張家睿中醫師 Ray

張家睿中醫師 Ray 睡不好、腸胃差，很多健康問題只是開始。
這裡分享睡眠、腸胃、疼痛與日常保健知識，希望讓大家用容易理解的方式認識中醫。
📍竹北｜仁人中醫・人文中醫

18/07/2026

診間常有患者問我，為什麼健檢突然發現血管有問題，明明平常都沒感覺。
Patients often ask me why their checkup suddenly flagged a vascular issue when they never felt anything wrong.

其實這正是血管疾病最麻煩的地方——動脈粥狀硬化是數十年緩慢進展的過程，血管本身沒有痛覺，狹窄到一定程度之前通常沒有任何症狀。等到胸悶、胸痛、或健檢紅字出現時，血管往往已經被影響很久了。
That's actually the tricky part about vascular disease — atherosclerosis progresses silently over decades, and blood vessels don't have pain receptors, so there are usually no symptoms until the narrowing becomes significant. By the time chest tightness, pain, or an abnormal checkup shows up, the vessels have often been affected for a long time.

飲食是這個過程裡最能自己掌握的一環。炸物、加工食品、飽和脂肪、精緻澱粉這類食物，長期吃會增加血管負擔；酪梨、堅果、鮭魚、橄欖油、綠茶、花青素莓果這類食物則相反。一項針對7,447名高心血管風險受試者的大型研究顯示，地中海飲食搭配特級橄欖油或堅果，比起低脂飲食，可以降低30%的重大心血管事件（中風、心肌梗塞、心血管死亡）。
Diet is the part of this process you can actually control. Fried food, processed food, saturated fat, and refined starch add to the burden on your vessels over time; avocado, nuts, salmon, olive oil, green tea, and anthocyanin-rich berries do the opposite. A large study of 7,447 high-cardiovascular-risk participants found that a Mediterranean diet with extra-virgin olive oil or nuts reduced major cardiovascular events — stroke, heart attack, cardiovascular death — by 30% compared to a low-fat diet.

中醫的角度來看，長期過食肥甘厚膩的食物容易生痰濁，痰瘀互結阻滯脈道，這個概念跟現代醫學講的血管斑塊堆積方向是一致的。
From a Chinese medicine perspective, long-term overconsumption of rich, greasy food generates "phlegm-turbidity," which combines with blood stasis to obstruct the vessels — a concept that lines up with modern medicine's plaque buildup.

如果你有胸悶胸痛、走路小腿痠痛需要休息才能繼續走、或不明原因喘不過氣，尤其又有三高或抽菸病史，這些是需要立即就醫評估的紅旗症狀，不是靠飲食調整就能取代。你上次檢查血管相關的數值是什麼時候？留言告訴我。
If you have chest tightness or pain, calf pain when walking that forces you to stop and rest, or unexplained shortness of breath — especially with a history of high blood pressure, blood sugar, cholesterol, or smoking — these are red flags that need immediate medical evaluation, not something diet alone can fix. When was the last time you checked your vascular-related numbers? Let me know in the comments.

#中醫師查證 #血管保養 #張家睿中醫師

17/07/2026

小腿粗、水腫、大肚子摸起來鬆軟——這些感覺很多人都有，但你可能沒想過，這可能是身體在提醒你濕氣重了。
Thick calves, swelling, a soft puffy belly — a lot of people experience this, but you might not realize it can be your body signaling too much dampness.

中醫怎麼看這件事：豐隆穴是足陽明胃經的絡穴，聯絡脾胃兩經。脾胃負責運化身體裡的水濕，一旦運化失常，水濕就會停聚，變成中醫說的「痰濕」——不只表現在下肢水腫、腹部鬆軟，也可能連帶出現舌苔厚膩、容易疲倦嗜睡這些徵象。
Here's the TCM view: Fenglong is the connecting point of the Stomach meridian, linking the spleen and stomach systems. These two organs are responsible for moving fluids through the body — when that process falters, fluid accumulates into what TCM calls "phlegm-dampness," which shows up not just as leg swelling or a soft belly, but sometimes also a thick, greasy tongue coating and constant fatigue.

