I. Overview
Deafness is a condition in which hearing is diminished and significantly lower than normal. It is mostly caused by congenital or acquired lesions of the cochlea, auditory nerve and auditory center that prevent the sound waves transmitted to the inner ear from being felt. When deafness is caused by deafness, it is called deafness. This section focuses on sensorineural deafness due to drug intoxication. There is no specific treatment for sensorineural deafness in modern Western medicine.
Modern treatment of deafness with acupuncture has been published as early as 1927. In the 1950s and the late 1960s and early 1970s, there were two climaxes of acupuncture treatment for deafness and deafness. Although there are different views on this, the series of work done, and the cases accumulated, have undoubtedly been undeniably helpful in gaining a deeper understanding of the clinical patterns of acupuncture in the treatment of this disease.
In recent years, the work on acupuncture in the treatment of sensorineural deafness, especially drug-intoxicated deafness, continues to be carried out, and appears to be more objective and meticulous in clinical observation, with most cases being repeatedly tested before and after treatment, and with the change in hearing curve as one of the objective grounds. In terms of acupoint stimulation methods, in addition to the original electroacupuncture, drum capsule acupuncture, buried thread, acupoint injection and other kinds of therapies, emphasis has been placed on acupuncture points and techniques, resulting in some improvement in efficiency.
Overseas, mainly in Japan and France, since the 1970s, they have also started to focus on the research of acupuncture for deafness, and generally believe that acupuncture is effective for some deafness patients. The acupuncture points are roughly similar to those in China, and the method is based on acupuncture.
The efficiency of acupuncture in treating sensorineural deafness was about 24-65% in the 1970s, and currently, it is about 80%.
It has been found that acupuncture may improve the nutrition of the auditory endings through the enhancement of the vascular permeability of the inner ear, so that some functions can be restored to the incompletely damaged part; at the same time, acupuncture can increase the amplitude of the cochlear potential in some patients, which reflects the improvement of the cochlear function. Acupuncture can also enhance cortical excitability. However, in general, the understanding of the objective rules of this subject is still very unclear.
II. Treatment
Body acupuncture (one)
(a) acupuncture points
Main acupoints: Ear Gate, Hearing Palace, Hearing Society, Cataract, Conjugate Pulse.
Supporting points: Baihui, Hegu, Zhongzhu, Waiguan, Foot Linobu; for mute, add Mute Gate and Lianquan.
(B) Treatment
The main acupuncture point is the main point, with additional supporting points as appropriate. Ear Gate, with the tip of the needle directed obliquely toward the lower part of the ear canal, 3.0-4.0 cm into the needle. Hearing Palace, with the tip of the needle angled backward and downward, slowly enter the needle at the same depth as above. Hearing Society point, with the needle tip angled slightly backward, at the same depth as above. For the cataract, the tip of the needle is directed slightly upward; for the blending point, the tip of the needle is directed obliquely downward toward the front, with the same depth for both points. Both points should be treated with a distinct soreness and swelling in the local area and ear canal. Baihui, with the needle tip pointing slightly backward, 0.3 to 0.5 cm. Hegu, with the needle tip pointing toward the index finger, 2.0 to 2.5 cm into the needle. Zhongzhu, stabbed vertically 1.5 to 2.0 cm.
Waiguan, pierce vertically to the same depth. Lin Weu, with the needle tip pointing slightly obliquely toward the ankle, is pierced 2.0 to 2.5 cm. Mute Gate, stabbed vertically into 3.0 to 4.0 cm. For Lianquan, the needle tip is directed backward and upward 3.0 to 4.0 cm. To the extent that the local soreness and swelling is heavy. Then all implement the infusion method, the requirements are as follows: into the needle when the rapid twisting into the needle tip into the skin that is to stop twisting, straight piercing to the appropriate depth, so that it produces a sense of getting gas. Then twist the needle several times with the flat complementary and flat diarrhea technique, retaining the needle for 30 minutes. During the needle retention period, can make a slight twisting needle. When the needle is not twisted, once a day, the acupuncture points are selected in rotation, every 10 times for a course of treatment. Stop acupuncture for 3-5 days.
(iii) Evaluation of therapeutic effect
The above method was used to treat sensorineural deafness. According to the clinical data that have been accumulated, the efficacy of this method for hysterical or psychogenic deafness, the efficacy of acupuncture is positive. For deafness, the efficacy of acupuncture is mainly manifested in subjective sensation, i.e., the patient feels an improvement in hearing after acupuncture, but the change in hearing curve after and before acupuncture is not obvious.
For example, for 30 patients with sensorineural deafness and mute disease, the statistics, with a hearing increase of 10 decibels as effective, the result of deafness efficiency of 36.7%, while deafness and mute disease is only 17.9%. The effective rate was 36.7% for deafness and only 17.9% for deafness. In addition, this method is less effective in treating conductive deafness, and most patients with deafness caused by otitis media have no effect (65-82% have no change in hearing).
