仲景"痰饮致眩"辨治梅尼埃病探析OA

Meniere's disease(MD)is characterized by episodic vertigo,fluctuating hearing loss,and tinnitus,and is classified under the category of xuanyun(vertigo)in Traditional Chinese Medicine.The principle proposed in Shanghan Zabing Lun(Treatise on Cold Damage and Miscellaneous Diseases)—that"phlegm-fluid retention disorders should be treated with warm herbs for harmonization"—has become the core rule for differentiating and treating xuanyun caused by phlegm-fluid retention in later generations.The zang-fu pattern differentiation of xuanyun due to phlegm-fluid retention includes:heart yang insufficiency with water qi overwhelming the heart;lung failing to disperse and descend with fluid retention in the upper jiao;spleen failing to transport and transform with fluid retention in the middle jiao;and kidney failing to vaporize and transform with fluid retention in the lower jiao.The corresponding herbal formulas are:Guizhi Jiagui Decoction(Cinnamon Twig Decoction with Extra Cinnamon)for heart yang insufficiency,Gancao Ganjiang Decoction(Liqorice and Dried Ginger Decoction)for lung cold with fluid retention,Zexie Decoction(Alisma Rhizome Decoction)for spleen deficiency with damp retention,and Zhenwu Decoction(True Warrior Decoction)for kidney yang deficiency.The core pathogenesis of xuanyun due to phlegm-fluid retention is rebellious water qi surging upward.This is further elaborated with a clinical case study to illustrate Zhang Zhongjing's theory of"dizziness caused by phlegm-fluid retention"in the differentiation and treatment of MD.