Based on the differentiation of deficiency (hyporeactivity) and excess (hyperreactivity) syndromes according to the Traditional Chinese Medicine (TCM) logic, 65 labyrinthine tinnitus cases of the example was classified into three groups, the excess constitutional type (18 cases), the deficiency constitutional type (37 cases) and the intermediate type (10 cases). Acupuncture treatment was carried out under the guidance of the basic principles of "seeking the fundamental of a disease in treatment"based on TCM.
The effect was evaluated using two parameters of subjective tinnitus assessment score in a special questionnaire (STS) and objective tinnitus loudness level in dB SL (OTL). Based on the changes in STS and OTL before and after the end of all therapeutic courses, the gross effective rate (GER) of 65 cases containing effective STS or OTL was 72.3%, while the strict effective rate where both STS and OTL showed effective (BER) was 47.7%. Among the three TCM syndromes differentiation groups, the excess constitutional type had the best therapeutic effect (66.7%of BER), fellows the deficiency constitutional type (48.7%of BER), and the intermediate type was the worst (only 10%of BER). Statistically, there was a significant difference among each syndrome differentiation group (p<0.05).
Meanwhile, the entire GER and BER went down to 55.4%and 38.5%respectively 2 months after the end of treatment to show a decreasing tendency of therapeutic effectiveness compared with those treatment rates immediately after the end of treatment. Especially, GER of the deficiency constitutional type showed a significant decrease (P<0.05).
We concluded that the TCM differentiation of deficiency and excess syndromes is a prerequisite for the determination of a correct acupuncture treatment for labyrinthine tinnitus. Through a thorough analysis and treatment on 65 clinical cases, the tinnitus of the excess constitutional type showed a higher reactivity for the treatment comparing to the other two types, the deficiency and the intermediate.

Traditional Chinese acupuncture was used in four cases of intractable tinnitus associated with presbyacusis, showing greater losses at higher frequencies while lower frequencies were only slightly below the normal threshold on a pure tone audiogram. Further audiologic evaluation by means of a speech discrimination test and short-increment sensitivity index (SISI) showed that cases 1 and 2 were the labyrinthine impairment type, case 3 was the mixed type, and case 4 was the retrolabyrinthine type. However, the etiology and pathogenesis of all patients were diagnosed as constitutional deficiency of kidney essence failing to nourish both the ear and brain, the so-called “sea of marrow” based on TCM differentiation. Following the principle of invigorating kidney essence and nourishing “Kidney Qi, ” acupuncture treatment was given around the ear as well as at distal points on the extremities once a week, with 10 sessions constituting one therapeutic course.
In cases 1, 2 and 3, a temporary minor reduction effect of tinnitus lasting half a day to a few days could usually be achieved by each acupuncture session, and long-term effects, with significant improvement of subjective intensity and loudness of tinnitus (which always dropped to 1/2-1/3 of the pretreatment levels) was possibly obtained after 3-4 treatment sessions. Acupuncture was less effective in case 4, in which some fluctuation of tinnitus loudness values was reported within the period of treatment, but there was no remarkable stable improvement, either in terms of loudness or disturbance of the tinnitus after 10 treatment sessions.
The results indicate that traditional Chinese acupuncture is a recommendable therapy in treating age-related tinnitus, especially the labyrinthine type or mixed type rather than the retrolabyrinthine type.