王士贞教授治疗突发性聋的经验介绍(1)
[摘要] 王士贞教授是全国著名中医耳鼻喉科专家，国家级老中医药专家学术继承人指导老师，中西医结合诊治耳鼻喉科疾病经验丰富。突发性聋是指原因不明突然发生的听力下降，目前治疗效果参差不齐。王教授治疗突发性聋因人施治，注重身心同治，善于借助现代医学技术协助诊治，重视辨病与辨证相结合，重视调理肝脾功能，善于内治与外治相结合，采用综合治疗以期回聪，临床上取得良好疗效。此外，对于听力障碍患者王教授善于引导其使用助听器以改善生活质量。笔者有幸跟师随诊，现将王教授治疗突发性聋经验总结如下，以供同道参考。
[关键字] 突发性聋;王士贞;名医经验;中医药
[中图分类号] R764.4 [文献标识码] A [文章编号] 1673-7210(2019)03(c)-0141-04
[Abstract] Professor Wang Shizhen is a famous expert in otolaryngology of traditional Chinese medicine， an academic tutor of national old Chinese medicine experts， and he has rich experience in the diagnosis and treatment of diseases of otolaryngology by integrating traditional Chinese and Western medicine. Sudden deafness refers to unexplained sudden hearing loss and the treatment has been irregularity at present. Professor Wang treat sudden deafness according to the characteristics of the patients， paying attention to both body and mind， with the help of modern medical technology in diagnosis and treatment， paying attention to the combination of disease differentiation and dialectical， concentrating on regulating liver and spleen function， good at combining internal treatment with external treatment， and treating comprehensively with a view to returning to hearing. Well clinical effect has been obtained. In addition， patients with hearing impairment can be guided to use hearing aids to improve their living quality. The author has the honor to follow the teacher in clinic， and summarize Professor Wang experience in the treatment of sudden deafness as following， for reference to the others.
[Key words] Sudden deafness; Wang Shizhen; Medical experience; Traditional Chinese medicine
突發性聋是指原因不明、突然发生，于72 h内听力损失达最高峰的听力下降(相邻两个频率听阈下降20 dBHL以上)[1]，属于中医“暴聋”范畴[2]。突发性聋可伴有耳鸣、眩晕、耳堵塞感等不适[3-4]，严重影响患者的生活、工作质量，使患者生活、心理受到严重伤害[5]。近年来突发性聋发病率有所增长，可能与起居无常，情绪失疏，饮食不节，寒暖失调等因素相关[6-9]。突发性聋越早治疗效果越好，积极治疗有助于提高疗效[10]。王教授治疗突发性聋患者注重望闻问切，因人施治，身心同治，注重外治与内治相结合，取得较好疗效。
1 审察内外，身心同治
王教授接诊突发性聋患者，会详细询问发病前是否有外感病史，个人生活、工作情况，如工作环境、工作压力、家庭关系、发病前的劳累和熬夜史、情绪波动等，发病的情景、听力下降的发展，耳鸣、眩晕等伴随症状，以及胃纳、睡眠、饮食、二便等情况，同时关注患者的情绪、表情、语速等细节。此外，四诊合参，重视舌脉审察，辨别证型和体质，把握病机。结合听力结果及个人情况同患者分析病情，给予患者适当的期待值和对病情的正确了解，减轻患者心理负担，从生活、工作、饮食、情绪等方面给予相应建议，鼓励患者积极配合治疗。
王教授认为，人体是一个整体，人与天地相应，在认识疾病过程中需要立足于局部，又须联系全身和外界环境。耳聋虽病变位于耳，但耳聋的发生不独于耳，五脏六腑皆可令人聋[11]，人体病症的产生无不体现整体的失调。外界环境时刻影响着人体，当外界环境急剧变化，或人体功能不能适应外界时，脏腑经络功能就会失调导致疾病发生。故诊察疾病需要诊察局部、整体及患者所处的外界环境(如地区、节气、精神环境和生活条件等)。突发性聋是其中一种病症，治疗突发性聋除了治疗疾病本身，仍需指导患者正确应对外界环境。突发性聋虽是突然发生之病症，但不仅归咎于病因，更有甚者是病理产物(如痰浊、瘀血等)累积到一定程度或虚损超过人体机能代偿而致。对于突发性聋，祛除病因是第一步，调理脏腑机能、促进机体自我修复是关键。此外，目前研究表明突发性聋越早治疗听力改善概率越大，因此，王教授会告知患者应把握早期治疗时机，暂时抛却外界干扰，释放压力，保持良好心情、睡眠、饮食。, http://www.100md.com(廖晓君 何伟平)
