서 론
(Sudden sensorineural hearing loss, SSHL)
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, ,
30-60%
1-2)
.
남혜정경희대학교 한의과 대학
Case Report
Oriental Medical Therapy for Sudden Sensorineural Hearing Loss
Hae-Jeong Nam
Department of Oriental Medicine, College of Oriental Medicine, Kyung Hee University
Objectives: Sudden sensorineural hearing loss (SSHL) is considered an ENT emergency. Despite being a well-recognized condition, SSHL remains one of the most controversial issues in otology. Nowadays, more and more patients have an interest in Oriental medicine for treatment of SSHL. So, to ascertain the therapeutic effect of Oriental Medicine on SSHL, nineteen cases of SSHL patients who had taken Oriental medical therapy in Kyung Hee Oriental Medical Hospital were examined and analyzed.
Methods: Nineteen patients who received over 10 times acupuncture therapy and a minimum 2 weeks of herbal medicine from Sep. 1, 2007 to Aug. 31, 2008 were examined and analyzed. The patients who were in the categories below were excluded:
- within 7 days after onset
- didn’t fulfill 10 times acupuncture therapy - failed to recheck hearing outcome after treatment - less than 30dB at mean dB from 250Hz~4000Hz.
Results: The patients consisted of 12 men and 7 women with a mean age of 45.63 years (19~76). Before treatment, 17 patients had tinnitus, 16 patients had pressure in the ear and 6 patients had dizziness, and mean dB of all patients was 66.89 dB. After treatment, 9 patients still had tinnitus, 4 patients felt pressure in the ear and 2 patents felt dizziness, and mean dB of all patients was 54.57dB. After treatment, 9 patients showed effectiveness in improving both hearing level and speech discrimination, 6 patients showed effectiveness only on speech discrimination and 4 patients showed no therapeutic effect.
Conclusion: Oriental medical therapy had some therapeutic effects on SSHL even it was started 7 days after onset of the disease.
Key Words : Sudden sensorineural hearing loss, SSHL, acupuncture, herbal medicine.
Received：11 February 2009 Revised：13 May 2009 Accepted：19 May 2009
Correspondence to：남혜정(Hae-Jeong Nam) 서울시 동대문구 회기동 1번지 경희대학교 한의과 대학
Tel：+82-2-958-9244, Fax：+82-2-958-9180, E-mail：handr90@korea.com
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3-9)
. corticosteroids
corticosteroids
10-13)
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3
15-17)
. MRI
corticosteroids
10 2
19 7
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대상 및 방법
1. 연구 대상
2007 9 1 2008 8 31
10 2
19 .
.
7 10
250Hz~4000Hz 30dB
2. 치료방법
1)
1 2
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2
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10
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4g, 2g
1 3-4
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6g, , , 4g, , ,
, , , , , , 2g,
, 6g.
.
: 2-12g, 2-6g
: ( ) 8-16g
: 8-12g, 2-4g
3. 청력 검사 및 평가 방법
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(noise room, SA-1000, ( ) , ) (GSI 61, Grason-Stadler, Inc. USA)
1 .
10 ,
.
125, 250, 500, 1000, 2000, 4000,
8000 Hz 250, 500,
1000, 2000, 4000 Hz 10dB
.
결 과
19 12 , 7
45.63 (19~76 ) .
Patient Sex Age Possible cause Past history Job Sleep Feces Diet Exercise Life cycle P1 F 42 overwork hypothyroidism teacher well constipation good none regular
P2 M 51 over
drinking hypertension office worker bad normal good none regular
P3 M 47 stress hyperlipemia public officer bad normal good none regular
P4 M 49 stress hypertension,
hyperlipemia businessman well constipation good none irregular
P5 M 33 stress none office worker well normal good none regular
P6 M 67 food
poisoning hypertension no job well normal lose
appetite none regular
P7 M 37 stress hyperlipemia
Meniere dis. merchant bad constipation good none irregular
P8 F 56 stress chronic rhinitis no job bad normal good walking regular
P9 M 29 stress none office worker well normal good none regular
P10 M 76 overwork prostatism businessman well normal good multi
exercise regular
P11 F 40 stress sterility no job bad diarrhea bad none regular
P12 M 50 stress Rt. ear deafness merchant bad normal good none irregular
P13 M 49 stress HIVD operation taxi driver bad diarrhea good none irregular
P14 F 47 stress
fatigue none business
woman well constipation good none regular
P15 F 39 overwork none business
woman well normal good none regular
P16 F 48 stress none no job well constipation good none regualr
P17 M 53
stress over drinking
hypertension hyperlipemia
HIVD
merchant bad normal good none irregular
P18 M 35 stress none office
worker bad normal good none irregular
P19 F 19 anger
stress none student bad normal bad none irregular
Table 1.
14 , 4
. 7
10 .
1 .
. .
.
1 .
(Table 1).
