Laryngitis means hoarseness of the voice or aphonia. It includes chronic laryngitis, injury of vocal cords, node on vocal cords, polypus on vocal cords and hysteria aphonia etc.
1 Data
There are totally 50 patients with 23 male and 27 female; youngest patient is 15 and oldest 65 with average 42; shortest duration of disease is two weeks and longest half year with average 2 months. All of patients have got diagnosis in ENT Department including 37 chronic laryngitis, 5 node on vocal cords, 4 polypus on vocal cords and 4 paralysis of vocal cords. According to differentiation of TCM, there are 26 lung and kidney yin deficiency, 10 spleen and lung qi deficiency and 14 qi stagnation and phlegm.
2 Treatment method
Points selection:
Primary points: Tianding (LI17), Lianquan (CV23)
Secondary points: Yuji (LU10) Ying-Spring Point, Taixi(KI3) Shu-Stream, Yuan-Source Point or Zhaohai (KI6) The Eihgt Confluent Point for lung and kidney yin deficiency;
Zusanli (ST36) He-Sea Point, Chize (LU5)He-Sea Point for spleen and lung qi deficiency;
LIV3, Lieque (LU7)Luo-Connecting Point the Eight Confluent Point or Fenglong (ST40) Luo-Connecting Point for qi stagnation and phlegm.
Manipulation: All of points mentioned above are performed by rotating reinforcing or reducing method. Retaining of needle is 20 minutes; treatment is once a day, 7 times of treatment are considered as one course, second course are begun 3 days break after first course. Needle in LI17 is 0.3 to 0.5 cun deep with perpendicular direction, needling sensation is local soreness and distension, radiates to throat; needle in CV23 is 1 to 1.5 cun deep with oblique insertion to tongue root, needling sensation is local numbness and radiates to heel; needle in ST36 is 1 to 2 cun deep with perpendicular direction, needling sensation radiates to toes; needle in LU5 is 0.5 to 0.8 cun deep with perpendicular direction, needling sensation has local soreness and distension, radiates to forearm or hand; needle in LU7 is 0.2 to 0.5 cun deep with slightly oblique direction to elbow, needling sensation has local soreness and distension, radiates to elbow and shoulder; needle in LIV3 is 0.5 to 1 cun deep with perpendicular direction, needling sensation has local soreness, distension and numbness, radiates to foot base; needle in ST40 is 1 to 1.5 cun deep with perpendicular direction, needling sensation radiates to foot instep.
3 Effect standard
Cured – hoarseness of the voice is disappeared; color and motion of vocal cords become normal.
Obvious effective – hoarseness of the voice is obviously relieved, node on vocal cords becomes smaller, and congestion is reduced.
Improved – hoarseness of the voice is relieved from continuous to intermittent; congestion is reduced.
No effect – no improvement on hoarseness of the voice and vocal cords.
4 Treatment result
Among 50 patients, 21 cured ( 42% ); 10 obvious effective ( 20% ), 13 improved ( 26% ), 6 no effect ( 12% ). So effective rate is 88%.
5 discussion
Acupuncture treatment has effective result for laryngitis. According to theory of TCM, laryngitis is mostly caused by qi deficiency due to too much speech; lung qi deficiency failing to control opening and closing of vocal cords; kidney deficiency because voice is from lung and founded from kidney. Hoarseness of voice has closed relation with lung and kidney meridians, also relates with spleen deficiency, phlegm and qi stagnation. Because spleen qi deficiency cannot control circulation of body fluid, phlegm accumulated by fluid can obstruct throat and cause edema and enlargement of vocal cords, low speech. Meanwhile, hoarseness of voice relates with emotional change because easily anger injures liver, liver stagnation can be transformed into fire; fire counteracts metal so that metal dysfunction leads to hoarseness of voice and mostly aphonia due to fire with deficient type. Combination of acupuncture with voice rest therapy can increase effect of treatment.
Primary points for treatment of laryngitis are LI17 and CV23. LI17 is the point of Large Intestine Meridian of Hand-Yangming, large intestine meridian has internal and external relation with lung meridian and throat is orifice of lung organ, so LI17 has indication of throat diseases; CV23 is point of Conception Vessel that runs through throat, so CV23 can treat throat diseases; both of LI17 and CV23 are local or nearby points to throat, so needling on both of them can regulate qi and blood circulation on affected area, eliminate swollen, produce body fluid, moisten throat and cure aphonia. In secondary points, LU10 is ying-spring point of lung meridian that clears heat, benefits throat and moisten dryness; KI3 and KI6 can nourish kidney yin to eliminate fire with deficient type; ST36 has functions to tonify qi in middle jiao, strengthen foundation of qi and blood and promote vocal cords; LU5 is he-sea point of lung meridian that descends upper perversion of qi, clear heat and moisten dryness; LU7 is luo-connecting point of lung meridian that regulates qi, eliminate phlegm and treat sore throat; LIV3 is yuan-primary point of liver meridian that can regulate liver qi; ST40 is luo-connecting point of stomach meridian that can eliminate phlegm and benefit throat.
In general, after 3 to 5 times for treatment of chronic laryngitis, spontaneous symptoms can be relieved, edema and congestion in throat are reduced given by throat test, but treatment is slow effect for enlargement of vocal cords, small node in vocal cords can be disappeared by acupuncture treatment but large node should be treated by comprehensive therapies.
Key Words: laryngitis, acupuncture
Writer: Jin Yanli
Comments: