Ullah Sana, Khan Shahid Ullah, Saleh Tawfik A, Fahad Shah
School of Life Sciences, Nanjing University Nanjing Jiangsu 210023 P. R. China.
College of Plant Sciences and Technology, National Key Laboratory of Crop Genetics Improvement, Huazhong Agricultural University Wuhan People's Republic of China
RSC Adv. 2018 May 22;8(33):18635-18646. doi: 10.1039/c8ra01924j. eCollection 2018 May 17.
Honey has been used as a folk medicine since 2100 BC; however, mad honey is different from normal natural or commercially available honey as it is contaminated with grayanotoxins, which leads to intoxication/poisoning upon consumption. Grayanotoxin is generally found in genus (family: Ericaceae) and is extracted by bees from nectar and pollens of flowers. Mad honey has been commonly used as an aphrodisiac (sexual stimulant), in alternative therapy for gastrointestinal disorders (peptic ulcer disease, dyspepsia, and gastritis), and for hypertension for a long time. Grayanotoxin acts on sodium ion channels and muscarinic receptors, leading to cardiac disorders (hypotension and different rhythm disorders including bradycardia, bradydysrhythmias, atrial fibrillation, nodal rhythm, atrioventricular block, and complete atrioventricular block) and respiratory depression. Patients may also exhibit any one symptom out of or combination of dizziness, blurred vision, diplopia, nausea, vomiting, vertigo, headache, sweating/excessive perspiration, extremity paresthesia, impaired consciousness, convulsion, hypersalivation, ataxia, inability to stand, and general weakness. Mad honey intoxication is diagnosed with honey intake history before the appearance of the signs and symptoms (clinical presentation), and the treatment is symptomatic. Prompt treatment includes intravenous infusions of atropine sulfate and fluids (saline infusions or simultaneous infusion of saline with atropine sulfate) if the patient presents bradycardia and severe hypotension. In case of a complete atrioventricular block, a temporary pacemaker is employed. Except for a single case from Lanping County (Southwest China), the prognosis for mad honey intoxication is very good, and no fatalities have been reported in modern medical literature excluding a few in the 1800s. Although fatalities are very rare, mad honey ingestion may still lead to arrhythmias, which can be life-threatening and hard to recognize. This article provides a brief introduction to honey, mad honey and its uses, the effects of mad honey intoxication/poisoning, and its diagnosis, prognosis, and treatment.
自公元前2100年以来，蜂蜜就一直被用作民间药物；然而，疯蜜与普通天然蜂蜜或市售蜂蜜不同，因为它被杜鹃花毒素污染，食用后会导致中毒。杜鹃花毒素一般存在于杜鹃花属植物（杜鹃花科）中，由蜜蜂从花蜜和花粉中提取。长期以来，疯蜜一直被用作壮阳药（性兴奋剂）、用于胃肠道疾病（消化性溃疡、消化不良和胃炎）的替代疗法以及治疗高血压。杜鹃花毒素作用于钠离子通道和毒蕈碱受体，导致心脏疾病（低血压和不同的心律紊乱，包括心动过缓、缓慢型心律失常、心房颤动、结性心律、房室传导阻滞和完全性房室传导阻滞）和呼吸抑制。患者还可能出现头晕、视力模糊、复视、恶心、呕吐、眩晕、头痛、出汗/多汗、肢体感觉异常、意识障碍、抽搐、流涎过多、共济失调、无法站立和全身虚弱等症状中的任何一种或多种症状组合。疯蜜中毒根据症状和体征（临床表现）出现之前的蜂蜜摄入史进行诊断，治疗为对症治疗。如果患者出现心动过缓和严重低血压，及时治疗包括静脉输注硫酸阿托品和液体（生理盐水输注或生理盐水与硫酸阿托品同时输注）。如果出现完全性房室传导阻滞，则使用临时起搏器。除了中国西南部兰坪县的一个病例外，疯蜜中毒的预后非常好，现代医学文献中除了19世纪有少数几例死亡报告外，没有死亡病例报告。虽然死亡非常罕见，但食用疯蜜仍可能导致心律失常，这可能危及生命且难以识别。本文简要介绍了蜂蜜、疯蜜及其用途、疯蜜中毒的影响、诊断、预后和治疗。
