Part 1 of 6 in the "Stress, sleep and TCM theory" series. The list of the other five is at the foot of this part.

"Someone online said I have liver qi stagnation — is that right?" These two terms — 「肝气」 and 「心神」 — circulate widely and are just as widely misused.

The answer first. In TCM theory, the liver governs the free flow of qi: 「肝」 keeps qi moving freely through the whole body. The heart governs the spirit: 「心」 governs mental, conscious and thinking activities. Both sentences come from the WHO's 2022 standard terminology for TCM.

So in TCM theory 「肝气郁结」 is about whether qi is flowing, and 「心神不宁」 is about whether the mind is settled.

This part does only the definitions, and one thing that matters just as much: what these two terms are not.

The short version

• In TCM theory, 「肝」 and 「心」 name functional systems, not organs of anatomy — that is how the WHO's standard terminology defines both systems.
• So the liver function figures on a blood test cannot measure 「肝气」: that report measures the liver as an organ.
• In the WHO standard, 「肝气郁结」 and 「心神不宁」 are both the names of patterns, describing a state — not another word for a mood.
• Why mood, appetite and the menstrual cycle sit under one word in the theory is part 2; when to see a doctor first is 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.

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. First: the TCM "liver" is not your liver

As with 「肾」, this is easily confused.

In TCM theory, 「肝」 is the name of a functional system. The WHO's standard terminology for TCM defines the liver system as a functional system composed of the liver, gallbladder, tendons, nails and liver meridian.

The same standard likewise defines the heart system as a functional system, composed of the heart, small intestine, blood vessels, face, tongue and heart meridian.

In other words, 「肝」 and 「心」 in TCM theory name a set of functions, not the single organ of anatomy.

• The liver function figures on a blood test measure the liver as an organ. They are not the TCM 「肝气」, and the two do not map onto each other.
• The 「心」 in 「心神」 is likewise not the heart as an organ. Heart tests are a doctor's work; 「心神」 is assessed by a TCM practitioner.

II. What 「肝气」 and 「心神」 actually are

Everything below is TCM theory, defined from the WHO's 2022 standard terminology and the Hong Kong Department of Health's public material.

① The liver governs the free flow of qi (肝主疏泄). The WHO standard's description is: the liver maintains free flow of qi over the entire body. The same standard describes qi as the intangible, high-mobility nutritive substance that maintains vital activities.

The same standard records 「肝喜条达而恶抑郁」 — the liver likes to flow freely and dislikes suppression: liver qi needs to be soft and unobstructed, and free flow of qi guarantees its normal functions; and that the emotion of the liver is anger.

So 「肝气郁结」 in TCM theory is the name of a pattern (the WHO standard calls it the liver qi stagnation pattern), describing a state in which the liver fails to maintain the free flow of qi.

It is a judgement a practitioner reaches after assessment, not another word for a mood.

② The heart governs the spirit (心主神明). The WHO standard's description is: the heart dominates the vital activities and governs mental, conscious and thinking activities. Hong Kong's Chinese Medicine Regulatory Office says the same: the heart governs the blood vessels and stores the spirit.

So 「心神不宁」 is about the mental side not settling.

The WHO standard lists the disquieted heart spirit pattern and notes that it often results from emotional disturbance or medical conditions. That second half is why part 5 exists.

With the definitions in place, one more thing needs saying: these words belong after a consultation. The same set of presentations can point to different patterns in TCM theory.

Which pattern applies is the practitioner's judgement after seeing the whole picture — not a label for a reader to match against themselves. How that order runs is part 6.

The words used in this part

All four are the WHO standard's own vocabulary, and you will meet them directly in TCM material or in what a practitioner says.

• Functional system — the term the standard uses to define the liver system and the heart system: the name of a set of functions, not one organ.
• Qi (气) — the standard's description is: the intangible, high-mobility nutritive substance that maintains vital activities. Every use of "qi" in this series means that sentence.
• Free flow (疏泄) — the two characters inside 「肝主疏泄」, which the standard explains as the liver maintaining free flow of qi over the entire body. What it governs is part 2.
• Pattern (证) — the name of a judgement a practitioner reaches after seeing the whole picture. The liver qi stagnation pattern and the disquieted heart spirit pattern are both pattern names in the standard, not labels a reader can apply to themselves.