Body acupuncture (bis)
(I) Acupuncture points
Main acupuncture point: complete bone.
Companion points: auditory gong, concoction, cataract, jiaosun, eumen, lidui, shangyang, guanchong, baihui.
(B) Treatment
The main acupuncture point is the complete bone point, with two to three additional supporting points as appropriate. For the completion bone point, take the point on the same side of the deaf ear. Ask the patient to sit upright with the head slightly tilted forward and use a 28-30 gauge needle, about 2-2.5 inches long. The patient should feel a sense of numbness, swelling, itching, and heat in the ear, or a sense of tingling and openness in the ear, and then use a quick twisting and small lifting method for 0.5 to 1 minute. inch, so that the ear is swollen, as if there is wind.
For Shang Yang, Guan Chong, and Li Tui, use a trigeminal needle to puncture and bleed; for Baihui, use a skin needle to make a moderate percussion for 5 minutes; for the remaining points, use the conventional acupuncture method and retain the needles for 30 minutes; the technique is flat tonic and flat diarrhea or tonic. If the patient is a pediatric patient, no needles are left in place. The treatment should be carried out once a day or every other day, 10 times as a course of treatment, stop acupuncture for 3 days, and then proceed to the next course of treatment.
During the treatment period, the following formula can be taken internally: Yinhua 30g, Lianjia 15g, Burdock 15g, Chrysanthemum 15g, Radix et Rhizoma 15g, Tribulus terrestris 15g, Radix Platycodon 15g, Licorice 15g, 1 decoction twice a day.
(C) Efficacy evaluation
Efficacy criteria: effective: hearing in one ear improved by more than 30 decibels; effective: hearing in one ear improved by 15-20 decibels; ineffective: not reached the effective standard.
This method was mainly used to treat antibiotic toxic deafness. A total of 229 cases were treated. Among them, 72 cases were evaluated according to the above criteria: 27 cases (37.5%) were effective, 35 cases (48.6%) were effective, and 10 cases (13.9) were ineffective, with a total effective rate of 86.1%.
Electroacupuncture
(A) Acupuncture points
Main acupuncture point: Hearing Palace, Ear Gate.
Supporting acupoints: cataract, auditory receptacle, wai guan, zhong zhu, he gu.
(B) Treatment method
The main acupuncture point is the main point, and the supporting acupuncture point can be added if the effect is not obvious. The main acupuncture point is taken one point at a time, and the depth of acupuncture: <9 years old, 1-1.2 inches; 10-15 years old, 1.3-1.5 inches; 16 years old and above, 1.6-2.2 inches. To get qi, depending on the cooperation, turn on the electroacupuncture instrument, continuous wave, frequency of about 100 times / min, the intensity of the patient can tolerate as degree. The electricity is turned on for 25 to 30 minutes.
Matching points can be used for rapid acupuncture method, into the needle to have soreness, numbness, swelling and other needle sensation, and to stop twisting the needle when radiating around. If there is no needle sensation when the needle is left, twist and mash the needle 1 to 2 times. Generally use medium strength manipulation, such as patients feel dull, can be appropriate to increase the manipulation. If the patient is young and uncooperative, the duration of needle retention can be shortened or no needle retention. Daily or every other day, 15 times for a course of treatment, stop needling 7 days, continue the next course of treatment.
(C) efficacy evaluation
This method is mainly used for antibiotic toxic deafness, and can also be used for other sensorineural deafness.
A total of 315 cases were treated, and the efficiency ranged from 73 to 94%. For further analysis of 215 cases, the total efficiency was only 21% in 100 cases treated for one course, 49% in 105 cases treated for one to two courses, and 73% in 115 cases treated for more than two courses. This indicates that the efficacy seems to increase with the increase of treatment course. It was also found that the efficacy decreased with increasing age.
Acupoint injection
(I) Acupuncture points
Main acupuncture points: auditory gong, auditory meeting, cataract, and concoction.
(B) Treatment method
Solution: 500,000 units of coenzyme A plus 0.1 mg (1 ml) of vitamin B12 injection.
Select 1 point at a time and rotate each point. Using a No. 5 dental needle, inject the above medicinal solution after getting gas from a direct stab into the needle. Every other day, 10 times for a course of treatment, the course of treatment interval of 1 week.
(iii) Evaluation of efficacy
This method is used for all kinds of sensorineural deafness.
Criteria for differentiation of efficacy: effective: hearing improvement of 11 decibels or more; effective: hearing improvement of 6-10 decibels; ineffective: no increase in hearing or less than the effective standard.
