Otitis Media

Introduction	Back to Top
Otitis media is a common inflammation of the middle ear. It is manifested by pain, fever, abnormal hearing, hearing disability, tinnitus, vertigo, etc. In clinical practice, it is often divided into secretory otitis media, acute pyogenic tympanitis, chronic pyogenic tympanitis, and adhesive tympanitis.

Etiology/Pathogenisis	Back to Top
Otitis media is a common inflammation of the middle ear. It is manifested by pain, fever, abnormal hearing, hearing disability, tinnitus, vertigo, etc. In clinical practice, it is often divided into secretory otitis media, acute pyogenic tympanitis, chronic pyogenic tympanitis, and adhesive tympanitis.

Primary Treatments with Medicinal Herbs	Back to Top
Shuang Liao Hou Feng Powder Wang Yu Lan treated 55 cases of otitis media with Shuang Liao Hou Feng Powder. She used a hydrogen peroxide solution (3%) to wash the antrum auris. Then she sprayed Shuang Liao Hou Feng Powder into the antrum auris. The procedure was performed once a day for 3 days, which constituted one course of treatment. The results indicated that after one course, 32 cases had fully recovered. After two courses, 17 cases had fully recovered. After 3 courses, 5 cases had fully recovered and one case had no improvement.(1)

Other Treatments with Medicinal Herbs	Back to Top
Bing Peng Powder Qi Jing Mei used Bing Peng Powder (a powder formula for Otitis media) to treat pyogenic tympanitis. She used hydrogen dioxide solution to wash the entotic pus clear, and then administered the appropriate amount of Bing Peng Powder into the ear. The procedure was repeated 2-3 times a day for 5 days, which constituted one course of treatment. During the acute stage, antibiotics and antipyretic analgesics were used together. After 1 – 2 courses of treatment, among the 40 cases, 34 had fully recovered, 5 cases showed significant improvement and one had no improvement. The total effectiveness rate was 97.5%.(2) Jian's Otitis Media Formula Wei Jian, et al. treated exudative tympanitis by using methods of ventilating the lung, eliminating dampness, and clearing the ear passage. The herbs used were Su Ye (Flos Sappan), Ju Hua (Chrysanthemum), Ge Gen (Pueraria), Zhao Ci (Gleditisia Spine), Fu Ping (Herba Spirodelae), Bai Zhu (Atractylodes), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Ze Xie (Alisma), and Gan Cao (Licorice), combined with other herbs or with some of the mentioned ingredients being omitted according to the symptoms. These herbs were decocted in water to be taken once daily. For treatment of tympanitis with hydrops, the perforation of Shrapnell's membrane aspiration method was performed. For treatment for rhinitis and accessory nasosinusitis, the methods used were topical treatment, physiotherapy, eustachian tube inflation, and auditory massage. The results indicated that of the 68 cases, 49 cases had significant improvement and 19 had some improvement.(3) Long Dan Xie Gan Decoction Fan Hua treated acute pyogenic tympanitis with Long Dan Xie Gan Decoction. The decoction is composed of Long Dan Cao (Gentiana Root), Jiao Shan Zhi (Gardeniae), Mu Tong (Akebia), Che Qian Zi (Plantain), Dan Huang Qin (Scutellaria), Ze Xie (Alisma), Sheng Di Huang (Rehmannia Root), Dang Gui (Dang Gui), Chai Hu (Bupleurum), and Sheng Gan Cao (Licorice), with some of them being omitted or supplemented with other ingredients in accordance to the symptoms. These herbs were decocted in water to be taken as one dose daily, and 5 doses composed one course of treatment. During treatment, the patients were asked to avoid smoking, alcohol, and hot pungent foods. Results revealed that after 1-4 courses of treatment, of the 52 cases of acute pyogenic tympanitis, 38 cases had significantly recovered, 10 cases had improved, and 4 cases had no improvement.(4) Qiu Yin Ye Hong Huan Song treated acute pyogenic tympanitis with Qiu Yin Ye (earthworm liquid). After washing the external auditory meatus clear with a hydrogen dioxide solution, the patient was asked to lie on a bed with the affected ear facing up and then put a few of drops of Qiu Yin Ye into the ear cavity. If the liquid was difficult to drip in, the practitioner used his or her index finger to press the patient's antilobium repeatedly, causing the liquid to seep into the middle ear cavity. About 10 minutes later, the patient was asked to lie laterally on the opposite side to let the liquid flow out. This treatment was performed 4 times a day and antibiotics were not used. Results showed that of the 28 cases, 19 cases had fully recovered, and 9 had some improvement. The total effectiveness rate was 100%.(5) Zhen's Otitis Media Formula Zhu Yu Zhen treated acute pyogenic tympanitis by administering herbal powder into the ear. The herbal powder was made up of Bing Pian (Borneolum) and Wu Bei Zi (Chinese Galla). The treatment was conducted once daily, and 7 days composed one course of treatment. Results showed that after 1-2 courses of treatment, all 32 acute pyogenic tympanitis patients had fully recovered.(6) Xue Fu Zhu Yu Decoction Zhuo Jia Wen used Xue Fu Zhu Yu Decoction to treat 40 cases of acute catarrhal otitis media. The decoction was made up of Tao Ren (Persica), Hong Hua (Carthamus), Jie Geng (Platycodon Root), Zhi Qiao (Aurantium Fruit), Chai Hu (Bupleurum), Chuan Xiong (Cnidium), Gan Cao (Licorice), Shi Chang Pu (Graassleaved Sweetflag Rhizome), Xin Yi Hua (Magnolia Flower), and Lu Lu Tong (Liquidambar). The ingredients were modified according to symptoms. These ingredients were decocted in water to be taken once a day. In a control group, 40 cases were treated with acetyl-spiramycin 0.25g, 4 times a day, and compound bromelain 2 tablets, 3 times a day. In treatment and control groups, the results are, respectively: 30 and 31 had fully recovered, 8 and 6 had some improvement, 2 and 3 had no improvement respectively. There was no apparent difference in the therapeutic effect between the two groups.(7)

