Apimedica: Bee Venom Acupuncture Used to Treat Facial Nerve Paralysis - 牵正穴的蜂疗应用

Apimondia Apimedica-Apiquality International Forum

Oct. 22-25, 2012

Zhenjiang, China

The Application of Qianzheng by Bee Apitherapy

ZHANG Li-fen , LI Wan-yao* ,WU Jiang-nan（Guangzhou university of Chinese Medicine, Guangzhou 510405,China）

Qianzheng acupoint is an extra nerve points on the head and neck （Ex-HN）, it doesn’t belong to the twelve main meridians. Qianzheng acupoint’s major functions is to treat wry mouth. Its function is simple and purposeful, it named by its major therapeutic function because its magic curative effect to facial nerve paralysis. Just as its name implies, “qian” means correct , “zheng” means natural form, it named qianzheng because it can correct deviation of the eye and mouth to be natural form.

With the development of medical science, bee apitherapy is concerned by doctors gradually and is used in clinic.

1、 LOCATION AND ANATOMY

Correct sitting postures or side-prone sitting, it is on the cheek, about 0.5 cun in front of the earlap. It parallels with the midpoint of ear lobe, one in each side.

According to its anatomy, it is in the superior of masseter. Under the acupoint, it has skin, hypoderm, parotid gland and masseter. The skin is dominated by buccal nerve of mandibular nerve. Masseter is dominated by Masseter branch of mandibular nerve. Inner parotid gland, it has masseter vein and artery.

2、 FUNCTIONS AND INDICATIONS

Expel the wind, clearing away heat, diminish inflammation and relieve pain and so on. Its main function is to treat facial nerve paralysis, it also uses to treat aphtha, glossitis, next toothache, parotitis and so on. Nowadays, people always use it to treat facial nerve paralysis, glossitis, stomatitis, dental ulcer, tinnitus, deafness, next toothache, parotitis and so on.

3、 MANIPULATE

The usual method is using the living bee to sting patients. First, we use soap or water to clean the position. In clinic, we use iodophor to disinfection the acupoints; Second, we use smooth forceps to pinch waist or abdomen of the bee, put its rump close to qianzheng acupoint, after sting, we can press the bee’s abdomen lightly in order to let more bee venom immit to the body. We can do the treatment for three times one day, each time can use four bee needles. We should draw out the bee needle in half minute for the first needling and observe for about 30 minute, if the patient has no allergic reaction to bee needle , we can go on to do the therapy. We retaining the needle half or one minute every bee needle and then draw out. After one minute, we do the next needling. We should let the patient to take a rest for about 10 minutes on the bed or chair when we finish the first course of treatment, then go on to do the second course of treatment. The bee venom immit the facial through the patients accept bee apitherapy to qianzheng, and that can correct facial symptoms.

4、 COMBINATION OF ACUPOINTS

Qianzheng is a extra nerve points on the face, it mainly treat facial diseases, usually combine with yifeng(SJ17), taiyang(EX-HN5), xiaguan(ST7), jiache(ST6) , chengjiang(RN24), quanliao(SI18), yangbai(GB14), yingxiang(LI20) and so on, 远端combine with quchi(LI11), waiguan(SJ5), taichong(LR3), qiuxu(GB40), zulinqi(GB41) and so on. It usually use to treat mouth ulcer in clinic: combine with chengjiang(RN24), yinjiao(DU28), dicang(ST4), hegu(LI4); treat parotitis: combine with yifeng(SJ17), hegu(LI4), treat arthritis of temporomandibular joint, combine with xiaguan(ST7), yemen(SJ2)

5、 ATTENTION

a. All the patients who accept bee apitherapy should take a rest at least for 10minutes and it not suitable to do the sports.

b. Before the therapy, it is not good for fed-upness or limosis. Between the therapy, it is not suitable to drink the pick-me-up.

c. The patients who accept the bee apitherapy for the first time appear light pain, we should not scared and can’t stop the therapy. If the patient has a fever, nausea, vomit, panic and sweating, we can use ataractic, for example: 25mg promethazine.

d. If we need to use bee venom Injection, we should do it under the salted doctor 's guidance.

e. The patients who have organic heart disease or have allergic reaction to bee needle can’t use bee apitherapy. Chinese medicine theory is “use of poisons as antidotes”. Through modern medical research, we know that bee venom can promote blood circulation to remove blood stasis, clearing and activating the channels and collaterals, relieve pain, can improve the blood cycle of disease part so as to treat the disease. Bee venom can repair the tissue ,cells and reduce nerve block through its function of promoting blood circulation to remove meridian obstruction, because of this , it can ease pain, diminish inflammation, regulate metabolic, strengthening organism immune system. “Right amount for medicine, excessive for poison”, according to this theory, bee venom also is a kind of good medicine. It has big different between doses, toxic dose and lethal dose. It has good effective to many intractable diseases although it contains toxin.

