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  很多人生气的时候,常常会脱口而出:“气得我肝疼!”传统医学里也有所谓“生气伤肝”的说法。但这种“肝疼”究竟是真实的身体不适,还是一种心理上的错觉?肝真的会因为生气而感到疼痛吗?今天,我们就来说说这个有趣的话题~

  “肝疼”和“肝疼”不一样

  要回答这个问题,就要首先理解一个现象,即人们对日常生活感受的描述常常会受到时代文化认知的影响,比如说古代人描述一个人皮肤好,会用“肤如凝脂”,而现代人表达同一个意思,有些人可能就会用“满脸的胶原蛋白”了。

  因此,一般人平时所说的气得“肝疼”和解剖学意义上的肝脏本身的疼痛并不是一回事。

  肝脏发生病变一般都会引起疼痛,比如肝炎、肝脓肿、肝癌发生时,可能会因为肿胀导致肝脏包膜张力增加,从而让病人感觉到上腹部有钝痛,同时还会伴有消化系统的其他不适症状,这些症状的发生多有一个由轻到重的过程,而且不会自行缓解,直到这种疼痛严重到足以引发人的警觉,敦促人尽快就医。

  而平时人们所说的气得“肝疼”其实一般时候并不是肝脏真的出问题了,往往只是大家对定位模糊的肚子疼的经验性描述,这种肚子疼通常都发生的比较迅速,而且一旦怒气消退,症状也随之消失,不至于产生严重后果。

  加拿大生理学家塞里(Sely.H)认为当机体受到伤害性刺激之后,会产生一系列生理生化的变化,以唤起体内的整体防御能力,主要表现有肾上腺素分泌增加,心率和呼吸加快,血压增高、出汗、手足发凉等。此时,全身血液优先供应心、脑、肺和骨骼肌肉系统,以确保机体处于“战斗”或“逃跑”的准备阶段。此时,消化系统就有可能出现一过性的功能紊乱,比如因胃肠道的蠕动不规律而引起腹痛。

  塞里的应激学说对心身医学有重要意义,此后许多应激研究都是在此基础上的修正、充实和发展的,但该学说后来也被研究者发现存在一些不足,比如该学说忽略了应激过程的心理成分。

  因为应激源(比如生气、发怒)可能是生物的、心理的、社会的和文化的,应激反应既有生理的也有心理的,应激过程也受个体多种因素的影响,认知评价和个人经历都会显著地影响应激的作用过程和结果。

  如果一个人原本就有“怒大伤肝”的心理预期,那么这个人就更有可能在生气时出现消化系统相关的症状,比如腹痛,而这一过程又会反过来强化他原有的“怒大伤肝”的认知,因此,他自然就很容易常常被气得“肝疼”了。

  很多疾病

  都与不良情绪有关

  事实上很多消化系统的疾病确实都与不良情绪有关。比如消化性溃疡、炎症性肠病、胃食管反流病、急性应激性溃疡、肠易激综合征、慢性胰腺炎等。

  情绪与消化系统疾病之间的关系是复杂的,既有生理机制的直接作用,也有心理因素的间接影响。例如,长期的焦虑和抑郁情绪可能会导致消化系统的慢性炎症,而这些炎症又会进一步加重情绪问题。此外,个体的心理素质和应对能力也在其中发挥重要作用。一些人可能更容易受到情绪应激的影响,而另一些人则能够更好地调节情绪,从而减少对身体的不良影响。

  情绪与心血管疾病之间也存在着密切的关系。消极情绪如愤怒、焦虑、抑郁等会激活交感神经系统、肾素-血管紧张素系统和下丘脑-垂体-肾上腺轴,导致心率加快、血压升高、血管收缩、炎症反应增强、氧化应激增加等[4]。

  18世纪时,医学界已经意识到生气发怒会引发心绞痛了,比如英国著名的外科医生约翰·亨特(JohnHunter,1728-1793)自己就有心绞痛的问题,他也发现巨大的情绪波动会引起心绞痛的发作。

  约翰·亨特是一位伟大的医生,非常善于利用一切机会观察学习疾病,当他的心绞痛发作时,他就会冲到镜子面前去仔细观察自己痛苦的表情。可他总是控制不了自己的脾气,在他生命中的最后一年,有一次他对一个死于一阵暴怒的人进行尸检之后,开玩笑地讲,自己的生命完全掌握在任何一个会在语言上激怒他的恶棍之手。孰料一语成谶,1793年10月16日,他在圣乔治医院的会议室与人发生激烈的辩论过后,痛苦地倒下了。

