Browse > Article
http://dx.doi.org/10.5667/tang.2012.0046

A deficiency of Yang by overuse of Ephedra in traditional medicinal aspects  

Jung, Jae Hun (DongUeeBoGam Korean Medicine Clinic)
Choi, Il Sook (Department of Food and Nutrition, College of Human Ecology, Kyung Hee University)
Publication Information
CELLMED / v.3, no.1, 2013 , pp. 2.1-2.5 More about this Journal
Abstract
Ephedra and ephedra alkaloids are sympathomimetic compounds extracted from the genus Ephedra. They have been used to treat colds and provide cough relief for centuries in oriental medicine. Recently, it has been reported that Ephedra plays a crucial role in weight loss and the enhancement of athletic performances. However, the overuse of Ephedra causes cardiovascular side effects such as increases in blood pressure, heart rate, and palpitations. Ephedra's adverse effects also were mentioned in Shan Han Lun, a famous formulary in traditional Chinese medicine. The present study demonstrated Ephedra's effects and the deficiency of Yang due to the overuse of Ephedra.
Keywords
Ephedra; Yang; side effects;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Yin PA. Ephedrine-induced intracerebral hemorrhage and central nervous system vasculitis. Stroke. 1990;21:1641.
2 Zha LL. Relation of hypothyroidism and deficiency of kidney yang. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1993;13:202-204.
3 Zahn KA, Li RL, Purssell RA. Cardiovascular toxicity after ingestion of "herbal ecstasy." J Emerg Med. 1999;17:289-291.   DOI   ScienceOn
4 Zhao Q, Jin R, Zhang B, Liu SM, Li M, Liu X, Li LZ, Zhang Q. Ridit analysis of experimental data from animal models of yang deficiency induced by different doses of hydrocortisone. Zhong Xi Yi Jie He Xue Bao. 2011;9:941-947.   DOI
5 Zhang Q, Zhang B, Jin R, Li LZ, Zhao Q, Liu XQ. Pharmacological effects of Oleum Cinnamomi and water extract of Cortex Cinnamomi in rats with yang-deficiency cold syndrome and the mathematical analysis Zhong Xi Yi Jie He Xue Bao. 2011;9:983-990.   DOI
6 Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagne J. Efficacy and safety of Ephedra and ephedrine for weight loss and athletic performance. JAMA. 2003a;289:1537-1545.
7 Shekelle P, Hardy M, Morton SC, Hardy M, Suttorp M, Roth E, Fungvig L, Mojica WA, Gagne J, Rhodes S. Ephedra and ephedrine for weight loss and athletic performance enhancement: Clinical efficacy and side effects. Evidence/Report/Technology Assessment No. 76 (prepared by Southern California Evidence-based Practice Center, RAND, under Contract No. 290-97-0001, Task Order No. 9). AHRQ Publication No. 03-E022. Rockville, MD: Agency for Healthcare Research and Quality. February 2003b.
8 Stossel AJ, Young GB, Feasby TE. Intracerebral hemorrhage and angiographic beading following ingestion of catecholaminergics. Stroke. 1985;16:734-736.   DOI   ScienceOn
9 Su W, Hu AX, DU H, Yuan K, Xu HF. Effects of Yiniao Recipe on serum antidiuretic hormone level and plasma ratio of cAMP to cGMP in rats with kidney-yang deficiency. Zhong Xi Yi Jie He Xue Bao. 2010;8:168-172.   DOI
10 Tang DH. Ephedra (hedrhuang'). Clin Toxicol Rev. 1996;18:255.
11 Toubro S, Astrup AV, Breum L, Quaade F. Safety and efficacy of long-term treatment with ephedrine, caffeine and an ephedrine/caffeine mixture. Int J Obes Relat Metab Disord. 1993;17:S69-S72.
12 USFDA. Phenylpropanolamine-Containing Drug Products for Over-the-Counter Human Use; Tentative Final Monographs. Federal Register. 2005;70:75988-75998.
13 USPDI. Drug Information for the Health Care Professional, 19th ed. (Thomson PDR/Micromedex, USA), 1999.
14 Vahedi K, Domingo V, Amarenco R, Bousser MG . Ischaemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for body building. J Neurol Neurosurg Psychiatry. 2000;68:112-113.   DOI   ScienceOn
15 Vanakoski J, Stromberg C, Seppala T. Effects of a sauna on the pharmacokinetics of midazolam and ephedrine in healthy young women. Eur J Clin Pharmacol. 1993;45:377-381.
