中医外治法治疗神经性耳鸣的临床研究进展  

Progress in Clinical Research on the Treatment of Neurogenic Tinnitus by External Treatment of Traditional Chinese Medicine

作　　者：孙鑫程 孙建华[1] SUN Xincheng;SUN Jianhua(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029;Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学,江苏南京210029

出　　处：《中医康复》2025年第5期61-66,共6页Traditional Chinese Medicine Rehabilitation

基　　金：江苏省研究生实践创新计划(SJCX24_0994);江苏省中医院高峰人才项目赞助(编号y2021rc04)。

摘　　要：神经性耳鸣是指在没有外部声源的情况下,患者主观感受到耳内或颅内出现嗡嗡声、蝉鸣声等无意义的异常声音,伴或不伴有患侧听力减退,是耳鼻喉科常见的临床症状。耳鸣的发病机制尚未明确,目前普遍认为耳鸣可能是由于外周听觉系统损伤而导致中枢听觉系统失衡,可能与中枢的过度兴奋有关,是多个脑区共同作用并影响大脑听觉回路的异常结果。当前仍无特效药物和治疗方法能让耳鸣消失。耳鸣在中医又称“蝉鸣”“耳渐鸣”“聊啾”“苦鸣”和“耳鸣耳聋”等,中医学认为其主要责之于肾,与心、肝等脏关系密切,基本病机为耳窍失于充养而致耳鸣。耳鸣可分为虚实两类,根据症状体征不同进行辨证论治。中医药在耳鸣治疗上历史悠久,方法多样且效果显著。外治法尤为常用,涵盖针刺、电针、温针灸、耳穴压豆、五行音乐疗法以及传统功法等。笔者旨在通过对耳鸣的病因病机和机制的探讨以及中医外治法治疗耳鸣的相关临床研究进行综述,以期为临床治疗该疾病提供理论依据。Neurogenic tinnitus refers to the subjective sensation of meaningless abnormal sound sensations such as buzzing and cicada chirping in the ear or skull in the absence of an external sound source,with or without hearing loss on the affected side,which is a common clinical symptom in E.N.T.department.The pathogenesis of tinnitus is not yet clear,and it is generally believed that tinnitus may be due to damage to the peripheral auditory system,resulting in an imbalance in the central auditory system,which may be related to the overexcitability of the center,and is the result of the abnormality of multiple brain regions that affect the auditory circuit of the brain.There are no specific medications and treatments to make tinnitus go away.Tinnitus is also known as"cicada chirping","ear gradual ringing","chattering","bitter ringing"and"tinnitus deafness"in traditional Chinese medicine.Traditional Chinese medicine believes that tinnitus is mainly related to the kidneys,and is closely related to the heart,liver and other organs.The basic pathogenesis is tinnitus caused by the loss of ear nourishment.Tinnitus can be divided into two categories:deficiency and excess,and syndrome differentiation and treatment are carried out according to different symptoms and signs.Traditional Chinese medicine has a long history in the treatment of tinnitus,with a variety of methods and remarkable results.External treatments are particularly commonly used,including acupuncture,electroacupuncture,warm acupuncture,auricular pressure beans,five elements music therapy,and traditional exercises.The purpose of this article is to discuss the etiology,pathogenesis and mechanism of tinnitus,as well as the relevant clinical research on the treatment of tinnitus by external treatment of traditional Chinese medicine,in order to provide a theoretical basis for the clinical treatment of tinnitus.

关 键 词：中医外治法 神经性耳鸣 发病机制 针刺 电针 温针灸 耳穴贴压 五行音乐疗法 鸣天鼓手法 

分 类 号：R276.1[医药卫生—中医五官科学]