有人是「天旋地转」——一转头、一起身，整个房间转起来、站不稳、恶心想吐；有人是「头重脚轻」——头闷闷的、发飘、注意力不集中，蹲久站起来眼前一黑。这些都归在中医的「眩晕」底下，但成因很不一样：耳石症（一动头就天旋地转几十秒）、颈源性（颈椎问题牵连）、气血亏虚（累出来的、蹲起发黑）、痰湿中阻（头重如裹、恶心）、肝阳上亢（常伴血压偏高、面红烦躁）。中医的重点不是「一味补」或「一味清」，而是先辨清是哪一种，再对证调理。不过在讲调理之前，有一条安全线要先记住——突发严重眩晕，如果伴随说话不清、一侧手脚无力、剧烈头痛，要按中风急症立刻就医（见下）。
For some it's the room spinning — you turn your head or stand up and everything whirls, you can't stay steady, you feel sick; for others it's light-headedness — a muffled, floaty head, poor focus, going grey on standing after a long squat. TCM files these under "xuanyun" (vertigo/dizziness), but the causes differ widely: BPPV/ear-stones (the room spins for seconds when you move your head), cervicogenic (from the neck), qi-and-blood deficiency (fatigue-driven, greying on standing), phlegm-damp (a heavy, muffled head with nausea), and ascendant liver-yang (often with higher blood pressure, a flushed face, irritability). TCM's point isn't to just "tonify" or just "clear" — it's to identify the pattern first, then treat it accordingly. Before any of that, one safety line: sudden severe vertigo with slurred speech, one-sided limb weakness or a severe headache is treated as a possible stroke — seek emergency care at once (below).
Bagi sesetengah orang, bilik berpusing — anda pusingkan kepala atau bangun dan semuanya berpusing, tak boleh berdiri tegap, rasa loya; bagi yang lain, kepala terapung — kepala berat, sukar fokus, gelap mata bila bangun selepas lama mencangkung. TCM meletakkannya di bawah "xuanyun" (pening/vertigo), tetapi puncanya berbeza: BPPV/batu telinga (bilik berpusing beberapa saat bila gerak kepala), servikogenik (dari leher), kurang qi dan darah (akibat penat, gelap mata bila bangun), kahak-lembap (kepala berat, loya), dan yang hati menaik (selalu dengan tekanan darah tinggi, muka merah, mudah marah). Matlamat TCM ialah kenal pasti corak dahulu, kemudian rawat mengikutnya. Sebelum itu, satu garis keselamatan: pening teruk mengejut dengan pertuturan kabur, anggota lemah sebelah atau sakit kepala teruk dianggap kemungkinan strok — dapatkan rawatan kecemasan segera (di bawah).
头晕种类不同，处理也不同
Different Kinds of Dizziness, Different Care
Jenis Pening Berbeza, Rawatan Berbeza
头晕不是一个病，而是很多不同问题的共同表现。搞清楚是哪一种，方向才对：有的在耳朵（耳石症）、有的在颈椎、有的是气血不够、有的是痰湿或肝阳。自己可以先大致对照下面几种，但确诊要靠医师四诊合参，必要时配合西医检查（如血压、耳科、影像）。最要紧的是先排除急症——中医调理是给「一般的、反复的」眩晕，急症得先走急诊。
Dizziness isn't one disease but a shared symptom of many problems. Getting the direction right means telling which: some sit in the ear (BPPV), some in the neck, some are too little qi and blood, some are phlegm-damp or liver-yang. You can roughly match yourself to the types below, but a diagnosis rests on a practitioner's four examinations, with Western checks (blood pressure, ENT, imaging) where needed. Most important is ruling out an emergency first — TCM care is for the ordinary, recurring kind of dizziness; an emergency belongs in A&E first.
Pening bukan satu penyakit tetapi simptom bersama banyak masalah. Mendapatkan arah yang betul bermakna mengenal pasti yang mana: ada di telinga (BPPV), ada di leher, ada kurang qi dan darah, ada kahak-lembap atau yang hati. Anda boleh padankan diri secara kasar dengan jenis di bawah, tetapi diagnosis bergantung pada empat pemeriksaan pengamal, dengan pemeriksaan Barat bila perlu. Paling penting menyingkirkan kecemasan dahulu — penjagaan TCM untuk pening biasa dan berulang; kecemasan ke A&E dahulu.
