Meniere’s Disease

(From "The Treatment of 42 Cases of Meniere’s

Disease with Ling Gui Zhu Gan Tang Jia Wei [Poria,
Cinnamon, Atractylodes & Licorice Decoction with
Added Flavors," by Xie Shou-liang, Hu Nan Zhong
Yi Za Zhi [Hunan Journal of Chinese Medicine], #1,
2000, p. 26)
From Jun. 1984 to Jul. 1999, the author of this
study treated 42 cases of Meniere’s disease with
Ling Gui Zhu Gan Tang Jie Wei. The author then
compared these outcomes with 30 cases of
Meniere’s disease treated with 654-2 (an
unidentified ready-made medicine in injectible
form) combined with Xi Bi Ling (an unidentified
ready-made medicine in capsule form).
Cohort description:
Altogether, there were 72 patients in this study,
with 42 in the treatment group and 30 in the
comparison group. Of the 42 patients in the
treatment group, 25 were male and 17 were
female. The oldest was 65 and the youngest was
22 years old, with a median age of 46. The shortest
course of disease was two days and the longest
was 10 years. Of the 30 patients in the comparison
group, 17 were male and 13 were female. They
ranged in age from 68-20, with a median age of 48
years. The shortest course of disease in this group
was three days and the longest was eight years.
Therefore, there was no marked statistical
difference in terms of sex, age, or disease duration
between these two groups (P , 0.05). Diagnoses
was based on history, clinical symptoms, and
examination. Criteria for diagnosis were based on
the Shanghai Medical University’s Shi Yong Nei Ke
Xue (A Study of Practical Internal Medicine)
published by the People’s Health & Hygiene Press.
Treatment method:
The treatment group received Ling Gui Zhu Gan
Tang Jia Wei: Sclerotium Poriae Cocos (Fu Ling),
20g, Ramulus Cinnamomi Cassiae (Gui Zhi), 10g,
Rhizoma Atractylodis Macrocephalae (Bai Zhu),
12g, Radix Glycyrrhizae (Gan Cao), 9g, Rhizoma
Alismatis (Ze Xie), 30g, lime-processed Rhizoma
Pinelliae Ternatae (Ban Xia), 18g, uncooked
Rhizoma Zingiberis (Sheng Jiang), 12g, Pericarpium
Citri Reticulatae (Chen Pi), 12g, uncooked Os
Draconis (Long Gu), 30g, and uncooked Concha
Ostreae (Mu Li), 30g. One ji of these medicinals
was boiled in water two times and the two
decoctions were then taken in three divided doses
per day. If there was severe vomiting, electrolytes
and fluids were intravenously replaced.
The comparsion group received Xi Bi Ling Jiao Nong
(Xi Bi Ling Capsules), 10mg, each evening before
going to bed. In addition, they received 10mg of
654-2 by intramuscular injection three times per
day. If there was severe vomiting, electrolytes and
fluids were intravenously replaced. Ten days
equaled one course of treatment for both groups.
Treatment outcomes:
Cure meant that all the symptoms basically
disappeared. Improvement meant that the clinical
symptoms partially disappeared or improved. No
effect meant that, after one course of treatment,
there was no marked improvement in symptoms.
Based on these criteria, in the treatment group, 33
cases were cured, eight improved, and only one
experienced no effect. Thus the total amelioration
rate in the treatment group was 97.6%. In the
comparison group, 19 cases were cured, five
improved, and six got no effect. Therefore, the
total amelioration rate in that group was 80.0%.
Hence statistical difference in outcomes between
these two groups was marked (P + 0.05).
Author’s discussion:
According to the author, Meniere’s disease
corresponds to the traditional Chinese disease
category of "dizziness and vertigo." As Zhu Dan-xi
said, "No phlegm, no dizziness." This clearly
explains that most cases of this disease result from
phlegm dampness obstructing and stagnating the
clear orifices. The Jin Gui Yao Lue (Essentials from
the Golden Cabinet) says, "For diseases [due to]
phlegm rheum, one should use warm medicinals to
harmonize them," and, "If one has slight rheum,
one should expel this via urination." This formula
uses Cinnamon Twigs, Poria, Atractylodes
Macrocephala, Pinellia, Orange Peel, uncooked
Ginger, and Licorice to warm yang and transform
rheum, dry dampness and transform phlegm,
rectify the qi and harmonize the center. In addition,
the author uses large doses of Poria and Alisma to
disinhibit water and seep or percolate dampness in
order to clean the clear orifices. He then also adds
uncooked Dragon Bone and Oyster Shell in order to
settle, still, and quiet the spirit. When all these
medicinals are used together, their effect is to
transform phlegm, harmonize the center, and quiet
the spirit.
