Part 3 of 6 in the "Stress, sleep and TCM theory" series. The list of the other five is at the foot of this part.

Part 2 finished the three threads inside the theory. This part does two things: it sets the Western account of stress alongside, and then uses one crunch-season week to show how the theory reads a routine.

It reads a routine, not a person.

The short version

• The UK's National Health Service (NHS) puts it this way: "Stress is usually a reaction to mental or emotional pressure." "When you're feeling anxious or scared, your body releases stress hormones such as adrenaline and cortisol."
• The NHS also says this can be helpful for some people, but that if you're stressed all the time it can become a problem; its list of stress symptoms includes stomach problems, muscle tension or pain, sleeping too much or too little, and eating too much or too little.
• Both sides file sleep, appetite and bodily tension under "stress", but the two languages do not translate into each other: one speaks of hormones and organs, the other of qi movement and functional systems.
• One crunch-season week yields four readings in the theory; the matching practices are in the part 4 table.

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.

First, the things that cannot wait

⚠️ A safety note: TCM and Western medicine complement each other; it is not a choice between them. Difficulties with mood and sleep have a layer that needs professional assessment, and a TCM consultation does not substitute for that assessment. Asking for help is not weakness — there is professional support for this.

Thoughts of harming yourself — this is not something to wait on. Call 999 now, or go to the nearest hospital emergency department. To talk to someone, the Ministry of Health's Talian HEAL 15555 is open every day from 8 am to 12 midnight, public holidays included; Befrienders KL is open 24 hours on 03-7627 2929. You can also contact your doctor.

All seven items, and why each one means seeing a doctor first, are in part 5.

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.

I. The Western model, set alongside

The NHS's page on stress puts it this way: "Stress is usually a reaction to mental or emotional pressure." "When you're feeling anxious or scared, your body releases stress hormones such as adrenaline and cortisol."

The same page says this can be helpful for some people and might help you get things done or feel more motivated; but it might also cause physical symptoms such as a faster heartbeat or sweating, and if you're stressed all the time, it can become a problem.

Its list of stress symptoms includes stomach problems, muscle tension or pain, sleeping too much or too little, and eating too much or too little.

Both sides file sleep, appetite and bodily tension under "stress". But the two languages describe the same kind of experience without translating into each other: the NHS speaks of hormones and organs, TCM theory of qi movement and functional systems.

「肝主疏泄」 is not another name for cortisol, and cortisol is not the laboratory version of 「肝气」.

Neither side ranks above the other either. This section is the NHS's own account; the side above it is the account in the WHO's standard terminology. This article sets them next to each other and draws no conclusion for either.

II. A worked example: one crunch-season week, as the theory would read it

Suppose a week like this: five days finishing after ten, dinner pushed to half past nine, sitting all day, scrolling in bed until one, sleeping until noon at the weekend.

• Sitting all day, tense → the theory reads this as "qi not moving": in the WHO standard, the liver likes to flow freely and dislikes suppression, and qi should move; the Hong Kong Department of Health names moderate exercise as one of the four cornerstones of TCM health preservation, and that is the cornerstone this line answers to.
• Dinner at half past nine, eaten fast → the theory reads this as "the time for stomach qi to descend squeezed out": in the same standard, stomach qi needs to be unobstructed and flow downward, and the standard's description of the liver–stomach disharmony pattern is that it often occurs when liver qi stagnation affects the descending of stomach qi; the Hong Kong Department of Health's sleep guide puts it this way: dinner must be moderate, and there should be an interval between dinner and going to bed.
• Scrolling until one, mind still running → the theory reads this as "the heart not put to sleep first": the same sleep guide says TCM holds that one should "put the heart to sleep before the body", and that worry before bed harms the heart spirit.
• Sleeping until noon at the weekend → the theory reads this as "the daily routine lost": the same Department of Health material says one should sleep at fixed times and avoid late nights and lying in; move the sleep window and the timing of the three lines above moves with it.

