Insect medicine in traditional Chinese medicine: use with caution if you have allergies

First, let’s clarify the core conclusion: Insect medicinal materials within the scope of traditional Chinese medicine generally carry allergenic components such as heterogeneous proteins, histamines, and kinins. People with allergic constitution are 3-7 times more likely to induce allergic reactions after taking them or using them externally than the general population. Mild rashes, itching, nasal congestion, etc. Itchy and runny nose, in severe cases, may cause laryngeal edema and anaphylactic shock. Both traditional Chinese medicine and Western medicine generally recommend clinical practice: people with allergies should try to avoid using insect-based traditional Chinese medicine unless necessary. If they really need to use it, they must inform their allergy history in advance and try it in small doses under medical supervision.

When I was working as an assistant in an outpatient pharmacy, I met such a patient: a 42-year-old patient with a ten-year history of chronic urticaria and a typical hypersensitive constitution. I heard from a community health group that Quanxiaosoufengzhiprugi can cure urticaria, so I asked someone to buy Shengquanxiao Mo. I drank 3 grams of powder every day. Within 20 minutes after drinking it for the first time, I felt my lips were numb, my throat was tight, and there were wheals on my face and arms. I couldn’t breathe. When my family was sent to the emergency room, my blood pressure dropped. It took me a long time to recover. Later, he said that he was allergic to shrimps, and he never thought that the insect medicine and shrimps were the same.

The scorpions, centipedes, silkworms, woodworms, leeches, and nine-scented insects that we often hear about, and even the cantharis and white-flowered snakes that some people use to make wine, all belong to the category of insect drugs. Traditional Chinese medicine classifies these medicines as "blood and flesh products". Compared with grass roots and tree barks, they are much more powerful in searching for wind, dredging meridians, breaking blood stasis and dispersing stagnation. For many stubborn rheumatic pains, facial paralysis, nodules, migraines, and even in the auxiliary treatment of middle- and late-stage tumors, old Chinese medicine practitioners like to add a few insecticides, and the effect is indeed better than using herbal medicines alone.

But from the perspective of modern pharmacology, these "powerful" insecticides are indeed risky. The protein structure in their bodies is very different from that of human proteins. They are typical heterogeneous proteins and are strong allergens in themselves. In addition, many insects secrete histamine and kinin substances to defend themselves against natural enemies. Even if these ingredients are processed conventionally, it is difficult to completely remove them. When they enter the body of highly sensitive people, the immune system will directly treat it as a foreign invader and start an allergic reaction.

There are actually different trends in the use of insecticides in the industry today: Most Western medicine doctors in the allergy department are more cautious. As long as patients have a history of food allergies, allergic rhinitis, urticaria, or asthma, it is basically recommended to avoid all insecticides as much as possible. Even if there are insect ingredients in topical plasters or patches, it is best to test the sensitivity first.； However, many veteran Chinese medicine doctors who have been using insecticides all year round feel that there is no need to kill them all. They have their own set of risk reduction methods: for example, if the risk of allergy to raw insecticides is high, they use bran-fried, wine-based, or vinegar-based varieties to reduce allergens. When prescribing, they will also add anti-allergic drugs such as parsnips, black plums, and licorice for treatment. If they really want to give it to patients with high allergies, they will also let them do a small test first.

Don’t think that only eating it will cause problems. Last summer, I met a patient with herpes zoster. He took a folk prescription and crushed a live centipede and used it externally to relieve pain. However, after applying it for less than two hours, not only did he have a bunch of big blisters at the place where the medicine was applied, but he also had a fever and itchiness all over his body. It was also caused by allergies. The insect ingredients used externally can enter the body through broken skin, which can also induce allergies.

As for patients with allergies who really have to use insecticides in some cases, we generally recommend a two-step sensitivity test: the first step is a skin test. Grind the insecticide to be used into fine powder, add a little warm water to make a paste, apply it on the thin skin on the inner forearm, seal it with plastic wrap, and wait 2 If there is no redness, swelling, itching, or rash after 4 hours, do the second step of trial use. Boil water with a small amount of the medicine and take a sip. Observe for 4 to 6 hours if there is no discomfort. Then slowly increase to the regular dose. It is best to have a doctor monitor the whole process. If numbness, throat tightness, or itching occurs, stop taking the medicine immediately.

After all, insect medicine is indeed a "powerful medicine" in traditional Chinese medicine. It is very effective when used correctly, but it can easily lead to accidents if used incorrectly. Friends with allergies should not just stuff it into their mouths or apply it on their bodies based on any folk remedies. If they really need to use it, they should tell their doctor about their allergic history in advance. It is always better to be careful.