1, wind-heat invasion
Syndromes: At first, there are many common cold symptoms, such as acute onset, stuffy ears and swollen ears, tinnitus, decreased hearing, increased spontaneous sound, accompanied by headache, aversion to cold, fever, dry mouth and other systemic symptoms, floating pulse, thin fur and wind-heat invasion.
Analysis of syndrome differentiation: ① Syndrome differentiation: tinnitus and deafness appear in exogenous fever, and pulse floating number is the key point of syndrome differentiation. Pathogenesis: exogenous wind-heat imbalance, qi-filled ears, tinnitus and deafness. Fever, aversion to cold, rapid pulse and jaundice are exogenous symptoms.
2, liver fire is disturbed
Symptoms: Sudden tinnitus, such as hearing tidal sounds or wind and thunder, wind deafness is mild or severe, and it suddenly gets worse after depression and anger, with ear swelling, earache, dizziness, bitter mouth, dry throat, headache, red face, restlessness, insomnia at night, chest pain, constipation, short and red urine, yellow tongue coating and rapid pulse.
Analysis of syndrome differentiation: ① Syndrome differentiation: Sudden tinnitus and deafness, headache, red face, irritability, red tongue with yellow coating and strong pulse are the key points of syndrome differentiation. ② Pathogenesis: Because the foot shaoyang meridian enters the ear and collaterals in the liver belong to the gallbladder meridian, it leads to emotional depression, loss of liver-qi to relieve qi, stagnation of fire, or liver-qi injury to the liver, disturbance of liver-gallbladder fire, ignorance, tinnitus and deafness. The fire is burning, so the headache is red; Angry liver and gallbladder, disturbing the mind, so upset and irritable, sleepless at night; Stagnation of liver qi, obstruction of collaterals, fullness in chest and hypochondrium; Stagnation of liver fire and burning of body fluid in the intestine cause constipation. A red tongue with yellow fur and a rapid pulse is a symptom of liver depression turning into fire.
3. Stagnation of phlegm-heat
Symptoms: Cicada chirps in both ears, sometimes occlusion, such as deafness, chest tightness and excessive phlegm, tinnitus and dizziness, sometimes light and sometimes heavy, boredom, constipation, red tongue, yellow greasy fur and slippery pulse.
Dialectical analysis: ① Differentiation of symptoms and signs: cicada chirping in both ears is light and heavy, sometimes blocking breath, excessive phlegm, chest tightness, yellow and greasy fur and slippery pulse are the key points of syndrome differentiation. (2) Pathogenesis, phlegm-heat stagnation, blindness, and poor airway, so tinnitus is like a tide, and even qi-blocking deafness; Phlegm and turbidity are abundant, and qi activity is unfavorable, so chest tightness is full; Obstruction of phlegm-fire affects health, tastes bitter, and is not smooth; Yellow and greasy fur and slippery pulse are all symptoms of phlegm-fire.
4, kidney essence loss
Syndrome: After middle age, the hearing of both ears gradually declines, accompanied by low-pitched tinnitus, severe night, insomnia and dizziness; My waist and knees are sore, frequent nocturnal emission, heavy thirst, red tongue with little fur, and thin or thin pulse.
Analysis of syndrome differentiation: ① Syndrome differentiation: tinnitus and deafness after middle age, especially at night, with soreness of waist and knees, nocturnal emission, red tongue and thready pulse as the key points of syndrome differentiation. ② Pathogenesis: According to Confucian classics, when a person is forty years old, Yin Qi is half, and half is decline. Insufficient essence and blood, inability to clear the orifices, and excessive pathogenic fire lead to tinnitus and deafness; The waist is the house of the kidney, the kidney deficiency and bone marrow are not filled in the bone, and the waist and knees are sore; Kidney deficiency is disturbed by fire and interferes with seminal vesicle, so insomnia and wet dream excretion are more troublesome; Red tongue with little coating is a sign of kidney essence deficiency; The essence and blood are insufficient, so the pulse is weak; If you see essence and number at the same time, it is yin deficiency and fire flourishing.
5, spleen and stomach weakness
Syndrome: tinnitus and deafness, temporary reduction of rest, even worse fatigue, aggravated immediately after squatting. Burnout and fatigue, loss of appetite, abdominal distension after eating, thin stool, sallow complexion, weak pulse and thin white greasy fur.