The readings in quotation marks are this article's integration of the definitions above, not the standard's or the Department of Health's own words; each attribution named in a sentence covers only the definition in that sentence.

The matching practices — exercise earlier in the day, the timing of big meals and caffeine, the 60 minutes off the phone, a fixed sleep window — are in the part 4 table.

This passage reads a week's routine, not a person. The theory looks at these things together because, in its model, they all bear on whether qi is flowing.

Which pattern applies, if any, is the practitioner's judgement after seeing the whole picture, and it is not in this passage.

Fitting it into life in Malaysia

• Crunch season, exam season: the week above is that week. Put it into the part 4 table — hold the fixed wake-up time first, and let bedtime follow as closely as it can.
• A graphic wiring a TCM term to a hormone: that is two languages forced together. Use it as a starting point for a question and bring it to the consultation — see part 6.

The words used in this part

• Stress hormones — the NHS stress page's term; the examples it gives are adrenaline and cortisol. This is the vocabulary of the Western side.
• Liver qi stagnation (肝气郁结) — the name of a pattern in TCM theory; the definition is in part 1. It and the term above belong to two different languages.
• Daily routine (起居) — the word in the Hong Kong Department of Health's health-preservation material: how the day is arranged, including sleeping at fixed times and avoiding late nights and lying in.
• "Put the heart to sleep before the body" (先睡心，后睡眠) — the TCM saying quoted in the Department of Health's sleep guide: the mind must be calm before bed.

Frequently asked

Is 「肝气郁结」 just high cortisol? No. These are two languages' own terms: cortisol is an example of a stress hormone given on the NHS stress page, and 「肝气郁结」 is the name of a pattern in the WHO's standard terminology for TCM. Both sides file sleep, appetite and bodily tension under "stress", but no source puts an equals sign between those two terms, and neither does this article.

So which side should I believe? The question assumes a choice between them. TCM and Western medicine complement each other; this article sets the two accounts side by side and draws no conclusion for either. What does need deciding is when to see a doctor first — and that list is in part 5.

My week looks exactly like the one above. Does that mean I have liver qi stagnation? It does not. What is read above is a timetable, not a person. Which pattern applies is the practitioner's judgement after seeing the whole picture; the order is in part 6.

Better not to: blend the two languages into one sentence. Once blended, neither side's source matches any more, and what is left is just an assertion.

The other five parts in this series

• Part 1: What 「肝气」 and 「心神」 mean — two definitions, and what they are not
• Part 2: What "liver qi" models — one concept, three threads
• Part 4: What TCM theory arranges day to day — six habits in one table
• Part 5: See a doctor first in these situations — seven signs, and the reason for each
• Part 6: What actually happens at the consultation — routine first, then the pattern, then the direction

👉 If you are not sure where to begin with your own stress and poor sleep, 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 part 5 applies, see a doctor first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• NHS (UK), "Stress", page last reviewed 6 March 2026 — https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/
• World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 (entries 136 · 141 · 193 · 1315) — https://www.who.int/publications/i/item/9789240042322
• Chinese Medicine Regulatory Office, Department of Health, Hong Kong, "Health Preservation in Chinese Medicine — Sleep" (PDF) — https://www.cmro.gov.hk/files/gb/useful_information/public_health/feature_articles/TCM_019.pdf
• Chinese Medicine Regulatory Office, Department of Health, Hong Kong, "Health Maintenance and Common Bare-handed Exercises" — https://www.cmro.gov.hk/html/gb/useful_information/public_health/exhibit_boards/Health_Maintenance_and_Common_Bare-handed_Exercises.html
• Ministry of Health Malaysia, Hospital Pendang (Kedah State Health Department), Info Kesihatan 2024 (the Talian HEAL 15555 number and its hours) — https://jknkedah.moh.gov.my/hpendang/index.php?option=com_sppagebuilder&view=page&id=139
• Befrienders Kuala Lumpur (the 24-hour line) — https://www.befrienders.org.my/

