中医治疗耳鸣(神经性耳鸣)研究概况

Survey of TCM Treatment of Neurological Tinnitus

耳鸣(神经性耳鸣)发病率较高,“木郁之发,……甚则耳鸣眩转”“头痛耳鸣,九窍不利,肠胃之所生也”“髓海不足,则脑转耳鸣”,与肝脾肾三脏相关,分为肝火上扰、痰火郁结、肾精亏损、脾胃虚弱四种证型,有针灸、中药、针药结合、中西医结合等治疗,体现整体观与辨证论治;针灸治疗包括体针、腹针、穴位注射、艾灸等,局部取穴与远端取穴配合,穴位刺激可改善耳内微循环、产生新兴奋灶、降低交感神经兴奋性、改变耳内缺血,缓解耳鸣;中药治疗活血化瘀、化痰开窍、升清降浊、疏肝解郁、补脾益肾等,改善耳内缺氧。多种方法综合可增强疗效,减轻耳鸣。中医对耳鸣缺乏明确定义,疗效判定标准不准确,未来应明确中医治疗机制,增加随访使疗效更有说服力。

The incidence of tinnitus(neural tinnitus) is high, "the hair of Mu Yu,... even the tinnitus and vertigo" "headache and tinnitus, nine unfavorable, the stomach is also born" "the lack of marrow, then the brain turns to tinnitus", It is related to the three organs of liver, spleen and kidney. It is divided into four types: liver fire disturbance, bonfire stagnation, kidney essence loss, spleen and stomach weakness.It has acupuncture, Chinese medicine, acupuncture combined with Chinese and Western medicine, and reflects the overall view and syndrome differentiation. Acupuncture treatment includes body acupuncture,abdominal acupuncture, acupoint injection, moxibustion, etc. Local acupoints and distal acupoints can be combined. Acupoint stimulation can improve microcirculation in the ear, generate new excitation foci, reduce sympathetic nerve excitability, and change the ear defects. Blood, relieve tinnitus;Chinese medicine treatment of promoting blood circulation, removing phlegm, clearing phlegm, soothing liver and relieving depression,tonifying spleen and kidney, etc., improve hypoxia in the ear. A variety of methods can enhance the efficacy and reduce tinnitus. Traditional Chinese medicine lacks a clear definition of tinnitus, and the criteria for efficacy evaluation are inaccurate. In the future, the mechanism of Chinese medicine treatment should be clarified, and the follow-up will increase the efficacy to be more convincing.