题名

針灸結合類固醇治療突發性耳聾病例報告

并列篇名

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

DOI

10.6516/TJTCM.202003_23(1).0017

作者

陳昱婷(Yu-Ting Chen);葉家豪(Chia-Hao Yeh);陳冠宇(Kuan-Yu Chen)

关键词

突發性耳聾 ; 針灸 ; 中醫 ; sudden sensorineural hearing loss ; acupuncture ; traditional Chinese medicine

期刊名称

中醫藥研究論叢

卷期/出版年月

23卷1期(2020 / 03 / 30)

页次

209 - 219

内容语文

繁體中文

中文摘要

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。

英文摘要

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.

主题分类 醫藥衛生 > 中醫藥學
醫藥衛生 > 藥理醫學
参考文献
  1. (元)滑壽(1965).難經本義.台北:藝文印書館.
  2. 宋.宋徽宗勅編:大德重校聖濟總錄,清康熙間影鈔元刊本,北京 1662;卷一百一十四;1。
  3. (明)張介賓(1983).景岳全書.台北:台灣商務印書館.
  4. (明)楊繼洲(2002).針灸大成.上海:上海古籍出版社.
  5. (唐)王冰(1968).重廣補註黃帝內經素問.台北:藝文印書館.
  6. (唐)王冰(1968).重廣補註黃帝內經素問.台北:藝文印書館.
  7. (唐)王冰(1968).重廣補註黃帝內經素問.台北:藝文印書館.
  8. (晉)皇甫謐(1968).針灸甲乙經.台北:藝文印書館.
  9. (清)王士雄(2002).溫熱經緯.上海:上海古籍出版社.
  10. (清)吳謙(2017).醫宗金鑑.台南:士一文化事業股份有限公司.
  11. Amorim, Diogo,Amado, José,Brito, Irma,Fiuza, Sónia M.,Amorim, Nicole,Costeira, Cristina,Machado, Jorge(2018).Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research.Complementary Therapies in Clinical Practice,31,31-37.
  12. Bethesda, MD(2000).Sudden Deafness.National Institutes of Health.
  13. Chung, Shiu-Dong,Hung, Shih-Han,Lin, Herng-Ching,Sheu, Jau-Jiuan(2015).Association between sudden sensorineural hearing loss and anxiety disorder: a population-based study.European Archives of Oto-Rhino-Laryngology,272(10),2673-2678.
  14. Howick, Jeremy,Chalmers, Iain,Glasziou, Paul,Greenhalgh, Trish,Heneghan, Carl,Liberati, Alessandro,Moschetti, Ivan,Phillips, Bob,Thornton, Hazel,Goddard, Olive,Hodgkinson, Mary(2011).Jeremy Howick, Iain Chalmers (James Lind Library), Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti,Bob Phillips, Hazel Thornton, Olive Goddard and Mary Hodgkinson. "The Oxford 2011 Levels of Evidence"..
  15. Kim, Jong-Yeup,Lee, Jong Won,Kim, Myoungsuk,Kim, Min Jae,Kim, Dong-Kyu(2018).Association of Idiopathic Sudden Sensorineural Hearing Loss With Affective Disorders.JAMA Otolaryngology-Head & Neck Surgery,144(7),614-621.
  16. Roh, Daeyoung,Chao, Janet Ren,Kim, Do Hoon,Yoon, Kyung Hee,Jung, Jae Hoon,Lee, Chang Hyun,Shin, Ji-Hyeon,Kim, Min Jae,Park, Chan Hum,Lee, Jun Ho(2017).Psychological stress as a measure for treatment response prediction in idiopathic sudden hearing loss.Journal of Psychosomatic Research,102,41-46.
  17. Stachler, Robert J.,Chandrasekhar, Sujana S.,Archer, Sanford M.,Rosenfeld, Richard M.,Schwartz, Seth R.,Barrs, David M.,Brown, Steven R.,Fife, Terry D.,Ford, Peg,Ganiats, Theodore G.,Hollingsworth, Deena B.,Lewandowski, Christopher A.,Montano, Joseph J.,Saunders, James E.,Tucci, Debara L.,Valente, Michael,Warren, Barbara E.,Yaremchuk, Kathleen L.,Robertson, Peter J.(2012).Clinical practice guideline: sudden hearing loss.Otolaryngology-Head and Neck Surgery,146(1S),S1-S35.
  18. Tseng, Chih-Chieh,Hu, Li-Yu,Liu, Mu-En,Yang, Albert C.,Shen, Cheng-Che,Tsai, Shih-Jen(2016).Risk of depressive disorders following sudden sensorineural hearing loss: A nationwide population-based retrospective cohort study.Journal of Affective Disorders,197,94-99.
  19. Weber, Peter C(2019).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..https://www.uptodate.com/contents/sudden-sensorineural-hearing-loss
  20. Yin, Chang Shik,Park, Hi-Joon,Nam, Hae Jeong(2010).Acupuncture for Refractory Cases of Sudden Sensorineural Hearing Loss.THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,16(9),973-978.
  21. Zhang, Xin-chang,Xu, Xiu-ping,Xu, Wen-tao,Hou, Wen-zhen,Cheng, Ying-ying,Li, Chang-xi,Ni, Guang-xia(2015).Acupuncture Therapy for Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.PLoS ONE,10(4),e0125240.
  22. 沈邑穎(2012).古典經絡針灸大家周左宇醫道精要.台北:橡實文化.
  23. 黃維三(2010).針灸科學.台北:國立編譯館.
  24. 楊維傑(1999).董氏奇穴針灸學.台北:志遠書局.
  25. 撰人不詳(1968).黃帝內經素問靈樞經.台北:藝文印書館.
  26. 撰人不詳(1968).黃帝內經素問靈樞經.台北:藝文印書館.