After two courses of treatment, 12 cases (25.0%) were effective, 10 cases (20.9%) were effective and 26 cases (54.1%) were ineffective, with a total effective rate of 45.9%. It was found to be more effective for senile deafness and salicylic acid toxic deafness.
Head acupuncture
(I) Acupuncture points
Main acupoints: acoustic memory area, speech formation area, dizzy hearing area.
Supporting points: temporal 3 needles, thoracic area, additional motor area, language area.
Acoustic memory area location: located in the posterior part of the superior temporal gyrus and middle temporal gyrus of the cerebral cortex and the inferior end of the superior marginal gyrus and angular gyrus. The projection on the scalp is inferior and posterior to the parietal tuberosity.
Location of the speech formation area: below the acoustic memory area and 3 cm long posterior to the mastoid process.
Location of the temporal 3 needles: the surface mark of the lateral fissure of the brain is used as the wing point (3.5 cm posterior and then 1.5 cm up from the lateral canthus) to the line of the parietal tuberosity. There are 3 zones. Zone 1: from about 1 cm anterior to the lower edge of the parietal tuberosity backwards, 3 cm long; Zone 2: 1.5 cm above the tip of the ear backwards, 3 cm long; Zone 3: 2 cm below the tip of the ear backwards, 3 cm long. The above 3 zones are all at an angle of 15-20 degrees to the horizontal line.
Location of the additional motor zone: a diamond-shaped area located 3 to 4 cm in front of the motor zone, on both sides of the upper point of the motor zone 4 cm forward.
(B) Treatment
The main point is the main point, with additional supporting points as appropriate. Take both sides, using a No. 28 1.5″ to 2.0″ long milli-needle, in which the acoustic memory zone is more extensive, cross into 2 needles in this zone, and into 1 needle in each of the remaining zones. After selecting the right point and quickly stabbed into the subcutaneous, the depth is best to under the capillary tendon membrane, no twisting, no strong stimulation, the needle body gradually parallel to the skin, sent to the required length. Retain the needle for 1.5 to 2 hours. Needle 1 time every other day, 10 times for a course of treatment. The course of treatment interval 3 ~ 5 days.
(C) Evaluation of efficacy
A total of 63 cases were treated, 20 cases were treated with electroacoustometry before and after the treatment, and it was confirmed that the efficiency rate of voice frequency hearing recovery was 25.0-65.0%, and the efficiency rate of high frequency hearing recovery was 20.0-45.90%. 43 cases of young children were treated with scalp acupuncture before and after the comparison of brainstem evoked potentials, and the cumulative efficiency rate was 74.4%. Meanwhile, 63 patients showed significant improvement in their clinical symptoms.
This method is mainly used for antibiotic toxic deafness.
Laser irradiation of acupuncture points
(I) Acupuncture points
Main acupuncture point: Hearing Palace.
Supporting points: Mute Gate and Upper Lianquan.
(B) Treatment
All the above three acupoints are taken. Irradiation with a semiconductor gallium arsenide laser therapy instrument. Wavelength 8700 ~ 9040 Å, infrared light, output laser peak power of 300 mW or more, continuously adjustable, light pulse frequency of 250 ~ 1000 Hz, spot diameter 0.1 ~ 7 mm. Direct irradiation of the auditory point for 10 minutes and the matching points for 5 minutes each. Once a day, Sunday off, 90 times for a course of treatment.
(III) Evaluation of therapeutic effect
A total of 45 pediatric deafness patients with 86 ears were treated, including 25 cases who had used different ototoxic drugs, 1 case caused by traumatic brain injury, and 19 cases with unknown causes. As a result, 10 ears were cured (normal ABR, i.e., brainstem auditory evoked potential, hearing threshold within 30 DbHL), 28 ears were effective (ABR hearing threshold lowered by more than 20 DbHL), 19 ears were effective (ABR hearing threshold lowered by more than 10 DbHL), and 29 ears were ineffective, with an overall effective rate of 66.3%.
Auricular acupuncture plus acupoint injection
(I) Acupuncture points
Main acupoints: Shen Men, Sympathetic, Kidney, Liver, External Ear, Heart, Brain, Subcortical, Frontal Occipital.
Supporting points: cataract, Fengchi (both body points)
(B) Treatment
The main acupuncture points are taken 6 to 7 points at a time, with additional body points as appropriate. All with acupuncture. The auricular points are routinely sterilized and then needled vertically, without penetrating the cartilage, with strong stimulation and twisting techniques after needling. 2 cases per day, 2 to 4 hours of needle retention, 2 to 3 times of twisting in between. The acupuncture points are treated with acupuncture injection, 1 ml of vitamin B1 injection, and 0.5 ml of each of cataract and fengchi points are injected into the acupuncture points quickly.