| ObjectiveTinnitus is in three major problems on otology (tinnitus, deafness and dizziness) of the first. Due to the understanding of Western medicine pathogenesis of tinnitus is not clear, there is lack of effective treatment. Because of emphasising on Nourishing Yin and tonifying kidney, easily hurt the stomach and unsatisfactory effectiveness, TCM is also not widely recognized. Based on the much research, my tutor believe that the etiology and pathogenesis of tinnitus is the spleen and stomach disorders as the center. This research intends to through the data of high quality to prove the theory and regulating the spleen and stomach in treating tinnitus can obtain good short-term and long-term effect. And then to formulate a normative therapeutic strategy of tinnitus with TCM.MethodsThis research includes two parts. The first part is a theoretical research. In this part, we want to find out the core pathogenesis of tinnitus by literature. The second part is a clinical study which includes three sections. The first section is an observation about the risk factors of the tinnitus. In this section,we want to analysis of the relationship between diet, sleep, emotional and the incidence of tinnitus, so as to analysis of the relationship between the spleen and stomach disorders and the incidence of tinnitus. The second section aims to observe the curative effect of regulating the spleen and stomach as the center for the treatment of tinnitus. In this section,we interviewed participants by telephone about the curative effect of Chinese medicine in the treatment of tinnitus. The third section is to study on the basic therapy that regulating the spleen and stomach as the center for the treatment of tinnitus. In this section, the participants were divided into different groups, each group was treated by different methods that were based on basic therapy. And then comparing the curative effect of the basic therapy coupled with other methods and the simple use of basic therapy. The data collected and entered into the computer, and statistical analysis was performed by SPSS20.0 Chinese version of the software, there are statistically significant differences in P<0.05.ResultsIn the first part, We learn through Huangdi’s Internal Classics that the spleen and stomach disorders is the fundamental cause of tinnitus. And improper diet, living impermanence, emotion disordered are three important factors causing the spleen and stomach disorders. In the first section of part two, compared with healthy people, there is no statistically significant difference in gender, age, occupation, and the difference was at the spleen and stomach disease history, Feiganhouwei diet, cold food, cold drug use history, pressure, PRO score, PSQI score etc. So the spleen and stomach disease history, Feiganhouwei diet, cold food, cold drug use history, pressure, high PRO score, high PSQI score are the causes of tinnitus. In the second section, A total of 333 cases of tinnitus patients were collected for statistical analysis, after an average of 33.64±37.07 days of treatment, there were 5 cases cured (1.50%), 25 cases markedly effective (7.51%),79 cases effective (23.72%) and 224 cases invalid (67.27%), the total effective rate was 32.73%;a total of 283 cases were followed up at least once after an average of 23.68±9.47 months from newly diagnosed, there were 39 cases cured(13.78%),46 cases markedly effective(16.25%), 117 cases effective (41.34%) and 81 cases invalid (28.62%), the total effective rate was 71.38%; a total of 91 cases were followed up twice after an average of 57.48±7.91 months from newly diagnosed, there were 37 cases cured (40.66%), 21 cases markedly effective (23.08%),26 cases effective (28.58%) and 7 cases invalid (7.69%), the total effective rate was 92.31%. Merging the two groups of data, Sorting the data according to the diagnosis time, and then comparing the curative effect, we find that the effective rate is increasing year by year. There was a statistically significant difference in efficacy among～2 year,2 year～ and 4 year ～. Further analysis of the factors influencing the efficacy of tinnitus, we find that the effective was only related with PRO score and TEQ score. In the third section, a total of 122 cases to meet the requirements were collected, 54 cases with the basic therapy coupled with other methods and 68 cases with the simple use of the basic therapy. There is no statistical significance difference between the groups. After an average of 39.25±39.058 days of treatment, the group with the simple use of the basic therapy were 0 case cured (0%),9 cases markedly effective (13.24%),10 cases effective (14.71%) and 49 cases invalid (72.06%), the total effective rate was 27.94%. The group with the basic therapy coupled with other methods were 1 case cured (1.85%),4 cases markedly effective (7.40%), 11 cases effective (20.37%) and 38 cases invalid (70.37%), the total effective rate was 29.63%. There is no statistical significance difference between the groups by chi square test.ConclusionThis study confirmed that "Qing Yang subsidence, turbid Yin on the inverse" (Huangdi’s Internal Classics) caused by the spleen and stomach disorders is one of the core pathogenesis of tinnitus. And improper diet, living impermanence, emotion disordered are three important factors causing the spleen and stomach disorders. Regulating of the spleen and stomach is the key to the treatment of tinnitus. The method mainly includes two aspects. On the one hand, it is important to educat the patients to adjust diet, sleep, emotional and other bad habits. On the other hand, it is also important to regulating the spleen and stomach by oral administration of Chinese medicine, auricular point sticking, day drum and other method such as acupuncture and acupoint injection. But it is not the more the method used, the better the effectiveness. By regulating the spleen and stomach are the effective treatment of tinnitus, and the longer the time, the better the effectiveness. Because of its effieieney but simple and inexpensive, it is worth of clinical application. |
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