Disease and Condition Overview
Tinnitus and Hearing Impairment are characterized by interference in hearing and difficulty in hearing. Tinnitus is objective perception of echoes or crackling sounds in the ear that impedes hearing. Hearing Impairment is that patient has various degree of difficulty in hearing, even deaf. In Chinese medicine, it is differentiated into asthenic and sthenic syndromes. Sthenic syndrome is caused by external wind heat or emotional distress, diet, dampness and phlegm, the repressed qi becomes fire, rising upward through the channel and blocking the clear;asthenic syndrome is often caused by prolonged illness, weakened constitution, resulting in qi and blood deficiency or due to deficiency in kidney essence cannot rise up to nourish the years.
Clinically, the cause of tinnitus and hearing impairment should be differentiated from hypertension, arteriosclerosis, infectious disease, poisoning and external injuries.
Pair-point Treatment Combinations
(1) Yifeng (SJ 17), Tinghui (GB 2) (Fig 51)
Yifeng (SJ 17) regulates sanjiao (upper, middle and lower jiao) qi, dispels wind opens the luo-connecting channels ; Tinghui (GB 2) regulates liver and gallbladder qi, dispels wind clears heat. This pair-point combination, one anterior and one posterior, dispels wind clears heat, and resolves shaoyang, opens the luo-connecting channels. Appropriate for all types of tinnitus and hearing impairment.
Needling techniques:
1. Yifeng (SJ 17) from lateral, posterior to medial interior, from lateral, posterior to medial, interior direction oblique insertion 1 cun.
2. Tinghui (GB 2) perpendicular insertion 1 cun.
(2) Waiguan (SJ 5), Zulinqi (GB 41) (Fig 14)
Waiguan (SJ 5) is luo-connecting point of the hand-shaoyang channel, opens the blockage of qi and clears heat at Sanjiao (upper, middle and lower jiao ). Zulinqi (GB41) disperses and reduces liver and gallbladder, opens channels and invigorates luo-connecting channels, clears heat and resolves phlegm. This pair point combination, one superior and one inferior, located on the same channel, the two points echo and couple the effects of each other, clear reduce liver and gallbladder, disperse and open shaoyang. Appropriate for Tinnitus / Hearing Impairment caused by liver and gallbladder fire heat rising upward and misting the orifices.
Needling techniques:
1. Waiguan (SJ 5) perpendicular insertion 1 cun.
2. Zulinqi (GB 41) perpendicular insertion 1 cun.
(3) Sidu (SJ 9). Tianyou (SJ 16) (Fig 56)
Sidu ( SJ9 ) : on the dorsum of the forearm, on the line connecting Yangchi (SJ 4) and the olecranon, 5 cun proximal to the dorsal crease of the wrist, between the radius and the ulna.
Tianyou (SJ 16): on the lateral side of the neck, directly below the posterior border of the mastoid process, on the level of the mandibular angle, and on the posterior border of the sternocleidomastoid muscle.
Sidu (SJ 9): regulates the qi of the shaoyang, induces the pathogenic heat to migrate downward. Tianyou ( SJ 16) regulates qi of the ear orifice, clears heat and reduces fire. This pair point combination, one superior and one inferior, both points are located on the same channel, compounding the effects, dispersing and opening shaoyang. Appropriate for Tinnitus / Hearing Impairment caused by shaoyang pathogenic heat.
Needling techniques:
1. Sidu (SJ 9) perpendicular insertion 1 cun.
2. Tianyou (SJ 16) from lateral to medial, perpendicular insertion 1 cun.
(4) Tinghui (GB 2), Jinmen (BL 63) (Fig 57)
Tinghui (GB 2) : on the face, anterior to the intertragic notch. When the mouth open, the point is located in a depression posterior to the condyloid process of the mandible.
Jinmen ( BL 63 ) : on the lateral side of the foot, directly inferior to the anterior border of the lateral malleolus, on the lower border of the cuboid bone.
Tinghui (GB 2): disperses and opens the qi from ear, clears and reduces liver and gallbladder damp heat. Jinmen (BL63) disperses and opens taiyang qi, regulates qi and blood. This pair point combination, one superior and one inferior, disperse and open taiyang and shaoyang qi, disperse pathogenic factors and clear obstructed orifices. Appropriate for tinnitus/hearing impairment caused by attack of external pathogenic qi.
Needling techniques:
1. Tinghui (GB 2) perpendicular insertion 1 cun.
2. Jinmen ( BL 63 ) perpendicular insertion 0.5 cun.
(5) Tinghui (GB 2), Yingxiang (LI 20) (Fig 58)
Tinghui (GB 2) : on the face, anterior to the intertragic notch. When the mouth is open, the point is located in a depression posterior to the condyloid process of the mandible.
Yingxiang (LI 20) : in the nasolabial groove, beside the midpoint of the lateral border of the ala nasi.
Tinghui (GB 2): clears and reduces damp heat in liver and gallbladder, disperses and opens qi around the ear. Yingxiang (LI 20) promotes lung, clears intestine. disperses and opens qi around the nose. This pair point combination, working in synergy, clear heat disperse pathogenic factors, disperseand open qi, regulate the opening and closing of orifices. Appropriate for tinnitus / hearing impairment caused by blocked qi.
Needling techniques:
1. Tinghui (GB 2) perpendicular insertion 1 cun.
2. Yingxiang (LI 20) towards anterior, superior direction oblique insertion 0.5 cun.
(6) Guanyuan (RN 4), Shenshu (BL 23) (Fig 30)
Guanyuan (RN 4) is the point where congenital yin and yang reside. Shenshu (BL 23) is where the qi and blood from the kidney infuse. This pair point combination, one anterior, one posterior, work to tonify kidney solidify original qi, benefit and nourish yin, restore ear functions. Appropriate for tinnitus/ hearing impairment caused by congenital endowment deficiency, or loss or damage of original, yuan qi.
Needling techniques :
1. Guanyuan (RN 4) perpendicular insertion 1 cun
2. Shenshu (BL 23) towards spine direction oblique insertion 1.5 cun.
3. Or use moxibustion.
Commentaries
The causes of tinnitus and hearing impairment are very complex, therefore, before applying acupuncture treatment, it is important to perform complete and thorough examinations and obtain concise diagnosis. Once the etiology of tinnitus has been identified. unless there is physiological damage to the ear drum and hearing loss is almost one hundred percent. acupuncture has definite effects on all other types of tinnitus and hearing impairment. In addition, lifestvle and attitude changes and adjustment will contribute to the treatment of tinnitus and hearing impairment.
Local Yifeng (SJ 17), Tinghui ( GB 2 ) point combination is appropriate for all types of tinnitus/ hearing impairment.
However, the shaoyang channel is the main channel in external pathogenic qi invading the ear. therefore.
If liver and gallbladder fire, heat rising upward, then select the Waiguan (SJ 5), Zulinqi ( GB 41 ) pair point.
If caused by attack of external pathogenic wind heat, then select Sidu ( SJ 9 ),Tianyou ( SJ 16)pair-point combination.
If it is after the external pathogenic qi attack, difficult to differentiate by channels, or involving multiple channels, then select Tinghui ( GB 2 ), Jinmen (BL 63)pair-point combination.
Or if it is because of the irregular flow of qi. Causing unclearing of the orifice, select Tinghui (GB 2 ), Yingxiang ( LI 20 ) pair-point combination.
Finally, for the deficiency syndrome of tinnitus/hearing impairment, then use Guanyuan (RN 4), Shenshu (BL 23) pair-point combination.