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huáng 麻黃           (in English and Chinese 中英文)

By: Joe Hing Kwok Chu

Pharmaceutical name:

英文藥名﹕

herba ephedrae

Biological name:

拉丁文學名﹕

(1). ephedra sinica Stapf., 草麻黄 (cao ma huang)

(2). ephedra equisetina Bunge, 木賊麻黄 (mu zei ma huang)

(3). ephedra intermedia Schrenk et Mey. 中麻黄(zhong ma huang)

 

Pron. in Japanese:

日語發音﹕

ma o

Pron. in Korean:

韓語發音﹕

ma hwang 

Pron. in Cantonese:

粵音﹕

maa4  wong4

Other Names:

別名﹕

xin jiang xue lian hua (incorrectly called. xin jiang xue lian hua is a different herb.)

新疆雪蓮花 (誤稱。新疆雪蓮花 是不同的植物。)

Common Name:

語國家普通名﹕

ephedra, ma huang, belcho, Chinese ephedra, desert herb, ephedrine, heral ecstasy, Joint fir, Mongolian ephedra, Pakistani ephedra, popotillo, sea grade, teamster’s tea, yellow astringent, yellow horse.

Distribution:

產地﹕

It is mainly produced in Jilin, Liaoning,  Inner Mongolia, Heilongjiang, Hebei, Shanxi, Shaanxi, Gansu, Qinghai, Xinjiang, Henan provinces of China.

主産於:吉林,遼寧,内蒙古,黑龍江,河北,陕西,甘肅,青海,新疆,山西,河南等省。

Properties

(characteristics)﹕

性味﹕

acrid, slightly bitter and warm.

辛,微苦 ,温。

Channels (meridians) entered:

歸經﹕

 lung and bladder 

肺,膀胱。

Medical functions:

L-ephedrine can increase the contraction of heart muscle thus increases the cardiac output. L-ephedrine causes less arrhythmia than epinephrine but if there is physical diseases of the hearts or if the patients are using digitalis it can cause arrhythmia. L-ephedrine can cause systolic and diastolic pressure to go up.

L-ephedrine can cause the smooth muscle to relax.

Ma huang water extract (boiled in water) has antibiotic property.

L-麻黃素能增進心肌之收縮而增加心臟的輸出量。L-麻黃素比起麻黃素其導致心律不整發生較少。但若有心臟病或病人用洋地黃則能致心律不整。L-麻黃素可導致心臟的收縮壓與擴張壓增高。

L-麻黄素能導致平滑肌鬆弛

麻黄煎剤有抗菌作用。

Actions & Indications:

主治﹕

(1) For promoting sweating, and rid of cold due  to excessive exposure to chill and wind where pores become tight and unable to sweat and pulse shows floating and large. Take when the herbal tea is warm.

(2) For soothing of wheezing asthma.

(3) For promoting urination if taken when the liquid of the herb tea is cool.

(4) For treating cough and asthma of small children, external use.

(5) For controlling bed wetting

(6) For stopping nose bleeding

(7) For controlling diarrhea of small children

1)促進出汗由於侵入,毛孔收缩,不能出汗,脈搏浮而洪。入藥作煎剤,温服,取汗。
(2)減輕哮喘。
3煎剤冷服利尿作用
(4)外用可用於治療咳嗽,小哮喘。
(5)用於控制夜間遺尿。
(6)血。
(7)控制小兒腹瀉

Chemical ingredients:

化學成份﹕

1. Saponins

  • cao ma huang: its main saponin in  is l-ephedrine, about 40~90% of the total saponins. The second highest saponin is  pseudo-ephedrine, and contain small amount of L-N-methylephedrine, d-N-methyl-pseudoephedrine, d-nor-pseuddoephedrine, ephedine,  benzyl-methylamine [1], 3,4-dimethyl-5phyloxazolidine, 2,3,4-trimethyl-5-phenyloxazolidine[2], and the more effective part of ma huang for soothing asthma:  2,3,5,6-tetramethylpyrazine[3].

  • mu zie ma huang contains  1.15~1.75% of saponin and among the important ingredients are L-ephedrine and d-pseudo-ephedrine.

  • zhong ma huang contains 1.5% of saponin, with the anti-inflammatory ingredient of ephedroxane.[4]

 

The above three varieties of ma huang contain about the same chemical ingredients.

  • mu zie ma huang contains the highest amount of saponin.

  • Cao ma huang contains lesser amount of saponin.