位置怎麼找：外膝眼（膝蓋外側凹陷）與外腳踝連線的中點，再往脛骨外緣移兩指幅——重點是「脛骨外緣」，不是連線正中央的骨頭上。很多簡化說法只講「連線中點」，容易讓人直接壓在小腿骨上，位置偏了，效果自然打折。
Here's how to find it: take the midpoint between the outer knee dimple and the outer ankle bone, then move about two finger-widths toward the outer edge of the shin bone — the key detail is "beside the shin bone," not directly on top of it. A lot of simplified instructions just say "the midpoint of the line," which often leads people to press right on the bone itself, missing the actual point and getting less benefit.

每天按壓30下，力道以痠脹為度就好，不需要過度用力。皮膚如果有傷口、感染或不明腫塊，先避開該處。要提醒的是，如果水腫合併呼吸困難、心悸，或單側下肢腫脹又加劇疼痛，這些是心臟、腎臟或血栓的警訊，不是單純濕氣，需要立即就醫，按穴位沒辦法取代這一步。
Press 30 times a day, firm enough to feel a mild ache — no need for excessive force. If there's a wound, infection, or unexplained lump on the skin, avoid that area. One important reminder: if swelling comes with breathing difficulty, heart palpitations, or one-sided leg swelling with worsening pain, those are warning signs for heart, kidney, or blood clot issues — not simple dampness — and need immediate medical attention. Acupressure can't substitute for that.

#豐隆穴 #濕氣重 #穴位 #張家睿中醫師 #中醫養生

17/07/2026

台股今天下跌2,953.71點，創下史上最大單日跌點。先別急著去公園卡位，也別急著研究哪張長椅有遮雨棚。

人在突然承受壓力時，腎上腺素會讓呼吸、心跳加快，血壓也可能暫時上升；有些人還會頭痛、胃緊、肩頸僵硬、煩躁或睡不好。

用中醫語言來說，情緒不舒、胸悶、一直歎氣、兩脅緊繃，常從「肝失疏泄、氣機鬱滯」理解。但這裡說的肝氣，不等於肝功能，也不能拿來解釋所有胸痛與心悸。

所以你現在缺的不是紙箱，是肝氣的出口。今晚先做三件事：把手機放下、延長吐氣、出去走10分鐘。先讓身體退出戰鬥模式，再決定下一步。

如果胸痛持續、冒冷汗、呼吸困難、暈厥，或疼痛延伸到手臂、背部、頸部或下顎，請立即就醫，不要只當作壓力或肝鬱。

傳給那個去年蒐集一堆股東會帳篷、折疊椅、保冷袋和露營燈的朋友。先關心他，不是去跟他借裝備。本文不構成投資建議。

#台股 #壓力管理 #自律神經 #肝氣鬱結 #張家睿中醫師

16/07/2026

最近如果突然喉嚨很痛，不一定就是新冠；但也不適合完全不理它。

疾管署2026年7月14日公布，第27週國內新冠門急診就診2,811人次，較前一週增加34.4%。喉嚨痛、發燒、咳嗽與流鼻水都可能出現在新冠，也可能是流感或其他呼吸道感染，所以不能只靠症狀自行確診。

真正需要特別注意的是65歲以上、慢性病、免疫低下及其他重症高風險族群。出現疑似症狀時，不建議先自行調理好幾天再說；應儘早快篩並就醫，由醫師評估是否需要抗病毒治療及確認用藥安全。

如果出現喘或呼吸困難、持續胸痛／胸悶、意識不清、嘴唇發青、無法飲水服藥，或尿量明顯減少，請立即就醫。

中藥或症狀照護可以有輔助位置，但不能取代高風險族群的抗病毒評估時窗。把這則傳給家裡那個身體不舒服，還總說「睡一覺就好」的人。

#新冠 #喉嚨痛 #抗病毒治療 #高風險族群 #張家睿中醫師

16/07/2026

診間常有患者說，我的eGFR報告寫60多，醫師說還好，應該沒事吧？
Patients often tell me their eGFR came back in the 60s and their doctor said it's fine, so they assume there's nothing to worry about.