突发眩晕，如果同时出现说话含糊不清、一侧手脚无力或麻木、口眼歪斜、看东西重影、走路偏斜站不住、剧烈头痛或意识改变——这可能是中风，请立刻叫救护车送医院，不要先来看中医（想了解中风可看我们的中风后遗症针灸康复）。另外，第一次发作的剧烈眩晕、伴突发单侧耳聋、剧烈头痛或头部外伤后眩晕，也要尽快就医排查。分不清时，一律先当急症处理最安全。
Sudden vertigo with slurred speech, one-sided limb weakness or numbness, a drooping face, double vision, veering or an inability to stand, a severe headache or altered consciousness may be a stroke — call an ambulance and go to hospital at once, don't come to a TCM centre first (to learn more, see our piece on stroke recovery and acupuncture). Also, a first-ever bout of violent vertigo, or one with sudden one-sided deafness, a severe headache, or after a head injury, needs prompt medical checks. When unsure, treat it as an emergency — that's safest.
Pening mengejut dengan pertuturan kabur, anggota lemah atau kebas sebelah, muka herot, penglihatan berganda, terhuyung atau tak boleh berdiri, sakit kepala teruk atau kesedaran berubah mungkin strok — panggil ambulans dan ke hospital segera, jangan ke pusat TCM dahulu (lihat rencana pemulihan strok dan akupunktur). Juga, serangan pening ganas kali pertama, atau dengan pekak sebelah mengejut, sakit kepala teruk, atau selepas kecederaan kepala, perlu pemeriksaan segera. Bila tak pasti, anggap ia kecemasan.
你的头晕，比较像哪一种？
Which Kind of Dizziness Is Yours?
Pening Anda Jenis Yang Mana?
以下四类最常见，你可能是其中一种，也可能是几种夹杂（例如气血虚又带点痰湿）。仅供对照，实际以医师辨证为准。
These four are the most common; you may be one, or a mix (say deficiency with some phlegm-damp). For rough matching only — the practitioner's pattern diagnosis decides.
Empat ini paling biasa; anda mungkin satu, atau campuran. Untuk padanan kasar sahaja — diagnosis corak pengamal yang menentukan.
翻身、抬头、躺下、起床的瞬间天旋地转，往往几十秒就停，反复因某个头位诱发。这是内耳耳石移位所致，西医常做「复位」处理见效快；中医可配合调理体质、缓解伴随的恶心与反复倾向。若确诊耳石症，别硬扛，尽早做复位。
The room whirls in the instant you roll over, tilt your head, lie down or get up — usually stopping in seconds, set off by a certain head position. It's displaced inner-ear crystals; Western repositioning manoeuvres work fast, and TCM can support the constitution and ease the nausea and the tendency to recur. If it's confirmed BPPV, don't tough it out — get repositioned early.
Bilik berpusing pada saat anda membalik badan, dongak, baring atau bangun — biasanya berhenti dalam beberapa saat, dicetus oleh posisi kepala tertentu. Ia hablur telinga dalam yang beralih; manuver reposisi Barat berkesan cepat, dan TCM boleh menyokong perlembagaan serta melegakan loya.
转头、久低头后发晕，常伴颈肩僵硬酸痛、头胀。久坐低头族多见，是颈椎劳损、气血上荣受阻牵连清窍。方向是松解颈肩、疏通经络、改善头部气血供应，针灸推拿常有帮助。改善用眼与低头姿势也很关键。
Dizziness after turning the head or long periods looking down, often with a stiff sore neck and shoulders and head pressure. Common in desk-bound, head-down workers — cervical strain hampering the flow of qi and blood to the head. The direction is to release the neck and shoulders, free the channels and improve blood supply to the head; acupuncture and tui na often help. Fixing screen and head-down posture matters too.
Pening selepas memusing kepala atau lama menunduk, sering dengan leher dan bahu kaku serta kepala tegang. Biasa pada pekerja meja — ketegangan servikal menghalang aliran qi dan darah ke kepala. Arahnya melonggarkan leher dan bahu serta melancarkan saluran; akupunktur dan tui na sering membantu.
