Wang Zhongyuan, Hou Xianqing, Dai Shuhong, Ji Baichun, She Yunshan, Sun Yunzhang (Audiological Research Group, Bethune Medical College and Deafmutism Research Co-operative Group of Jilin Province, Changchun)
Observations on the mechanism of the therapeutic effect of acupuncture concerning deafness were carried out both experimentally and clinically.
1. Pathological findings of deafness: Auditory threshold shift was observed in 70 guinea pigs subjected to white noise stimulation of 128 db for ten hours. Acupuncture at "Tinggong" point was then applied on the next day to half of the animals, while the r
est of the animals without acupuncture served as control. Animals were killed eight weeks later and the whole cochlear preparations from left side of the animals was dissected and examined. Noise stimulation caused damage in some of the hair cells in the cochlea. The damaged hair cell population was counted. A mean value was obtained for each mm. of the Corti's organ in both groups of the animals, acupuncture treated and control, and the damage curves were plotted with the mean values of every mm. for each of the two groups for comparison and comparison of both groups was carried out turn by turn. For the control group, the mean damage curve was the highest in the third turn, then came down in a slope in the second turn and almost approached its normal value in the first turn. For the group that received acupuncture, the mean damage curve in the third and the first turn as compared with the control group were essentially the same, but the curve in the second turn was significantly lower than that of the control group. That is to say, this is the place where damage of the hair cells was distinctly less than those in the control group. It is possible that the damage of the hair cells were in a stage of reversibility and that necrosis of the damaged hair cells was prevented by the application of acupuncture which improved the cochlear microcirculation and hair cell nutrition. As for the third turn damage to the hair cells was so severe that necrosis of hair cells was inevitable, and it was not possible for acupuncture to exert its effect upon the hair cells.
2. Physiological study of hearing: The effect of electro-acupuncture at the "Tinggong" point and promontory area upon the cochlear potentials, by the use of transtympanic technique and treatment with the computer, was observed in sensori neuro-deafness of various types. Under the action of 90db click, the range of fluctuation of the amplitude of cochlear potentials was observed in 60 ears (53 deaf patients), and the upper limit of 90% individuals treated statistically was found to be 24.3%. Therefore, the fluctuations of the amplitudes of cochlear potentials over a value of 25% in either direction in comparison with the amplitudes before electro-acupuncture stimulation would be considered to be significant. The results after five minutes electro-acupuncture stimulation are shown in the following table.
It can be seen from the table that the cochlear potentials were raised with the application of electro-acupuncture to either "Tinggong" or promontory area in some of the patients. As we know, an increase in the amplitude of cochlear potentials would be a reflection of the promotion of cochlear hair cell function. This might partly account for the therapeutic effect of electro-acupuncture at "Tinggong" point or promontory area. The therapeutic effects of the electro-acupuncture at promontory area in relation to changes in cochlear potentials were analyzed in 42 ears (30 deaf patients). It was found that 7 of the 8 ears with elevation of cochlear potentials were therapeutically effective, with only one ineffective. There was no therapeutic effect at all in 27 of a total of 3 ears with no changes in their cochlear potentials and also in the one with decrease of cochlear potential. It can be seen therefore that the therapeutic effect would be probably better in those with elevation of cochlear potentials following the application of promontory electro-acupuncture.
3. Therapeutic trials: 129 cases of sensori neuro-deaf patients were treated with promontory electro-acupuncture for therapeutic trial. After disinfection, the promontory needle (specially made) was allowed to penetrate the ear drum to reach the promontory area and electro-stimulation were carried out for 10 minutes. The process was repeated every other day and it was assumed that a total of 10 stimulations would be considered as a full therapeutic course. At the end of the therapeutic course, it was found to be effective in promoting hearing in 15 cases (with an average promotion of more than 10db in 3 consecutive frequencies) and highly effective in 16 cases (with an average promotion of more than 20db in 3 consecutive frequencies). In other words it was found to be effective in a total of 31 cases, with an total effective rate of 24%, the effect being more marked in those with sudden deafness and those who attended the clinic for treatment early. The standard of therapeutic effect was deduced on the basis of fluctuated range of auditory threshold that we encountered in our work. Comparing 250310 fluctuation values from data obtained by the examination of 2400 ear-times in 182 deaf-mute patients, it was found statistically that the probability is less than 5% with an average promotion of 10db in 3 consecutive frequencies, 15db in two consecutive frequencies and 20db in one frequency. Comparisons between the puretone audiometry and the speech audiometry were also carried out in some of the patients and it was found that there were improvements of 5 db in SRT and a promotion of 10% in PBmax in the majority of the 20 ears whose pure tone audiometry were found to be effective with an average promotion of 10db in 3 consecutive frequencies. Prediction of the therapeutic effect by combining the indices of pure tone, SRT and PBmax would prove to be more accurate and reliable.
