Case Study & Research of Meniere's Disease Patient
Meniere's disease, defined by western medicine, is a distention of compartments in the inner ear due to an unknown cause. The often thought causes include head trauma and viral infection. As far as manifestations, there is usually vertigo (dizziness where the room seems to spin around you), tinnitus, and possibly hearing loss. Underneath Meniere's disease is a variety of types, but the basic difference is whether their onset was acute or chronic, and which of the three symptoms is worse.
A female patient around 28 years old came into the clinic with a Western diagnosis of Meniere's disease, of a particular variety known as labyrinthitis (acute onset of vertigo with little to no hearing loss). Amazingly, within 4 treatments almost all symptoms of the disorder were gone. Even though she suffered with the symptoms for the past 7 months straight, they returned after the initial four treatments but one time and then never again.
What was most interesting was that I did not think at the time that I was giving a Meniere's specific treatment. Instead I found a TCM diagnosis (in this case liver qi stagnation with yang rising) and followed through with it. In other words I did not use any "magical" empirical point known to the ancients for vertigo or dizziness. In effect it became a proof that the theory of Chinese medicine wasn't just a complete farce, but instead a meaningful pursuit in treating problems that didn't have "magic" points.
My patient's main complaints were dizzy spells. They had been going on since last November (7 months). For her, the room tilts, occurring three to four times a week, felt particularly at the vertex of the head, was better with rest, and was definitely stress related. Her complexion is rather pale yet she tended towards warmth. She also had migraines once every 2-3 months which manifested right in the point yin tang. In addition she had stress related headache's about three times a week, tinnitus once a week which was high pitched, and alternating stools between hard and soft. Her tongue was scalloped with a purple body and her pulse was tight and slippery. I diagnosed her with classic Liver Qi stagnation with some yang rising up to the head. My treatment was simple, Chinese style acupuncture: LI4, Liv3, GB 20, SI19, Tai Yang, Yin Tang, GV 20, TW 5, and GB 41.
Research produced four different articles relating directly to Meniere's disease and the symptoms that she had. What was most interesting in studying the four was that only slight differences could be found between them and in turn between them and my own case study. One of the articles I am omitting here because its focus was solely on electro-acupuncture and the results presented were not compelling enough to warrant writing about.
All of the articles (including the electro article) agreed upon but two possible etiologies and pathologies that cause the disorder to manifest. They are "liver yang rising from qi stagnation" and "phlegm & damp in the middle burner." One also mentioned a quick stab at a possible diagnosis of kidney and liver yin deficiency but that it was very rare and it wasn't included in the study. An interesting thing to note is that all the studies, being TCM theory based, stated an uneven population of men and women, with a much higher frequency of occurrence in men, and in turn all their studies had a greater male population. Yet in the western medical book it mentioned no such predisposition of the disorder to men, and in fact stated there were hints of the opposite.
The first study was very simply laid out, placing the 30 plus patient population into one of the two diagnoses of liver stagnation or phlegm-damp. It's point selection for liver stagnation were GB20, LV3, GV20, YT, KD3 with moxa on the kidney and liver shu points. For phlegm-damp the selection was ST8, TW17, ST36, PC6, GB43, and ST40. The study followed the patient's symptoms while giving treatments multiple times a week as one course, and treating for three courses. Eighty percent of the patient responded and were considered cured after the finish of the third course. The other twenty all had a great reduction in symptoms. Thirty percent of the whole population had a relapse of symptoms within one year, most of which came from the non-cured patients.
The second study was almost a perfect mimic of the first and had very similar conclusions. The point selection for liver stagnation were LV3, SP6, KD3, LV8, TW17, and SI19. They used ST36, SP3, ST40, SP9, PC6, GB20, TW17, SI19 for the cases with phlegm-damp. The study included a greater number of patients than the first (72), again mostly male. This population enjoyed a seventy percent cure rate, a seventeen percent lessening of symptoms, and a mere twenty percent of relapse within a year. In this case it is kind of interesting to note that they used GB20 in the phlegm cases and not with the liver qi stagnation that could cause wind or yang to rise up. Yet, the results seemed no less successful.
The final study had less of a conclusion since it was only most of the way finished and it seemed a publisher's deadline must have been looming and they only published partial results. However, they were very promising. Their point selections for liver pattern was LV2, LV3, GV20, TW17, and SI19. Phlegm patterns received SP6, ST36, ST40, SI19, and TW17. A population was not given since the final number wasn't calculated. In the article it gave an average example of a typical patient and the results were a complete cure of all symptoms after but three treatments. It was stated that that was the "average patient." Promising results indeed.
After going over my patients signs and symptoms I definitely think I made the correct decision to utilize the Liver yang rising from Qi stagnation approach as opposed to phlegm-damp since her damp sings were few and far between. It was almost difficult to write a paper that felt comprehensive given how congruent all the clinical studies and case studies have been in treating this disease. It was truly difficult to find a significant difference in the studies that were done in either point selection or treatment principle. The reason I discluded the electro-study is because it's results were poor and it definitely doesn't seem like the way to go in treating when these two simple methods appear so effective. The only things that differed, amusingly, were how they introduced the disease itself from a western standpoint. It didn't seem like they all read the same text to garner a definition of the disorder.
All of the studies had excellent short and long term outcomes. My patient for example, I still keep in touch with and has yet to have any relapse for over 8 months now and is feeling wonderful. The minor recurrence of symptoms in a few of the studies were reported in cases of long standing disease and the recurrence was again treated successfully with acupuncture. To me this seems like one that should go on the walls in doctors offices of when to just let it go and refer to acupuncture.
Sources1. Tierney, Lawrence. M. Current: Medical Diagnosis & Treatment. Connecticut: Norwalk. 1995, p179.
2. Tian, Zhen-ming. "Treatment by Electro-Acupuncture of Meniere's Disease." Journal of Chinese Medicine #61, p27-29, 1999.
3. Chell, Keith. "Treatment by Acupuncture of Meniere's Disease." Journal of Chinese Medicine #55, p5-9, 1997.
4. Zhong-hou, LU. "Meniere's Syndrome Treated with Acupuncture: a Report of 30 Cases". International Journal of Clinical Acupuncture. Vol 8, p295-296, 1997.
5. Zhou, Hong Zi. "Treatment by Acupuncture of Meniere's Disease." International Journal of Clinical Acupuncture. Vol 9, p195, 1999.