蹲久或起身眼前发黑、头晕发飘、乏力、面色偏白、心悸、劳累后加重。这是气血不足、清阳不升、脑窍失养，产后、月经量多、久病、过劳的人常见。方向是益气养血、健脾升清，把「本」补起来，头晕才稳得住。
Going grey on standing after a long squat, floaty dizziness, fatigue, a pale complexion, palpitations, worse after exertion. This is too little qi and blood, clear yang failing to rise, the head undernourished — common after childbirth, heavy periods, long illness or overwork. The direction is to boost qi and nourish blood, strengthen the spleen and lift the clear yang, shoring up the root so the dizziness settles.
Gelap mata bila bangun selepas lama mencangkung, pening terapung, letih, muka pucat, berdebar, lebih teruk selepas bekerja. Ini kurang qi dan darah, yang jernih gagal naik, kepala kurang bekalan — biasa selepas bersalin, haid banyak, sakit lama atau terlalu penat. Arahnya menambah qi dan memupuk darah serta mengangkat yang jernih.
痰湿：头重如裹湿毛巾、胸闷、恶心、舌苔厚腻，体型偏胖、爱吃甜腻者多见，方向健脾化痰。肝阳上亢：头胀痛、面红、耳鸣、烦躁失眠、常伴血压偏高，压力大、熬夜者多见，方向平肝潜阳。这两类属「实」，不能一味补，补错反而更晕。
Phlegm-damp: a head heavy as if wrapped in a wet towel, chest tightness, nausea, a thick greasy tongue coat — common in heavier builds and sweet-greasy eaters; the direction is to strengthen the spleen and resolve phlegm. Ascendant liver-yang: a distending headache, a flushed face, tinnitus, irritability and poor sleep, often with higher blood pressure — common with stress and late nights; the direction is to calm the liver and subdue yang. These are "excess" patterns — tonify by mistake and the dizziness worsens.
Kahak-lembap: kepala berat seperti dibalut tuala basah, sesak dada, loya, lidah bersalut tebal — biasa pada yang berbadan besar dan gemar manis-berminyak; arahnya mengukuhkan limpa dan menyahkan kahak. Yang hati menaik: sakit kepala mengembang, muka merah, tinnitus, mudah marah dan tidur teruk, sering dengan tekanan darah tinggi; arahnya menenangkan hati. Ini corak "lebih" — jangan tonik.
安心中医怎么帮头晕眩晕？
How An Xin TCM Helps with Dizziness
Bagaimana An Xin TCM Membantu Pening
辨清证型之后，中医用针灸加科学中药对证调理，虚证补、实证清、夹杂的兼顾。方向对了，好转是发作的程度减轻、次数减少、每次持续的时间缩短——不那么天旋、恶心少了、头没那么重、蹲起也不那么发黑。眩晕成因多、快慢因人而异，我们不承诺时间表，只强调对证、规律地调。
Once the pattern is clear, TCM uses acupuncture plus concentrated herbs to match it — tonify for deficiency, clear for excess, cover both for mixed. Get it right and improvement shows as bouts easing in intensity, coming less often, and lasting a shorter time each — less spinning, less nausea, a lighter head, and less greying on standing. Dizziness has many causes and varies from person to person; we don't promise a timeline, only care matched to the pattern, done regularly.
Setelah corak jelas, TCM menggunakan akupunktur serta herba tumpat untuk memadankannya — tonik untuk kurang, nyahkan untuk lebih, liputi kedua-dua untuk campuran. Arah yang betul menunjukkan serangan kurang teruk, jarang berlaku, dan lebih singkat setiap kali — kurang berpusing, kurang loya, kepala lebih ringan. Pening ada banyak punca dan berbeza antara individu; kami tidak menjanjikan jadual, hanya rawatan yang dipadan dengan corak.
针灸取头部与相关经络穴位，帮助通调气血、升清降浊、缓解眩晕与伴随的恶心；颈源性的还会松解颈肩。对反复发作、伴颈肩僵硬或恶心明显的人，针灸能较快缓解当下的难受，配合中药一起调更整体。
Acupuncture uses points on the head and related channels to regulate qi and blood, lift the clear and settle the turbid, and ease the vertigo and nausea; for the cervicogenic kind it also releases the neck and shoulders. For recurring bouts with stiff shoulders or marked nausea, acupuncture can relieve the immediate discomfort fairly quickly, and works more completely alongside herbs.
