那个「嗡——」的声音，只有你自己听得到。白天忙起来还好，一到夜深人静、准备睡觉，它反而更清楚，越听越烦，越烦越睡不着。有人是蝉鸣般的细响，有人是像潮水、像轰隆隆的低鸣。很多人第一反应是「耳朵是不是坏了」，但耳鸣往往不是耳朵单独的问题——中医看的是，你的身体正透过耳朵在提醒什么。
That "eeee—" sound only you can hear. During a busy day it fades into the background, but once the night turns quiet and you lie down to sleep, it gets clearer, more irritating — and the more you listen, the less you sleep. For some it's a faint cicada-like ring; for others a roaring, tide-like hum. Many people's first thought is "is my ear broken?" — but tinnitus is often not an ear problem alone. In TCM, it's the body signalling something through the ear.
Bunyi "eee—" yang hanya anda dengar. Pada siang hari ia pudar ke latar belakang, tetapi apabila malam menjadi sunyi dan anda berbaring untuk tidur, ia menjadi lebih jelas dan menjengkelkan — semakin didengar, semakin sukar tidur. Bagi sesetengah orang ia dengungan halus seperti riang-riang; bagi yang lain deru seperti ombak. Ramai fikir "adakah telinga saya rosak?" — tetapi tinnitus selalunya bukan masalah telinga sahaja. Dalam TCM, ia isyarat badan melalui telinga.
为什么耳朵会一直响？
Why Do Your Ears Keep Ringing?
Mengapa Telinga Anda Terus Berdengung?
中医有一句话：「肾开窍于耳。」耳朵和肾的关系最密切，同时又是「宗脉之所聚」——多条经脉在耳部交会。所以耳鸣表面上在耳朵，根源却常常在肾、在肝、在脾。有人是熬夜、压力、情绪一上来就「嗡」得厉害；有人是年纪渐长、身体虚了，安静时才听见那细细的蝉鸣。同样是耳鸣，来路完全不同，调理方向也完全不同。
A classic TCM line: "The kidney opens into the ear." The ear is most closely tied to the kidney, and is also where many meridians converge. So while tinnitus appears in the ear, its root often lies in the kidney, liver, or spleen. For some, it roars after late nights, stress, or a flare of temper; for others, it's a faint cicada-like ring heard only in the quiet as the body weakens with age. Same symptom, entirely different origins — and entirely different directions of care.
Satu pepatah TCM: "Buah pinggang membuka ke telinga." Telinga paling rapat dengan buah pinggang, dan juga tempat pertemuan banyak meridian. Jadi walaupun tinnitus muncul di telinga, puncanya sering di buah pinggang, hati, atau limpa. Bagi sesetengah orang ia mengaum selepas tidur lewat atau tekanan; bagi yang lain dengungan halus yang didengar hanya dalam kesunyian apabila badan lemah dengan usia.
辨别耳鸣，第一步先分「实」和「虚」。声音大、突然出现、情绪激动或熬夜后加重、用手按住耳朵反而更响——多属实证（肝火、痰火），重点在「清、在泻」；声音细如蝉鸣、慢慢出现、越累越明显、按住耳朵反而减轻——多属虚证（肾虚、气血虚），重点在「补」。这两个方向几乎相反：实证乱补会火上加油，虚证猛清会越清越弱。分错方向，往往越调越糟。
Step one in sorting out tinnitus: excess or deficiency. A loud sound, sudden onset, worse after emotional upset or late nights, and louder when you press the ear points to excess (liver-fire, phlegm-fire) — the focus is to clear and drain. A faint, cicada-like ring, gradual onset, worse the more tired you are, and softer when you press the ear points to deficiency (kidney, qi-and-blood) — the focus is to tonify. These two directions are almost opposite: tonifying an excess pattern feeds the fire; draining a deficient one weakens it further. Get it wrong and it tends to worsen.
