Tinnitus may be the most common ear problem. Unfortunately, so far there is no proven effective treatment and the best cure for it is prevention. The good news is that Chinese medicine practitioners have accumulated experiences from practices in previous thousands of years. Today, they treat tinnitus with acupuncture, herbal therapy, or massage. And several controlled studies have shown that they could help get rid of the unwanted noise to a certain extent.
Tinnitus refers to ringing or buzzing in the ears when no external sound is present. This is not a disease but a symptom of other problems associated with ear, blood vessels, heart, brain, or other organs. So, to get rid of tinnitus finding the underlying cause is a priority. Over the years acupuncture and Chinese herbal therapy have been clinically proved to treat tinnitus effectively.
Chinese herbal treatment for tinnitus
According to Western medicine, there are subjective tinnitus and objective tinnitus. Similarly, tinnitus can be categorized into a few patterns in TCM (traditional Chinese medicine) based on some specific named symptoms.
1. Wind-heat invasion. The patients of this pattern are characterized by abrupt onset and mild symptoms of low pitched sounds, feeling of fullness in the ear, and increased volume of their own voice. It may follow nasal congestion, runny nose, cough, and other exterior symptoms of lung meridian. Besides, TCM practitioners often observe congestive eardrums, pink tongue, thin white coating, and floating-rapid pulse. By the way, the patients with this pattern are more likely to be diagnosed with acute secretory otitis media.
The treatment should follow the theory of Liu Yuan Su (1120 – 1200), who believed that the root of this condition lay in lung disorders. So, the treatments of tinnitus include dispelling wind, ventilating lung, and unblocking the orifices. And Yin Qiao San is one of the typical formulas. The commonly used herbs are Jin Yin Hua (Flos Lonicerae), Lian Qiao (Fructus Forsythiae), Jie Geng (Radix Platycodi), Xing Ren (Semen Armeniacae), Jing Jie (Herba Schizonepetae), Fang Feng (Radix Saposhnikoviae), Chan Tui (Periostracum Cicadae), and Shi Chang Pu (Rhizoma Acori Tatarinowii). Besides, Gua Lou (Fructus Trichosanthis) can be added for excess phlegm and Xin Yi (Flos Magnoliae), Cang Er Zi (Fructus Xanthii), and Bai Zhi (Radix Angelicae Dahuricae) for nasal congestion.
2. Liver-fire rising. This pattern is characterized by acute onset, severe symptoms and loud ringing. Because it is closely related to changes of spirit and sentiment, anger can worsen the symptoms. And it’s often accompanied by red tongue, yellow coating, wiry and rapid pulse, bitter taste in mouth, upset, dizziness, headache, irritability and other symptoms of liver-fire blazing.
As its name suggested, this pattern is caused by liver fire rising. So, the basic therapies in tinnitus treatment are to clear liver, purge heat, and unblock the orifices and the preferred formula is Long Dan Xie Gan Tang and its modifications. The commonly used herbs include Long Dan Cao (Radix Gentianae), Huang Qin (Radix Scutellariae), Zhi Zi (Fructus Gardeniae), Dang Gui (Radix Angelicae Sinensis), Ze Xie (Rhizoma Alismatis), Sheng Di Huang (Radix Rehmanniae), Mu Tong (Caulis Akebiae), Chai Hu (Radix Bupleuri), Shi Chang Pu (Rhizoma Acori Tatarinowii), Man Jing Zi (Fr. Viticis), and Ci Shi (Magnetitum).
3. Turbid phlegm obstruction. This pattern is characterized by long duration and obvious symptoms of ear ringing, dizziness, heaviness of the head, and ear fullness. They may be accompanied by chest tightness, poor appetite, swollen tongue with teeth marks on sides, thick greasy coating, and slippery-wiry pulse.
