耳鸣的中西医认识  

On Understanding of Tinnitus in Traditional Chinese and Western Medicine

作　　者：余亚斌[1] 张剑宁[1] 李明[1] 黄平[1] YU Ya-bin;ZHANG Jian-ning;LI Ming;HUANG Ping(Yueyang Integrated Chinese and Westem Medicine Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai,China,200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《河南中医》2020年第11期1652-1655,共4页Henan Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会中医药科技创新项目(ZYKC201701016)。

摘　　要：耳鸣不外虚实两端,虚者多为五脏气血之虚,实者常为外感六淫、痰浊阻滞、实火上扰,故历代医家在耳鸣治疗上以整体调理、辨证论治为基础,从调整脏腑功能、阴阳平衡着手,疏补结合,补虚损以调气机。中医经络理论认为,耳部与十二经脉有着密切的联系,亦与大脑紧密联系。现代研究发现,单纯的耳蜗病变并不能解释耳鸣及其多种伴随症状发生的原因,耳鸣相关脑区如耳蜗核、下丘、听皮层等听觉通路上的重要区域以及与情绪相关的听觉外系统可能参与耳鸣中枢调节的复杂过程。中医对耳鸣病因病机的认识及中医经络理论对耳鸣中枢的认识,与现代医学对耳鸣中枢的认识相吻合。中医能通过整体观念和辨证论治有效发挥对机体的自稳调节功能,减轻或消除耳鸣及其不良心理反应。现代医学对耳鸣中枢的认识有助于了解耳鸣的发生机理。中医理论结合现代医学,对临床治疗耳鸣有积极的指导意义。According to TCM,tinnitus is usually caused by deficiency and excess.The deficiency mostly refers to deficiency of qi and blood in the five zang-organs,while the excess is often caused by six exogenous factors,phlegm turbidity blockage,and excess fire disturbance.Therefore,doctors in the past dynasties,based on the overall conditioning and syndrome differentiation,have started from the adjustment of the overall viscera and the balance of yin and yang,combined with dredging stagnation and tonifying deficiency damage to regulate qi.According to the meridian theory of TCM,the ear is closely related to the twelve meridians,as well as to the brain.Modern studies have found that simple cochlear lesions cannot explain the causes of tinnitus and its accompanying symptoms.Tinnitus related brain regions such as cochlear nucleus,inferior colliculus,auditory cortex and other important areas of auditory pathway,as well as emotion related external auditory system,may participate in the complex process of tinnitus central modulation.The understanding of tinnitus etiology and pathogenesis in TCM and the cognition of tinnitus center in meridian theory of TCM are consistent with that of modern medicine.TCM can effectively exert the self-regulation function of the body through holistic concept and syndrome differentiation and treatment,reduce or eliminate tinnitus and its adverse psychological reaction.The understanding of tinnitus center in modern medicine is helpful to understand the mechanism of tinnitus.The theory of TCM combined with modern medicine has a positive guiding significance for the clinical treatment of tinnitus.

关 键 词：耳鸣 耳鸣中枢 经络理论 中西医结合 

分 类 号：R276.164.45[医药卫生—中医五官科学]