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* Corresponding author,E-mail：liwanyao@yahoo.com.cn

牵正穴的蜂疗应用

张丽芬，李万瑶*，吴江南

（广州中医药大学，广州 510405，中国）

牵正穴为头颈部经外奇穴名（Ex-HN），它不属于十四经中的腧穴，穴在面 颊部。因该穴主治口喎，治疗范围比较单纯，针对性较强，对面瘫病证有奇效，就以其主要治疗功用命名。顾名思义，牵正的“牵”为纠正之意；“正”为正常，本穴是将原来的口眼歪斜纠正为正常之态而命名。蜂毒疗法随着医学科学的发 展，逐渐为医家所重视，并应用于临床，

1) 取穴与解剖正坐位或侧伏位，穴位于面颊部，在耳垂前0.5 寸，与耳垂中点相平处。两

侧各一穴。解剖观察，此穴在咬肌上。穴下为皮肤、皮下组织、腮腺和咬肌。皮肤由

下颌神经的颊神经分布。咬肌由下颌神经的咬肌支支配。皮下组织内有咬肌动静脉支分布。

2) 功能与主治祛风清热，通经活络，消炎止痛等。本穴主治面瘫为主，即可治疗面神经麻痹，尚有口疮，舌炎、口腔炎、口腔溃疡、下牙痛，耳鸣耳聋，腮腺炎等。

3) 蜂针操作常用的方法是用活蜜蜂螫入人体。临床上先消毒欲针穴位，用镊子轻轻捏住活蜜蜂的腰腹部，将其尾部放到牵正穴处。活蜂直刺时待刺入后，再用手指轻轻拍打穴位四周以减少蜂针的疼痛，并能促使蜂毒尽量注入人体。可每天分1-2 次蜂螫，初针者最好用散刺或点刺，可以每次针1-4 下。也可用一只蜂的牵正穴丛集式刺法[i]。初螫后半分钟内将蜂针拔出，观察30 分钟，如无严重过敏反应，即可进行常规治疗。点刺时每螫一下，留蜂针1-2 秒钟，拔出后停1 秒钟再针第二下。每完成一次治疗后，让患者在床上或椅上休息10 分钟左右，再进行第二次治疗。通过病人接受蜜蜂螫刺牵正穴后，使蜂毒进入面颊局部，以达到治疗改善面部症状的目的。

4) 蜂针治疗配穴牵正穴为面部奇穴，大多治疗面部疾病，常用配穴有翳风穴[ii]，太阳、下关、颊车、承浆、颧髎、阳白、迎香等穴；远端可配用曲池、外关、太冲、丘虚、足临泣等。临床常用治口疮：配承浆穴、龈交穴、地仓穴、合谷穴；治腮腺炎：配翳风穴、合谷穴；治下颌关节炎配下关穴、液门穴。