其實腎功能的完整判讀，需要看兩個數字：腎絲球過濾率eGFR，和尿液白蛋白肌酐比UACR。eGFR分期是G1（≥90，功能正常但可能有損傷）、G2（60-89，輕度下降）、G3a（45-59，中度下降）、G3b（30-44，中重度下降）、G4（15-29，重度下降）、G5（

15/07/2026

診間常有患者拿著健檢報告來問我，LDL 105是不是超標很危險。
Patients often bring their reports to clinic asking if an LDL of 105 is dangerously high.

其實這個問題沒有單一答案。壞膽固醇LDL-C的目標值，現在的指引是依心血管風險分層，不是一個數字適用所有人：一般健康成人（低風險）目標是低於130、有部分危險因子（中風險）低於115、糖尿病或慢性腎臟病患者（高風險）低於100、已有心血管疾病但非極高風險（非常高風險）要到低於70、已發生過心肌梗塞或中風這類極高風險族群，目標甚至要低於55。
Actually, there's no single answer. Current guidelines stratify LDL-C targets by cardiovascular risk, not a one-size-fits-all number: generally healthy adults (low risk) target under 130, those with some risk factors (moderate risk) under 115, diabetics or chronic kidney disease patients (high risk) under 100, those with existing cardiovascular disease but not extreme risk (very high risk) under 70, and those who've had a heart attack or stroke (extreme risk) even under 55.

這代表「LDL要低於100」這句衛教常聽到的話，其實只適用其中一層。對一般健康的人來說，目標可以更寬鬆；但對已經有心血管疾病史的人來說，低於100反而不夠嚴格，容易讓人誤以為自己達標而放鬆警覺。
This means the commonly heard advice "LDL should be under 100" actually only applies to one tier. For generally healthy people, the target can be more relaxed. But for those with existing cardiovascular disease, under 100 isn't strict enough — it can create a false sense of being "in the clear."

其他三個數字比較單純：總膽固醇低於200、好膽固醇HDL要大於60、三酸甘油脂要小於150。如果你不確定自己屬於哪個風險分層，建議直接拿健檢報告跟醫師討論，不要自己套用單一數字判斷。你的LDL數字知道自己該對照哪一層嗎？留言告訴我。
The other three numbers are simpler: total cholesterol under 200, HDL over 60, and triglycerides under 150. If you're not sure which risk tier you fall into, bring your report to your doctor rather than judging it against a single number on your own. Do you know which tier your LDL number should be measured against? Let me know in the comments.

#中醫師查證 #血脂管理 #張家睿中醫師

14/07/2026

診間常有患者拿著血壓機的數字問我，130多算不算有問題，畢竟他們一直以為要到140才算高血壓。
Patients often show me readings in the 130s and ask if it's a problem — they've always thought 140 was the threshold for high blood pressure.

其實台灣中華民國心臟學會（TSOC）和台灣高血壓學會（THS）在2022年已經把高血壓的「診斷標準」從140/90下修到130/80 mmHg，而且改成以居家自我量測為主要依據，不再只看診間量的那一次。這代表很多人心裡的「140/90」已經是舊標準了。
The Taiwan Society of Cardiology (TSOC) and Taiwan Hypertension Society (THS) actually lowered the diagnostic threshold for hypertension from 140/90 to 130/80 mmHg back in 2022, and shifted to home self-measurement as the primary basis rather than a single clinic reading. That means the "140/90" many people still have in mind is already outdated.

完整分級是：正常血壓小於120/80、第一期高血壓130-139/80-89、第二期高血壓140/90或更高、嚴重高血壓超過180/120。想在家準確量血壓，THS建議「722法則」：一週量7天取第2到7天平均、一天量2次（早起和睡前）、每次量2遍間隔1分鐘取平均。
The full breakdown: normal is under 120/80, Stage 1 is 130-139/80-89, Stage 2 is 140/90 or higher, and severe is over 180/120. For accurate home measurement, THS recommends the "722 rule": measure 7 days a week (average days 2-7), twice a day (waking and before bed), twice each time one minute apart, then average.