(From "The Treatment of 25 Cases of Meniere’s
Syndrome with the Two Step Method," by Luo Shi-
wei, Si Chuan Zhong Yi [Sichuan Chinese
Medicine], #2, 2000, p. 34)
The authors of this article treated 25 cases of
Meniere’s syndrome with the two step method with
fully satisfactory treatment efficacy as described
below.
Cohort description:
All 25 patients in this study were seen as out-
patients. Of the 25, 11 were male and 14 were
female. They ranged in age from 30-65 years old,
and their course of disease had lasted from 1-6
years. All the patients had been diagnosed by
Western medicine as having Meniere’s syndrome,
and 20 patients had been previously treated with
Western medicinals without marked treatment
results.
Treatment method:
Step one consisted of taking Huo Chai Tang
(Agastaches & Bupleurum Decoction) with additions
and subtractions: Herba Agastachis Seu Pogostemi
(Huo Xiang), Radix Bupleuri (Chai Hu), and Radix
Angelicae Dahuricae (Bai Zhi), 10g each, Rhizoma
Atractylodis Macrocephalae (Bai Zhu), Sclerotium
Poriae Cocos (Fu Ling), Radix Platycodi Grandiflori
(Jie Geng), lime-processed Rhizoma Pinelliae
Ternatae (Ban Xia), Cortex Magnoliae Offiicinalis
(Hou Po), and Radix Scutellariae Baicalensis
(Huang Qin), 15g each, Radix Codonopsitis
Pilosulae (Dang Shen), 30g, Folium Perillae
Frutescentis (Zi Su Ye), Pericarpium Citri
Reticulatae (Chen Pi), and uncooked Rhizoma
Zingiberis (Sheng Jiang), 6g each. One ji was
administered per day after being boiled in water
and divided into three doses. This was continuously
administered for 2-3 ji.
Step two consisted of taking self-composed Nei Er
Xuan Yun Tang (Inner Ear Dizziness Decoction):
Semen Plantaginis (Che Qian Zi), Radix Achyranthis
Bidentatae (Niu Xi), and Spica Prunellae Vulgaris
(Xia Ku Cao), 12g each, Sclerotium Poriae Cocos
(Fu Ling), lime-processed Rhizoma Pinelliae
Ternatae (Ban Xia), Fructus Lycii Chinensis (Gou Qi
Zi), and uncooked Magnetitum (Ci Shi), 15g each,
Flos Chrysanthemi Morifolii (Ju Hua) and
Pericarpium Citri Reticulatae (Chen Pi), 10g each.
One ji was administered per day after being boiled
in water and divided into three doses. Seven days
equaled one course of treatment, and typically two
such courses were given before seeing treatment
effects. During this treatment, patients were
forbidden to eat acrid, peppery, uncooked,
chilled, or oily, slimy, stimulating foods.
Treatment outcomes:
Using this protocol, 22 patients were cured. This
meant that their dizziness and vertigo, tinnitus, and
vomiting disappeared and there was no recurrence
on follow-up after one year. The other four cases
improved. This meant that their clinical symptoms
markedly improved even though they did not
disappear.
Author‘s discussion:
This disease is characterized by a prolonged course
and frequent relapses. It is categorized in Chinese
medicine as "dizziness" and "vomiting." Most
Chinese doctors think that the disease mechanisms
at work in this condition are a loss of regulation in
the function of the liver, spleen, and kidneys with
counter flow and chaos of the qi mechanism. This
results in the qi of phlegm turbidity harassing
above. However, the author thinks that most cases
are due to excessive taxation fatigue and psycho
emotional stress allowing for external invasion.
Therefore, he first gives Huo Chai Tang to A) dispel
and eliminate external evils and B) regulate and
rectify the liver-gallbladder and spleen-stomach qi
mechanism, thus treating the branch condition.
Then he uses Nei Er Xuan Yun Tang to level the
liver and downbear counterflow, fortify the spleen,
transform phlegm, and eliminate dampness to treat
the root. After this treatment, if there is a liver-
kidney insufficiency, he consolidates the treatment
effects and prevents recurrence by prescribing Qi
Ju Di Huang Wan (Lycium & Chrysanthemum
Rehmannia Pills). If there is spleen-stomach
insufficiency, he prescribes Bu Zhong Yi Qi Wan
(Supplement the Center & Boost the Qi Pills) with
Xiang Sha Yang Wei Wan (Auklandia & Amomum
Nourish the Stomach Pills).