I. Deafness
For a disease. Deafness refers to varying degrees of hearing loss, or even loss of hearing. A person who has reduced hearing and does not hear true is called hard of hearing; a person who does not hear external sounds at all is totally deaf. It is one of the most common types of ear disease and, like tinnitus, can also occur as a complication of many diseases, as well as on its own. Deafness often develops from tinnitus. In Chinese medical literature, depending on the etiology, there are also “labor deafness”, “wind deafness”, “deficiency deafness”, “violent deafness” and “stroke deafness”. In Chinese medical literature, there are various names such as “labor deafness”, “wind deafness”, “deficiency deafness”, “violent deafness”, “stroke deafness”, “long term deafness”, etc.
II. Western medical mechanism
The human ear hears sound by two routes to the inner ear, namely air conduction and bone conduction.
The outer ear, middle ear, inner ear, auditory nerve and auditory center, all of which are structurally and functionally normal, are indispensable for conducting sound waves and producing hearing. Hearing impairment occurs when people have lesions in the conduction part of the auditory system, the perceptive part, or both parts. Depending on the location and nature of the deafness, it can be divided into three categories: conductive deafness (lesions in the ear canal and middle ear), sensorineural deafness (lesions in the inner ear, auditory nerve and auditory center), and mixed deafness.
The hearing loss is caused by damage to the hair cells of the spiral apparatus, the auditory nerve, the auditory conduction pathway, or neurons at all levels, resulting in impaired sound perception and transmission of nerve impulses. When the two are not distinguished clinically by conventional audiometry, they can be confused as sensorineural deafness. There are two types of deafness
1. Congenital deafness
(1) Hereditary deafness.
(2) Non-hereditary deafness: Viral infectious diseases such as rubella, mumps, influenza, syphilis, diabetes, nephritis, septicemia, cretinism, and other systemic diseases of the mother in early gestation, or extensive application of ototoxic drugs can cause fetal deafness.
2.Age-related deafness is a manifestation of the decline of the auditory organs during the aging process of human body.
3. Infectious deafness refers to sensorineural deafness produced by or complicated by various acute and chronic infectious diseases.
4.Deafness caused by systemic diseases: hypertension and arteriosclerosis are the most common ones.
5. Ototoxic deafness refers to deafness caused by the abuse of certain drugs or long-term exposure to certain chemicals.
6.Traumatic deafness: such as closed cranial trauma, which leads to concussion of the vagus, inner ear hemorrhage, and damage to sensory cells and ganglion cells.
7. Idiopathic sudden deafness refers to severe sensorineural deafness that occurs suddenly and instantaneously, and the patient can mostly provide the exact time, place and circumstances of the onset. It is currently thought to be associated with impaired blood supply to the inner ear or viral infection.
8. Other diseases, such as Meniere’s disease, cochlear otosclerosis, cerebellopontocerebellar occupational disease, multiple sclerosis, etc. are more common.
Etiology and pathogenesis
Emotion and will: qi depression into fire, liver fire up disturbance, obscure the clear orifices
Diet: gathering dampness into phlegm, phlegm depression into fire, phlegm and fire fatigue, damage to the spleen and stomach, lack of qi and blood, inability to support the upper orifice, loss of nourishment of the ear, loss of kidney essence after the disease, and empty medulla oblongata.
1. There are many causes of the disease, which can be caused by external and internal injury, diet, indulgence, and fatigue.
2, the pathological nature of the deficiency, the real. Deficiency is caused by deficiency of essence, qi and blood, which cannot be carried upward and causes the ear to lose its nourishment.
In terms of meridians and channels, the 12 meridians and 365 channels all go up to the face and go to the orifices, but they are mainly governed by Shaoyang. The internal organs are mainly involved in the liver, spleen and kidney.
Identification and typing
Key points of differentiation: The key points of differentiation of tinnitus and deafness are, first of all, to distinguish between deficiency and reality. In the case of deficiency, it is mostly due to deficiency of kidney energy and weakness of the spleen and stomach; in the case of solidity, it is mostly due to liver fire or phlegm fire stagnation.
V. Specific types of acupuncture treatment
Heavy hearing and hearing nothing: Ear Gate, Fengchi, Manxi, Cataract, Hearing Society, Hearing Palace.
1. Disturbance of liver fire
Main symptoms: sudden tinnitus and deafness, tinnitus like the sound of tide, or like the sound of wind and thunder, deafness sometimes light and sometimes heavy, every time after depression and anger, tinnitus and deafness suddenly aggravated, with ear swelling and ear pain, or headache and dizziness, red eyes and bitter mouth, irritable heart, constipation, red tongue, yellow moss, pulse bow and xuan number.
