針藥結合治療突發性耳聾一例

突發性耳聾為耳鼻喉科常見疾病。為急性（72小時內）不明原因之聽力喪失，聽力減退通常為單側，常伴耳鳴、眩暈等症。其致病機轉至今未明，多歸因於病毒感染、內耳循環不良或自體免疫疾病等。突發性耳聾黃金治療期為1至2週內，西醫第一線治療多以口服類固醇抑制內耳發炎，配合給予血漿擴張劑及血管擴張劑來增加內耳血液循環；若對口服類固醇無效或糖尿病患者，可予以內耳注射類固醇為主，輔以高壓氧治療。本例為一64歲男性患者，於感冒當日發現聽力驟降，西醫診斷為突發性耳聾（左耳感音性耳聾），患者雖曾至西醫診所及澄清醫院耳鼻喉科就診，然療效不彰。後至中榮傳統醫學科門診就診，經辨證屬肝腎虧虛（陰、血），肝失疏泄（氣火上逆），治則採滋補肝腎（陰、血），調暢肝氣。經針灸與科中治療後，患者自覺聽力改善。可見中醫在突發性耳聾治療上，亦扮演重要角色。

關鍵字

突發性耳聾；病毒感染；內耳注射；高壓氧；針灸；科學中藥

並列摘要

Sudden sensorineural hearing loss (SSNHL),a common disease in the department of otorhinolaryngology, is characterized by an acute sensorineural hearing loss, nearly always unilateral, that occurs within a 72-hour period, usually accompanied with tinnitus and vertigo. Most cases are idiopathic, others are often caused by viral infection, poor blood circulation or auto-immune disorders. The golden period for SSNHL treatment is one to two weeks. Glucocorticoids combined with plasma expander(Dextran) and vasodilator are considered first-line therapy for SSNHL to inhibit inflammation. Intratympanic glucocorticoids injection combined with Hyperbaric oxygen therapy (HBOT) are suggested if glucocorticoids is ineffective or for patients with diabetes. This patient is a 64-year-old male who got sudden hearing loss after he caught a cold, and was diagnosed as sudden deafness(sensorineural hearing loss, left ear). He had visited local clinic and Cheng Ching Hospital for medical treatment. However, his symptoms didn't relieve. As a result, he visited the Department of Traditional Chinese Medicine of Taichung Veterans General Hospital for help. Syndrome differentiation showed deficiency of liver and kidney(yin, blood) with dysfuntion of liver controlling dispersion(liver qi and fire flaring up).Based on it, we adopted nourishing liver and kidney(yin, blood) combined with smoothing the liver qi as a principle of treatment. After treatment with acupuncture and chinese medicine powder, his condition improved. This experience showed that Acupuncture and Chinese Medicine plays an important role in sudden hearing loss treatment.

並列關鍵字

Sudden sensorineural hearing loss (SSNHL) ； Viral infection ； Intratympanic glucocorticoids injection ； Hyperbaric oxygen therapy (HBOT) ； Acupuncture ； Chinese medicine powder