如果你的血壓超過180/120，又合併頭痛、胸痛、視力模糊或呼吸困難，這是高血壓危象，要立刻就醫，不是自己在家多量幾次就能處理的。你上次量血壓是多久以前的事？留言告訴我。
If your blood pressure exceeds 180/120 along with headache, chest pain, blurred vision, or difficulty breathing, that's a hypertensive crisis — seek immediate medical care, don't just remeasure at home. When was the last time you checked your blood pressure? Let me know in the comments.

#中醫師查證 #高血壓標準 #張家睿中醫師

13/07/2026

診間很常有患者拿著健檢報告來問我，這個血糖數字算不算有問題。
Patients often bring their checkup results to clinic and ask me whether their blood sugar numbers are a problem.

有3個數字，記住就能快速判斷是不是「糖尿病前期」：空腹血糖100-125 mg/dL、餐後血糖140-199 mg/dL、糖化血紅蛋白HbA1c 5.7-6.4%。這個區間還沒到糖尿病的診斷標準，但已經比正常值高，是身體發出的早期訊號。
There are 3 numbers worth remembering to quickly recognize "prediabetes": fasting glucose 100-125 mg/dL, post-meal glucose 140-199 mg/dL, and HbA1c 5.7-6.4%. This range doesn't meet the diagnostic threshold for diabetes yet, but it's already above normal — an early signal from your body.

這3個數字不用死背，找生活中已經很熟悉的東西對照就好記：空腹血糖對照機車常見的cc數（100-125cc），餐後血糖記1-4-9這個健康界線，糖化血色素則對照手機螢幕的吋數（5.7吋到6.4吋，從小尺寸到大尺寸手機都在這區間）。
You don't need to memorize these cold — match them to things you already know: fasting glucose lines up with common scooter engine sizes (100-125cc), post-meal glucose is the "1-4-9" line, and HbA1c matches common phone screen sizes (5.7" to 6.4", spanning compact to large phones).

數字越低越正常，越高風險越高。落在這個區間，代表現在是介入的好時機——調整飲食順序、飯後動一動、規律追蹤，很多人可以把數值拉回正常，不一定會走到糖尿病那一步。
Lower is more normal, higher means higher risk. Landing in this range means now is a good window to intervene — adjusting meal order, moving after meals, and regular follow-up can bring many people's numbers back to normal, without necessarily progressing to full diabetes.

這3個數字裡，餐後血糖異常的人，研究顯示介入效果最明確；單純空腹血糖或糖化血色素異常的人，介入實證相對少一點，但一樣值得注意。
Of the three, people with abnormal post-meal glucose show the clearest evidence for benefiting from intervention; those with only fasting glucose or HbA1c abnormalities have somewhat less evidence backing intervention, but it's still worth paying attention to.

如果你的數字落在這個區間，建議跟醫師討論追蹤頻率，不要等到診斷確定才開始行動。你上次健檢的血糖數字記得嗎？留言告訴我。
If your numbers fall in this range, talk to your doctor about follow-up frequency — don't wait for a formal diagnosis to start taking action. Do you remember your last checkup's blood sugar numbers? Let me know in the comments.

#中醫師查證 #糖尿病前期 #張家睿中醫師

你有沒有想過，為什麼你跟朋友吃一樣的東西，她沒事，你卻脹氣？Have you ever wondered why you and your friend eat the same food, but she's fine while you...
12/07/2026

你有沒有想過，為什麼你跟朋友吃一樣的東西，她沒事，你卻脹氣？
Have you ever wondered why you and your friend eat the same food, but she's fine while you end up bloated?

為什麼同樣感冒，有人三天好，你卻拖了兩個禮拜？
Why does the same cold clear up in three days for some people, but drag on for two weeks for you?

中醫的答案：體質不一樣。
TCM's answer: your constitutions are different.

