Why do many patients with tinnitus go to the doctor for examination and find that there is no obvious abnormality in their ears, but they often have tinnitus?
In fact, this situation is probably caused by qi deficiency and blood stasis, which is also the cause of recurrent tinnitus in clinic.
Regarding tinnitus, there are many incisive expositions in many Chinese medical books. For example, it is recorded in the Book of Pure Moon: "The essence and qi are harmonious, and the kidney qi is sufficient, so the eyes and ears are smart; If you overwork, you will become deaf. After middle age, whenever an old friend has tinnitus, such as the sound of wind and rain, cicada singing and tidal sound, it is pointed out that the ear is closely related to other viscera.
Traditional Chinese medicine believes that the ear is one of the five senses and nine orifices, and the qi and blood of the twelve meridians and 365 collaterals can ascend in the head and converge in the ear. In other words, our ears also need the "support" of viscera and qi and blood to ensure normal function. If qi and blood are not running smoothly and qi stagnation and blood stasis are blocked, tinnitus and deafness may occur. For example, the deficiency of qi and blood, weak promotion, will also form the syndrome of qi deficiency and blood stasis, which will lead to tinnitus.
For example, ears are like machines, and Chinese medicine says blood is equivalent to lubricating oil. In fact, the normal operation of every gear of a machine is inseparable from lubricating oil, otherwise there will be problems in gear operation. Qi deficiency can't promote blood transport, while blood stasis is like a stumbling block in the middle of the road, both of which will lead to insufficient blood nourishment in ear holes. Naturally, the main function of the ear will decline over time.
As mentioned above, long-term tinnitus is formed on the basis of imbalance of qi and blood in zang-fu organs, among which qi deficiency and blood stasis are common causes. Therefore, in view of this kind of tinnitus, the treatment and improvement are mainly based on invigorating qi and promoting blood circulation, and Buyanghuanwu decoction can be used as the basic prescription for adjustment and treatment.
This prescription, written by Wang Qingren, a physician in the Qing Dynasty, is specially designed for treating the sequelae of apoplexy due to qi deficiency and blood stasis, and it is the representative prescription of invigorating qi and promoting blood circulation.
The whole prescription re-uses Astragalus membranaceus to replenish vitality, with the intention of activating blood circulation, removing blood stasis and dredging collaterals; Angelica tail promotes blood circulation without hurting blood; Peach kernel, safflower, red peony root and Ligusticum chuanxiong cooperate with angelica tail to promote blood circulation and remove blood stasis; Lumbricus is good at dredging meridians and activating collaterals, and is good at walking, and is active all over the body for exerting medicinal functions. Yiqi Huoxue recipe, Yiqi not stagnation, Huoxue not damage. When the drugs are used together, they can promote the circulation of qi, remove blood stasis and dredge collaterals, thus alleviating the situation of qi deficiency and blood stasis.
Le Qisheng's TCM team also pointed out that the key point of TCM treatment is to treat both the symptoms and the root causes. If different diseases have the same syndrome, that is, the root cause of the disease is the same, they can be treated with the same prescription. Although Buyanghuanwu Decoction was originally established for the sequelae of apoplexy due to qi deficiency and blood stasis, it can actually be used flexibly in the treatment of tinnitus, and often achieves better curative effect.
Such as dizziness and soreness of waist and knees, Radix Rehmanniae Preparata, Cornus officinalis, Rhizoma Dioscoreae, Alismatis Rhizoma, Cortex Moutan, Radix Aconiti Lateralis Preparata, etc. Can be added to this prescription; Endothelium Corneum Gigeriae Galli, charred Sanxian, Rhizoma Acori Graminei and Poria are added for patients with poor appetite or dyspepsia; Palpitation, insomnia, dreaminess plus Salvia Miltiorrhiza Radix, Ziziphi Spinosae Semen, Os Draconis, Concha Ostreae, Cortex et Radix Polygalae and Radix Angelicae Sinensis; For patients with anxiety or depression, Radix Bupleuri, Radix Curcumae, Cortex Albizziae and Herba Menthae are added; Ramulus Cinnamomi, Radix Aconiti Lateralis Preparata, Cortex Cinnamomi, and Fructus Alpinae Oxyphyllae are added for those who are afraid of cold and frequent urination; Dry stool, Fructus Aurantii Immaturus, Radix et Rhizoma Rhei, Semen Platycladi, Fructus Cannabis, etc.
