Ma Huang (Ephedra)

Ma Huang also known as Ephedra is the herbaceous stem of Ephedra sinica, E. intermedia, or E. equisetina, which is a low shrub belonging to the Ephedraceae family. It is a relatively practical and common Chinese herbal medicine, which first appeared in <Shennong Ben Cao Jing> in the late Western Han Dynasty (about 100 BC).

There are about 40 species of Ephedra, which are distributed in Asia, America, Southeastern Europe, and Northern Africa. Most of them are xerophytes or semi-xerophytes, which are mostly found in dunes, semi-deserts, grasslands, deserts, sandy, rocky, or arid areas. Among them, 15 species of ephedra can be made into medicines. The most representative of them are Ephedra sinica, E. intermedia, and E. equisetina.

Ephedra sinica has strong adaptability and often grows on hillsides, plains, dry wastelands, river beds, and grasslands. They are distributed in Liaoning, Jilin, Inner Mongolia, Hebei, Shanxi, Northwest Henan, and Shaanxi in China, and Mongolia.

E. intermedia often grows in arid deserts, beaches, arid hillsides, or grasslands at an altitude of several hundred meters to more than 2,000 meters. They are distributed in Liaoning, Hebei, Shandong, Inner Mongolia, Shanxi, Shaanxi, Gansu, Qinghai, and Xinjiang provinces of China, Afghanistan, Iran, and Russia.

The woody stems of E. equisetina are tall. Its appearance is very similar to that of Euphorbia procera and Euphorbia nebrodensis. They often grow on ridges, mountain tops, and rock walls in arid areas. They can be found in Hebei, Shanxi, Inner Mongolia, Western Shaanxi, Gansu, and Xinjiang in China, Mongolia, and Russia.

In the autumn of each year, people gather the herbaceous stems of Ephedra sinica, E. intermedia, or E. equisetina, dry them in the sun, remove their woody stems, residual roots, and impurities, cut them into segments, use them directly, or stir-fry them with honey, and make them into Chinese herbs.

All parts of ephedra can be made into medicine. The stems and roots of ephedra need to be collected and used separately. The root of ephedra (Ma Huang Gen) is considered to be a distinct drug, which is used to treat spontaneous sweating and night sweats.

The main chemical components of Ma Huang are alkaloids. The alkaloid components are ephedrine, pseudoephedrine, N-methylephedrine, D-N-methylpseudoephedrine, desmethylephedrine, and D-desmethylpseudoephedrine. It also contains apigenin, kaempferol-7-O-rhamnoside, cinnamic acid, benzoic acid, ferulic acid, isoferulic acid, vanillic acid, amino acids, polysaccharides, tannins, volatile oils, octacosanol, Nonacosanol, nonacontanol, n-triacontanol, syringaresinol, and waxy.

Generally, light green or greenish Ma Huang with the brown-red core is the best.

Although Ma Huang is a medicine, and it is also a raw material for making methamphetamine. Many countries impose strict controls on ephedra and prohibit free trade in it. The U.S. Food and Drug Administration (FDA) banned the sale of products containing ephedrine in the United States in 2004[1].

According to <Shennong Ben Cao Jing>, the medicinal property of Ma Huang is relatively warm, with a pungent and bitter taste. It has a certain therapeutic effect on the pathological changes of the lung and bladder meridians.

In traditional Chinese medicine (TCM), Ma Huang is often used to promote sweating and relieve exterior symptoms, ventilate lung qi and relieve asthma, induce diuresis for remove edema, treat fever with anhidrosis caused by wind-cold, influenza, chronic pharyngitis, migraine, psoriasis, frostbite, enuresis, sleep apnea syndrome, hiccups, upper gastrointestinal bleeding, acute nephritis, renal failure, jaundice viral hepatitis, sciatica, rheumatic arthritis, yin carbuncles, subcutaneous nodules, Raynaud’s disease, and infectious purulent inflammation.

There are about 200 kinds of Chinese medicine prescriptions containing Ma Huang, such as Ma Huang Tang, Da Qing Long Tang, and San Ao Tang.

