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Ménière's Disease : Treatment
   
Western Medicine
Chinese Medicine
Treatment comprises management of symptoms; when this fails, surgery or chemical ablation (destruction) can be considered.
Medical management

Medical treatment is usually tried first, but the many categories of medical management indicate how difficult it is to treat this disorder. The aims of treatment are to reduce symptoms and to prevent hearing loss. The following are currently used:
sedatives
anticholinergic agents
vitamins
agents that increase blood flow
histamine desensitization
antihistamines
control of body fluid
allergy management
metabolic therapy
endocrine (hormone) therapy
physical therapy, and
various combinations of these.

Bed rest is essential. Controlled trials of the efficacy of any treatment of an acute attack have been difficult to complete because of the unpredictable and variable nature of the disease.

Surgical treatment

About 20 per cent of patients fail to respond to medical management and need surgery to relieve disabling vertigo. Patients who have lost hearing respond well to an operation that removes the inner ear (labyrinthectomy). This involves the complete removal of the vestibular (balance) end-organ. For patients who still have serviceable hearing, removal of the vestibular nerve is the procedure of choice, offering a 90 to 95 per cent success rate in vertigo control while preserving hearing.

Anatomy of the Ear
In a chemical labyrinthectomy gentamicin can be administered through the eardrum.
(Stedmans's Medical Dictionary 27th edition copyright 1999)

Chemical labyrinthectomy

Patients who are either not suited for or refuse surgery, but yet fail to respond to medical treatment, may benefit from an injection of gentamicin sulfate given into the ear. This injection is carefully administered and allows gentamicin to be absorbed through the eardrum to create a chemical labyrinthectomy whilst preserving hearing.

Bilateral Ménière's disease

Patients with active Ménière's disease in both ears are treated with systemic injections of streptomycin sulfate. The injection is given daily with close monitoring of vestibular (balance) function; treatment is stopped after the first signs of toxicity to the balance function and before the onset of hearing loss.
 

TCM treatment of Ménière's disease is based on two principles:

Elimination in conditions of excess; and tonifying in conditions of deficiency.
Dealing with symptoms in the acute stage; and dealing with the origin of the disorder when it is chronic.

Chinese Medicine

Deficit in the sea of marrow

Therapeutic aim: To nourish yin, tonify kidneys, replenish essence and benefit marrow.

Prescription:
shu di huang processed rehmannia root
shan zhu yu Asiatic cornelian cherry fruit
shan yao common yam root
mu dan pi tree peony bark
ze xie oriental water-plantain root
fu ling Indian bread
gou qi chi Chinese wolfberry fruit
ju hua chrysanthemum
shi jue ming sea-ear shell
duan mu li processed oyster shell
bai shao white peony root
he shou wu fleece flower root

A Chinese patent medicine such as Qiju Dihuang bolus is recommended as it can nourish yin and tonify the kidneys.

Deficiency in qi and blood

Therapeutic aim: To replenish qi and blood, reinforce the spleen and calm the mind.

Prescription:
huang qi milk-vetch root
dang shen pilose asiabell root
dang gui Chinese angelica
long yan rou longan aril
suan zao ren spine date seed
bai shu large head atractylodes root
fu ling Indian bread
mu xiang costus root
yuan zhi thin-leaf milkwort root
zhi gan cao liquorice root (processed with honey)

A Chinese patent medicines such as Guipi bolus is recommended to reinforce the spleen, benefit qi and promote blood production.

Flood of cold-dampness

Therapeutic aim: To warm the kidney yang, eliminate coldness evil and promote diuresis (elimination of fluid from the body by urination).

Prescription:
fu zi monkshood
fu ling Indian bread
bai shu large head atractylodes root
sheng jiang fresh ginger
bai shao white peony root
zhi gan cao liquorice root (processed with honey)

A Chinese patent medicine such as Fugui Bawei bolus is recommended. This warms the kidneys and reinforces the yang part of body.
Disturbance of liver-yang

Therapeutic aim: To smooth the liver, expel wind evil, nourish the yin and depress the yang component.

Prescription: Tianma Gouteng drink
tian ma tall gastrodia tuber
gou teng gambir plant
sheng shi jue ming fresh abalone shell
niu xi achyranthes root
du zhong eucommia bark
sang ji sheng Chinese taxillus herb
huang qin baical skullcap root
zhi zi Cape jasmine fruit
ye jiao teng fleece flower stem
fu shen foria with hostwood
gan cao liquorice root

A Chinese patent medicine such as Longdan Xiegan bolus is recommended. This clears heat and fire evils, promotes liver function and detoxifies.
Viscous phlegm obstruction

Therapeutic aim: To reinforce the spleen and liver, expel dampness evil and phlegm.

Prescription:
fa ban xia pinellia tuber (processed with liquorice root and lime)
tian ma tall gastrodia tuber
bai shu large head atractylodes root
fu ling Indian bread
ju hong dried tangerine peel
sheng jiang fresh ginger
da zao Chinese date
gan cao liquorice root

Acupuncture and moxibustion

The use of acupuncture and moxibustion can be helpful, for alleviating symptoms like vertigo and tinnitus. Treatment is conducted as follows:
When applying general methods, the usual acupuncture points are:
Bai-hui, shen-ting, shen-men, er-men, nei-guan, shen-mai, he-gu, zu-shan-li, feng-long, pi-shu, shen-shu, guan-yuan, feng-chi, xing-jian and zhong-wan.
Three or four acupoints are stimulated each time.
When applying otopuncture therapy, the acupuncture points are:
Forehead, heart, shen-men, kidney, occipital and inner ear.
Two to three acupoints are stimulated each time.
When applying acupoint injection, the recommended acupuncture points are:
He-gu, zu-shan-li, tai-chong, yi-ming or nei-guan, feng-chi and si-du.
Two to three acupoints are stimulated each time. Injections can include danshen, ginseng and Chinese angelica.