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Er Long Zuo Ci Wan

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Specifically for Tinnitus

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Why it works for Tinnitus:

TCM rationale. In TCM, tinnitus with a low “cicada-like” tone, worse at night, often stems from Kidney & Liver Yin deficiency with relative Yang rising. Er Long Zuo Ci Wan is a Liu-Wei-Di-Huang-Wan–based formula that tonifies Kidney/Liver Yin and anchors Yang (with Ci Shi / Magnetitum), classically indicated for tinnitus and hearing loss. Yin Yang House

Modern mechanistic findings (preclinical). In vitro and animal work suggests extracts of Er Long Zuo Ci protect cochlear hair cells from ototoxic injury, reduce hair-cell loss, and modulate apoptosis/inflammation pathways (e.g., p53/Bak, ERK/STAT3). SpringerLink

Network-pharmacology analyses. Multiple studies map formula constituents to targets linked to hearing loss/tinnitus (oxidative stress, autophagy, apoptosis), offering a plausible multi-target mechanism. (These are computational/indirect, not proof of efficacy.) Frontiers

Recent narrative/umbrella reviews. Contemporary reviews of TCM for auditory disorders note clinical use and signals of benefit for Er Long Zuo Ci Wan but emphasize the need for better-designed trials. ScienceOpen

How to use for Tinnitus:

Typical over-the-counter label directions (vary by brand; follow your specific label or practitioner):

  • Plum Flower/Min Shan teapills: common labels list 8 pills, 3×/day, or 3–4 tablets, 2×/day after meals. Some practitioner guides allow temporarily higher doses early on (e.g., 12–18 pills 2×/day) then taper. VitalGoods
  • Tablet versions (e.g., Guang Ci Tang “YinVive Hearing”): 5 tablets, 2–3×/day with or before meals. Chinese Herbs Direct
  • Classical honey-pill dosing: 9 g per dose with warm salty water (historical reference). Modern products standardize to small pills/tablets—use modern labels unless your practitioner specifies otherwise. Yibian

Duration: Many clinicians trial 4–8 weeks, reassessing every 2–4 weeks; longer courses are common for chronic tinnitus. (This practice pattern is reflected in practitioner guides/labels; exact duration is not standardized.) Colorado Chinese Medicine University®

Ingredients (typical modern formula): Shu Di Huang (Rehmannia), Shan Zhu Yu (Cornus), Shan Yao (Dioscorea), Ze Xie (Alisma), Mu Dan Pi (Moutan), Fu Ling (Poria), Ci Shi (Magnetitum), often Chai Hu (Bupleurum); some Australian listings include Wu Wei Zi (Schisandra) or Shi Chang Pu/Jiu Jie Chang Pu variants. Check your brand’s label. VitalGoods

Scientific Evidence for Tinnitus:

Systematic review & meta-analysis (2021): 9 RCTs (n=694). Er Long Zuo Ci Wan (alone or combined with acupuncture/Western meds/auricular therapy) showed higher “clinical effective rate” vs controls (OR≈4.45). Authors note risk of bias and heterogeneity; adverse-event and relapse data insufficient. d.wanfangdata.com.cn

Randomized trial (2016–2017): Betahistine vs. Betahistine + Er Long Zuo Ci Wan for neuropathic tinnitus (n=60). The combination group had better tinnitus scores and otoacoustic emission outcomes. (Chinese journal; small size.) Baidu Xueshu

Other combo trials: Er Long Zuo Ci Wan + acupuncture or + Songling Xuemai Kang showed higher response rates than monotherapy in small randomized studies; again, Chinese-language with limited blinding/reporting. Baidu Xueshu

Preclinical work: Mouse cochlear-explants and animal models report hair-cell protection, lower ABR thresholds, and modulation of inflammatory/apoptotic pathways after Er Long Zuo Ci extracts. These support biological plausibility but do not prove clinical benefit. SpringerLink

Contemporary reviews: Recent reviews on TCM for auditory disorders echo the signal of benefit yet call for larger, well-controlled trials. ScienceOpen

Specific Warnings for Tinnitus:
  • Pregnancy & nursing: Most labels advise avoid in pregnancy (and often while breastfeeding) unless specifically directed by a qualified clinician. Healthylicious
  • Wrong pattern / acute ear disease: Not appropriate as sole therapy for acute ear infections, sudden sensorineural hearing loss, or allergy-driven/“excess-heat” tinnitus. Seek urgent medical care for sudden hearing loss or new neurologic symptoms. 1stchineseherbs.com
  • Drug interactions & comorbidities: Reputable references recommend professional oversight when combining with prescription meds (e.g., ototoxins, anticoagulants) due to multi-herb compositions and theoretical interactions; check brand-specific interaction notes. hellopharmacist.com
  • Quality & composition vary: Constituents can differ slightly by manufacturer/region (e.g., inclusion of Schisandra/Chang Pu). Choose GMP-certified brands listed in regulatory registers where possible (e.g., Australia’s ARTG-listed versions). innerpath.com.au
  • Adverse effects: Trials/meta-analyses report few adverse events, but reporting is limited. Monitor for GI upset or headaches; discontinue and seek advice if symptoms worsen. d.wanfangdata.com.cn

General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

Er Long Zuo Ci Wan (二龙左慈丸), sometimes translated as “Pill for Deafness from Left [Side] by Master Ci”, is a traditional Chinese herbal formula. It originates from classical Chinese medicine texts and has been used for centuries to treat ear-related conditions such as tinnitus (ringing in the ears), hearing loss, and dizziness associated with internal imbalances.