16 Waluga M, Janusz M, Karpel E, Hartleb M, Nowak A. Cardiovascular effects of ephedrine, caffeine, and yohimbine measured by thoracic electrical bioimpedance in obese women. Clin Physiol. 1998;18:69-76.   DOI   ScienceOn
17 Wang JG, Pan L, Wu B, Wang M. Familial characteristics of kidney-yang deficiency and cold syndrome. J Toxicol Environ Health A. 2006;69:1939-1950.   DOI   ScienceOn
18 Wei M, Zhao XS, Sun XM, Chen J, Luo R. Differential gene expressions in kidney Yang deficiency in individuals with sub-health status. Nan Fang Yi Ke Da Xue Xue Bao. 2011;31:248-251.
19 Wiener I, Tilkian AG, Palazzolo M. Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: Temporal relationship to pseudoephedrine use. Cathet Cardiovasc Diagn. 1990;20:51-53.   DOI   ScienceOn
20 Xiong GB, Yao WL, Wu FH. Shenfu Qiangjing decoction improves non-inflammatory and non-liquefied semen in kidney-yang deficiency men. Zhonghua Nan Ke Xue. 2009;15:1138-1141.
21 Lee MK, Cheng BW, Che CT, Hsieh DPH. Cytotoxicity Assessment of ma-huang (Ephedra) under different conditions of preparation. Toxicol Sci. 2000;56:424-430.   DOI   ScienceOn
22 Lefebvre H, Noblet C, Moore N, Wolf LM. Pseudo-phaeochromocytoma after multiple drug interactions involving the selective monoamine oxidase inhibitor selegiline. Clin Endocrinol. 1995;42:95-98.   DOI   ScienceOn
23 Li L, Wang JF, Xiong DJ. Effect of gushen pelyuan recipe on Bcl-2 and Bax mRNA expressions in cochlea tissue of rats with Shen-yang deficiency syndrome. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29:533-536.
24 Li Y, Huang L, Zhao Y, Wang C, Li R, Gu Y, Liu X, Huang L, Wang S. Effect of epimedii folium processed with different refining temperatures and amounts of sheep's oil on kidney-yang deficiency rats. Zhongguo Zhong Yao Za Zhi. 2011;36:2250-2254.
25 Liu L, Liu LG, Lu M, Ran WJ. Observation on therapeutic effect of electroacupuncture combined with Chinese herbs for treatment of prolapse of lumbar intervertebral disc of yang deficiency and cold coagulation type. Zhongguo Zhen Jiu. 2009;29:626-628.
26 Liu ML, Wang ZR, Nan YY. Effects of Wenyang Shengjing Decoction containing serum on the estradiol secretion of Leydig cells of sterile rats of shen-yang deficiency. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012;32:248-252.
27 Lu D, Wo X, Wo L, Li Y, Tang L, Yang Z. Effects of warm and tonify kidney-yang herbs on liver mitochondria proteome of kidney-yang deficiency rats. Zhongguo Zhong Yao Za Zhi. 2009;34:1251-1256.
28 Lu X, Xiong Z, Li J, Zheng S, Huo T, Li F. Metabonomic study on 'Kidney-Yang Deficiency syndrome' and intervention effects of Rhizoma Drynariae extracts in rats using ultra performance liquid chromatography coupled with mass spectrometry. Talanta. 2011;83:700-708.   DOI   ScienceOn
29 Lyons CC, Turnay JH. Pseudoephedrine toxicity in renal failure. Br J Clin Pract. 1996;50:396-397.
30 Mourand I, Ducrocq X, Lacour JC, Taillandier L, Anxionnat R, Weber M. Acute reversible cerebral arteritis associated with parenteral ephedrine use. Cerebrovasc Dis. 1999;9:355-357.   DOI   ScienceOn
31 Morgenstern LB, Viscoli CM, Kernan WN, Brass LM, Broderic JP, Feldmann E, Wilterdink JL, Brott T, Harwitz RI. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology. 2003;60:132-135.   DOI   ScienceOn
32 Onuigbo M, Alikhan M. Over-the-counter sympathomimetics: A risk for cardiac arrhythmias in pregnancy. South Med J. 1998;91:1153-1155.   DOI   ScienceOn
33 Pasquali R, Baraldi G, Cesari MP, Melchionda N, Zamboni M, Stefanini C, Raitano A. A controlled trial using ephedrine in the treatment of obesity. Int J Obes. 1985;9:93-98.
34 Pederson KJ, Kuntz DH, Garbe GJ. Acute myocardial ischemia associated with ingestion of bupropion and pseudoephedrine in a 21-year-old man. Can J Cardiol. 2001;17:599-601.