Langkah pertama: lebihan atau kekurangan. Bunyi kuat, tiba-tiba, lebih teruk selepas emosi atau tidur lewat, dan lebih kuat apabila ditekan menunjukkan lebihan (api-hati, api-kahak) — fokusnya membersihkan. Dengungan halus, beransur-ansur, lebih teruk apabila penat, dan reda apabila ditekan menunjukkan kekurangan — fokusnya menguatkan. Kedua-dua arah hampir bertentangan — salah arah, ia menjadi lebih teruk.
在马六甲，还有几个很现代、很本地的诱因让耳鸣特别容易找上门：长时间戴耳机、音量开太大，直接刺激内耳；长期熬夜、压力大、情绪紧绷，肝火一上来耳朵就响；办公室冷气吹加上疲劳，气血运行差，耳窍失养。所以同样是耳鸣，年轻上班族多是肝火、气滞，年长者多是肾虚，处理方式并不一样。
In Melaka, a few very modern, very local triggers make tinnitus prone to show up: long hours with earphones at high volume, directly straining the inner ear; chronic late nights, stress, and tension, where liver-fire rises and the ears ring; and air-conditioning plus fatigue in the office, leaving the qi and blood too sluggish to nourish the ear. So the same tinnitus differs by person — younger office workers tend toward liver-fire and stagnation, older adults toward kidney deficiency.
Di Melaka, beberapa pencetus moden dan tempatan menjadikan tinnitus mudah muncul: berjam-jam dengan fon telinga pada kelantangan tinggi; tidur lewat kronik, tekanan, dan ketegangan yang menaikkan api-hati; dan penyaman udara serta keletihan di pejabat. Jadi tinnitus yang sama berbeza mengikut orang.
你的耳鸣，是哪一种？
Which Kind of Tinnitus Do You Have?
Tinnitus Anda Jenis Yang Mana?
临床上，耳鸣大致分成这几种常见证型。很多人是虚实夹杂，或从实证拖久转成虚证，需要医师四诊辨证。
Clinically, tinnitus falls into a few common patterns. Many people are a mix of excess and deficiency, or have let an excess pattern drag into a deficient one — a practitioner's four-part assessment sorts it out.
Secara klinikal, tinnitus terbahagi kepada beberapa corak biasa. Ramai orang adalah gabungan lebihan dan kekurangan — penilaian pengamal mengasingkannya.
耳鸣声大如潮水、轰鸣，突然发作或情绪激动、熬夜后加重，常伴口苦、面红、头胀、易怒、失眠。多见于压力大、爱熬夜、脾气急的上班族。方向是清肝泻火——这时候若还猛喝补汤、进补，等于火上浇油。
A loud, tide-like or roaring ring, sudden onset or worse after emotional upset and late nights, often with a bitter mouth, flushed face, head distension, irritability, and poor sleep. Common in stressed, night-owl, quick-tempered office workers. The direction is to clear liver-fire — piling on tonic soups here is pouring oil on the flame.
Dengungan kuat seperti ombak atau deru, tiba-tiba atau lebih teruk selepas emosi dan tidur lewat, sering dengan mulut pahit, muka merah, mudah marah, dan tidur terganggu. Biasa pada pekerja pejabat yang tertekan. Arahnya membersihkan api-hati — sup penambah di sini menambah api.
耳鸣声闷、耳朵像被塞住，头重头昏、胸闷、痰多，身体偏沉重，舌苔厚腻。多见于体型偏胖、爱吃生冷油腻甜食、湿热重的人。方向是化痰清热、通窍——光补肾没用，得先把痰湿化开。
A muffled ring with a blocked-up ear, a heavy foggy head, chest tightness, lots of phlegm, a heavy body, and a thick greasy tongue coat. Common in heavier builds who love cold, greasy, sweet food and carry damp-heat. The direction is to resolve phlegm, clear heat, and open the orifice — tonifying the kidney alone won't help until the phlegm-damp clears.
