Otogenic vertigo is a common disorder that affects the vestibular system and often leads to significant discomfort and impaired daily functioning. Traditional Chinese medicine (TCM), including acupuncture and moxibustion, has long been used to manage vertigo symptoms. However, the effectiveness and methodology of these treatments have rarely been systematically investigated in the medical literature. This review summarizes current evidence on acupoint selection, treatment methods, and therapeutic effects of acupuncture and moxibustion for otogenic vertigo, and provides a reference for TCM-based clinical practice.

A literature search was performed using the PubMed database with the terms “otogenic vertigo,” “acupuncture treatment,” and “acupuncture point selection.” A total of 34 relevant articles were identified. These reports suggest that clinical treatment should consider the functions of the zang-fu organs and meridians, and that different acupuncture methods should be selected according to syndrome differentiation, especially the distinction between deficiency and excess patterns. Acupuncture and moxibustion therapy should be based on careful acupoint selection guided by syndrome differentiation, and further refined by clinical experience.

In TCM, the treatment of otogenic vertigo with acupuncture and moxibustion involves choosing appropriate needling techniques under the guidance of TCM theory and following the principles of syndrome, disease, and meridian differentiation. Common methods include body acupuncture, auricular acupuncture, scalp acupuncture, acupoint injection, electroacupuncture, and moxibustion. A wide variety of acupoints have been reported. Individualized treatment according to each patient’s specific presentation appears to be both effective and safe, helping to improve vertigo symptoms and cerebral blood perfusion.

Introduction

Otogenic vertigo is an idiopathic inner ear disease that falls under the TCM categories of “vertigo” and “dizziness.” According to TCM theory, it is usually attributed to dysfunction of the viscera and meridians. Therefore, syndrome differentiation is essential, and treatment should be adjusted based on the patient’s constitution and the relative balance of deficiency and excess. This individualized strategy aims to optimize therapeutic outcomes.

Epidemiological studies suggest that the incidence of otogenic vertigo is approximately 5–20 cases per 1000000 people, with a higher incidence in women (male-to-female ratio about 1:1.89). Clinically, patients typically present with sudden rotational vertigo, which is often aggravated by changes in head or body position. Autonomic symptoms such as tinnitus, hearing loss, nausea, vomiting, pallor, cold sweating, and hypotension are common. Endolymphatic hydrops is regarded as a characteristic pathological feature.

With advances in TCM and in acupuncture and moxibustion techniques, these methods have been increasingly applied in clinical practice and have achieved notable therapeutic effects in some patients. Acupuncture is minimally invasive and has relatively few side effects, making it a preferred option for many individuals. In practice, TCM physicians select acupoints according to each patient’s symptoms and constitution, frequently using points on the head, neck, and limbs such as Fengchi (GB20), Baihui (GV20), Taiyang (EX-HN5), Tinggong/Auditory Palace (SI19), and Shenmen (HT7).

Various needling and moxibustion methods may be applied, including manual acupuncture, electroacupuncture, and different forms of moxibustion. Method selection depends on symptom patterns and individual tolerance. Beyond symptom control, acupuncture and moxibustion aim to regulate zang-fu functions and meridian circulation, thereby improving overall health and reducing recurrence.

Methods

PubMed was used as the primary database to identify clinical studies, reviews, case reports, and guidelines related to acupuncture treatment of otogenic vertigo. The main search terms included “otogenic vertigo,” “acupuncture treatment,” and “acupuncture point selection.” Combining these with Boolean operators helped refine the search. For example, “Otogenic Vertigo AND Acupuncture Treatment” identified articles addressing both the disease and intervention, while “Acupuncture Treatment OR Acupuncture Point Selection” broadened the scope to capture studies focusing on treatment or acupoint patterns.

Additional filters such as time frame, article type (e.g., clinical trials, reviews, guidelines), and specific study populations were applied as needed to improve the relevance and quality of the included literature. To make the findings clinically useful, the review also summarized practical information such as standard operating procedures for different acupuncture modalities. For example, body acupuncture protocols often include Fengchi (GB20) and Baihui (GV20), with a needling depth of about 1–1.5 inches and needle retention for 20–30 minutes per session, administered 2–3 times per week over 6–8 weeks. Similar details are provided for auricular acupuncture, scalp acupuncture, and acupoint injection.

Understanding Otogenic Vertigo in TCM

In TCM, otogenic vertigo is often described using concepts such as imbalance of the viscera, disharmony of meridians, internal obstruction by phlegm and turbidity, water retention, and deficiency of marrow or the “sea of marrow” affecting the ear and orifices. Classic texts such as the Huangdi Neijing and Danxi Xinfa describe symptoms of tinnitus, dizziness, confusion, vomiting, and a sense of falling, providing an early theoretical basis for understanding vertigo and hearing-related disorders.

Clinically, otogenic vertigo is often regarded as a syndrome of “root deficiency and branch excess.” Excess components include wind, fire, phlegm, cold-dampness, and blood stasis, whereas deficiency involves the liver, spleen, kidney, qi, and blood. Spleen–kidney deficiency is seen as the underlying root, while wind, fire, phlegm, and stasis are the predominant manifestations. Classical theory emphasizes that “all dizziness belongs to the liver,” reflecting the importance of liver wind and liver–kidney balance in the pathogenesis.