Akupunktur menggunakan titik pada kepala dan saluran berkaitan untuk mengatur qi dan darah, mengangkat yang jernih, dan melegakan pening serta loya; untuk jenis servikogenik ia juga melonggarkan leher. Untuk serangan berulang, ia melegakan dengan agak cepat, dan lebih lengkap bersama herba.
按证型配科学中药（浓缩颗粒）：气血虚的益气养血、健脾升清；痰湿的健脾化痰、和胃降逆；肝阳上亢的平肝潜阳、清火。关键是别搞反——虚证乱清会更虚，实证乱补会更晕。若正在吃降压等西药，务必告诉医师，中西药一并安排，别自行停药。
Matched to the pattern with concentrated herbs (granules): boost qi and nourish blood and lift the clear for deficiency; strengthen the spleen and resolve phlegm for phlegm-damp; calm the liver and subdue yang for liver-yang. The key is not to get it backwards — clearing a deficiency deepens it, tonifying an excess worsens the spin. If you take blood-pressure or other medicine, tell the practitioner so both are arranged together; never stop it on your own.
Dipadan dengan herba tumpat (granul): menambah qi dan darah untuk kurang; mengukuhkan limpa dan menyahkan kahak untuk kahak-lembap; menenangkan hati untuk yang hati. Kuncinya jangan terbalik. Jika anda mengambil ubat tekanan darah, beritahu pengamal supaya diatur bersama; jangan berhenti sendiri.
发作时先坐稳或躺下、别急着动、抓扶稳固处防跌倒；平时规律作息、别熬夜、少大甜大腻（防痰湿）、情绪与压力要疏解（防肝阳）。耳石症该复位就复位，血压问题该测该控，反复或加重的眩晕要配合西医查清病因。中医调理与这些检查从不冲突，是一起把头晕的根找出来、调回去。
During a bout, sit or lie down, don't rush to move, and hold something firm to avoid a fall; day to day, keep a regular routine, avoid late nights, go easy on sweet-greasy food (against phlegm-damp), and release stress and emotion (against liver-yang). Get BPPV repositioned, monitor and control blood pressure, and have recurring or worsening dizziness checked by a doctor for its cause. TCM care and these checks never conflict — together they find the root and set it right.
Semasa serangan, duduk atau baring, jangan tergesa bergerak, dan pegang sesuatu yang kukuh untuk mengelak jatuh; setiap hari, kekalkan rutin, elak berjaga lewat, kurangkan makanan manis-berminyak, dan lepaskan tekanan. Reposisi BPPV, pantau tekanan darah, dan periksa pening berulang dengan doktor. Penjagaan TCM dan pemeriksaan ini tidak pernah bercanggah.
重点：头晕先分清、再调理，急症先走急诊。眩晕成因太多，「补」不是万能——虚证要补、实证要清，搞反了更晕。所以别自己乱买补品或凉茶，先让医师辨证。两条红线：① 立刻急症——突发眩晕伴说话不清、一侧手脚无力、口眼歪斜、看东西重影、剧烈头痛或意识改变，按中风处理、立刻叫救护车；② 先查西医——反复眩晕伴听力下降/耳鸣/耳闷（看耳鼻喉）、血压偏高相关（规律控压别停药）、不明原因骤然消瘦或持续加重（查病因）。中医调理与必要的西医检查从不冲突。
Key point: sort the dizziness first, then treat — and an emergency goes to A&E first. Vertigo has too many causes for "tonifying" to be a cure-all — deficiency needs tonifying, excess needs clearing, and backwards makes it worse. So don't self-buy tonics or cooling teas; let a practitioner read the pattern first. Two red lines: ① an emergency — sudden vertigo with slurred speech, one-sided limb weakness, a drooping face, double vision, a severe headache or altered consciousness is treated as a stroke; call an ambulance at once; ② see a doctor first — recurring vertigo with hearing loss, tinnitus or a blocked ear (see an ENT), anything blood-pressure-related (control it regularly, don't stop medicine), and unexplained weight loss or steady worsening (find the cause). TCM care and necessary medical checks never conflict.
