从肝郁肾虚治疗主观性耳鸣病案一则
Treatment of Chronic Subjective Tinnitus Based on Theory of "Hepatic Stagnation and Kidney Deficiency"
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1.北京中医药大学东直门医院脑病科,北京 101100
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熊航. 从肝郁肾虚治疗主观性耳鸣病案一则[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43052807&Fpath=home&index=0
XIONG Hang. Treatment of Chronic Subjective Tinnitus Based on Theory of "Hepatic Stagnation and Kidney Deficiency"[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43052807&Fpath=home&index=0
熊航. 从肝郁肾虚治疗主观性耳鸣病案一则[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43052807&Fpath=home&index=0 DOI:
XIONG Hang. Treatment of Chronic Subjective Tinnitus Based on Theory of "Hepatic Stagnation and Kidney Deficiency"[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43052807&Fpath=home&index=0 DOI:
病史摘要,2,患者某,男, 41岁,主因“双耳耳鸣时作10余年,加重10余天”于2023年2月14日就诊。患者10余年前因工作压力大导致双耳耳鸣时作,时轻时重,曾多次外院耳鼻喉专科检查并确诊为主观性耳鸣。10余天前患者情绪激动后出现双耳耳鸣加重,轰鸣如闻潮声,双耳闷堵感,无听力下降,头胀痛、位置不固定,头昏沉,无恶心呕吐,胸胁胀满,口干、口苦,过度担心,心烦,急躁易怒,乏力明显,颈肩及左上臂疼痛不适,腰膝酸软,食欲差,入睡困难,易醒、早醒,醒后不能再次入眠,二便调。患者既往高尿酸血症病史,不服药;发现焦虑抑郁状态数年,不服药。曾长期服用甲钴胺、抗焦虑药治疗该病,效欠佳,遂来我院门诊寻求中医诊治。四诊信息:面色晦暗黧黑,舌暗淡瘀斑、苔白腻,脉弦细微数。中医诊断 耳鸣;郁证(肾虚肝郁证)西医诊断 主观性耳鸣;焦虑状态干预措施 患者晕针无法针刺,予纯中药辨证施治,以平肝补肾,化痰清火,同时嘱患者心身并调,低嘌呤饮食、忌咖啡因烟酒等食物。疗效转归 先后复诊9次,服中药后诸症均明显好转,耳鸣平素几乎感觉不到。
Summary of case history ,The patient Somebody, male, 41 years old, went to a doctor on February 14, 2023 due to "chronic subjective tinnitus" for more than ten years, aggravating for 1 month". More than 10 years ago, the patient experienced recurrent tinnitus in both ears due to work pressure, ranging from mild to severe. The patient had seen doctors in other hospitals for many times, and no abnormality was found in the head MRI and other examinations. The diagnosis was subjective tinnitus. More than 10 days ago, the patient experienced increased tinnitus in both ears but no hearing loss, headache and dizziness, chest and rib fullness, dry mouth, bitter mouth, excessive worry, poor sleeping, obvious fatigue, and poor appetite. The patient had a history of Hyperuricemia and anxiety for several years. The patient had taken mecobalamin, Anxiolytic and other drugs to treat the disease for a long time, but the effect was not good, so he came to our outpatient clinic to seek TCM treatment. Symptoms and signs: recurrent tinnitus in both ears, dizziness, headache, fullness in the chest and ribs, dry mouth, bitter mouth, irritability, excessive worry, obvious fatigue, poor sleep. The complexion is dark and swarthy, the tongue is dull with ecchymosis, the fur is white and greasy, and the pulse strings are subtle.,TCM diagnosis,2,tinnitus (hepatic stagnation and kidney deficiency),Western medicine diagnosis,2,chronic subjective tinnitus,Therapeutic methods ,Provide pure traditional Chinese medicine for syndrome differentiation and treatment. The prescription is mainly made of raw magnetite, and diagonal medicine is used to calm the liver, tonify the kidney, dissipate phlegm, and clear fire. At the same time, patients are advised to pay attention to mind and body coordination, and avoid caffeine, tobacco and alcohol.,Clinical outcomes,2,After the treatment of TCM, the patient recovered from chronic subjective tinnitus.
耳鸣郁证肝郁肾虚证
tinnitusanxietyhepatic stagnation and kidney deficiency
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