Dialectical analysis: ① Syndrome differentiation: tinnitus and deafness, light and heavy, drowsiness of limbs, lethargy, eating less, loose stool, thin pulse and thin fur are the key points of syndrome differentiation; ② Pathogenesis: the spleen and stomach are weak, so the clear qi cannot rise, and the ear channels are empty, so tinnitus and deafness occur; If the spleen is weak and late, and the stomach is weak and dull, then you will eat less loose stool; Deficiency of spleen-yang in limbs leads to weakness, thready pulse and greasy fur, all of which are manifestations of weakness of temper and elegance.
Causes of tinnitus
1, mainly ear diseases.
For example, diseases of the external ear, such as otitis externa, cerumen embolism and foreign bodies in the external ear, acute and chronic inflammation of the middle ear, tympanic membrane perforation, otosclerosis, Meniere's disease syndrome and acoustic neuroma in the inner ear, can all cause tinnitus.
2, vascular diseases can also cause tinnitus.
Such as glomus jugulare tumor, ear small blood vessel dilatation, vascular malformation and hemangioma. Tinnitus from vein is mostly noisy, and tinnitus from artery is consistent with pulse.
3, a variety of diseases can cause tinnitus.
Almost any cause that can cause ear diseases will cause tinnitus symptoms, but the relationship with hearing is complicated. Tinnitus may be caused by a small eyeball touching the eardrum, but it may also be caused by a tumor located in the auditory nerve. Others such as otosclerosis (a disease that occurs in the ossicles of the middle ear), ototoxic drug poisoning, noise, etc. , can cause different degrees of tinnitus. Tinnitus has many manifestations, some on one side and some on both sides. Some appear intermittently, and some continue; Light tinnitus when quiet, heavy noisy when downtown.
4, the causes of noise
People have such an experience that if they suddenly hear firecrackers, there will be a long echo in their ears, which will fade for a long time. This is that external noise temporarily damages people's auditory nerves. People who have been working in a noisy environment for a long time, such as tractors and car drivers, traffic police, armed police, soldiers, disco staff, mahjong artists, long-term participants in meetings and operators of various equipment, are all victims of noise. Long-term noise stimulation has caused nerve damage in the inner ear most of the time.
5. Others
Some systemic diseases can also cause tinnitus-such as autonomic nervous disorder, insufficient cerebral blood supply, pre-stroke, hypertension, hypotension, anemia, diabetes, malnutrition and so on. The incidence of tinnitus in people over 60 years old is as high as 30%. The main reason is that the auditory nervous system degenerates with age.
6, excessive fatigue, lack of sleep, emotional tension can also lead to tinnitus.
Causes of head trauma, muscle clonus, systemic diseases, such as anemia, hypertension, diabetic hypothyroidism, hypoglycemia, autoimmune diseases, vasospasm diseases, etc. , can be accompanied by tinnitus, tinnitus of unknown cause accounts for about 40% of the tinnitus population. Tinnitus is caused by membrane permeability disorder or changes of hair cells inside and outside the cochlea, or synaptic metabolism disorder of hair cells, or short circuit between auditory nerve fibers.
How to treat tinnitus?
1, tonifying kidney and replenishing essence
Traditional Chinese medicine believes that the kidney is closely related to the ear, and the kidney is the innate foundation, storing essence and producing marrow, and opening the brain to the ear. Deficiency of kidney essence leads to ear hole malnutrition, ranging from tinnitus to hearing loss and even deafness. In addition, there are premature graying of hair and beard, weakness of waist and knees, loss of libido, pale white tongue, heavy and thin pulse and so on. The therapeutic method of tonifying kidney and replenishing essence is to add and subtract Erlong Zuo Ci Pill, Qiju Dihuang Pill and Liuwei Dihuang Decoction: Radix Rehmanniae Preparata 30g, Rhizoma Polygonati 20g, Rhizoma Dioscoreae 20g, Cornu Cervi Pantotrichum 3g, Carapax et Plastrum Testudinis 12g, Heche 3g, Rhizoma Dioscoreae 12g, Fructus Lycii 15g, Achyranthis Radix 12g.
2. Clearing away heat and resolving phlegm
Traditional Chinese medicine advocates treating tinnitus and deafness from kidney and phlegm. Most of these patients have sudden tinnitus, obesity, dizziness, abdominal distension, cough, hypochondriac pain, excessive and sticky phlegm, yellow and greasy tongue, slippery pulse and so on. It is characterized by phlegm-heat stagnation, so clearing heat and resolving phlegm is the treatment principle. Wendan Decoction, Qingqi Huatan Pill and Hushi Huatan Pill are the main ingredients: Fructus Trichosanthis 12g, Almond 10g, Fructus Aurantii Immaturus 10g, Rhizoma Arisaematis Preparata 12g, Rhizoma Pinelliae Preparata 8g, Fructus Aurantii 8g, and Huo Ling 10g.