Treatment: Clearing the liver and draining heat to open the orifice.
Acupuncture points: Hearing Palace, Ear Gate, Cataract, Zhongzhu, Hearing Hui, Tai Chong, Xingma.
Summary: Hearing Palace is a localized acupuncture point to unblock the meridians and blood in the ear; Ear Gate, Cataract and Zhongzhu belong to Sanjiao meridian, and Hearing Society belongs to Shaoyang Bile meridian, which are all connected to the ear. Take Taichong and Xingma to clear the liver and remove heat.
Selection of acupuncture points to follow the symptoms: add Waiguan and Fengchi for both wind and heat evils.
Key points of operation: Hearing Palace, Ear Gate, Hearing Society acupuncture should be deep, stabbing when the patient open mouth, can be stabbed into about 1.5 inches, twisting method, so that the ear after the needle feeling that the needle out. Use the diarrhea method for the rest of the points.
2.Phlegm and fire stagnation
Symptoms: constant ringing in both ears like cicadas, sometimes occlusion like deafness; stuffiness in the chest and epigastrium, phlegm, dysuria, greasy tongue and slippery pulse.
Treatment: Clearing phlegm and turbidity.
Points to be taken: Hearing Palace, Ear Gate, Cataract, Fenglong, Neiting and Waiguan.
Summary of the formula: This formula takes Hearing Palace, Ear Gate and Cataract to open the congestion of the ear orifice; takes Fenglong and Neiting to clear heat and resolve phlegm, harmonize the stomach and subdue turbidity; takes Waiguan to unblock Shaoyang meridian qi and restore dizziness in the ear.
Selecting acupuncture points according to the symptoms: add Foot San Li for poor appetite.
Operation points: when taking the hearing gong and ear gate, make the patient open his mouth and acupuncture as before. Use the diarrhea method for the remaining points.
3. Kidney essence deficiency
Main symptoms: Tinnitus and deafness that persist for a long time, more so at night. Dizziness, dizziness, lumbar and back pain, spermatorrhea and slippage. The tongue is red or pale and the pulse is thin and weak.
Treatment: Tonifying the kidney and filling the essence.
Acupuncture points: Kidney Yu, Liver Yu, Guan Yuan, Sanyinjiao, Shengong, Shenghui.
Summary: This formula takes Kidney Yu, Liver Yu, Liver and Kidney together, and adds Guan Yuan to enrich the lower yuan and fill the kidneys; Sanyinjiao tonifies the deficiency of the three yin; Hearing Palace is the meeting of Shaoyang and Sun of the hands and feet, and Hearing Hui belongs to the bile meridian of Shaoyang of the feet.
Selecting points according to the symptoms: seminal emission plus Jing Gong and Tai Xi; impotence plus Zhen Men.
Operation points: when taking the hearing gong and hearing Hui points, make the patient open his mouth and acupuncture as before. The remaining points are applied with tonic method and can be combined with moxibustion.
4. Weakness of the spleen and stomach
Symptoms: tinnitus is light at first and heavy at second, and becomes deaf when strained, dizziness and fatigue, weakness of the limbs, poor appetite and loose stools. Thin white tongue coating and thin pulse.
Treatment: Strengthening the spleen, benefiting Qi and raising Yang.
Points to be taken: Out of the corner of the eye, Qi Hai, Foot San Li, Bai Hui, Hearing Palace.
Summary: This formula takes Spleen Yu and Foot San Li to tonify the spleen and stomach and replenish the middle qi; takes Qi Hai to cultivate and replenish the vital energy; takes Bai Hui to raise the qi of the clear yang; takes Sheng Gong as a localized point to unblock the qi and blood of the meridians in the ear and to open the ear orifices.
Selecting acupuncture points according to the symptoms: Tianshu for loose stools and Zhonggui for loss of appetite.
Key points of operation: apply tonic method, and can be combined with moxibustion method.
Other therapies
1.Auricular acupuncture
Acupuncture points: subcortical, endocrine, liver, kidney, taking ipsilateral or bilateral points.
Method: use strong stimulation, or electroacupuncture, stay for 0.5-1h, once a day or every other day, 15-20 times for a course of treatment.
2, head acupuncture points.
Take points: bilateral halo hearing area.
Method: Using the rapid stabbing method, along the scalp into a certain depth, twisting method, continuous 5-10min, and then retain the needle for 30min. 2-3 days needle treatment 1 time.
3.Water acupuncture
Acupuncture points: hearing Gong, cataract, Fengchi points.
Drug selection: vitamin B1, vitamin B12, salvia injection.
