眩暈 Vertigo

眩暈，通常稱為頭暈眼花，是一種常見的症狀。輕者發作短暫，平臥閉目片刻即安；重者如乘坐舟車，旋轉起伏不定，以致站立不穩。或時輕時重，兼見他證而遷延不愈。本證見於高血壓、動脈硬化、貧血、神經官能症、耳源性眩暈等疾病。

Vertigo, commonly referred to as dizziness or lightheadedness, is a frequently encountered symptom. Mild cases are brief and relieved by lying down; severe cases resemble motion sickness with spinning or swaying sensations. It is seen in hypertension, arteriosclerosis, anemia, neurosis, and labyrinthine vertigo.

病因病機 Etiology & Pathomechanism

起病常與素質薄弱、病後體虛、憂思鬱怒及飲食厚味等有關。本證的發生有因心脾虧損、氣血不足、不能上充髓海而發；有因腎陰不足，肝失濡養，肝陽上擾清竅所致；有因素屬濕盛之體，過食厚味，聚濕成痰，上蒙清陽為病。

The onset is often related to constitutional weakness, post-illness debility, excessive worry or emotional frustration, and the consumption of rich, greasy foods. This condition may arise from Heart–Spleen deficiency, where insufficiency of qi and blood fails to ascend and nourish the “sea of marrow” (the brain). It may also result from Kidney-yin deficiency, which leads to inadequate nourishment of the Liver, allowing Liver yang to rise and disturb the clear orifices. Another cause is a constitution prone to excessive dampness; overeating rich, heavy foods leads to dampness accumulating into phlegm, which then rises to obscure the clear yang and cause disease.

辨證 Pattern Identification

頭暈旋轉，兩目昏黑，泛泛欲吐，甚至昏眩欲仆。
氣血不足：神疲乏力、面色晄白、心悸失眠、舌淡脈細。
肝陽上亢：腰酸腿軟、舌紅脈弦、因惱怒而誘發。
痰濕中阻：胸痞、噁心嘔吐、食慾不振、心煩、苔厚膩、脈滑。

Vertigo with a spinning sensation, visual dimness, nausea, and in severe cases, a tendency to faint.
Qi–blood deficiency: fatigue, pale complexion, palpitations, insomnia, pale tongue, and a thin pulse.
Liver yang rising: lower back soreness, leg weakness, red tongue with a wiry pulse, episodes triggered by anger or emotional agitation.
Phlegm–damp obstruction: chest oppression, nausea or vomiting, poor appetite, irritability, thick greasy tongue coating, and a slippery pulse.

治療 Treatment

針灸 Acupuncture

(1) 氣血不足 Qi–Blood Deficiency

治法：培補脾胃。毫針補法，可灸。
處方：脾俞、足三里、氣海、百會
方法：補脾胃以生氣血；百會氣海補氣行血，充養髓海以止眩。

Method: Tonify Spleen & Stomach with reinforcing needling; moxibustion optional.
Points: BL20, ST36, CV6, GV20.
Supports qi-blood formation and nourishes the “sea of marrow” to relieve vertigo.

(2) 肝陽上亢 Liver Yang Rising

治法：清潛肝陽。毫針瀉法。
處方：風池、肝俞、腎俞、行間、俠溪
方義：瀉風池、俠溪、行間以平肝潛陽；補肝俞腎俞以滋肝腎之陰。

Method: Clear and subdue Liver yang using the reducing method.
Points: GB20, BL18, BL23, LR2, GB43.
Reduces hyperactive Liver yang while reinforcing Liver–Kidney yin to treat the root.

(3) 痰濕中阻 Phlegm–Damp Obstruction

治法：運脾化痰。平補平瀉，可灸。
處方：豐隆、中脘、內關、解溪、頭維
方義：健脾滌痰（中脘、豐隆）；內關降逆止嘔；頭維近取明竅；解溪降胃氣化痰。

Method: Resolve phlegm and strengthen Spleen with balanced needling; moxibustion optional.
Points: ST40, CV12, PC6, ST41, ST8.
Clears phlegm turbidity, harmonizes the Stomach, and treats dizziness.

耳針與頭針 Auricular & Scalp Acupuncture

耳針 Auricular

選穴：腎、神門、枕、內耳、腦。
方法：每次 2–3 穴，中強刺激，留針 20–30 分鐘，間歇運針。

Points: Kidney, Shenmen, Occiput, Inner Ear, Brain. Moderate–strong stimulation; needle retention 20–30 minutes.

頭針 Scalp

選區：雙側暈聽區。每日一次，5–10 次為一療程。

Bilateral vertigo–hearing line; once daily; 5–10 sessions per course.

附註 Notes

內耳性眩暈宜少飲水、進淡食；屬眩暈綜合徵者先治原發病。
平時宜保持安靜、避免噪音；痰濕重者忌肥膩生痰之品。

Reduce water intake during inner-ear vertigo; treat underlying conditions first. Avoid noise; reduce greasy, phlegm-producing foods if phlegm-damp predominates.

附：高血壓 Appendix: Hypertension

高血壓指安靜狀態收縮壓 >140、舒張壓 >90 mmHg；可分原發性與繼發性。早期可無症狀，或見頭痛、頭暈、耳鳴、心悸、失眠；後期可累及心腦腎。

Hypertension is defined as SBP >140 and DBP >90 mmHg at rest. Early stages may be asymptomatic or include headache, dizziness, tinnitus, palpitations, insomnia; later it may affect heart, brain, and kidneys.

高血壓的針灸治療 Acupuncture Treatment

處方：曲池、足三里；風池、太衝。
加減：頭痛（印堂、太陽）、失眠（安眠、神門）、心悸（郄門、內關）。
方法：兩方交替，每日或隔日一次，10 次為療程。

Points: LI11, ST36; GB20, LR3. Additional: Yintang & Taiyang for headache; Anmian & HT7 for insomnia; PC4 & PC6 for palpitations. Alternate prescriptions daily or every other day; 10 sessions constitute one course.

出處 / Source

针灸学 / 邱茂良 主編. 上海：上海科學技術出版社，1985.10（2020.9 重印）

Acupuncture Textbook, ed. Qiu Maoliang. Shanghai Science & Technology Press, Oct 1985 (Reprinted Sept 2020).