RESUMO
In cases of pulsatile tinnitus, the presence of organic disease should be suspected, and many of them can be treated once the cause is identified. However, there are idiopathic cases in which the cause cannot be identified, and there is no established treatment for them. Here, we report 2 cases in which Kampo medicine was effective for idiopathic pulsatile tinnitus. Case 1 was a 50-year-old man. He had been stressed for half a year due to the change of job title in his workplace, and he had left pulsatile tinnitus a month ago. We administered saikokaryukotsuboreito, and his tinnitus disappeared in a week. Case 2 was a 30-year-old woman. She gave birth 4 months ago, and after giving birth, she had less sleep and was tired and stressed. She started to notice right pulsatile tinnitus and dizziness from a month ago. We administered nyoshinsan, and her tinnitus and dizziness disappeared in 2 months. In both cases, they were aware of hot flashed on their face as a symptom of qi counterflow, and Kampo treatment improved the symptom together with pulsatile tinnitus. It is possible that blood flow in the head increased with qi counterflow, causing relative stenosis of the blood vessels in the head, leading to turbulence in the lumen of the blood vessels, and hearing pulsatile tinnitus.
RESUMO
Nyoshinsan is one of the Kampo formulations for the treatment of hot flash or dizziness, which are typically seen in chi-no-michi syndrome (characterized by physical and/or mental symptoms related to female hormone variation). But nyoshinsan is less frequently prescribed than three major formulas in gynecological field including tokisyakuyakusan, kamishoyosan and keisibukuryogan. Furthermore, few case series study of nyoshinsan has been reported so far. To elucidate clinically useful indication sho of nyoshinsan, we retrospectively analyzed medical records of the patients prescribed nyoshinsan for past 5 years in our institute. In consequence, majority of patients prescribed nyoshinsan had both blood stasis and qi-abnormality including qi-deficiency, qi-stagnation and qi-counterflow due to physical or mental stresses. On the other hand, they rarely had signs of fluid retention. These findings may be useful for more effective clinical application of nyoshinsan.