Introduction
Auditory vertigo, also known as Meniere's disease, is a kind of non-inflammatory disease due to dysfunction of vestibule and retention of fluid in labyrinth. The main clinical manifestations are vertigo, metamorphopsia, inability to stand and sit, nausea, vomiting and sweating, accompanied by undulatory deafness and tinnitus as well as spontaneous and horizontal nystagmus. This disease pertains to the conception of “dizziness” in TCM usually caused by asthenia of the spleen and stomach, hyperactivity of liver yang, endogenous production of wind and yang as well as wind, fire and phlegm attacking the upper orifices; or by insufficiency of yin essence, qi and blood as well as malnutrition of the lucid orifices.
Syndrome Differentiation
1. Insufficiency of Qi and Blood
Vertigo, aggravation in movement, recurrence with overstrain, spiritual lassitude, pale complexion, palpitation, insomnia, light-colored tongue and thin pulse.
2. Hyperactivity of Liver Yang
Vertigo due to emotional changes, frequent nausea, flushed cheeks, bitter taste in the mouth, dry throat, fullness in the chest and hypochondria, aching and weakness of the loins and knee, reddish tongue with scanty fur, taut, thin and rapid pulse.
3. Consumption of Kidney Essence
Frequent vertigo, aggravation in the night, spiritual lassitude, amnesia, aching and weakness of the loins and knees, tinnitus, deafness, hypoacusis, dreaminess and seminal emission, tidal fever and night sweating, reddish tongue with scanty fur and thin and rapid pulse.
4. Retention of Dampness and Phlegm in the Middle Energizer
Vertigo, heaviness and wrapped sensation in the head, chest oppression and nausea, even vomiting of phlegm and saliva, somnolence and lassitude, poor appetite, white and greasy tongue fur as well as soft and slippery pulse.
Treatment
1. Body Acupuncture
Prescription: Baihui (GV 20) and Fengchi (GB 20).
Modification: For insufficiency of qi and blood, Pishu (BL 20), Zusanli (ST 36), Qihai (CV 6) and Guanyuan (CV 4) are added; for hyperactivity of liver yang, Ganshu (BL 18), Shenshu (BL 23), Xingjian (LR 2) and Xiaxi (GB 43) are added; for consumption of kidney essence, Shenshu (BL 23), Taixi (KI 3 ), Sanyinjiao (SP 6 ), Guanyuan (CV 4) and Xuanzhong (GB 39) are added; for retention of dampness and phlegm in the middle energizer, Pishu (BL 20), Weishu (BL 21 ), Fenglong (ST 40), Yinlingquan (SP 9) and Zhongwan (CV 12) are added.
Performance: For asthenia of qi and blood and consumption of kidney essence, mild reinforcing and reducing needling techniques are used to needle Baihui (GV 20) and Fengchi (GB 20), reinforcing needling technique is used to needle the other acupoints or with the combination of moxaroll moxibusiton. For hyperactivity of liver yang, Fengchi (GB 20) is needled in the direction of the nose tip with rotating and twirling reducing techniques and Baihui (GV 20) is needled horizontally with twirling and rotating reducing technique; Ganshu (BL 18) and Shenshu (BL 23) are needled obliquely toward the spinal column with reinforcing needling technique; Xingjian (LR 2) and Xiaxi (GB 43) are needled with reducing technique. For retention of dampness and phlegm in the middle energizer, Pishu (BL 20) and Weishu (BL 21) are needled with reinforcing needling technique, the rest of the acupoints are needled with reducing technique.
2. Ear Acupuncture
Prescription: Kidney (CO10), Ear Shenmen (TF4), Occiput (AT3), Internal Ear (LO6) and Brain (AT3, 4i).
Performance: Each time 2 - 3 acupoints are selected and needled with medium and strong stimulation. The needles are retained for 20 - 30 minutes with manipulation at intervals. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear acupressure alternatively on both ears 3 - 4 times a day.
3. Scalp acupuncture
Selection of area: Vertigo-auditory zone on both sides.
Performance: The needling is done once a day with medium and strong stimulation and longer retention of the needles.