中醫九種體質，對應九種不同的生病模式與養生方向：
The nine TCM constitution types correspond to nine different health patterns and care approaches:

🌿 平和質——機器運轉良好，最健康的體質
🌿 Balanced — everything running smoothly, the healthiest type

⚡ 氣虛質——睡了 8 小時還是累，手機電量永遠在 15%
⚡ Qi Deficiency — still tired after 8 hours of sleep; phone battery stuck at 15%

❄️ 陽虛質——別人穿短袖，你還在穿外套
❄️ Yang Deficiency — others wear short sleeves; you're still in a jacket

🔥 陰虛質——睡著了，半夜還是會醒，虛火往上竄
🔥 Yin Deficiency — fall asleep but wake in the night; deficiency-heat rising

💧 痰濕質——吃不多但就是瘦不下來，排水管堵住了
💧 Phlegm-Dampness — not eating much but can't lose weight; the drainage is blocked

☀️ 濕熱質——臉油、長痘、口苦，梅雨天住在身體裡
☀️ Damp-Heat — oily skin, acne, bitter mouth; like a sticky summer monsoon inside

🌑 血瘀質——黑眼圈不是沒睡好，是怎麼睡都這樣
🌑 Blood Stasis — dark circles aren't from poor sleep; they're there no matter how much you sleep

☁️ 氣鬱質——常常嘆氣，心情低落說不上為什麼
☁️ Qi Stagnation — frequent sighing, low mood with no obvious reason

🌸 特稟質——換季就開始打噴嚏，免疫警報器太靈敏
🌸 Special/Allergic — sneezing at every season change; immune alarm too sensitive

你是哪一種？往上翻翻看。
Which one are you? Scroll back up to find out.

找到之後，把這篇分享給你最好的朋友——她的體質可能跟你完全不一樣，她的養生方法也應該不一樣。
Once you find yours, share it with your best friend — her constitution may be completely different from yours, which means her health approach should be too.

⚠️ 安全提醒：圖鑑僅供初步了解，確認自己的體質建議找中醫師診斷。
⚠️ Safety note: This guide is for general reference only. For accurate constitution identification, consult a licensed TCM physician.

#中醫體質 #九種體質 #體質調理 #張家睿中醫師 #中醫養生

12/07/2026

診間很常有患者問我，吃飽飯到底該不該動一下。
Patients often ask me whether they should move around after eating.

答案是肯定的，而且動的方式有差。碳水化合物吃下肚後，血糖快速上升會刺激胰島素分泌，長期反覆這樣，細胞對胰島素會越來越不敏感，也就是胰島素阻抗——這跟肥胖、慢性發炎、失智風險、癌症風險都有關。
The answer is yes — and how you move matters. After eating carbs, blood sugar rises quickly and triggers insulin release. Over time, repeated spikes make cells less responsive to insulin — insulin resistance — which is linked to obesity, chronic inflammation, and even dementia and cancer risk.

飯後走路10-15分鐘確實有幫助，但研究顯示深蹲效果更強：飯後做深蹲可以降低血糖21-52%，比走路更有效，因為深蹲直接動用大腿和臀部的大肌群，肌肉收縮本身就能讓血糖進入細胞，這個機轉不需要依賴胰島素。
Walking 10-15 minutes after a meal does help, but research shows squats are more effective: post-meal squats can lower blood sugar by 21-52%, outperforming walking, because squats directly engage the large thigh and glute muscles. Muscle contraction itself lets glucose enter cells — a mechanism that doesn't rely on insulin.

如果你正在用藥控制糖尿病，或有心血管病史，運動強度請先跟醫師討論；飯後運動也建議以緩和的深蹲或散步為主，不要飯後劇烈運動或衝刺跑步。你飯後習慣做什麼？留言告訴我。
If you're managing diabetes with medication or have a history of heart disease, discuss exercise intensity with your doctor first. And keep post-meal exercise gentle — squats or walking — not intense workouts or sprinting right after eating. What do you usually do after a meal? Let me know in the comments.

#中醫師查證 #血糖控制 #張家睿中醫師

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