Acupuncture Continuing Education

Acupuncture Plus Herbs Quiet Tinnitus

Shanghai Tongren Hospital researchers conclude that acupuncture combined with herbal medicine is effective for the alleviation of tinnitus. References to tinnitus exist throughout ancient Traditional Chinese Medicine (TCM) literature, including approximately ten references in the Huangdi Neijing (The Yellow Emperor’s Classic of Medicine). Now, modern research verifies the efficacy of both acupuncture and herbal medicine for the treatment of tinnitus.

 

SI19 tinggong 

 

Hospital researchers achieved an 85.7% total treatment effective rate using acupuncture combined with herbal medicine. Participants were placed in treatment protocol groups according to TCM diagnostic patterns: kidney yin deficiency, hyperactivity of liver and gallbladder fire, excess heart fire, unrisen lucid yang qi. Each of these diagnostic patterns are syndromes based on a series of symptoms. For example, kidney yin deficiency patients have several of the following symptoms: lower back soreness, loss of hair, insomnia, mental restlessness, night sweating, malar flush, excessive heat of the palms, feet, and chest. 

For each diagnostic pattern group, a specific acupuncture point prescription and herbal medicine formula were prescribed. The primary acupoints selected for all treatment participants were the following:

  • Ermen (TB21)
  • Tinggong (SI19)
  • Tinghui (GB2)
  • Yifeng (TB17)
  • Zhongzhu (KD15)

Additional acupoints were administered based on differential diagnostic patterns. For kidney yin deficiency patients, the following acupuncture points were added:

  • Shenshu (BL23)
  • Guanyuan (CV4)

For hyperactivity of liver and gallbladder fire patients, the following acupoints were added:

  • Taichong (LV3)
  • Qiuxu (GB40)
  • For excessive heart fire, the following acupoints were added:
  • Shaofu (HT8)
  • Shaochong (HT9)

For unrisen lucid yang, the following acupoints were added:

  • Zusanli (ST36)
  • Sanyanjiao (SP6)

Needling of the ear’s tragus employed a classic three point prescription for the treatment of hearing disorders: Ermen (TB21), Tinggong (SI19), Tinghui (GB2). With the patient’s mouth open, a needle was perpendicularly inserted into each acupoint to a depth of 0.5 – 1 inches. Zusanli (ST36) and Sanyinjiao (SP6) were pierced to a depth of 1 – 1.5 inches. Subsequently, the rest of the acupoints were inserted and a 30 minute needle retention time was observed. One acupuncture session was conducted daily for 2 consecutive weeks. TCM herbal formulas were prescribed based on diagnostic patterns. For kidney yin deficiency patients, a modified version of the herbal formula Er Long Zuo Ci Wan was prescribed, which contained the following herbs:

  • Shu Di Huang 15 g
  • Shanyao 15 g
  • Fu Ling 15 g
  • Mu Dan Pi 15 g
  • Ze Xie 15 g
  • Shan Zhu Yu 15 g
  • Ci Shi 30 g
  • Wu Wei Zi 9 g
  • Sheng Long Gu 30 g
  • Sheng Mu Li 30 g

For hyperactivity of liver and gallbladder patients, a modified version of the herbal formula Long Dan Xie Gan Tang was prescribed, which contained the following herbs:

  • Long Dan Cao 9 g
  • Zhi Zi 12 g
  • Chai Hu 10 g
  • Huangqin 15 g
  • Che Qian Zi 15 g
  • Ze Xie 15 g
  • Sheng Di Huang 15 g
  • Dang Gui 10 g
  • Bai Shao Yao 15 g
  • Chuan Lian Zi 15 g
  • Yu Jin 15 g

For excess heart fire patients, a modified version of the herbal formula Dao Chi San was prescribed, which contained the following herbs:

  • Sheng Di Huang 6 g
  • Mu Tong 6 g
  • Sheng Gan Cao 6 g
  • Dan Zhu Ye 6 g

For unrisen lucid-yang patients, a modified version of the herbal formula Bu Zhong Yi Qi Tang was prescribed, which contained the following herbs:

  • Dang Shen 15 g
  • Huang Qi 15 g
  • Bai Zhu 15 g
  • Gan Cao 5 g
  • Dang Gui 10 g
  • Chen Pi 10 g
  • Sheng Ma 9 g
  • Chai Hu 10 g
  • Fu Shen 15 g
  • Shi Chang Pu 10 g

The prescribed dosage was one decoction daily. The above ingredients were brewed with water to obtain a 200 ml decoction, which was then split into 2 servings, taken separately in the morning and at night. Patients consumed the TCM herbal medicine at this rate for 2 consecutive weeks.