[关键字] 突发性聋;王士贞;名医经验;中医药
[中图分类号] R764.4 [文献标识码] A [文章编号] 1673-7210(2019)03(c)-0141-04
[Abstract] Professor Wang Shizhen is a famous expert in otolaryngology of traditional Chinese medicine， an academic tutor of national old Chinese medicine experts， and he has rich experience in the diagnosis and treatment of diseases of otolaryngology by integrating traditional Chinese and Western medicine. Sudden deafness refers to unexplained sudden hearing loss and the treatment has been irregularity at present. Professor Wang treat sudden deafness according to the characteristics of the patients， paying attention to both body and mind， with the help of modern medical technology in diagnosis and treatment， paying attention to the combination of disease differentiation and dialectical， concentrating on regulating liver and spleen function， good at combining internal treatment with external treatment， and treating comprehensively with a view to returning to hearing. Well clinical effect has been obtained. In addition， patients with hearing impairment can be guided to use hearing aids to improve their living quality. The author has the honor to follow the teacher in clinic， and summarize Professor Wang experience in the treatment of sudden deafness as following， for reference to the others.
[Key words] Sudden deafness; Wang Shizhen; Medical experience; Traditional Chinese medicine
突發性聋是指原因不明、突然发生，于72 h内听力损失达最高峰的听力下降(相邻两个频率听阈下降20 dBHL以上)[1]，属于中医“暴聋”范畴[2]。突发性聋可伴有耳鸣、眩晕、耳堵塞感等不适[3-4]，严重影响患者的生活、工作质量，使患者生活、心理受到严重伤害[5]。近年来突发性聋发病率有所增长，可能与起居无常，情绪失疏，饮食不节，寒暖失调等因素相关[6-9]。突发性聋越早治疗效果越好，积极治疗有助于提高疗效[10]。王教授治疗突发性聋患者注重望闻问切，因人施治，身心同治，注重外治与内治相结合，取得较好疗效。
1 审察内外，身心同治
王教授接诊突发性聋患者，会详细询问发病前是否有外感病史，个人生活、工作情况，如工作环境、工作压力、家庭关系、发病前的劳累和熬夜史、情绪波动等，发病的情景、听力下降的发展，耳鸣、眩晕等伴随症状，以及胃纳、睡眠、饮食、二便等情况，同时关注患者的情绪、表情、语速等细节。此外，四诊合参，重视舌脉审察，辨别证型和体质，把握病机。结合听力结果及个人情况同患者分析病情，给予患者适当的期待值和对病情的正确了解，减轻患者心理负担，从生活、工作、饮食、情绪等方面给予相应建议，鼓励患者积极配合治疗。
王教授认为，人体是一个整体，人与天地相应，在认识疾病过程中需要立足于局部，又须联系全身和外界环境。耳聋虽病变位于耳，但耳聋的发生不独于耳，五脏六腑皆可令人聋[11]，人体病症的产生无不体现整体的失调。外界环境时刻影响着人体，当外界环境急剧变化，或人体功能不能适应外界时，脏腑经络功能就会失调导致疾病发生。故诊察疾病需要诊察局部、整体及患者所处的外界环境(如地区、节气、精神环境和生活条件等)。突发性聋是其中一种病症，治疗突发性聋除了治疗疾病本身，仍需指导患者正确应对外界环境。突发性聋虽是突然发生之病症，但不仅归咎于病因，更有甚者是病理产物(如痰浊、瘀血等)累积到一定程度或虚损超过人体机能代偿而致。对于突发性聋，祛除病因是第一步，调理脏腑机能、促进机体自我修复是关键。此外，目前研究表明突发性聋越早治疗听力改善概率越大，因此，王教授会告知患者应把握早期治疗时机，暂时抛却外界干扰，释放压力，保持良好心情、睡眠、饮食。, http://www.100md.com(廖晓君 何伟平)