I. The concept of tinnitus
Tinnitus is a sound in the ear that is perceived by the patient, but there is no corresponding sound source in the surrounding environment. In quiet situations, sometimes the sound of tinnitus increases. It is easily affected by fatigue, rest, sleep, menstruation, metabolic reactions and changes in blood circulation in the head. Clinically, tinnitus should be distinguished from phantom hearing. Tinnitus is often a simple sound tone sensation, while phantom hearing is a compound sensation of speech or sound.
II. Tinnitus is divided into two categories according to its nature.
1. Primary tinnitus, also known as non-vibratory tinnitus, which is common in clinical practice, such as Ménière’s disease, various kinds of ototoxic deafness, senile deafness, noise damage, auditory neuroma, and phytodysfunction.
2. Other perceptual tinnitus, also known as vibratory tinnitus, is less common, and the examiner can also hear loud sounds, mostly “clacking” or pulsating murmurs. It is often associated with spasm of the palatal sailor muscle or stapedius muscle, or caused by jugular vein body tumor.
What diseases are associated with tinnitus?
1. Systemic diseases: When kidney disease, hepatobiliary disease, diabetes, tuberculosis, chronic bronchitis, etc. lead to systemic dysfunction, tinnitus often appears as a symptom. Therefore, a middle-aged or elderly person who originally did not have tinnitus symptoms but suddenly developed tinnitus in the near future should have his blood pressure, blood lipids and ECG checked in time to clarify whether he is suffering from hidden heart disease.
2. Weakness: It is often caused by insufficient vascular tone and poor local blood supply, which is considered by Chinese medicine to be caused by kidney deficiency or weakness of qi and blood. If the liver and kidney are Yin deficiency, there is usually dizziness, insomnia, waist acidity and red tongue, etc. If the kidney is Yang deficiency, there is usually cold waist and limbs, more nocturnal urination and light tongue, etc.
3.Neurasthenia: It is often accompanied by headache, dizziness, insomnia, dreaminess, etc. This kind of tinnitus is also related to depression.
4.Ear disorders: Patients have a history of ear disease and tinnitus is aggravated at night. Depending on the location of the lesion, it can be divided into transonic tinnitus and sensorineural tinnitus. Transonic tinnitus can occur when there is cerumen, foreign body, inflammation and swelling in the outer ear, congestion, entrapment or perforation of the tympanic membrane, fluid in the middle ear and tympanosclerosis. The sound-sensitive part of the ear is the cochlea of the inner ear. If inner ear concussion, edema, or auditory neuroma occurs, it will stimulate the cochlea of the inner ear to produce tinnitus. This kind of tinnitus is mostly sensorineural tinnitus.
5. Neck disorders: When neck tumors or other neck diseases compress the carotid artery, it can cause tinnitus on the compressed side. Tinnitus is characterized by persistent, low-pitched tinnitus, and the degree of tinnitus may change with changes in body position.
6. Drug poisoning damages the inner ear god: high doses of quinine, chloroquine and other drugs can cause severe tinnitus. Drugs such as gentamicin, streptomycin and kanamycin can damage the auditory nerve and vestibular nerve, which can cause tinnitus. If the drugs are not stopped in time, it can develop into deafness and be difficult to recover.
IV. Causes of tinnitus
There are many causes of tinnitus, most of them are due to comprehensive factors, generally speaking, they are related to the following aspects:
1. External ear disorders: such as cerumen embolism, foreign bodies in the external ear canal.
2.Middle ear disorders: acute and chronic purulent otitis media, eustachian tube dysfunction, secretory otitis media, etc.
3. inner ear disorders: labyrinthitis, Ménière’s disease, various ototoxic deafness, degenerative inner ear, senile deafness, noise damage, blast deafness, etc.
4. otosclerosis.
5.Post-vagal disorders: central disorders, auditory neuroma, meningitis, etc.
6. systemic disorders: cardiovascular disorders (hypertension, atherosclerosis, etc.), hematological disorders, systemic metabolic diseases such as diabetes, hyperlipoproteinemia, hypothyroidism or hyperthyroidism, renal failure, etc. In addition, plant nerve disorders and neurasthenia may lead to tinnitus.