In this case, tinnitus occurs when phlegm turbidity arises and blocks the upper orifices. For that reason, the principles of effective treatment are to resolve phlegm, descend the turbid, regulate the stomach, and unblock the orifices. The most commonly used formula is Er Chen Tang and its modifications. The commonly used herbs include Zhi Ban Xia (Rhizoma Pinelliae Preparatum), Chen Pi (Pericarpium Citri Reticulatae), Fu Ling (Poria), Jiang Can (Bombyx Batryticatus), Shi Chang Pu (Rhizoma Acori Tatarinowii), Yi Yi Ren (Semen Coicis), Bai Zhi (Radix Angelicae Dahuricae), and so on.
4. Liver-kidney deficiency. This pattern persists for a long time and affects mostly the elderly, according to conclusion based on clinical practice. It is characterized by cicada-like noises that are not so loud, perhaps accompanied by achiness and weakness in lower back and knees, vertigo, dry eyes, and other symptoms of liver-kidney deficiency. In addition, TCM practitioners often observe red tongue with little coating and thready pulse. The therapeutic principle is to nourish the kidney, strengthen the essence, and nourishing yin for suppressing hyperactive yang. One of typical formulas is Er Long Zuo Ci Wan and the commonly used herbs include Sheng Di Huang (Radix Rehmanniae), Shan Zhu Yu (Fructus Corni), Shan Yao (Rhizoma Dioscoreae), Shi Chang Pu (Rhizoma Acori Tatarinowii), Niu Xi (Radix Achyranthis Bidentatae), Tu Si Zi (Semen Cuscutae), Fu Pen Zi (Fructus Rubi), and more.
If the patients have obvious symptoms of flaring-up of the heart-fire, such as upset, irritability, insomnia, mouth sores, red tip of tongue, and rapid thready pulse, the treatment principle is to clear heart fire and nourish kidney yin. In this case, Dao Chi San is the preferred formula. The commonly used herbs are Sheng Di Huang (Radix Rehmanniae), Huang Qin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis), Dan Zhu Ye (Herba Lophatheri), Suan Zao Ren (Semen Zizyphi Spinosae), and more.
5. Weakness of the spleen and stomach. This pattern is characterized by low spirits, fatigue, weakness, dizziness, worse symptoms after fatigue, poor appetite, pale tongue, thin white or thick coating, and weak pulse. The treatment principle is to invigorate spleen and replenish Qi and invigorate splenic yang. So, the best optional formulas include Bu Zhong Yi Qi Tang, Shen Ling Bai Zhu San, Bai Zhen Tang, and the like. The commonly used herbs are Dang Shen (Radix Codonopsis), Huang Qi (Radix Astragali), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Sheng Ma (Rhizoma Cimicifugae), Ge Gen (Radix Puerariae), Chen Pi (Pericarpium Citri Reticulatae), Dang Gui (Radix Angelicae Sinensis), and more.
Chinese acupuncture for tinnitus
1. Excess patterns. The treatment protocols are to clear liver and drain fire and open the blocked upper orifices (ear). The treatment focuses on points of Foot-Shaoyang and Hand-Shaoyang. The main treatment points include Yifeng (SJ17), Tinghui (GB2), Xiaxi (GB43), and Zhongzhu (SJ3). When it comes to auxiliary points, Tai Chong (LV3) and Qiuxu (GB40) can be added for flaming up of Liver-Gallbladder Fire, Waiguan (TE 5) and Hegu (LI4) for exterior syndromes related to exogenous pathogenic wind, and Shenshu (B-23) and Guanyuan (RN4) for kidney deficiency. And filiform needles should be used and applied the reducing method.
2. Deficiency patterns. The treatment protocols are to tonify the kidney and nourish seven orifices. The treatment focuses on points of Foot-Shaoyin and Hand-Taiyang. The main treatment points include Taixi (KI3), Zhaohai (KI6), and Tinggong (SI-19). When it comes to auxiliary points, Shenshu (B-23) and Qihai (CV 6) can be added for kidney-qi deficiency and Shenshu (B-23) and Ganshu (BL 18) for liver-kidney deficiency. And filiform needles should be used and applied the reinforcing method. By the way, moxa cones can be used on the affected area for kidney-qi deficiency.