Dengungan tersekat dengan telinga seperti tersumbat, kepala berat dan pening, dada sesak, kahak banyak, badan berat. Biasa pada mereka yang suka makanan sejuk, berminyak, manis. Arahnya menyuraikan kahak dan membuka saluran — menguatkan buah pinggang sahaja tidak membantu.
耳鸣声细如蝉鸣，慢慢出现、时轻时重，夜深或安静时最明显，按住耳朵会减轻，常伴腰膝酸软、头晕、健忘、听力慢慢下降。多见于年长者、久病、长期熬夜纵欲后。方向是补肾填精、滋养耳窍，需要较长的调理周期。
A thin, cicada-like ring, gradual and fluctuating, clearest at night or in the quiet, softer when you press the ear, often with a sore lower back and knees, dizziness, forgetfulness, and slowly fading hearing. Common in older adults, after long illness, or chronic overwork. The direction is to tonify kidney essence and nourish the ear — this takes a longer course.
Dengungan halus seperti riang-riang, beransur-ansur, paling jelas pada waktu malam atau senyap, reda apabila ditekan, sering dengan belakang dan lutut lenguh, pening, pelupa, dan pendengaran perlahan berkurang. Biasa pada orang tua. Arahnya menguatkan intipati buah pinggang — ini mengambil masa lebih lama.
耳鸣声细、劳累后明显加重、休息后减轻，按之减轻，常伴面色苍白或萎黄、乏力、心悸、容易累、食欲差。多见于产后、大病后、长期操劳、脾胃虚弱的人。方向是健脾益气、养血充耳，一边补气血一边通耳窍。
A faint ring that flares with exertion and eases with rest, softer when pressed, often with a pale or sallow face, fatigue, palpitations, and poor appetite. Common after childbirth, serious illness, or long overwork with a weak spleen and stomach. The direction is to strengthen the spleen, boost qi, and nourish blood to fill the ear.
Dengungan halus yang menjadi teruk dengan aktiviti dan reda dengan rehat, sering dengan muka pucat, keletihan, berdebar, dan selera lemah. Biasa selepas bersalin atau kerja berat berpanjangan. Arahnya menguatkan limpa, menambah qi, dan memupuk darah.
中医怎么处理耳鸣？
How Does TCM Treat Tinnitus?
Bagaimana TCM Merawat Tinnitus?
中医处理耳鸣的核心，不是硬压那个声音，而是先分清是肝火、痰火、肾虚，还是气血虚，再决定该清、该化、还是该补。方向对了，耳鸣是慢慢「安静下来」，而不是被强行盖住。
The core of TCM's approach isn't to force the sound down, but to first tell apart liver-fire, phlegm-fire, kidney deficiency, or qi-and-blood deficiency, then decide whether to clear, resolve, or tonify. Get the direction right and the tinnitus gradually quietens, rather than being masked.
Teras pendekatan TCM bukan menekan bunyi itu secara paksa, tetapi mengasingkan api-hati, api-kahak, buah pinggang lemah, atau qi-darah lemah dahulu, kemudian menentukan arah. Arah yang betul menjadikan tinnitus perlahan-lahan reda.
肝火上扰常用龙胆泻肝汤清肝泻火；痰火郁结用温胆汤、清气化痰类化痰通窍；肾精亏虚用耳聋左慈丸、六味地黄丸滋阴补肾；气血亏虚用归脾汤、益气聪明汤健脾养血。核心永远是先辨虚实——同样喊「耳鸣」，实证和虚证用药几乎相反。
Longdan Xiegan Tang to clear liver-fire; Wendan Tang or phlegm-clearing formulas for phlegm-fire; Erlong Zuoci Wan or Liuwei Dihuang Wan to nourish and tonify the kidney; Guipi Tang or Yiqi Congming Tang to strengthen the spleen and nourish blood. The core is always sorting excess from deficiency first — the same word "tinnitus" calls for near-opposite herbs.