5) 疾病治疗例面部疾病是此穴的主治，是面神经麻痹蜂针治疗的主要穴位，但不完全局限在治

疗面痛与面瘫方面，其他疾病也可治疗，如急慢性腮腺炎、下颌关节炎，牙龈肿痛，类风湿病的面部疼痛与麻痹的病变等。面神经麻痹，又称(面神经炎,贝尔氏麻痹,亨特综合症)，俗称"面瘫"、"歪嘴巴"、“歪歪嘴”、“吊线风”等，是以面部表情肌群运动功能障碍为主要特征的一种常见病。一般症状是口眼歪斜，它是一种常见病、多发病，不受年龄限制。患者面部往往连最基本的抬眉、闭眼、鼓嘴等动作都无法完成。面瘫的临床表现十分特殊：病人往往于清晨洗脸、漱口时突然发现一侧面颊动作不顺、嘴巴歪斜。病侧面部表情肌完全瘫痪者，表现出：前额皱纹消失、眼裂扩大、鼻唇沟平坦、口角下垂，露齿时口角向健侧偏歪。病侧不能作皱额、蹙眉、闭目、鼓气和噘嘴等动作。鼓腮和吹口哨时，因患侧口唇不能闭合而漏气。进食时，食物残渣常滞留于病侧的齿颊间隙内，并常有口水自该侧淌下。由于泪点随下睑内翻，使泪液不能按正常引流而外溢。面瘫分为周围性和中枢性两种。以上的症状为周围性面瘫，如中枢性面瘫常表现为鼻以下部位的瘫痪症状，而不会影响的眼睑的闭合。其中周围性面瘫发病率很高，而最常见者为面神经炎或贝尔麻痹。平常人们所常说的面瘫，在多数情况下是指面神经炎而言。因为面瘫可引起十分怪异的面容，所以也被人们称为“毁容病”。注意对于中枢性面瘫要治疗头部的原发病灶。往往在面神经麻痹发生前，大部分患者存在身体疲劳、睡眠不足、精神紧张及身体不适等情况。防止面瘫最好的办法是：病毒感染是常见的病因之一，常出现耳内的疱疹，同时心理因素也是引发面神经麻痹的因素之一。故此平时要保持良好的心情，防止病毒感染，保证充足的睡眠，并适当进行体能运动，增强人体免疫力。面神经麻痹作为一种症状或体征，须仔细寻找病因，如果能找出病因要及时进行处理，有一些原因要配合其他医药进行治疗，如重症肌无力、肿瘤或颞骨感染等，可以导致面瘫及其进程。面神经麻痹也可能是一些危及生命的神经科疾患的早期症状，如脊髓灰白质炎或Guillian-Barre 综合征，早期诊断有助于挽救生命。

【典型疾病例案】

应用蜂疗针牵正穴治疗面神经麻痹症某男, 28 岁, 2008 年3 月11 日初诊。右侧口眼歪斜20 天。20 天前因劳累受风, 次日晨起后自觉右耳后疼痛伴面部麻木, 右眼闭合不全, 流泪, 饮漱时口角漏水。先在他所医院服用中西药治疗(用药不详)，效果不显, 遂到本院就诊。检查见右额纹消失, 右眼露眼, 球结膜充血, 下睑稍外翻, 不能皱额蹙眉, 右鼻唇沟平坦。口角左歪, 鼓腮漏气, 右乳突下方轻压痛, 医者以蜂针刺治疗。第一次取牵正穴为主，次与翳风穴点刺。其他治疗交替配以阳白、丝竹空、颊车、地仓、四白、迎香等穴（每次用其中3-4 穴即可）。后期每穴用蜂一只，先是蜂刺入就取针，逐渐随蜂螫次数增多，而从点刺发展为直刺，并延长蜂针留置时间。一般留置1-4 分钟。每周治疗3 次。2 个疗程痊愈。临床上应用蜂疗针牵正穴，治疗面神经麻痹，诸多文献表明疗效显著，虽然有人用针灸方法治疗，但往往蜂针效果更显著。特举病案为例，说明牵正穴的应用一隅及临床蜂疗应用可见一斑。

【蜂针治疗注意事项】

a. 接受蜂毒疗法者，治疗结束后应休息10 分钟以上，不宜治疗后进行剧烈活动。

b. 治疗前不可饱食亦不可空腹，以免晕针。

c. 凡初次接受治疗者，出现轻微的疼痛，局部略红肿，不必惊慌，更不要轻易停止治疗。如出现发烧、恶心、呕吐、惊慌出汗者，可用镇静剂，如肌肉注射25 毫克异丙嗪即可缓解其毒副作用。

d. 现有将蜂毒制成注射制剂用于治疗。但使用蜂毒注射液者，应在有经验的医生指导下使用，不可随便自用。

e. 凡患各种器质性心脏病者，对蜂毒过敏者禁用蜂蜇。中医理论认为，以毒攻毒，现代经过医药学家的临床研究表明，蜂毒有活血化瘀、通经止痛之功，能改善病变部位的循环，增加血液供应，从而达到治病的效果。蜂毒通过其活血通络的作用修复组织细胞及减少神经阻滞作用，使之达到镇痛、消炎、调节代谢、增强机体免疫力的作用。但根据中医“适量为药，过量为毒”的理论，蜂毒亦是一种良药，药用量及中毒量或致死量相差悬殊，虽含有毒素，实是良药，对许多顽固性的疾病有良好疗效。