Observations on the mechanism of the therapeutic effect of acupuncture concerning deafness were carried out both experimentally and clinically.
1. Pathological findings of deafness: Auditory threshold shift was observed in 70 guinea pigs subjected to white noise stimulation of 128 db for ten hours. Acupuncture at "Tinggong" point was then applied on the next day to half of the animals, while the r
est of the animals without acupuncture served as control. Animals were killed eight weeks later and the whole cochlear preparations from left side of the animals was dissected and examined. Noise stimulation caused damage in some of the hair cells in the cochlea. The damaged hair cell population was counted. A mean value was obtained for each mm. of the Corti's organ in both groups of the animals, acupuncture treated and control, and the damage curves were plotted with the mean values of every mm. for each of the two groups for comparison and comparison of both groups was carried out turn by turn. For the control group, the mean damage curve was the highest in the third turn, then came down in a slope in the second turn and almost approached its normal value in the first turn. For the group that received acupuncture, the mean damage curve in the third and the first turn as compared with the control group were essentially the same, but the curve in the second turn was significantly lower than that of the control group. That is to say, this is the place where damage of the hair cells was distinctly less than those in the control group. It is possible that the damage of the hair cells were in a stage of reversibility and that necrosis of the damaged hair cells was prevented by the application of acupuncture which improved the cochlear microcirculation and hair cell nutrition. As for the third turn damage to the hair cells was so severe that necrosis of hair cells was inevitable, and it was not possible for acupuncture to exert its effect upon the hair cells.2. Physiological study of hearing: The effect of electro-acupuncture at the "Tinggong" point and promontory area upon the cochlear potentials, by the use of transtympanic technique and treatment with the computer, was observed in sensori neuro-deafness of various types. Under the action of 90db click, the range of fluctuation of the amplitude of cochlear potentials was observed in 60 ears (53 deaf patients), and the upper limit of 90% individuals treated statistically was found to be 24.3%. Therefore, the fluctuations of the amplitudes of cochlear potentials over a value of 25% in either direction in comparison with the amplitudes before electro-acupuncture stimulation would be considered to be significant. The results after five minutes electro-acupuncture stimulation are shown in the following table.
It can be seen from the table that the cochlear potentials were raised with the application of electro-acupuncture to either "Tinggong" or promontory area in some of the patients. As we know, an increase in the amplitude of cochlear potentials would be a reflection of the promotion of cochlear hair cell function. This might partly account for the therapeutic effect of electro-acupuncture at "Tinggong" point or promontory area. The therapeutic effects of the electro-acupuncture at promontory area in relation to changes in cochlear potentials were analyzed in 42 ears (30 deaf patients). It was found that 7 of the 8 ears with elevation of cochlear potentials were therapeutically effective, with only one ineffective. There was no therapeutic effect at all in 27 of a total of 3 ears with no changes in their cochlear potentials and also in the one with decrease of cochlear potential. It can be seen therefore that the therapeutic effect would be probably better in those with elevation of cochlear potentials following the application of promontory electro-acupuncture.
3. Therapeutic trials: 129 cases of sensori neuro-deaf patients were treated with promontory electro-acupuncture for therapeutic trial. After disinfection, the promontory needle (specially made) was allowed to penetrate the ear drum to reach the promontory area and electro-stimulation were carried out for 10 minutes. The process was repeated every other day and it was assumed that a total of 10 stimulations would be considered as a full therapeutic course. At the end of the therapeutic course, it was found to be effective in promoting hearing in 15 cases (with an average promotion of more than 10db in 3 consecutive frequencies) and highly effective in 16 cases (with an average promotion of more than 20db in 3 consecutive frequencies). In other words it was found to be effective in a total of 31 cases, with an total effective rate of 24%, the effect being more marked in those with sudden deafness and those who attended the clinic for treatment early. The standard of therapeutic effect was deduced on the basis of fluctuated range of auditory threshold that we encountered in our work. Comparing 250310 fluctuation values from data obtained by the examination of 2400 ear-times in 182 deaf-mute patients, it was found statistically that the probability is less than 5% with an average promotion of 10db in 3 consecutive frequencies, 15db in two consecutive frequencies and 20db in one frequency. Comparisons between the puretone audiometry and the speech audiometry were also carried out in some of the patients and it was found that there were improvements of 5 db in SRT and a promotion of 10% in PBmax in the majority of the 20 ears whose pure tone audiometry were found to be effective with an average promotion of 10db in 3 consecutive frequencies. Prediction of the therapeutic effect by combining the indices of pure tone, SRT and PBmax would prove to be more accurate and reliable.
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