Acupuncture & Acupressure	Back to Top
Jin Yong treated chronic pyogenic tympanitis with acupoint catgut embedding therapy. Main acupoints used were Ting Gong (SI 19), Ting Hui (GB 2) and Yi Feng (TE 17), supplemented with Wai Guan (TE 5), Taixi (KI 3), and Taichong (LR 3). After locating the acupoint acutely, the catgut was embedded into it to an appropriate depth, followed by withdrawing the penetrating needle rapidly. Pressed the needle hole with an alcohol cotton ball to prevent bleeding and then the local needle hole was covered with a piece of plaster for 2 ~ 3 days. The treatment was conducted once every 30 days. Results showed that of the 56 cases, 43 fully recovered, 11 had significant improvement, and 2 cases had no improvement. The total effectiveness rate was 96%.(8)

Footnotes	Back to Top
¹ Wang Yu Lan. Treating 55 cases of otitis media with Shuang Liao Hou Feng San. Hubei Journal of TCM. 1994;16(6):37. ² Qi Jing Mei. Treating 40 cases of pyogenic tympanitis with Bing Peng San. Journal of External Application of TCM. 1999;8(4):48. ³ Wei Jian, et al. Report on treating 68 cases of exudative tympanitis by ventilating the lung, eliminating dampness and clearing the ear passage. China Journal of Integrated Otorhinolaryngology. 1999;7(3):152. ⁴ Fan Hua. Treating 52 cases of acute pyogenic tympanitis with Long Dan Xie Gan Tang. Zhejiang Journal of Traditional Chinese Medicine. 1999;34(10):437. ⁵ Hong Huan Song. Treating 28 cases of acute pyogenic tympanitis with Qiu Yin Ye. Zhejiang Journal of Integrated Medicine. 1999;9(5):355. ⁶ Zhu Yu Zheng, et al. Treating 32 cases of pyogenic tympanitis by blowing herbal powder into the ear. Journal of Folk Chinese Medical Treatment. 1999;7(6):6. ⁷ Zhou Jia Wen. Treating acute catarrhal otitis media with Xue Fu Zu Yu Tang. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology 1999;(2):41. ⁸ Jin Yong. Treating 56 cases of chronic pyogenic tympanitis by acupoint catgut embedding therapy. Shanghai Journal of Acupuncture. 1997;16(1):41.