Frequently asked

What does 「肝气郁结」 actually mean? In TCM theory the liver governs the free flow of qi, maintaining free flow of qi over the entire body — that is the WHO standard's description. 「肝气郁结」 is the name of a pattern, describing a state in which the liver fails to maintain that free flow. It is a practitioner's term after assessment, not a synonym for "in a bad mood". Why mood, appetite and the cycle sit under one word in the theory is in part 2.

If I have liver qi stagnation, will my liver function test be abnormal? They are not the same thing. Liver function figures measure the liver as an organ; the TCM 「肝」, as the WHO standard defines it, is a functional system. Whether your liver function is fine is for the doctor reading the report; whether 「肝气」 is flowing is for the TCM practitioner's assessment.

Is 「心神不宁」 the same as an anxiety disorder? They are two different languages. 「心神不宁」 (the 「心神不宁证」 pattern in TCM theory) is the name of a pattern, about the mind not settling; the WHO standard notes that it often results from emotional disturbance or medical conditions. An anxiety disorder is a psychiatric diagnosis, assessed by a doctor. If anything listed in part 5 applies, see a doctor first.

Better not to: take a short video's or a forwarded graphic's terminology as your own diagnosis. These two words sit after a consultation, not before it.

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.

The other five parts in this series

• Part 2: What "liver qi" models — one concept, three threads
• Part 3: The two languages side by side, and one crunch-season week
• 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

• World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 (entries 70 · 73 · 133 · 136 · 141 · 142 · 224 · 1161 · 1240) — https://www.who.int/publications/i/item/9789240042322
• Chinese Medicine Regulatory Office, Department of Health, Hong Kong, "Health Preservation in Chinese Medicine — Maintain a Healthy Mental State" — https://www.cmro.gov.hk/html/gb/useful_information/public_health/feature_articles/Health_Preservation_in_Chinese_Medicine-Maintain_a_Healthy_Mental_State.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 1 篇，共 6 篇。另外五篇的清单在文末。

「医师，网上说我这是肝气郁结，是真的吗？」这两个词——「肝气」和「心神」——是常被转发、也常被误用的中医术语。

先说结论。 中医理论认为「肝主疏泄」：「肝」负责让全身的气顺畅流动；「心主神明」：「心」主宰精神、意识与思维活动。世界卫生组织 2022 年的中医术语标准是这两句话的出处。

所以「肝气郁结」讲的是气通不通，「心神不宁」讲的是精神定不定。

这一篇只做定义，以及一件同样重要的事：这两个词不是什么。

一分钟看完

• 在中医理论里，「肝」「心」是功能系统的名称，不是解剖学上的器官——世界卫生组织的中医术语标准就是这样定义这两个系统的。
• 所以验血报告上的肝功能指数量不到「肝气」：那张报告量的是肝脏这个器官。
• 「肝气郁结」「心神不宁」在世界卫生组织的标准里都是证的名称，描述的是一个状态，不是一种情绪的别名。
• 为什么情绪、胃口与月经在理论里挂在同一个词底下，第 2 篇说；哪些情况请先看医生，第 5 篇说。

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、先分清楚：中医的「肝」不是您的肝脏

和「肾」一样，这一点很容易混淆。

在中医理论中，「肝」指的是一个功能系统。世界卫生组织的中医术语标准把「肝系统」定义为由肝、胆、筋、爪甲与肝经组成的功能系统。

同一份标准把「心系统」同样定义为一个功能系统，由心、小肠、血脉、面、舌与心经组成。

换句话说，「肝」「心」在中医理论里是一组功能的名称，不是解剖学上的那一个器官。

• 验血报告上的肝功能指数，量的是肝脏这个器官。它不是中医所说的「肝气」，两者不互相对应。
• 「心神」的「心」，同样不是心脏这个器官。心脏的检查由医生做，「心神」由中医师辨证。