本文是「压力、睡眠与中医理论」系列的第 3 篇，共 6 篇。另外五篇的清单在文末。

第 2 篇说完理论里的三条线。这一篇做两件事：把西医讲压力的说法并排放在旁边，然后用一个加班季的一周，示范理论会怎么读一张作息表。

读的是作息，不是某个人。

一分钟看完

• 英国国民保健署 NHS 的说法：压力通常是对精神或情绪压力的反应；人在感到焦虑或害怕时，身体会释放肾上腺素、皮质醇等压力荷尔蒙。
• NHS 也说这对一些人有帮助，但长期处于压力之下就可能成为问题；它列出的表现包括胃部不适、肌肉紧绷或疼痛、睡太多或太少、吃太多或太少。
• 两边都把睡眠、胃口、身体紧绷放在「压力」底下，但两套语言不是互译：一边讲荷尔蒙与器官，一边讲气的流动与功能系统。
• 一个加班季的一周可以用理论读出四件事；对应的做法在第 4 篇的表里。

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。

先说不能等的几件事

⚠️ 安全提醒：中医与西医是互相补位的关系，不是二选一。情绪与睡眠的困扰有需要专业评估的层面，中医问诊不能取代那个评估。寻求协助不是脆弱，这是有专业支援的范围。

出现伤害自己的念头——这不是可以等的事。请立刻拨打 999，或前往最近的医院急诊部。若想找人谈一谈，卫生部的 Talian HEAL 15555 每天早上 8 时至午夜 12 时开放，包括公共假期；Befrienders KL 24 小时热线：03-7627 2929。您也可以联络您的医生。

完整的七项，以及每一项为什么要先看医生，见第 5 篇。

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。

一、西医的模型，放在旁边看

英国国民保健署 NHS 的压力页这样说：压力通常是对精神或情绪压力的反应；人在感到焦虑或害怕时，身体会释放肾上腺素、皮质醇等压力荷尔蒙。

同一页说这对一些人有帮助，可能让人把事情做完、更有动力；但也可能带来心跳加快、出汗等身体反应，长期处于压力之下就可能成为问题。

它列出的压力表现包括胃部不适、肌肉紧绷或疼痛、睡太多或太少、吃太多或太少。

两边都把睡眠、胃口、身体紧绷放在「压力」底下。但两套语言在说同一类经验，不是互译：NHS 讲的是荷尔蒙与器官，中医理论讲的是气的流动与功能系统。

「肝主疏泄」不是皮质醇的另一个名字，皮质醇也不是「肝气」的化验室版本。

两边也没有高低之分。这一页列的是 NHS 自己的说法，上面那一边是世界卫生组织术语标准里的说法；本文并排放着，不替任何一边下结论。

二、一个例子：加班季的一周，理论会这样读

假设这样一周：连续五天十点后下班，晚餐推到九点半，一坐一整天，睡前刷手机到一点，周末睡到中午。

• 一坐一整天、绷着 → 理论会读成「气没有动」：按世界卫生组织的标准，肝喜条达而恶抑郁，气要顺；香港卫生署把适量运动列为中医养生四大基石之一，对着的就是这一条。
• 晚餐推到九点半、吃得急 → 理论会读成「胃气下行的时间被挤掉」：按同一份标准，胃气要通畅下行，而标准对「肝胃不和证」的说明是，这个证常发生在肝气郁滞影响胃气下降时；香港卫生署的睡眠篇写的是：晚餐必须饮食有节，并与入寝相隔一段时间。
• 刷手机到一点、思绪停不下来 → 理论会读成「心没有先睡」：香港卫生署的睡眠篇说，中医认为应「先睡心，后睡眠」，睡前忧虑会伤心神。
• 周末睡到中午 → 理论会读成「起居失常」：同一个卫生署的养生资料说，应定时睡眠，避免熬夜和久卧；睡眠时段一挪，前面三条的时间也跟着挪。