32.63 (8~115 ) patient 1, 4, 11, 19 4 15
2 . Patient 3, 18
17
MRI
corticosteroids ,
, . 7
12
. 13 , 6
17
Patient
Duration of illness (days)
Side
Co-related symptoms
Examination (Inc MRI)
ENT admission
history
Corticosteroids therapy
OM* treatment
history
Mean Tinnitus Pressure dB
of ear Dizzy
P1 13 L exist exist none full-exam yes keep oral taking
keep injection no 92
P2 15 R exist exist exist full-exam yes keep oral taking yes 37
P3 17 L exist exist none full-exam no self-stop no 98
P4 11 L exist exist none full-exam yes keep oral taking yes 72
P5 20 R none none none full-exam yes finish no 92
P6 30 L none none exist full-exam yes keep oral taking no 90
P7 75 R exist exist exist full-exam yes finish yes 40
P8 30 R exist exist none full-exam yes finish yes 34
P9 35 R exist exist none full-exam yes finish yes 67
P10 17 L exist none none full-exam yes finish no 69
P11 8 L exist exist none full-exam yes self-stop no 51
P12 30 L exist exist none full-exam yes finish no 58
P13 115 L exist exist exist full-exam yes finish yes 117
P14 55 L exist exist exist full-exam yes selp-stop no 80
P15 48 L exist exist exist full-exam yes finish yes 54
P16 18 L exist exist none full-exam yes finish no 43
P17 50 R exist exist none full-exam yes finish no 51
P18 23 L exist exist none full-exam no finish no 36
P19 10 L exist exist none full-exam yes keep injection no 90
*
OM treatment history means previous oriental medicine therapy history before visit this hospital
Table 2.. 16
, 6
. 19
66.89 dB .
2 (Table 2).
12.89 (10~20 ) . Patient 11, 19 17
2
. 8 (
6 , 2 ) 9
. 12
4 . 4
2
. 19
54.57dB 12.32
dB .
3 (Table 3).
19 250-4000Hz
10dB
9 10dB
6 .
4 . 9
74.11dB, 49.77dB
. 17.11
41.11 . 6
47.17dB, 42.67dB
Improvement Patient Duration
(days) Acu-Tx time
Remained-symptoms Mean dB
Tinnitus Pressure of ear Dizzy
Before After Before After Before After Before After
Improved both hearing
and speech discrimination
P1 13 16 ＋ ± ＋ ― ― ― 92 75
P3 17 18 ＋ ― ＋ ― ― ― 98 62
P4 11 15 ＋ ± ＋ ― ― ― 72 21
P5 20 12 ― ― ― ― ― ― 92 68
P9 35 17 ＋ ± ＋ ― ― ― 67 47
P10 17 10 ＋ ― ― ― ― ― 69 55
P11 8 14 ＋ ± ＋ ― ― ― 51 27
P18 23 10 ＋ ＋ ＋ ― ― ― 36 13
P19 10 10 ＋ ＋ ＋ ― ― ― 90 80
Improved only speech discrimination
P2 15 15 ＋ ± ＋ ― ＋ ― 37 30
P7 75 14 ＋ ＋ ＋ ― ＋ ― 40 36
P12 30 10 ＋ ＋ ＋ ― ― ― 58 51
P15 48 20 ＋ ＋ ＋ ＋ ＋ ― 54 52
P16 18 10 ＋ ± ＋ ― ― ― 43 37
P17 50 10 ＋ ± ＋ ― ― ― 51 50
Not Improved
P6 30 14 ― ― ― ― ＋ ― 90 82
P8 30 10 ＋ ＋ ＋ ＋ ― ― 34 37
P13 115 10 ＋ ＋ ＋ ＋ ＋ ＋ 117 117
P14 55 10 ＋ ― ＋ ＋ ＋ ＋ 80 97
＋ : means exist, ± : means improved, ― : means absolutely removed.
Before & After : means before treatment and after treatment
Table 3.. 39.33
46.33 . 4
80.25dB, 83.25
dB 57.50 .
54.75 .
(Table 4, Fig. 1, 2, 3).
고 찰
.
,
, ,
, , .
Fig. 1.
Number
Mean±SD Age
(year)
Duration (day)
Hearing before Tx(dB)
Hearing after Tx(dB) Improved both hearing level &
speech discrimination 9 41.11±16.02 17.11±8.29 74.11±21.00 49.77±24.40
Improved only speech discrimination 6 46.33±6.68 39.33±22.78 47.17±8.37 42.66±9.45
No improvement 4 54.75±9.03 57.50±40.10 80.25±34.56 83.25±34.00
Table 4.
. 2
2
.
19 2
.
Fig. 3.
Fig. 2.
.
2 .
7
7
3,4,7,10)
.
30-60%
18,19)10)
.
1-2
, 156
20)118 14
82 (69.49%)
65 58 (89.23%) 14
38 (24.35%) .
10 -2
1 -2
3
21,22).
France Van
12)3 10
corticosteroids systemic therapy
corticosteroids 12 2/3
10dB corticosteroids
, 10 10
2 .
.
9 17.11±8.29
. , ,
40-60%
23)