Method: 0.2-0.4ml per acupuncture point, according to the routine acupuncture point injection by water injection. Daily or every other day 1 time.
4.Moxibustion method
Acupuncture points: hear the palace, cataract, hear the meeting.
Method: Warm the burning moxa stick at 1 inch from the acupuncture point for l0-15 min each time. 1 time daily or every other day.
5.Magnetic therapy
Commonly used points: Ear Gate, Hearing Palace, Hearing Society, Cataract, Mute Gate.
Alternate points: Neiguan, Waiguan, Lianquan.
Methods: compress method; magneto-acupuncture method
6.Acupressure
Acupressure: Hegu (diarrhea), Cataract, Hearing Palace, Hearing Society, Ear Gate, Fengchi (both diarrhea), Bile Yu (diarrhea), Kidney Yu, and Foot Sanli (tonic) to treat tinnitus.
VI. Mechanistic research
Regarding the mechanism of acupuncture for treating deafness and tinnitus, some people consider that acupuncture may increase the excitability of the cortical centers, thus improving the ability to perceive sound, and believe that the mechanism of action of acupuncture for deafness may be.
1. acupuncture may reduce the degenerative necrosis of spiral organ hair cells and induce the undamaged cochlear spiral organ hair cells to play a compensatory role, thus improving auditory function.
2. acupuncture may enhance blood circulation to the cochlea and improve metabolic status.
3. Acupuncture may increase the excitability of the cortical auditory center, thus enhancing the auditory perception.
At present, acupuncture is used to treat deafness and tinnitus, and the local acupuncture points are mainly the empirical points around the ear and head and face, such as the ear gate, the hearing palace, the hearing session, the cataract, the corner sun, the dizzy hearing area, and the four sacred cong, etc. The body acupuncture points are generally limited to the hand and foot Shaoyang meridian and the liver and kidney meridians, and their efficacy has been confirmed by most people. In order to better improve the therapeutic effect, acupuncture points should be selected and matched from acupuncture and moxibustion meridian theory, such as the five transfusion points, the eight meridian meeting points, the original meridian matching, and the yu-xue matching.
VII. Regulation, prognosis and summary
It is necessary to take care of tinnitus and deafness from the aspects of diet, mood, and living.
1. In patients with tinnitus and deafness caused by liver qi stagnation, it is especially important to pay attention to mental conditioning to make them feel comfortable.
2. For people with phlegm and fire stagnation, attention should be paid to reducing fatty and sweet diets.
3. For those with tinnitus and deafness due to kidney deficiency, special attention should be paid to rest and reduce room strain, and reduce warm and dry food.
4. Patients with spleen deficiency should pay attention to dietary regimen and can cooperate with self-massage therapy in the treatment. The method is to press the mouth of the external auditory canal with the palms of both hands and repeatedly strike the occipital mastoid with the four fingers, then open and close the external auditory canal with the palms of the hands in a regular manner, once a day in the morning and once in the evening, for 3-5 min each time.
5.For tinnitus and deafness caused by systemic diseases, the original disease should be actively treated.
6.For those who have organic lesions in the ear canal and need surgical treatment, it should be carried out in time.
7.The usual prohibition of ear digging, keeping the ear canal clean, avoiding strain and abstaining from sexual intercourse have positive significance for treatment and prevention.
The prognosis of tinnitus and deafness varies depending on the severity of the disease. For those who are deaf, the prognosis is better if the evidence is properly examined and treated.
Acupuncture treatment: 1.
1. Treatment and main formula: The ear is the upper yang, so the principle of unblocking the Shaoyang meridian qi is taken as the main principle, and the hand and foot Shaoyang meridian points are taken as the main points.
2. Basic formula: Nearby, take cataracts and hearing sessions; far away, take Zhongzhu and Manxi.
3.According to the evidence with acupuncture points
(1) Fire in the liver and gallbladder: with Tai Chong and the above points together to clear the liver and drain the fire.
(2) Phlegm and fire: with Fenglong and Sanyinjiao in combination with the main formula to expel phlegm and open the orifices.
(3) Kidney essence deficiency: with Kidney Yu, Tai Xi and the upper points to tonify the kidney and nourish Yin and submerge Yang.
(4) Spleen and Stomach deficiency: combining Spleen Yu, Foot San Li and the upper point to strengthen the spleen and benefit Qi, so that Qi and Blood can be transferred to the ear.
4. Method of operation: actual evidence with diarrhea, deficiency evidence with flat tonic and flat diarrhea. Moxibustion is also used. The cataract and the hearing acupuncture should pay attention to the angle and depth of the needle, and avoid violent and substantial lifting and thrusting.