3. Promoting blood circulation and removing blood stasis
Traditional Chinese medicine believes that chronic tinnitus is caused by "long-term illness in blood", "long-term illness with excessive blood stasis", blood stasis blocking ear holes, poor circulation of qi and blood, and malnutrition in ear holes. The microcirculation of patients with blood stasis syndrome in traditional Chinese medicine changes obviously. This kind of patients are partly caused by vasospasm and blocked blood flow after the blood vessels in the ear are stimulated. Western medicines such as 654-2, Sibelium and Salvia Miltiorrhiza Injection are used to relieve spasm and restore blood flow. These patients have clinical manifestations of blood stasis, such as headache, orientation, dizziness, dark purple tongue, and thready and astringent pulse. Treatment: promoting blood circulation, removing blood stasis and dredging orifices. The prescription is Wang Qingren Tongqiao Huoxue Decoction: peach kernel 10g, safflower 6g, musk 0.3g, ginger 5 pieces, onion 2 pieces, red dates 5 pieces, Chuanxiong 6g, red peony root 10g.
4, drinking water method
Phlegm drink is the pathological product of abnormal metabolism of water and liquid, which stays in the local part of the body. Phlegm is divided into hot and cold, phlegm is invisible, and drinking is divided into quality. Drinking alcohol in the body can cause tinnitus and dizziness. Diuretic and detumescence drugs can relieve vestibular and labyrinthine edema of inner ear, relieve nerve compression and promote local lymphatic reflux. Key points of syndrome differentiation: cold limbs, pale complexion, thin phlegm, pale tongue, white greasy fur and slippery pulse. Treatment: Drain water, add and subtract Gui Ling Shugan Decoction and Wuling Powder from Treatise on Febrile Diseases: Huo Ling 15g, Guizhi 10g, Atractylodes macrocephala 12g, Alisma orientalis 6g, Leonurus japonicus 20g, Ji Fang 6g, Astragalus membranaceus 30g and Plantago asiatica 10g.
5. Clearing liver and reducing fire
Some patients with tinnitus are either caused by pyogenic bacteria infection or have a history of hypertension, and they are addicted to spicy food, depressed anger and liver fire, and inflammation along the meridian. TCM syndrome differentiation belongs to excess heat and liver fire. There is an official with a liver general, and he is vigorous and vigorous. If the liver fails to reach the level, it will be depressed, and it will turn into fire, which will disturb the resuscitation, and then tinnitus will occur, such as thunder, rumbling and rumbling, often accompanied by ear swelling and earache, pus discharge, fever, headache and dizziness, red face and red eyes, bitter mouth and dry throat, irritability, red tongue with yellow coating and strong pulse. It is advisable to calm the liver log, clear the liver and reduce fire. Prescriptions include Longdan Xiegan Decoction, Tianma Gouteng Decoction, Zhengan Xifeng Decoction, etc. 9g of Gentiana scabra, 0/2g of Gastrodia elata, 0/0g of Uncaria rhynchophylla, 0/2g of Achyranthes bidentata, 0/0g of Scutellaria baicalensis Georgi, 0/0g of Chrysanthemum morifolium, 0/2g of Paeonia lactiflora, and 0/2g of Paeonia lactiflora.
Step 6 dispel wind and clear heat
Most patients with new tinnitus are caused by virus infection, with acute onset and cold symptoms. TCM syndrome differentiation belongs to wind-heat syndrome. Exogenous wind-heat, adverse menstrual attack, tinnitus like cicada, sudden deafness or occlusion. The symptoms are relieved after pressing the tragus or pulling the auricle with your fingers. Often accompanied by fever, aversion to cold, headache, stuffy nose and runny nose, dry mouth and throat, general fatigue, red tongue, thin yellow fur and floating pulse. Yinqiao Powder is suitable for dispelling wind and clearing heat, and its prescription is revised as follows: honeysuckle 10g, forsythia suspensa 10g, bamboo leaves 6g, Schizonepeta tenuifolia 10g, buffalo horn 6g, chrysanthemum 10g, cicada slough 6g, kudzu vine root 10g, and scutellaria baicalensis Georgi/kloc.