二、「肝气」与「心神」到底是什么

以下全部是中医理论的说法，用世界卫生组织 2022 年的中医术语标准与香港卫生署的公开资料来定义。

① 肝主疏泄。 世界卫生组织的标准对「肝主疏泄」的说明是：肝维持全身之气的顺畅流动。「气」在同一份标准里的说明是：维持生命活动的、无形而流动性高的营养物质。

同一份标准也记录「肝喜条达而恶抑郁」：肝气需要柔和、无阻，气顺畅流动是它正常运作的前提；以及「肝在志为怒」——怒与肝相配。

所以，「肝气郁结」在中医理论中是一个证的名称（世界卫生组织标准称「肝郁气滞证」），描述的是肝未能维持气的顺畅流动这个状态。

它是医师辨证之后给出的判断，不是一种情绪的别名。

② 心主神明。 世界卫生组织的标准对「心主神明」的说明是：心主宰生命活动，并主管精神、意识与思维活动。香港卫生署中医药规管办公室的说法相同：「心主血脉而藏神」。

所以，「心神不宁」讲的是精神活动这一面安定不下来。

世界卫生组织的标准把「心神不宁证」列为一个证，并注明它常源于情志扰动或疾病。后一半是第 5 篇存在的原因。

有了定义，还有一件事要说清楚：这些词属于问诊之后。 同一组表现在中医理论中可能指向不同的证。

哪一个证成立，是医师看过整体之后的判断，不是读者拿来对照自己的标签。这个顺序怎么走，第 6 篇说。

这篇出现的几个词

四个都是世界卫生组织那份标准自己在用的词，看中医资料或听医师说话时会直接遇到。

• 功能系统（functional system）——标准用来定义「肝系统」「心系统」的那个词：一组功能的名称，不是一个器官。
• 气（qi）——标准的说明是：维持生命活动的、无形而流动性高的营养物质。本系列每次用到「气」，指的都是这一句。
• 疏泄——「肝主疏泄」里的那两个字，标准解释为肝维持全身之气的顺畅流动。第 2 篇讲它管的是什么。
• 证（pattern）——医师看过整体之后给出的判断的名称。「肝郁气滞证」「心神不宁证」都是标准里的证名，不是读者可以给自己贴的标签。

常见问题

「肝气郁结」到底是什么意思？ 中医理论认为「肝主疏泄」，肝维持全身之气的顺畅流动——这是世界卫生组织那份标准的说明。「肝气郁结」是一个证的名称，描述肝未能维持这种顺畅流动的状态。它是医师辨证后的用语，不是「心情不好」的同义词。为什么情绪、胃口与月经在理论里放在同一个词底下，见第 2 篇。

肝气郁结，验血的肝功能会不正常吗？ 两者不是同一件事。肝功能指数量的是肝脏这个器官；中医的「肝」按世界卫生组织标准的定义是一个功能系统。肝功能有没有问题，由医生看报告；「肝气」通不通，由中医师辨证。

心神不宁就是焦虑症吗？ 不是同一套语言。「心神不宁」（中医理论中的「心神不宁证」）是一个证的名称，讲的是精神活动安定不下来；世界卫生组织的标准注明它常源于情志扰动或疾病。焦虑症是精神科的诊断，由医生评估。第 5 篇列出的情况出现，请先看医生。

不要这样做： 不要把短视频或转发图里的术语当成自己的诊断。这两个词的位置在问诊之后，不在之前。

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。

这个系列的另外五篇

• 第 2 篇：「肝气」在理论里是怎么一回事——一个概念，三条线
• 第 3 篇：两套语言并排看，和加班季那一周的读法
• 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

• 世界卫生组织，《WHO international standard terminologies on traditional Chinese medicine》，2022（条目 70 · 73 · 133 · 136 · 141 · 142 · 224 · 1161 · 1240）— https://www.who.int/publications/i/item/9789240042322
• 香港卫生署中医药规管办公室，〈中医养生之“怡神养心”〉— https://www.cmro.gov.hk/html/gb/useful_information/public_health/feature_articles/Health_Preservation_in_Chinese_Medicine-Maintain_a_Healthy_Mental_State.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/