Deafness refers to a variety of pathogenic factors that cause hearing loss in one or both ears to varying degrees, and in severe cases, can lead to total deafness. Clinically, deafness is divided into three categories: transonic deafness, sensorineural deafness and mixed deafness.
Tinnitus and deafness can exist separately or together. Generally speaking, long-term tinnitus can lead to deafness, which is called “tinnitus is the beginning of deafness, and deafness is the gradual of tinnitus”.
V. Understanding of tinnitus and deafness in Chinese medicine
When it comes to tinnitus and deafness, many people think that they are caused by kidney deficiency, but this is not entirely true. Chinese medicine has rich experience in understanding and treating tinnitus and deafness, and its basic features are three.
In Chinese medicine, “the ear is the gathering of the clan and veins”, so deafness and tinnitus are closely related to the functional status of the whole body organs and meridians, and are not limited to the kidney.
According to Chinese medicine, the causes of deafness and tinnitus include deficiency, wind, fire, phlegm and stasis, and are often clinically classified as external evil attack, liver fire disturbance, body deficiency and kidney deficiency, phlegm blocking the ears and stasis blocking the zonewalks.
In addition to taking Chinese medicine internally according to the different types of symptoms, it is often combined with local external treatment such as acupuncture and massage. Because tinnitus and deafness are often caused by multiple factors, treatment is also often taken in a comprehensive way.
VI. Treatment of tinnitus and deafness
1. Eliminate the cause of the disease and treat it according to the different causes. Patients with tinnitus should distract their attention and reduce the attention to tinnitus as much as possible, or cover up the sound of tinnitus by listening to music to reduce the disturbance of tinnitus, and pay attention to eliminate the psychological pressure.
2.Hyperbaric oxygen therapy can improve the microcirculation of the cochlea and improve the oxygen supply.
3.Western medicine treatment mostly uses vasodilator drugs, hormone drugs, nutritional nerve drugs, vitamin drugs and other comprehensive treatment. If tinnitus causes excessive mental irritability and anxiety that affects sleep, antidepressants and anticonvulsants can be used together. For the treatment of drug-related deafness, detoxification therapy (sedation of calcium gluconate) and desensitization therapy should also be carried out as early as possible.
4.Chinese medicine is treated on the basis of identification and combined with modern medical examination methods.
5.Acoustic frequency resonance therapy
Preventive care for patients with deafness and tinnitus
1. Actively prevent and treat purulent otitis media and secretory otitis media, and properly deal with nasal and sinus diseases, adenoidal hypertrophy and tonsillitis. Pay attention to exercise, strengthen physical fitness and prevent colds; quit the bad habit of ear digging; keep sufficient sleep and avoid overwork and emotional fluctuations; pay attention to prevent water from entering the ear.
2. Strictly control the use of ototoxic drugs such as streptomycin, gentamicin, kanamycin, Nitazoxin, Sinequan, chloramphenicol, etc., and reduce the dosage and duration of medication as much as possible.
3. Avoid noise stimulation as much as possible and reduce the time of exposure to noise. Try to use headphones to listen to MP3, reduce the time and frequency of cell phone reception.
4, for patients with hypertension, hyperlipidemia, atherosclerosis, should control blood pressure, use drugs to reduce blood viscosity and dilate blood vessels.
5.For elderly people who have liver and kidney yin deficiency, they can insist on taking Liu Wei Di Huang Wan or Deafness Left Magnetic Pill, etc.; for those who have kidney yang deficiency, they can insist on taking Jin Kui Ren Qi Wan. Those who have a family history of early deafness, after the age of 40, it is advisable to take Liu Wei Di Huang Wan every night to prevent premature hearing loss.
6, usually can often eat walnuts, black sesame, black fungus, black beans and other foods, more zinc-rich food, such as fish, beef, pork liver, chicken, eggs, a variety of seafood; apples, walnuts, tomatoes, etc.
7, guide massage method: ear screen listening to the palace points press the middle fingers of both hands press the ear screen of both ears, clockwise and counterclockwise massage 100 times each, press a loose 100 times a day; point kneading cataract point – hands on the head, thumb pressed in the recess behind the earlobe cataract point, clockwise and counterclockwise direction, 100 times a day. “The two hands are placed symmetrically across the occipital area on both sides, so that the index finger slides down from the middle finger and strikes the occipital bone heavily, 24 times on each side, and 24 times on both hands at the same time.