Benefits

  • Inhibiting Asian influenza A virus and respiratory syncytial virus.
  • Anti-inflammation, inhibiting croton oil-induced ear swelling in mice, and carrageenan-induced foot edema in mice.
  • Inhibiting the release of allergic mediators, selectively constricting the capillaries of the nasal cavity and mucosa, and relieving acute colds and nasal mucosal congestion.
  • Lowering blood glucose and triglycerides in serum.
  • Speeding up the heart rate, enhancing myocardial contractility, increasing cardiac output, constricting blood vessels, and raising blood pressure.
  • Exciting the cerebral cortex, subcortical center, respiratory center, and vascular movement center, shortening the hypnotic effect time of barbiturates.
  • Inhibiting the proliferation of liver and spleen cells, suppressing immunity, and treating autoimmune diseases and atopic allergies.
  • Relaxing the smooth muscles of the gastrointestinal tract and promoting gastrointestinal emptying.
  • Promoting the synthesis of adipocytes and inhibiting lipolysis promoted by norepinephrine.
  • Enhancing the tension of the bladder deltoid muscle and bladder sphincter, reducing bladder urine output, and treating enuresis.
  • Relaxing bronchial smooth muscle, relieving bronchial smooth muscle spasm, and expanding bronchus.
  • Ventilating lung qi, relieving cough and asthma caused by obstruction of lung qi.
  • Promoting the secretion of sweat glands, relieving the fever with anhidrosis and the body feeling cold caused by wind-cold.
  • Promoting urination, treating edema and dysuria caused by the failure of lung qi to disperse and descend.
  • Inhibiting Staphylococcus aureus, Haemophilus influenzae, Streptococcus A, Pneumococcus, Neisseria, Bacillus subtilis, Escherichia coli, Candida albicans.

Combinations

  • It can be used in combination with Fu Zi (Radix Aconiti Lateralis Preparata) and Xi Xin (Asarum) to treat the fever with the body feeling severe cold, sore throat, and fatigue caused by wind-cold.
  • It can be used in combination with Ku Xing Ren (Bitter Apricot Seed), Yi Yi Ren (Semen Coicis), and Zhi Gan Cao (Radix Glycyrrhizae Preparata) to promote sweating and relieve fever and body pain caused by rheumatism.
  • It can be used in combination with Gui Zhi (Ramulus Cinnamomi), Ku Xing Ren (Bitter Apricot Seed), and Zhi Gan Cao (Radix Glycyrrhizae Preparata) to treat fever with anhidrosis, body feeling cold, headache, body pain, asthma, thin and white tongue coating, and tight pulse caused by wind-cold.
  • It can be used in combination with Gui Zhi (Ramulus Cinnamomi), Zhi Gan Cao (Radix Glycyrrhizae Preparata), Ku Xing Ren (Bitter Apricot Seed), Sheng Jiang (Fresh Ginger), and Hong Zao (Fructus Jujubae) to treat headaches, body pains, fever without sweating, irritability, and thirst caused by wind-cold.
  • It can be used in combination with Yi Mu Cao (Leonurus), Jie Geng (Radix Platycodi), and Gan Cao (Licorice Root) to relieve cough and resolve phlegm, and treat sleep apnea syndrome.

Side effects

Studies have confirmed that overdose may cause liver and kidney damage.

Overdose of it may cause dizziness, headache, tinnitus, nausea, vomiting, excitement, irritability, insomnia, chest tightness, palpitations, increased blood pressure, dilated pupils, and difficulty urinating.

In severe cases, it can cause myocardial infarction, respiratory failure, ventricular fibrillation, or death.

Precautions and Warnings

  • The dosage of Ma Huang should be controlled at 2-10g.
  • It can be made into decoction, tinctures, medicinal liquors, pills, or powders.
  • It contains volatile oils and is not recommended for long decoctions.
  • The unprocessed Ma Huang is recommended to promote sweating, the honey-fried Ma Huang is recommended to relieve cough and asthma.
  • It has strong medicinal effects, and people with mild wind-cold should not take it.
  • People who are allergic to Ma Huang ingredients should not take it.
  • People with hematemesis syndromes should not take it.
  • People with spontaneous sweating and night sweats should not take it.
  • People with insomnia, hypertension, or irritability should not take it.
  • Pregnant women, the elderly, or people with a physical deficiency should not take it.
  • It should not be used to treat asthma caused by lung and kidney deficiency.
  • It should avoid simultaneous use with furazolidone, pargyline, isopropanol, methylphenylhydrazine, phenelzine, Pheniprazine, isoniazid, niacinamide, Xin Yi Hua (Flos Magnoliae), and Shi Wei (Folium Pyrrosiae).