引号里的「读法」是本文依上面几条定义作的整理，不是标准或卫生署的原句；每一句点出的出处，只对应它前面那一句定义。

对应的做法——运动放在白天、大餐与咖啡因的时间、手机的 60 分钟、固定的睡眠时段——在第 4 篇的表里。

这一段读的是一周的作息，不是读某个人。理论把这几件事放在一起看，是因为在它的模型里，它们都关系到气顺不顺。

哪一个证成立、成不成立，是医师看过整体之后的判断，不在这一段里。

大马生活里怎么安排

• 加班季、考试季：上面那一周就是它。把它写进第 4 篇的表——固定起床时间先保住，睡觉时间尽量跟上。
• 一张图把中医的词接上荷尔蒙：那是两套语言被硬接在一起。可以当作提问的起点，带去看诊时问，见第 6 篇。

这篇出现的几个词

• 压力荷尔蒙（stress hormones）——NHS 压力页用的词，它举的例子是肾上腺素与皮质醇。这是西医那一边的语言。
• 肝气郁结——中医理论里一个证的名称，定义见第 1 篇。它和上面那个词属于两套语言。
• 起居——香港卫生署养生资料里的词：作息的安排，包括定时睡眠、避免熬夜和久卧。
• 先睡心，后睡眠——香港卫生署睡眠篇引的中医说法：睡前必须保持心情平静。

常见问题

「肝气郁结」就是皮质醇高吗？ 不是。这是两套语言各自的词：皮质醇是 NHS 压力页举的压力荷尔蒙例子，「肝气郁结」是世界卫生组织中医术语标准里一个证的名称。两边都把睡眠、胃口、身体紧绷放在「压力」底下，但没有一份资料把这两个词画上等号，本文也不画。

那到底该信哪一边？ 这个问题本身假设了二选一。中医与西医是互相补位的关系；本文把两种说法并排放着，不替任何一边下结论。真正要分辨的是什么时候必须先看医生——那一份清单在第 5 篇。

我这一周正好就是上面那样，是不是代表我肝气郁结？ 不代表。上面读的是一张作息表，不是一个人。哪一个证成立，是医师看过整体之后的判断，顺序见第 6 篇。

不要这样做： 不要把两套语言混成一句话用。混起来之后，两边的出处都对不上，剩下的只是一个说法。

这个系列的另外五篇

• 第 1 篇：「肝气」与「心神」是什么——两个定义，和它们不是什么
• 第 2 篇：「肝气」在理论里是怎么一回事——一个概念，三条线
• 第 4 篇：中医理论怎么安排作息——六个习惯的一张表
• 第 5 篇：这些情况请先看医生——七项信号，和每一项的理由
• 第 6 篇：看诊时实际会做什么——先作息，再辨证，然后才是方向

👉 如果您不确定「我这种压力大、睡不好，该从哪里谈起」，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；若您有第 5 篇列出的情况，请先看医生。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 英国国民保健署 NHS，〈Stress〉，页面最后审阅日期 2026 年 3 月 6 日 — https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/
• 世界卫生组织，《WHO international standard terminologies on traditional Chinese medicine》，2022（条目 136 · 141 · 193 · 1315）— https://www.who.int/publications/i/item/9789240042322
• 香港卫生署中医药规管办公室，〈中医养生－睡眠篇〉(PDF) — https://www.cmro.gov.hk/files/gb/useful_information/public_health/feature_articles/TCM_019.pdf
• 香港卫生署中医药规管办公室，〈中医养生及常见的徒手养生保健运动〉— https://www.cmro.gov.hk/html/gb/useful_information/public_health/exhibit_boards/Health_Maintenance_and_Common_Bare-handed_Exercises.html
• 马来西亚卫生部，Hospital Pendang（吉打州卫生局），Info Kesihatan 2024（Talian HEAL 15555 的号码与开放时间）— https://jknkedah.moh.gov.my/hpendang/index.php?option=com_sppagebuilder&view=page&id=139
• Befrienders Kuala Lumpur（24 小时热线号码）— https://www.befrienders.org.my/