Perkara utama: kenal pasti pening dahulu, kemudian rawat — kecemasan ke A&E dahulu. Pening ada terlalu banyak punca untuk "tonik" menjadi penyembuh serba boleh — kurang perlu tonik, lebih perlu dinyahkan, dan terbalik menjadikannya lebih teruk. Jadi jangan beli tonik atau teh sejuk sendiri. Dua garis merah: ① kecemasan — pening mengejut dengan pertuturan kabur, anggota lemah sebelah, muka herot, penglihatan berganda, sakit kepala teruk atau kesedaran berubah dianggap strok; panggil ambulans segera; ② jumpa doktor dahulu — pening berulang dengan hilang pendengaran, tinnitus atau telinga tersumbat (ENT), berkaitan tekanan darah (kawal, jangan berhenti ubat), dan berat turun tanpa sebab atau makin teruk. Penjagaan TCM dan pemeriksaan perubatan tidak pernah bercanggah.
常见问题
Frequently Asked Questions
Soalan Lazim
头晕、眩晕反反复复，中医怎么看？I keep getting dizzy or feel the room spinning — how does TCM see it?Saya kerap pening atau rasa bilik berpusing — bagaimana TCM melihatnya?+
中医把「眩晕」分虚实两大类、几种常见证型：耳石症（一动头就天旋地转几十秒）、颈源性（颈椎牵连）、气血亏虚（蹲下站起眼前发黑、乏力）、痰湿中阻（头重如裹、恶心）、肝阳上亢（常伴血压偏高、面红烦躁）。方向不是「一味补」或「一味清」，而是先辨清是哪一种：虚证益气养血、健脾化痰；实证平肝潜阳、化痰通络。找对证型，才好转得稳。
TCM sorts dizziness and vertigo into deficiency and excess patterns: BPPV/ear-stone type (the room spins for seconds when you move your head), cervicogenic (from the neck), qi-and-blood deficiency (going grey on standing, fatigue), phlegm-damp (a heavy, muffled head with nausea), and ascendant liver-yang (often with higher blood pressure, a flushed face, irritability). The point isn't to just tonify or just clear — it's to identify the pattern first, then nourish qi and blood or resolve phlegm for deficiency, or calm the liver and free the channels for excess. KKM-registered practitioners use acupuncture and concentrated herbs by pattern.
TCM mengelaskan pening dan vertigo kepada corak kurang dan lebih: jenis BPPV/batu telinga (bilik berpusing beberapa saat bila gerak kepala), servikogenik (dari leher), kurang qi-darah (gelap mata bila bangun, letih), kahak-lembap (kepala berat berloya), dan yang hati menaik (selalu dengan tekanan darah tinggi, muka merah, resah). Intinya bukan sekadar 'pupuk' atau 'nyahkan' — tetapi kenal pasti corak dahulu, kemudian pupuk qi-darah atau surai kahak untuk kurang, atau tenangkan hati untuk lebih. Pengamal berdaftar KKM menggunakan akupunktur dan herba tumpat ikut corak.
耳石症、颈椎、气血虚——头晕怎么分清？Ear-stones, neck or qi-blood deficiency — how do I tell dizziness types apart?Batu telinga, leher atau kurang qi-darah — bagaimana bezakan jenis pening?+
几个简单线索：翻身、抬头、躺下的瞬间天旋地转、几十秒就停，多是耳石症（BPPV）；转头、低头久了发晕、伴颈肩僵硬，多是颈源性；蹲久站起眼前发黑、平时容易累、面色差，多是气血亏虚；头重像裹着湿毛巾、胸闷恶心、舌苔厚腻，多是痰湿；头胀、面红、烦躁、血压偏高，多是肝阳上亢。不过自己分只是参考，确诊要靠医师四诊合参，必要时配合西医检查。
A few simple clues: the room spinning for seconds the instant you roll over, look up or lie down is often BPPV (ear-stones); dizziness after turning or looking down for a while, with a stiff neck and shoulders, is often cervicogenic; going grey on standing from a squat, tiring easily, a poor complexion, is often qi-and-blood deficiency; a head heavy as if wrapped in a wet towel, chest tightness and nausea, a thick greasy tongue coat, is often phlegm-damp; a distended head, flushed face, irritability and higher blood pressure is often ascendant liver-yang. Self-sorting is only a guide — diagnosis needs a practitioner's four examinations, with Western tests where needed.