Psychological intervention for the treatment group was also provided. It involved cognitive and behavioral therapy to relieve patient anxiety and help them adapt to their surroundings by listening to music as a distraction from symptoms. Patients received psychological counseling after tinnitus was mitigated in order to reinforce the therapeutic effects and boost treatment efficacy. The tinnitus severity of each patient was graded before and after the treatment course based on the Tinnitus Handicap Inventory (THI). After treatment, the treatment efficacy for each patient was categorized into 1 of 4 tiers:

  • Recovery: Complete absence of tinnitus. Absence of accompanying symptoms. No relapse within 1 month of post-treatment.
  • Significantly effective: Tinnitus severity decreased by 2 THI grades or more.
  • Effective: Tinnitus severity decreased by 1 THI grade.
  • Not effective: No improvement in tinnitus severity.

The total treatment effective rate for each patient group (treatment and control) was derived as the percentage of patients who achieved at least an effective tier of treatment positive outcomes. The clinical results of this study demonstrate that tinnitus patients benefit from a combination of acupuncture and herbs.

This confirms the findings of Xue et al., whose research entitled Treatments Of Cervical Tinnitus Between Neck Acupoints Acupuncture And Traditional Acupuncture published in the Jilin Journal of Traditional Chinese Medicine concluded that acupuncture benefits patients with tinnitus. They investigated a type of tinnitus related to cervical disorders at the Central Hospital of Otolaryngology and Head and Neck Surgery (Chaoyang City, China). The researchers achieved an 80% total effective rate using the following acupuncture points:

  • Yiming (extra)
  • Tianyou (SJ16)
  • Fengchi (GB20)
  • Wangu (GB12)
  • Tinggong (SI19)
  • Zhongzhu (KD15)
  • Shangyang (LI1)
  • Kunlun (BL60)
  • Juegu (GB39)
  • Ashi

The frequency of treatment was once per day for a total of 18 acupuncture treatments. Song et al. had similar results in their investigation. The used the following acupuncture points:

  • TB17 (Yifeng)
  • GB2 (Tinghui)
  • SJ21 (Ermen)
  • SI19 (Tinggong)
  • LU7 (Lieque)
  • GB43 (Xiaxi)
  • SJ3 (Zhongzhu)
  • LR3 (Taichong)
  • GB40 (Qiuxu)

The total effective rate was 91.18% with the following breakdown of improvement tiers: 64.17% fully recovered, 14.71% significant improvements, 11.76% slight improvements, 8.82% no improvements. Tinnitus is a difficult and often intractable illness. The researchers tested various approaches to the application of acupuncture and herbal medicine. The results demonstrate that consistent and frequent acupuncture and herbal medicine treatments yield significant positive patient outcomes for patients with tinnitus.

 


References:
Fan XL & Li L. (2014). Observations on the Efficacy of Combined Acupuncture and Medicine plus Psychological Intervention in Treating Nervous. Shanghai J Acu-​mox. 33(5).​​

Li Y, Yang H, Zhang L et al. (2010). Moxibustion combined with electroacupuncture in treating nervous deafness. Shanghai Journal of Acupuncture and Moxibustion. 29(8): 521-522. ​​

Xue H. (2015). Treatments of cervical tinnitus between neck acupoints acupuncture and traditional acupuncture. Jilin Journal of Traditional Chinese Medicine. 35(9).

Yingli Song, Li, Shilin, Yan Xiao, and Jiang Wu. "Efficacy Observation of Acupuncture Combined with Ginger Moxibustion to Treatment of 34 Cases of Intractable Tinnitus." Zhongyi Zhongyao (Traditional Chinese Medicine and Herbs) Aug. 2013: 277-278.

 

 

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