基于“脾胃虚则九窍不通”理论从脾胃论治耳鸣刍议

耳鸣是常见病、多发病,居耳科三大难题(耳鸣、耳聋、耳眩晕)之首,西医目前对于耳鸣尚缺乏确切有效的治疗方法,祖国传统医学在耳鸣治疗方面虽然较西医存在较大优势,然而,多数医家常常囿于《内经》“肾开窍于耳”理论,治疗上往往束于“滋阴补肾”之桎梏。金元四大家之一的李东垣在《内经》“脾不及,则令人九窍不通”基础上进一步详尽阐释了其“脾胃虚则九窍不通论”,对后世从脾胃辨治耳鸣方面起了承前启后的作用,文章从脾胃与耳窍的联系及脾胃失调致耳鸣的病因病机两方面加以剖析,试图探其秘旨。

On the Treatment of Tinnitus from Spleen and Stomach Deficiency

Tinnitus is a common and frequently-occurring disease in modern medicine,ranking first among the three difficult problems in otology(tinnitus,deafness and vertigo).At present,there is no definite and effective treatment for tinnitus in Western medicine.Although the Traditional Chinese Medicine has greater advantages over western medicine in the treatment of tinnitus,most doctors are often confined to the theory of“opening kidney to ear”in Neijing,and the treatment is often confined to nourishing Yin and tonifying the kidney.Li Dongyuan,one of the four great scholars in Jin and Yuan Dynasties,further elaborated his theory of“spleen and stomach deficiency but nine orifices are incomprehensible”on the basis of Neijing,which played a connecting role in treating tinnitus from spleen and stomach for later generations.This paper analyzed the relationship between spleen and stomach and ear orifices,and the etiology and pathogenesis of tinnitus caused by spleen and stomach disorder,in order to explore its secret purpose.