Bridging mechanistic evidence and clinical perspectives: traditional Chinese medicine in Menière's disease
- 1The First Affiliated Hospital of Hunan University of Chinese Medicine
Abstract
Ménière's disease (MD) is a debilitating inner-ear disorder characterized by recurrent vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness, with endolymphatic hydrops serving as its pathological hallmark. Conventional management, which includes comprising lifestyle modifications, pharmacotherapy, and surgical interventions for refractory cases and often yields limited efficacy and carries risk of adverse effects, underscoring the imperative for safer, more effective therapeutic strategies. Traditional Chinese Medicine (TCM), encompassing herbal phytotherapy and acupuncture, holds a rich clinical history in managing vertiginous conditions and is increasingly scrutinized within contemporary biomedical research. This review comprehensively reviews the mechanistic foundations and therapeutic utility of TCM in MD, aiming to establish it as a scientifically grounded component of personalized, evidence-based integrative management. We synthesize clinical and experimental evidence linking TCM interventions to core pathophysiological pathways in MD, specifically the regulation of molecular fluid transport, modulation of neuroinflammatory signaling cascades, enhancement of inner-ear microcirculation, and promotion of neuroplastic processes. Mechanistically, specific herbal formulations modulate aquaporin expression to restore endolymphatic fluid homeostasis, suppress MAPK and NF-κB-mediated inflammatory activity, improve cochleovestibular blood flow, and attenuate oxidative stress and apoptosis. Clinically, acupuncture has been associated with alleviation of symptom severity, accelerates central vestibular compensation, and preserves auditory and vestibular function. Integrating these insights, we propose a multi-tiered mechanistic model wherein TCM exerts immediate anti-inflammatory and fluid-regulatory effects, facilitates medium-term vestibular compensation, and provides long-term neuroprotection to potentially modify disease progression. By relating mechanistic insights to clinical data, this review highlights TCM as a promising adjunctive modality that warrants further rigorous investigation, offering a framework to inform mechanism-oriented treatment strategies and guide future translational and clinical research. Throughout the manuscript, we explicitly distinguish experimental evidence, mechanistic hypotheses, and human clinical evidence to facilitate critical appraisal.
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BibTeX
@article{ye2026bridging,
title = {{Bridging mechanistic evidence and clinical perspectives: traditional Chinese medicine in Menière's disease}},
author = {Shuting Ye and Zhenhua Zhu},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1915230},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1915230/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Bridging mechanistic evidence and clinical perspectives: traditional Chinese medicine in Menière's disease
AU - Shuting Ye
AU - Zhenhua Zhu
PY - 2026
DA - 2026/10/20
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1915230
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1915230/full
AB - Ménière's disease (MD) is a debilitating inner-ear disorder characterized by recurrent vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness, with endolymphatic hydrops serving as its pathological hallmark. Conventional management, which includes comprising lifestyle modifications, pharmacotherapy, and surgical interventions for refractory cases and often yields limited efficacy and carries risk of adverse effects, underscoring the imperative for safer, more effective therapeutic strategies. Traditional Chinese Medicine (TCM), encompassing herbal phytotherapy and acupuncture, holds a rich clinical history in managing vertiginous conditions and is increasingly scrutinized within contemporary biomedical research. This review comprehensively reviews the mechanistic foundations and therapeutic utility of TCM in MD, aiming to establish it as a scientifically grounded component of personalized, evidence-based integrative management. We synthesize clinical and experimental evidence linking TCM interventions to core pathophysiological pathways in MD, specifically the regulation of molecular fluid transport, modulation of neuroinflammatory signaling cascades, enhancement of inner-ear microcirculation, and promotion of neuroplastic processes. Mechanistically, specific herbal formulations modulate aquaporin expression to restore endolymphatic fluid homeostasis, suppress MAPK and NF-κB-mediated inflammatory activity, improve cochleovestibular blood flow, and attenuate oxidative stress and apoptosis. Clinically, acupuncture has been associated with alleviation of symptom severity, accelerates central vestibular compensation, and preserves auditory and vestibular function. Integrating these insights, we propose a multi-tiered mechanistic model wherein TCM exerts immediate anti-inflammatory and fluid-regulatory effects, facilitates medium-term vestibular compensation, and provides long-term neuroprotection to potentially modify disease progression. By relating mechanistic insights to clinical data, this review highlights TCM as a promising adjunctive modality that warrants further rigorous investigation, offering a framework to inform mechanism-oriented treatment strategies and guide future translational and clinical research. Throughout the manuscript, we explicitly distinguish experimental evidence, mechanistic hypotheses, and human clinical evidence to facilitate critical appraisal.
SN - 1664-2295
ER -