  • zhong ma huang contains the least amount of saponin. [1]

2. Vaporizing Ingredients

among the 38 kinds of ingredients from cao ma huang, some of them are:

  •  2,3,5,6-tetramethylpyrazine,

  • 1-apha-terpineol,

  • beta-terpineol,

  • terpineol-4,

  • --menth-2-en-7-ol,

  • 1,3,4 -trimethyl-3-trimethyl-3-cyclohexene-1carboxaldehyde[3].

3. Flavone

4. Organic Acids

5. Other Ingredients

 

Normal Dosage:

常用量﹕

2.5 g to 6 g. Large amount up to 15 g.

2.5 至6 克,大劑量亦有用15 克。

Samples of formulae:

處方舉例﹕

ma huang tang 麻黃湯

ge gen tang 葛 根 湯

Modern Research:

現代研究﹕

l-ephedrine toxicity

Cautions:

禁忌﹕

Undesirable side effects:

Ma huang can excite the CNS. If the dosage is too large, toxic reactions include headache, restless, insomnia, palpitation, tightness in chest area, tears and nose dripping, uncomfortable, fever, sweating nonstop, upper belly discomfort, dry mouth, nausea, vomiting, ringing in the ears, body temperature and blood pressure rising, it can cause heart rate to go up or heart attack or stroke. Large dosage can suppress the heart and causes the heart to slow down. 

Not to use in patients who are deficient, with instant sweating, cough with asthma due to qixu (qi deficient), pixu (spleen deficient) with edema, or patients  with heart problems, or hypertension or prostatitis,  and patients with glucose-6-phosphate dehydrogenase deficiency should not use ma huang.

Traditionally ma huang is not used in diet formulae nor as a recreation drug. Avoid prescribing ma huang if you do not have the experience and diagnostic skill especially in pulse reading. It can be dangerous if used incorrectly.

Prolong use for weight loss in the West has caused serious liver problems. The severity of liver injury due to ephedra ranges from mild, asymptomatic elevations in serum enzymes to clinically apparent acute liver injury and to acute liver failure. Chronic use of ephedra has been linked to a chronic hepatitis-like syndrome, but recovery is prompt when ephedra is stopped. There have been no instances of vanishing bile duct syndrome attributed to ephedra. Recurrence of liver injury is typical when ephedra is restarted, and rechallenge should be avoided. There is no apparent cross sensitivity to liver injury between ephedra and other weight loss agents or herbal preparations, but ephedra was previously found in many commercial herbal preparations.[1]

 

Do not use with Furanzolidone, (Furazolidonum,Furoxone). May induce mania if used  with phenelzine.

患有葡萄糖-六-磷酸鹽去氫酵素缺乏症(蚕豆症)之病人忌用。

麻黃具有興奮大腦皮層 的作用,如用量較大,輕者包括口乾﹐神經質﹐過度興奮而致失眠,焦慮,頭痛,視力模糊以及意識混亂 且易發汗,發汗過多易造成心悸,嚴重時腦出血,癲癇,精神官能症及心律不整﹐ 還可能導致休克。 因此,若體虛之人,表虛自汗,氣虛喘咳, 脾虛水腫者患心臟病,高血壓,前列腺炎患者不可用。 劑量過大能抑制心臟﹐可導致心跳變慢。葡萄糖-6-磷酸鹽去氫酶缺乏症者不可用麻黄。

傳統上,麻黄不作减肥用,亦非作娱樂用。如對中醫的辨証有經驗,精通把脉最好避免用麻黄。

不可與呋喃唑酮(痢特靈 ) 同用。如與苯乙肼同用可能導致癫狂。

Antidote:

If toxicity occurs after taken orally, induce vomiting, and use laxative to decrease the absorption. If there is serious nervous reaction or spasm, chloral hydrate CCl3.CH(OH)can be used. Oxygen can also be used.

如果內服中毒現象催吐,並用瀉藥,以減少吸收。如果有嚴重的神經反應或痙攣,可用水合三氯乙醛 CCl3.CH(OH)2 氧氣也可使用。

[1] http://livertox.nih.gov/Ephedra.htm

The Food and Drug Administration of U.S.A. has banned the sale of dietary supplements containing ephedra effective on April 12, 2004.

Products Affected by the Ban

All dietary supplements are affected by the ban if they contain a source of ephedrine alkaloids, including:

  • ephedra
  • ma huang
  • sida cordifolia
  • pinellia.

The rule does not pertain to:

  • traditional Chinese herbal remedies
  • herbal teas regulated as conventional foods subject to FDA regulation under other sections of the law
  • drugs that contain chemically synthesized ephedrine.

Check with your regulatory agency for update.

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Last update:Feb 25, 2013 ; 12:28 p.m. LAH