Formula berbeza mengikut corak — api-hati, api-kahak, buah pinggang lemah, atau qi-darah lemah. Terasnya sentiasa membezakan lebihan daripada kekurangan dahulu.
针灸常在耳周取听宫、听会、耳门、翳风等穴，直接疏通耳窍气血；再配远端穴——肝火加太冲、侠溪泻火，肾虚加太溪、肾俞补肾，气血虚加足三里、三阴交补益。局部加远端，一边通、一边调，很多人几次后觉得响的程度和困扰感明显减轻。
Acupuncture commonly uses Tinggong, Tinghui, Ermen, and Yifeng around the ear to open the qi and blood there, paired with distal points — Taichong and Xiaxi to drain liver-fire, Taixi and Shenshu to tonify the kidney, Zusanli and Sanyinjiao to boost qi and blood. Local plus distal points work together; many notice the loudness and distress ease markedly after a few sessions.
Akupunktur biasanya menggunakan Tinggong, Tinghui, Ermen, dan Yifeng di sekeliling telinga, digandingkan titik jauh mengikut corak. Ramai perasan kelantangan dan gangguan berkurang selepas beberapa sesi.
实证、新发的耳鸣，方向对了往往几周内就见效。虚证、久鸣的，一般需要1–3个月，让响的程度减轻、出现次数减少、每次持续时间缩短，尤其是夜间和安静时的困扰慢慢淡下去。目标不是保证「一声不响」，而是把身体的失衡调回来、让耳鸣不再放大你的睡眠和情绪。
For an excess or new-onset tinnitus, the right direction often shows results within a few weeks. A deficient, long-standing one usually needs 1–3 months to reduce the loudness, lower how often it appears, and shorten each episode — especially easing the night-time and quiet-moment distress. The goal isn't to guarantee total silence, but to correct the underlying imbalance so the tinnitus no longer magnifies your sleep and mood.
Untuk tinnitus lebihan atau baru, arah yang betul sering menunjukkan hasil dalam beberapa minggu. Yang kronik biasanya memerlukan 1–3 bulan untuk mengurangkan kelantangan, kekerapan, dan tempoh. Matlamatnya bukan menjamin senyap sepenuhnya, tetapi membetulkan ketidakseimbangan.
一个安全底线，请一定记住：有一种耳鸣要当急症处理。如果你的耳鸣是突然发生、单侧、并且伴随听力明显下降，很可能是「突发性耳聋」——发病后 72 小时内是黄金治疗期，必须尽快看耳鼻喉科，越早处理恢复机会越大，千万别只想着看中医、拖着观察。此外，搏动性耳鸣（声音和心跳同步、一跳一跳）、或耳鸣伴随天旋地转、恶心呕吐、单侧持续加重，都要先做西医检查，排除血管、听神经、梅尼埃等问题。中医调理与必要的西医检查，从来不冲突——该查的先查，该调的慢慢调。
One safety line to remember: one kind of tinnitus is an emergency. If your tinnitus is sudden, one-sided, and comes with noticeable hearing loss, it may be sudden sensorineural hearing loss — the first 72 hours are the golden window, so see an ENT as fast as possible; the earlier it's treated, the better the recovery. Don't sit on it hoping TCM alone will do. Also, pulsatile tinnitus (a beat in time with your heart), or tinnitus with spinning vertigo, nausea, or a one-sided worsening, warrants medical assessment first to rule out vascular, auditory-nerve, or Ménière's causes. TCM care and necessary medical checks never conflict — investigate what needs investigating, then treat.
Satu garis keselamatan: satu jenis tinnitus adalah kecemasan. Jika tinnitus anda tiba-tiba, sebelah, dan disertai kehilangan pendengaran ketara, ia mungkin pekak mengejut — 72 jam pertama adalah tetingkap emas, jadi jumpa pakar ENT secepat mungkin. Tinnitus berdenyut (seirama denyutan jantung), atau disertai pening berpusing, mual, atau memburuk sebelah, memerlukan pemeriksaan perubatan dahulu. Penjagaan TCM dan pemeriksaan perubatan tidak pernah bercanggah.