Beberapa petunjuk mudah: bilik berpusing beberapa saat sebaik anda berpaling, mendongak atau berbaring selalunya BPPV (batu telinga); pening selepas memusing atau menunduk lama, dengan leher dan bahu kaku, selalunya servikogenik; gelap mata bila bangun dari mencangkung, cepat letih, muka pucat, selalunya kurang qi-darah; kepala berat seperti dibalut tuala basah, sesak dada dan loya, selalunya kahak-lembap; kepala tegang, muka merah, resah dan tekanan darah tinggi selalunya yang hati menaik. Menilai sendiri hanya panduan — diagnosis perlu pemeriksaan pengamal.
头晕什么情况要立刻就医、不能拖？When is dizziness an emergency — see a doctor at once?Bila pening ialah kecemasan — jumpa doktor segera?+
以下情况按急症处理、立刻就医：突然剧烈眩晕伴说话含糊不清、一侧手脚无力或麻木、口眼歪斜、看东西重影、剧烈头痛或意识改变——这可能是中风，请立刻叫救护车，不要先来看中医。此外，反复眩晕伴听力下降、耳鸣、耳闷要看耳鼻喉科；血压偏高相关的头晕要规律控压、别自行停药；不明原因骤然消瘦或持续加重的头晕要查病因。中医调理与必要的西医检查从不冲突。
Treat these as emergencies and seek care immediately: sudden severe vertigo with slurred speech, one-sided limb weakness or numbness, a drooping face, double vision, a severe headache or altered consciousness — this may be a stroke, so call an ambulance and don't come to a TCM centre first. Also, recurring vertigo with hearing loss, tinnitus or ear fullness needs an ENT; blood-pressure-related dizziness needs steady control, not stopping medicine on your own; and unexplained rapid weight loss or steadily worsening dizziness needs its cause found. TCM care and necessary medical checks never conflict.
Anggap ini kecemasan dan dapatkan rawatan segera: vertigo teruk mengejut dengan pertuturan kabur, anggota lemah atau kebas sebelah, muka herot, penglihatan berganda, sakit kepala teruk atau kesedaran berubah — ini mungkin strok, panggil ambulans dan jangan datang ke pusat TCM dahulu. Juga, vertigo berulang dengan hilang pendengaran, tinitus atau telinga penuh perlukan ENT; pening berkaitan tekanan darah perlukan kawalan tetap, bukan berhenti ubat sendiri; dan berat turun mendadak tanpa sebab perlu dicari puncanya. Penjagaan TCM dan pemeriksaan perubatan tidak pernah bercanggah.
眩晕发作时，当下自己可以怎么办？What can I do in the moment when vertigo strikes?Apa boleh saya buat ketika vertigo menyerang?+
立刻停下、别乱动，找地方坐下或躺下、扶稳防跌倒；闭上眼、慢慢深呼吸，等最厉害那一阵过去；别开车、别爬高、别站在楼梯或马路边。耳石症那种一动头就天旋地转，常几十秒到一两分钟自行缓解。但如果眩晕反复发作，要就医查清原因，别硬扛；一旦伴说话不清、手脚无力、剧烈头痛，按中风急症立刻叫救护车。
Stop at once and don't move about — sit or lie down and hold onto something to avoid a fall; close your eyes and breathe slowly until the worst passes; don't drive, climb, or stand near stairs or the road. The BPPV kind, where the room spins the instant you move your head, often settles by itself in seconds to a minute or two. But if vertigo keeps recurring, get the cause checked rather than toughing it out; and if it comes with slurred speech, limb weakness or a severe headache, treat it as a stroke emergency and call an ambulance at once.
Berhenti serta-merta dan jangan bergerak — duduk atau baring dan pegang sesuatu untuk elak jatuh; tutup mata dan bernafas perlahan sehingga yang paling teruk berlalu; jangan memandu, memanjat atau berdiri dekat tangga atau jalan. Jenis BPPV, di mana bilik berpusing sebaik anda gerak kepala, selalunya reda sendiri dalam beberapa saat hingga seminit dua. Tetapi jika vertigo berulang, periksa puncanya; dan jika disertai pertuturan kabur, anggota lemah atau sakit kepala teruk, anggap kecemasan strok dan panggil ambulans segera.