Principles of Acupoint Selection

The main acupoints commonly selected for otogenic vertigo include Baihui (GV20), Fengchi (GB20), Neiguan (PC6), Zusanli (ST36), Fenglong (ST40), and Yifeng (TE17). Acupuncture and moxibustion prescriptions are formulated based on syndrome differentiation and then refined using clinical experience. In general, treatment follows the principles of:

• Regulating zang-fu organs (especially liver, spleen, and kidney);
• Harmonizing meridians and promoting qi and blood circulation to the head and ears;
• Resolving phlegm and dampness, calming liver wind, and clearing fire;
• Combining root (deficiency) and branch (excess) treatment to relieve symptoms and reduce recurrence.

耳源性眩暈是影響前庭系統的常見疾病，患者往往出現明顯不適與日常功能受損。包含針灸與艾灸在內的 傳統中醫，一直被用來緩解眩暈相關症狀，但其具體療效與操作方法，在現代醫學文獻中仍較少有系統性探討。 本文依據現有研究，整理耳源性眩暈針灸與艾灸治療中常用的選穴原則、治療方法與臨床效果，作為中醫臨床 治療的參考。

研究者使用 PubMed 資料庫進行文獻檢索，關鍵字包括「otogenic vertigo」「acupuncture treatment」 與「acupuncture point selection」，共納入 34 篇相關文獻。整體結果顯示，臨床治療時需重視 藏腑功能與經絡運行情況，並依「虛實」與證型差異，選擇不同的針灸方法。針灸與艾灸處方應在 辨證論治的基礎上進行選穴，再結合臨床經驗加以調整。

從中醫觀點而言，耳源性眩暈的針灸與艾灸治療，是在中醫理論指導下，遵循 「辨證、辨病、辨經」的原則，選擇合適的刺激方式與穴位。常用技術包括體針、耳針、頭針、 穴位注射、电針與艾灸等，臨床上所涉穴位眾多。依患者具體體質與症狀進行個體化治療，整體而言 具有一定安全性與療效，有助於改善眩暈症狀並提升腦部血流灌注。

中醫對耳源性眩暈的認識

耳源性眩暈在中醫屬於「眩」「暈」等範疇，多與臟腑失調與經絡不暢有關。病機可涉及 藏腑失和、經絡失衡、痰濁內阻、水濕壅盛，或髓海不足、耳竅失養等。 《黃帝內經》中曾記載「厥陰之勝，則耳鳴、眩冒、嘔吐」，《壽世保元》《丹溪心法》等 古籍也對眩暈的臨床表現與病因，多有論述。

臨床上多認為耳源性眩暈屬於「本虛標實」之證：其標實可見風、火、痰濁、寒濕、瘀血等； 其本虛則多關涉肝、脾、腎，以及氣血不足。脾腎虧虛常被視為發病之本，而風、火、痰、瘀 則為主要表現。《素問·至真要大論》有「諸風掉眩，皆屬於肝」之說，亦強調肝風與肝腎軸線 在眩暈病機中的重要性。

臨床表現與針灸治療優勢

現代流行病學研究指出，耳源性眩暈的發病率約為每百萬人口 5–20 例，女性略多於男性 （男女比約 1:1.89）。臨床主要表現為突發性的旋轉感或眩暈，常因頭位或體位改變而加劇， 並可伴隨耳鳴、聽力下降、噁心、嘔吐、面色蒼白、冷汗、血壓下降等自主神經症狀， 而內淋巴積水為常見病理改變之一。

近年隨著中醫針灸與艾灸技術不斷發展，耳源性眩暈的相關臨床報告逐漸增多。針灸屬微創治療， 不良反應相對較少，對部分不耐受西藥或希望減少用藥的患者具有吸引力。實務上， 醫師會根據患者具體症狀與體質，選取頭頸及四肢的相關穴位，例如： 風池（GB20）、百會（GV20）、太陽（EX-HN5）、聽宮（SI19）、神門（HT7）等， 並視需要配合電針或艾灸。

文獻檢索與研究方法簡述

本文以 PubMed 為主要檢索平台，收集與「耳源性眩暈針灸治療」相關的臨床研究、綜述、 病例報告與指南等文獻。關鍵字主要包括「otogenic vertigo」「acupuncture treatment」 及「acupuncture point selection」，並透過「AND」「OR」等布林邏輯運算進一步縮小或擴大 檢索範圍，例如：「Otogenic Vertigo AND Acupuncture Treatment」可鎖定同時涉及疾病與治療的研究， 而「Acupuncture Treatment OR Acupuncture Point Selection」則可擴大至治療方式或選穴規律的相關報告。

研究者亦可視需要設定檢索時間範圍、文章類型（如臨床試驗、綜述、指南等）與特定族群， 以提升文獻品質與臨床相關性。為增加臨床可操作性，原文同時整理了各類針灸技術的 操作步驟，例如體針常以風池（GB20）、百會（GV20）為主穴，針刺深度約 1–1.5 吋， 留針 20–30 分鐘，每週 2–3 次，療程約 6–8 週，並對耳針、頭針與穴位注射等方法提出相應建議。

常用穴位與選穴原則

耳源性眩暈常用的主要穴位包括：百會（GV20）、風池（GB20）、內關（PC6）、足三里（ST36）、 豐隆（ST40）、翳風（TE17）等。臨床處方一方面依據辨證結果，另一方面結合醫師個人 經驗進行加減配伍。整體選穴原則可概括為：

• 調和肝、脾、腎等臟腑功能，兼顧氣血陰陽平衡；
• 疏通經絡、活血化瘀，引清陽上達頭目、通利耳竅；
• 化痰祛濕、平肝熄風、清熱降火，以減輕眩暈與耳鳴；
• 兼顧「治本」與「治標」，既控制急性發作，又降低復發風險。