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針灸結合類固醇治療突發性耳聾病例報告

A Case Report: Acupuncture Combined with Oral Corticosteroid for Sudden Sensorineural Hearing Loss

摘要


突發性耳聾是一項耳鼻喉科的急症,患者會出現突然聽力下降,大多為單側發生,常伴隨耳悶、耳塞、耳鳴、眩暈等症狀。目前西醫第一線治療用藥為類固醇且在發生後兩週內接受治療則預後較良好。由於目前突發性耳聾的真正病因尚未明確,也增加治療方式及療效的不確定性,因此有許多病患會尋求中醫協助。本案例為一位30歲女性,於壓力事件發生後出現突發性耳聾,中醫辨證為肝鬱氣滯,氣鬱化火,上擾耳竅,以針灸配合類固醇治療,循經選取三焦經、小腸經、膽經的穴位,亦針對病機辨證取穴,經治療於兩周後完全恢復。此有效案例希望可以提供同道作為突發性耳聾的治療參考。

關鍵字

突發性耳聾 針灸 中醫

並列摘要


Sudden sensorineural hearing loss (SSNHL) is considered an alarming symptom that often prompts an urgent visit to an otolaryngology specialist. It occurs abruptly, developing loss of hearing, and is usually unilateral. Most patients present with a sensation of a blocked or full ear. And it is often accompanied by tinnitus or vertigo. Oral corticosteroid has been considered first-line therapy for SSNHL. The prognosis is better in patients with treatment started within 2 weeks after onset. The etiology of SSNHL is uncertain, and the management strategies are vary and uncertain. As a result, patients may seek complementary and alternative medicines such as traditional Chinese medicine (TCM). This patient was a 30 years old female presented with unilateral sudden hearing loss after a stressful event. The pattern was binding depression of liver qi, transforming into fire, harassing the ear. She had been treated by acupuncture combined with oral corticosteroid. The acupuncture points were located on the Sanjiao Meridian, Small Intestine Meridian, and Gallbladder Meridian. We also chose other acupuncture points due to TCM etiology and pathogenesis theory. After two weeks of acupuncture combined with oral corticosteroid treatment, the hearing loss of the patient fully recovered. Therefore, this case report is provided as a clinical reference for treatment of SSNHL.

參考文獻


Peter C Weber, MD, FACS. (2019). Sudden sensorineural hearing loss. In Lisa Kunins, MD (Ed.), UpToDate. Retrieved Feb 15, 2019., from https://www.uptodate.com/contents/sudden-sensorineural-hearing-loss.
Bethesda, MD. National Institute of Health. Sudden Deafness. National Institutes of Health; 2000. NIH publication 00-4757.
Robert J. Stachler, Sujana S. Chandrasekhar, Sanford M. Archer, Richard M. Rosenfeld, Seth R. Schwartz, David M. Barrs, Steven R. Brown, Terry D. Fife, Peg Ford, Theodore G. Ganiats, Deena B. Hollingsworth, Christopher A. Lewandowski, Joseph J. Montano, James E. Saunders, Debara L. Tucci, Michael Valente, Barbara E. Warren, PsyD, Kathleen L. Yaremchuk, Peter J. Robertson. Clinical practice guideline: sudden hearing loss, Otolaryngology-Head and Neck Surgery 2012; 146 (1S): S1-35.
元.滑壽:難經本義,藝文印書館,台北 1965;卷下;10。
撰人不詳:黃帝內經素問靈樞經,藝文印書館,台北 1968;卷四;9。

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