该文从“浊毒阻窍”理论出发，结合六经辨证阐述了耳鸣的发病机制及其治疗策略。认为“浊毒”是由情志、饮食、 代谢失常所产生的致病因素与病理产物，可导致脏腑、经络等的功能失调，“浊毒阻窍”为耳鸣的核心病机。依据六经辨 证，耳鸣可从初期少阳疏泄不利、进展期太阴运转无力以及后期少阴亏损失养分期辨治，治疗可分别采用和解少阳透邪、 补土助运以祛浊、滋水培元以化浊的方法，方药可分别以小柴胡汤、逍遥散合参苓白术散、耳聋左慈丸为基础方进行加减。 “浊毒阻窍”理论结合六经辨证论治耳鸣，不仅丰富了中医对耳鸣病机的理解，也为中医临床治疗耳鸣提供了新的思路。

This study elucidates the pathogenesis and treatment strategies for tinnitus based on the theory of turbid toxin obstructing the orifices and by combining the theory of six-meridian syndrome differentiation. It is pointed out that turbid toxin is a pathogenic factor and a kind of pathological product arising from emotional disturbances，dietary irregularities， and metabolic dysfunctions， which leads to the dysfunction of zang-fu organs and meridians. The core pathogenesis of tinnitus is identified as turbid toxin obstructing the orifices. Following the theory of six-meridian syndrome differentiation，tinnitus can be treated in stages：in the early stage，tinnitus is attributed to shaoyang’s failure in conveying and dispersing；in the progressive stage，tinnitus is due to taiyin’s inability of transportation and transformation；in the late stage，tinnitus results from insufficient shaoyin failing in nourishment. Correspondingly，therapies of harmonizing shaoyang to expel pathogens，strengthening the spleen to eliminate turbidity，and nourishing the kidneys to resolve turbidity are performed with the modified use of Xiao Chaihu Decoction，Xiaoyao San combined with Shenling Baizhu San，and Erlong Zuoci Pills，respectively. The integration of the theory of turbid toxin obstructing the orifices and the theory of six-meridian syndrome differentiation not only enriches the traditional Chinese medicine pathogenesis of tinnitus，but also provides new insights for its clinical treatment.

R276.445

广东省佛山市“十四五”中医重点专科项目（编号：ZDZKJS12）