身心同辨治耳鸣验案举隅
增强出版A clinical case report of combined physical therapy and psychological counseling in the treatment of tinnitus
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1.上海市长宁区天山中医医院耳鼻咽喉科,上海 200051
2.上海中医药大学附属市中医医院耳鼻咽喉科,上海 200071
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陈婕, 郭裕. 身心同辨治耳鸣验案举隅[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745980&Fpath=home&index=0
CHEN Jie, GUO Yu. A clinical case report of combined physical therapy and psychological counseling in the treatment of tinnitus[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745980&Fpath=home&index=0
陈婕, 郭裕. 身心同辨治耳鸣验案举隅[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745980&Fpath=home&index=0 DOI:
CHEN Jie, GUO Yu. A clinical case report of combined physical therapy and psychological counseling in the treatment of tinnitus[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745980&Fpath=home&index=0 DOI:
病史摘要,2,郝某,女,65岁,半年前无明显诱因下出现双耳鸣,夜间明显,影响睡眠。半年来反复辗转于上海各大医院的脑、内、耳鼻喉科就诊,查遍所有相关检查,均未提示有明显器质性疾病。因对于前期外院的各类耳鸣治疗效果均不满意,故前来郭裕教授门诊寻求中医治疗。四诊信息 持续性双耳鸣,夜间明显,伴有身热汗出、心烦气燥、腰酸乏力,夜寐欠安、起夜数次、多梦纷扰,胃纳可,二便调。舌红,苔薄,脉细数。中医病证 患者老年女性,平素心烦不寐,腰酸乏力,入睡前心理负担较重,属于肾阴不足。精血不足,不能上充于清窍,耳窍失养则耳鸣耳聋。长期耳鸣困扰,四处求诊无果,因而伤及情志,肝失条达,故精神抑郁,情绪不宁。中医治法 益精通窍,疏肝解郁,身心同调。中医诊断 耳鸣(肾精亏损证)西医诊断 慢性主观性耳鸣干预措施 在就诊及治疗过程中,结合中医问诊和认知行为疗法对患者适时进行心理疏导,考虑患者对口服药物的抗拒,给予每周1~2次翳风穴穴位注射特色疗法,每次左右耳交替注射治疗,同时根据其体质特征结合五音治疗。整个治疗过程中无西医治疗。疗效转归 治疗前后分别对患者采用耳鸣评分量表和VAS评分评估耳鸣症状的减轻程度,两项分值均减少被认为是临床上有意义的改变。
Summary of case history, Ms. Hao, 65 years old, she developed tinnitus in both ears six months ago, which was obvious at night and even affected her sleep. In the past six months, she had repeatedly visited the departments of brain medicine, internal medicine, and otolaryngology in major hospitals in Shanghai. All relevant examinations have been completed, and no obvious organic diseases have been suggested. The patient was dissatisfied with the results of various tinnitus treatments previously performed in other hospitals, so she came to Professor Guo Yu's expert clinic to seek TCM treatment. The patient had persistent tinnitus in both ears, which was obvious at night. She also had body fever, sweated a lot. She was easily upset, had a irritable temper, suffered from backache and lacked energy. She was not easily to fall asleep, waked up several times during sleep, and had many dreams. There was no problem with the stomach, and the stool and urine were normal. The tongue was red in color, with thin tongue coating and thin pulse.,TCM diagnosis, Tinnitus(Syndrome of deficiency of kidney essence),Western medicine diagnosis, Chronic subjective tinnitus,Therapeutic methods, During the patient's consultation and treatment, Professor Guo Yu combined the consultation techniques of traditional Chinese medicine and psychological cognitive behavioral therapy to provide timely psychological counseling to the patient. Considering the patient's refusal to take oral drugs to treat tinnitus, Professor Guo Yu gave her other traditional Chinese medicine. Method treatment, that is, the characteristic therapy of injecting drugs at acupoints around the ears, 1~2 times a week, alternately injecting drugs in the left or right ear each time, and at the same time, according to her physical characteristics, the patient is given traditional Chinese medicine music therapy. There was no western medicine treatment during the whole treatment process.,Clinical outcomes, Before and after treatment, doctors evaluated the patients with tinnitus rating scale and VAS score respectively, which were used to evaluate the degree of relief of tinnitus after treatment. Both scores decreased, so this patient's treatment was considered clinically effective.
耳鸣中医问诊认知行为疗法通法穴位注射
TinnitusTraditional Chinese medicine consultation techniquesCognitive-behavioral therapyTongfaAcupoint injection
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