The formula is composed primarily of Rehmannia root (Shu Di Huang) as its chief ingredient, supported by a combination of herbs such as Cornus officinalis (Shan Zhu Yu), Dioscorea opposita (Shan Yao), Alisma orientalis (Ze Xie), Poria cocos (Fu Ling), Moutan cortex (Mu Dan Pi), Magnetitum (Ci Shi), and sometimes others depending on the manufacturer.

It is traditionally classified under the category of Kidney- and Liver-tonifying formulas, particularly those that nourish yin and subdue yang. It’s often used when ear disorders are believed to stem from deficiencies or imbalances in the Kidney and Liver systems, according to Traditional Chinese Medicine (TCM) theory.

How It Works

From a TCM perspective, Er Long Zuo Ci Wan works by replenishing Kidney and Liver Yin, while simultaneously anchoring hyperactive Yang energy.

In TCM, the Kidneys are thought to “open to the ears” and govern hearing, while the Liver maintains the smooth flow of Qi and stores blood that nourishes the sensory organs. When the Yin energy (cooling, nourishing essence) of these organs is deficient, it allows Yang (active, hot energy) to rise excessively — leading to symptoms like tinnitus, dizziness, or gradual hearing loss.

Er Long Zuo Ci Wan nourishes the Yin to restore balance and uses ingredients like Magnetitum (Ci Shi) to anchor and calm the spirit, helping reduce symptoms of ear ringing and restlessness. The herbs work synergistically to:

  • Tonify Kidney Yin (Rehmannia, Cornus, Dioscorea)
  • Drain excess Fire and calm hyperactive Yang (Moutan Cortex, Alisma)
  • Stabilize essence and fluids to prevent further deficiency
  • Anchor Yang and improve ear function (Magnetitum)

From a biomedical viewpoint, although more modern research is limited, some studies suggest that Er Long Zuo Ci Wan may improve microcirculation in the inner ear, reduce oxidative stress, and support auditory nerve function, thereby helping to alleviate symptoms of tinnitus and sensorineural hearing loss.

Why It’s Important

Er Long Zuo Ci Wan remains an important formula because it addresses a common yet difficult-to-treat condition — chronic tinnitus and age-related hearing loss — using a holistic, body-strengthening approach rather than merely masking symptoms.

Its importance lies in its dual action: it not only targets ear symptoms but also treats the underlying systemic imbalance that contributes to them. In older adults or individuals experiencing fatigue, dizziness, or forgetfulness along with ear problems, it provides a means of supporting overall vitality and inner balance.

The formula is also valued because it represents one of the classic TCM strategies for managing degenerative conditions tied to aging or stress — by nourishing the body’s fundamental essence (jing) and preventing the escalation of internal heat and restlessness.

Considerations

While Er Long Zuo Ci Wan is widely used and generally considered safe when prescribed correctly, several important considerations apply:

Proper Diagnosis:

  • It is intended for ear problems due to Kidney and Liver Yin deficiency, not for all kinds of tinnitus or hearing loss. If symptoms are caused by infection, earwax blockage, or vascular issues, this formula may not be appropriate.

Possible Side Effects:

  • Mild digestive discomfort or fatigue may occur in some individuals, especially if taken in large doses or for extended periods. Those with Spleen Qi deficiency (signs include poor appetite or loose stools) may find it too rich or cloying.

Interactions and Precautions:

  • It should be used with caution if you are taking other herbal tonics or prescription medications, as the combined effects may alter absorption or metabolism.
  • Pregnant or breastfeeding women should use it only under professional guidance.
  • Those with acute infections or inflammatory ear conditions should avoid it until the condition stabilizes.

Quality and Source:

  • As with all traditional remedies, herbal quality and authenticity matter greatly. Users should choose products from reputable manufacturers that follow GMP standards and avoid unverified online sources.

Duration and Monitoring:

  • The effects are typically gradual; consistent use over weeks or months under a practitioner’s supervision yields the best results. It’s also advisable to monitor blood pressure and hearing function during long-term use, particularly for elderly patients.

Helps with these conditions

Er Long Zuo Ci Wan is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

Tinnitus 0% effective
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Tinnitus

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TCM rationale. In TCM, tinnitus with a low “cicada-like” tone, worse at night, often stems from Kidney & Liver Yin deficiency with relative Yang r...

0 votes Updated 1 month ago 5 studies cited

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