  这位生前为探索疾病的奥秘曾解剖过无数尸体的外科医生,死后也将自己的尸体献给了医学事业——对他的尸体解剖发现,其冠状动脉的病变已经很严重了。

  现代医学已经认识到情绪对疾病的影响,并采取了一系列综合治疗措施。除了传统的药物治疗外,心理治疗和行为干预也逐渐成为重要的治疗手段。例如,认知行为疗法(CBT)可以帮助患者识别和改变负面情绪,从而减轻症状。此外,一些研究表明,通过调节肠道菌群,也可以改善情绪状态,进而缓解消化系统的症状。

  不过,值得注意的是,与情绪相关的不适症状如果严重到需要就医的程度,实际上是很难迅速判断出来到底是以哪个器官的病理变化为主了。因为人体对内脏疼痛的感知,经常会出现定位不太准确的情况,比如说心绞痛确实最常表现为胸痛,但也有些不太典型的病例,会让病人感觉到腹痛,如果急诊科的医生经验丰富,就会通过基本的体格检查初步判断出病人的问题可能出在心脏,如果病人和医生都不太走运的话,这类不甚典型的病例,就有导致诊断延误的风险。

  我们应该如何处理愤怒情绪

  既然情绪对身体的影响如此显著,那么学会处理愤怒情绪就显得尤为重要。

  根据《生活方式医学》的建议,当愤怒的情绪出现时,最好是思考而不是仅仅做出反应,关键是要花时间思考问题,以明确为什么会出现这种愤怒,以及这种愤怒会产生其他什么影响,重点应放在寻找最佳办法上,以应对目前的处境。

  人们不要被愤怒所控制,应该尽快化解愤怒情绪,处理引起愤怒的方法包括与引发愤怒的人进行积极的沟通,重点是解决问题,而非责备。

  电影《教父》中有一句经典的台词:“不要憎恨你的敌人,那会影响你的判断力。”这句话不仅适用于电影中的情节,也适用于我们现实生活中的情绪管理。可惜老教父的大儿子没有学会这一点,他的愤怒可不只是让自己“气得肝疼”,直接中了对手的圈套,命丧于乱枪之下。

  但我们都很清楚,愤怒的情绪是在大脑中产生的,让我们控制愤怒情绪的指令也只能由大脑发出。那么,用黄油做成的刀具,它还能切割黄油本身吗?就像你在生气的时候,旁边有人好心劝你别生气啦,这种劝慰会奏效吗?

  可能不是那么容易。但不管怎么样,如果总是被气得“肝疼”,类似的建议,或许值得一试。

  策划制作

  作者丨李清晨哈尔滨儿童医院胸外科副主任医师

  审核丨闫杰首都医科大学附属北京地坛医院肝病中心主任医师

  策划丨林林

  责编丨杨雅萍

  审校丨徐来

  成都4月26日电“考古中国”重大项目重要进展工作会26日在四川成都召开,发布了蜀道考古调查阶段性成果。

  经过系统调查蜀道遗存信息,现阶段已初步掌握了6条蜀道主线保存较好路段的基本情况,形成了目前最为准确的“蜀道数据”。现阶段共调查蜀道里程2073千米,沿线分布各类文物遗存1034处,新发现文物遗存297处。

  蜀道不仅是中国古代中心地区与巴蜀地区的交通干线,更是体现中华文明连续性、创新性、统一性等突出特征的线性文化遗产。

  据了解,此次蜀道考古调查工作对蜀道及沿线遗存的保存现状进行了系统摸底,取得的阶段性成果有助于蜀道考古走向深入,推动蜀道遗产的保护、传承和利用。(完)

  中新社北京4月26日电(孔令佑)中国内线新锐杨瀚森26日正式宣布,将参加2025年美职篮(NBA)选秀。他有望成为第六位通过选秀登陆NBA的中国球员。

  据其中方经纪公司表示,杨瀚森已经完成2025年NBA选秀报名,顺利获得参选资格,并将于5月3日赴美进行特训和选秀前的准备工作。今年1月份,杨瀚森与美方经纪公司克拉驰体育集团签约。该集团由知名篮球经纪人里奇·保罗创建,旗下拥有勒布朗·詹姆斯、安东尼·戴维斯、达龙·福克斯等多位NBA球星。

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