Allergic reactions
It is well known that acupuncture can effectively treat allergic diseases. However , since the 1970s , have been reported , the use of injection, moxibustion, acupuncture and other methods of bee , the body can induce varying degrees of allergic reactions occur . Although the prognosis is usually good , but sometimes there may be heavier syndromes noteworthy. Recently , some simple application cents acupuncture or electro-acupuncture , cause allergic reactions reported.
[ Reason ] injury
First, the physical reasons for the leading cause of allergic reactions in patients with allergies themselves , many have asthma, urticaria, or a history of multiple drug allergies to pollen .
Second, the reason drugs generally refers to acupoint injection sensitization. And the injection of liquid contained in the relevant allergens , including herbal preparations can cause allergic reactions. At present , can cause allergic reactions have been reported in western vitamin B1, calcium Vidin gum , herbal preparations have Bupleurum injection, angelica injection , Danshen injection and summer without injection.
Salvia Injection: As a 40 -year-old female patient suffering from rheumatic heart disease , heart failure to the clinic for treatment. On the same day and the next day at Ximen points each injection salvia liquid 2ml. The next day the Illuminati throat itching, redness and swelling at the injection site to see the afternoon , the evening appeared a large lower body hives, itchy . Not used other drugs the patient during this period. Rash faded to 11th , four days after the disappearance . Made after an allergy test to prove that the patients were positive Salvia Injection [1 ] .
Bupleurum injection : a 25 -year-old male patient with a fever treatment. Previously healthy , no history of drug allergy . Diagnosed with the flu , giving Bupleurum injection 4ml injection bilateral Quchi . Point injection is completed after 5min, patients feel dizziness, chest tightness , Nursing and supine , shortness of breath occurs after about 1min , lips cyanosis , breathing 30 times / min, heart rate 156 beats / min, the whole law . I immediately began oxygen and give dexamethasone 5mg, 25mg intramuscular injection phenergan , ammonia tea minus 0.25 50% glucose 40ml bolus, hydrocortisone 200mg 5% glucose infusion . Symptoms after about 5min , 15min after the symptoms and signs disappeared [ 2 ] .
Xiatianwu Injection: Yellow × ×, female, aged 59, teacher. On March 8, 1990 visit. Patients with left knee swelling and two more than a month , plus even Yuhan and events to our hospital for treatment. Check: sore left knee , left knee eye tenderness ( + ) , ESR 16mm / h. With no injection 2ml summer knee eye , Zusanli acupoint injection per hole 1ml, day 1. On March 10 Note 3 pin hole , about 3h after local skin rash , facial mild itching , stopping two days , without making any treatment, facial rash and itching eliminated. And again on March 13th hole injection summer without an injection , body rash after 1h , flaky rash was the point , the color red , no itching [ 3 ] .
In addition, the compound Chinese medicine injections also sensitized reports, such as the case of male patients , aged 35, farmer. Complained of right arm and elbow numbness two more than a month , many times the treatment ineffective , calls for acupoint injection therapy. Angelica was one with the compound (containing safflower root, the final body ) , after routine disinfection. Trey needle in Quchi to have swelling numbness when injecting the drug solution 1ml. After毕后刚pull out the needle , the patient consciously flustered , covered with fever, itching , feeling the moment there is urgent need to defecate , when that fell into the toilet , then the patient was pale , sweating, Jueleng limbs, pulse micro-stricken . That is an intramuscular injection of epinephrine , 5min , the condition gradually improved , drink a bowl of sugar , after 20min symptoms [ 4 ] .
Third, moxibustion sensitization : may also be because the leaves contain certain allergens , someone who will moxa smoke oil to remove the cover , the inside of the forearm spreads but had moxibustion cause acute urticaria patients , the results after 10h , was deposited at the uncomfortable itching and allergic skin rashes , proven to be caused by allergies.
Fourth, venom allergy: apitherapy , a bee by bees carrying poison sac piercing needle acupuncture or tenderness therapy to achieve a purpose . Because the venom contains large amounts of peptides and enzymes, it has anti-inflammatory , antibacterial , analgesic , anti-radiation function, and enhance the body ‘s immune system , it is not only for rheumatism , rheumatoid , hepatitis B have effects on other diseases have better results. Notably , which contain a large number of amines , peptides, enzymes and substances in the venom , has its negative effects – bee venom allergic
Fifth, there are other reasons some patients , allergy have acupuncture needles or electro-acupuncture stimulation , but can not find all the above factors. There might be considered excessive regulation and acupuncture to stimulate the neuroendocrine system and cause a series of reactions that have anti- histamine and acetylcholine substance increases, so local vasodilation , increased permeability , and allergy symptoms . But its exact principle to be further explored .
Clinical manifestations
A general allergy : the most common allergic skin rashes , were as follows: the limitations ( points surrounding area ) small red rash , or systemic wheal -like papules, often covered with fever, itching unbearable, may be associated with severe chest , difficulty breathing , and even pale, sweating , pulse fine .
Time allergic reaction appear : Point injection often occurs immediately or shortly after moxibustion shall one to several hours , the longest reported in the literature up to 10h. There moxibustion caused by allergies , can often be repeated later in the moxibustion therapy. Acupuncture needle shortest students appear after 20min allergies , there occurred a few hours after taking the needle .
Second, venom allergy : the light performance of chest tightness, palpitations , dizziness, eyelid edema , fever , fatigue, localized itching obvious ; severe cases, anaphylactic shock, even life-threatening . Data showed that the venom into the body is not only a direct effect on the surface tissue , can induce allergic reactions, make the heart blood vessels to dilate , a large number of serum extravasation , cardiac interstitial inflammatory edema occurs , or even bleeding . Meanwhile toxins interfere with autonomic function , aggravate myocardial ischemia, which ultimately caused the damage myocardial structure and function. Of course, with improved myocardial damage and more rapid recovery of poisoning symptoms and , rarely sequelae . Mild reaction common, moderate reaction , followed by less severe anaphylactic shock. Most of delayed reaction , 10min to 2 days after ranging Less immediate responders .
[ Prevention ]
A former medical history of acupuncture should be careful history , to understand whether allergies, especially allergic to any of acupoint injection or moxibustion .
Second, the pre- test for injection, intramuscular or subcutaneous injection should be routine , some drugs are known to cause allergic reactions ( such as penicillin , streptomycin, procaine , vitamin B1 , etc. ) , should be made allergy test and prove non-responders before use. If the original point injection allergies, moxibustion therapy should be used with caution . Fengliao row must also be allergy test .
Third, careful observation aura acupuncture , moxibustion or acupuncture point injection process, such as allergic reactions threatened , they should immediately stop moxibustion therapy or injection.
Fourth, should prepare for acupuncture clinic should prepare the right amount of anti-allergy drugs. Such as anaphylactic shock , a life-threatening , both first-aid clinic at the request of pharmaceutical preparations and equipment , but also a doctor who has an initial first aid skills , especially with the auxiliary branch is more important.
[ Approach ]
There are local or systemic allergic rash , usually within a few days at a natural stopping point injection or subside after moxibustion . During this period should be applied antihistamines, vitamin C and other drugs, drink more water . If and fever , itching , dry mouth , restlessness and other symptoms , can be properly applied corticosteroids , such as prednisone , daily 20 ~ 30mg. Xiaofeng cooling prescription medicine is also effective .
When expressed as pale, sweating , pulse fine , in addition to intramuscular antihistamine drugs, intramuscular or intravenous injection of epinephrine may , when necessary , the injection of adrenal cortex hormones and other drugs.