与针灸。

无论身在何处，与持证中医师对坐。

汉方现代中医