在看诊之前，你现在可以先做的3件事
3 Things to Do Before Your Appointment
3 Perkara Yang Boleh Dilakukan Sebelum Temujanji
- 观察并记下你耳鸣的规律。声音是大还是细？像蝉鸣、嗡嗡，还是像潮水、轰鸣？什么时候最明显（安静、夜间、累后、情绪后）？单侧还是双侧？用手按住耳朵是更响还是减轻？有没有伴随听力下降、头晕、腰酸？看诊时说清楚这几点，医师辨虚实会又快又准，比只说「我耳朵一直响」有用得多。 Observe and note the pattern of your tinnitus. Loud or faint? Cicada-like buzz or a tide-like roar? When is it worst — quiet, night, after fatigue, after stress? One ear or both? Louder or softer when you press the ear? Any hearing loss, dizziness, or sore back with it? Describing these clearly lets the practitioner sort excess from deficiency quickly — far more useful than just "my ear keeps ringing." Perhatikan dan catat corak tinnitus anda. Kuat atau halus? Dengung atau deru? Bila paling teruk — senyap, malam, selepas penat? Sebelah atau dua-dua? Lebih kuat atau reda apabila ditekan? Ada kehilangan pendengaran atau pening? Menerangkan ini membantu pengamal dengan cepat.
- 给耳朵和大脑减负。控制耳机音量和时长（参考「60/60」：音量不超过 60%、每次不超过 60 分钟），远离持续的噪音环境；别熬夜、睡前少滑手机，减少用脑过度和肝火。越是安静时耳鸣越吵，可以放一点柔和的背景音（轻音乐、风扇声、白噪音）分散注意，别整晚死死盯着那个声音——你越紧张，它越响。 Ease the load on your ears and mind. Keep earphone volume and time in check (the "60/60" guide: under 60% volume, under 60 minutes at a time) and avoid constant noise; skip late nights and cut pre-sleep scrolling to reduce mental strain and liver-fire. Tinnitus feels loudest in silence, so a little soft background sound (gentle music, a fan, white noise) helps you stop fixating on it — the more anxious you are, the louder it seems. Kurangkan beban pada telinga dan minda. Kawal kelantangan dan masa fon telinga (panduan "60/60": bawah 60% kelantangan, bawah 60 minit); elak tidur lewat dan kurangkan skrol sebelum tidur. Tinnitus paling kuat dalam kesunyian, jadi bunyi latar lembut membantu anda berhenti terfokus padanya.
- 别一有耳鸣就疯狂进补「补肾」。这是最常见的误区。只有肾虚型才适合补，如果你其实是肝火、痰火的实证，猛吃补品、喝老火补汤，等于火上浇油，越补越响。实证的人反而要清淡、少熬夜、少酒、少浓茶咖啡、少辛辣煎炸；虚证的人才慢慢温养。到底该清还是该补，先让医师辨清虚实，别自己乱补。 Don't rush to "tonify the kidney" the moment you hear ringing. This is the most common mistake. Only deficiency patterns suit tonifying; if you actually have an excess pattern (liver-fire, phlegm-fire), piling on tonics and long-boiled soups pours oil on the fire and makes it louder. Excess types should eat light, cut late nights, alcohol, strong tea and coffee, and fried spicy food; only deficiency types are warmed and nourished slowly. Let a practitioner sort excess from deficiency first — don't self-tonify. Jangan tergesa-gesa "menguatkan buah pinggang" sebaik mendengar dengungan. Ini kesilapan paling biasa. Hanya corak kekurangan sesuai untuk penambah; jika anda sebenarnya corak lebihan, penambah dan sup memburukkannya. Biar pengamal membezakan lebihan daripada kekurangan dahulu.