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中醫治療突發性耳聾之病例報告

A Case Report of Sudden Onset Hearing Loss Treated with Traditional Chinese Medicine

摘要


突發性耳聾為耳鼻喉科門診常見之疾病,是指在3天內聽力在連續3個音頻的測試下均喪失30dB以上,常伴隨耳鳴及眩暈等症狀表現,西醫常規治療為口服或注射類固醇,本病症的預後與聽力喪失的嚴重度及眩暈症狀的表現有關,經過統計僅有三分之二病患的聽力可完全恢復,有不少患者聽力受到永久性影響,因而尋求中醫藥治療。本病例報告為一位14歲國中學生,突發單側性聽力喪失,伴隨耳鳴及眩暈,經過西醫投予抗生素及類固醇治療後,症狀均未見改善,故開始接受中醫治療。本案例之特色在於根據臨床症狀,經辨證論治後,以針刺疏通肝膽氣滯、補益脾氣,經過兩個月治療後聽力及耳鳴狀況恢復良好。追蹤整理中醫治療用藥紀錄,提供中醫臨床治療突發性耳聾之參考。

關鍵字

突發性耳聾 中醫藥 針灸

並列摘要


Idiopathic sudden sensorineural hearing loss (ISSNHL) is a common disease in otolaryngology clinics. It is defined as rapidly developing hearing loss within less than three days, and the level of the hearing loss is more than 30 dB in at least three consecutive frequencies, which usually accompanied with tinnitus and vertigo. Orally or intratympanic glucocorticoids are considered first-line therapy for SSNHL. However, the benefit of these drugs is unclear. And the prognosis for sudden sensorineural hearing loss (SSNHL) is related to the severity of hearing loss and vertigo symptoms. Approximately, only two-thirds of patients with SSNHL can be fully recovered, while the others are suffering from the condition permanently. Therefore Traditional Chinese Medicine may be a complement option to these patients. This case repot describes a 14-year-old student who suffered from unilateral hearing loss, accompanied by tinnitus and dizziness. After treatment with antibiotics and steroids, the situation did not improve. So he turned to receive traditional chinese medicine treatment. The characteristic of this case is that based on clinical symptoms, combined with Chinese medicine theory, the patient's SSHL was treated with acupuncture to soothe the liver, dispel the stagnation, and regulating qi-flowing for strengthening spleen. After two months treatment, his hearing loss and tinnitus has marked improvement. This paper would present the procedure of TCM treatment in a detailed introduction and discussion.

並列關鍵字

SSNHL Hearing loss Acupuncture

參考文獻


Bethesda, MD.: National Institute of Health. Sudden Deafness. National Institutes of Health. 2000. NIH publication 00-4757.
Yeo SW, Lee DH, Jun BC, Park SY, Park YS.:Hearing outcome of sudden sensorineural hearing loss: long-term follow-up. Otolaryngol Head Neck Surg. 2007; 136(2): 221-4.
Crane RA, Camilon M, Nguyen S, Meyer TA.:Steroids for treatment of sudden sensorineural hearing loss: A meta-analysis of randomized controlled trials. Laryngoscope. 2015; 125: 209-217.
Xenellis, J., Karapatsas, I., Papadimitriou, N., Nikolopoulos, T., Maragoudakis, P., Tzagkaroulakis, M., & Ferekidis, E.: Idiopathic sudden sensorineural hearing loss: Prognostic factors. The Journal of Laryngology & Otology. 2006; 120(9), 718-724.
程士德主編:內經《厥論》,知音出版社,台北 2001;407-408。

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