Ms. Zhao, 49, said that she often has tinnitus without obvious reasons, which is paroxysmal, such as cicada singing, which is obvious at night. After that, it gradually gets worse, showing persistence, accompanied by fatigue and fatigue, and often prone to nervousness, sigh, abdominal distension after meals, poor sleep, nocturia and dry stool. The tongue picture is pale and dark, and the tongue coating is thin and white. Zhao Nvshi went to the local hospital for examination and found that there was no obvious abnormality in the external auditory canal and tympanic membrane.
According to Ms. Zhao's symptoms and tongue diagnosis, etc. TCM syndrome differentiation is qi deficiency and blood stasis. Because the patient's body is deficient in both spleen and kidney, kidney deficiency and essence deficiency, and spleen deficiency is lost. On the one hand, qi and blood lack biochemical sources, so he can't go to Rong Qingqiao; On the other hand, water does not follow the usual path, and when it is wet, it means phlegm, which disturbs ear holes and causes tinnitus. At the same time, tinnitus at night is obviously due to qi deficiency, weak promotion, poor blood circulation, blood stasis, plus long illness and much blood stasis; Tinnitus can not be cured for a long time, and emotional stagnation leads to liver-qi discomfort, such as tension, anxiety, excessive breathing, poor sleep, etc. Spleen deficiency plus excessive anxiety hurts the spleen and stomach, which leads to fatigue and bloating after eating.
Therefore, based on Zhao Nvshi's complicated condition, the treatment is mainly to invigorate qi and promote blood circulation, and at the same time, we should pay attention to the methods of removing blood stasis and dredging collaterals, soothing the liver and strengthening the spleen and tonifying the kidney. In the early stage, we should pay more attention to the method of dredging meridians and promoting blood circulation, and work slowly and do fine work. The prescription is based on Buyanghuanwu decoction;
Radix Astragali, Flos Carthami, Rhizoma Chuanxiong, Semen Persicae, Radix Angelicae Sinensis, Fructus Schisandrae Chinensis, Rhizoma Acori Graminei and Cortex Moutan. 7 doses, daily 1 dose, decocted in water. Patients are required to keep a light diet and adjust their mood.
At the second visit, Ms. Zhao reported that tinnitus was slightly relieved, her spirit improved, her sleep improved, her mood improved slightly, her abdominal distension did not decrease significantly, and her urine and stool were normal. The tongue picture shows that the tongue is black and white with moss. Remove peach kernel and safflower from above, and add Atractylodis Rhizoma, Glycyrrhrizae Radix, invigorating spleen and qi, Herba Menthae for soothing liver and regulating qi, parched Gardenia for purging fire and relieving vexation, Concha Ostreae, Fructus Jujubae and Herba Epimedii for strengthening body resistance and tonifying deficiency, and take 7 doses continuously.
The third diagnosis: the patient's spirit improved, tinnitus symptoms further improved, sleep and mood improved significantly, and abdominal distension after meals was also significantly reduced. The adjusted prescription continued to take 7 doses, and symptoms such as tinnitus basically disappeared after follow-up.
Traditional Chinese medicine says that viscera and orifices are a whole, and the dysfunction of viscera is also manifested in otolaryngology orifices. The local manifestations of these orifices can reflect the overall pathological changes and affect the whole. Clinically, patients with tinnitus are often accompanied by other symptoms, such as insomnia and abdominal distension. Therefore, in order to get rid of tinnitus, we should pay attention to the combination of the whole and the part, and on the basis of the whole syndrome differentiation and treatment, select the prescription and medicine according to the specific situation and make corresponding adjustments.
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