35 Porta M, Jick H, Habakangas JA. Follow-up study of pseudoephedrine users. Ann Allergy. 1986;57:340-342.
36 Bray GA. Drug treatment of obesity. Best Pract Res Clin Endocrinol Metab. 1999;13:131-148.   DOI   ScienceOn
37 Breum L, Pederson JK, Ahlstrom F, Frimodt-MOller J. Comparison of an ephedrine/caffeine combination and dexfenfluramine in the treatment of obesity: A multi-centre trial in general practice. Int J Obes Relat Metab Disord. 1994;18:99-103.
38 Cai GR, Li PW. Body temperature changes in cancer patients with yin or yang deficiency and blood stasis syndrome. Zhong Xi Yi Jie He Za Zhi. 1990;10:726-728.
39 Cantox Health Sciences International. Safety assessment and determination of a tolerable upper limit for ephedra. (Ontario, Canada: Cantox Health Sciences International), 2000.
40 Chen M, Kuang A, Chen J. Effect of monoamine neurotransmitters in the hypothalamus in a cortisol-induced rat model of yang-deficiency. Zhong Xi Yi Jie He Za Zhi. 1990;10:292-294.
41 Cockings JG, Brown M. Ephedrine abuse causing acute myocardial infarction. Med J Aust. 1997;167:199-200.
42 Daly PA, Krieger DR, Dulloo AG, Young JB, Landsberg L. Ephedrine, caffeine, and aspirin: safety and efficacy for treatment of human obesity. Int J Obes Relat Metab Disord. 1993;17:S73-S78.
43 Derreza H, Fine M, Sadaniantz A. Acute myocardial infarction after use of pseudoephedrine for sinus congestion. J Am Board Fam Pract. 1997;10:436-438.
44 Dingemanse J, Guentert T, Gieschke R, Stabl M. Modification of the cardiovascular effects of ephedrine by the reversible monoamine oxidase A-inhibitor moclobemide. J Cardiovasc Pharmacol. 1996;28:856-861.   DOI
45 Dulloo AG. Herbal stimulation of ephedrine and caffeine in the treatment of obesity. Int J Obes Relat Metab Disord. 2002;26:590-592.   DOI   ScienceOn
46 Greenway FL. The safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent. Obes Rev. 2001;2:199-211.   DOI
47 Greenway F, Herber D, Raum W, Morales S. Double-blind, randomized, placebo-controlled clinical trials with non-prescription medications for the treatment of obesity. Obes Res. 1999;7:370-378.   DOI   ScienceOn
48 Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing Ephedra alkaloids.N Engl J Med. 2000;343:1833-1838.   DOI   ScienceOn
49 Haller CA, Jacob P 3rd, Benowitz NL. Pharmacology of Ephedra alkaloids and caffeine after single-dose dietary supplement use. Clin Pharm Ther. 2002;71:421-432.   DOI   ScienceOn
50 Jonderko K, Kucio C. Effect of anti-obesity drugs promoting energy expenditure, yohimbine and ephedrine, on gastric emptying in obese patients. Aliment Pharmacol Ther. 1991;5:413-418.
51 Kaberi-Otarod J, Conetta R, Kundo KK, Farkash A. Ischemic stroke in a user of theradrene: A case study in alternative medicine. Clin Pharmacol Ther. 2002;72:343-346.   DOI   ScienceOn
52 Kernan WN, Viscoli CM, Brass LM, Brass LM, Broderic JP, Brott T, Feldmann E, Morgenstern LB, Wilterdink JL, Horwitz RI. Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med. 2000;343:1826-1832.   DOI   ScienceOn
53 Andraws R, Chawla P, Brown DL. Cardiovascular effects of ephedra alkaloids: a comprehensive review. Prog Cardiovasc Dis. 2005;47:217-225.   DOI   ScienceOn
54 Astrup A, Breum L, Toubro S. Pharmacological and clinical studies of ephedrine and other thermogenic agonists. Obes Res. 1995;3:537S-540S.   DOI   ScienceOn
55 Astrup A, Breum L, Toubro S, Hein P, Quaade F. The effect and safety of an ephedrine/caffeine compound compared to ephedrine, caffeine and placebo in obese subjects on an energy restricted diet: A double blind trial. Int J Obes Relat Metab Disord, 1992a;16:269-277.
56 Astrup A, Buemann B, Christensen NJ, Toubro S, Thorbek G, Victor OJ, Quaade F. The effect of ephedrine/caffeine mixture on energy expenditure and body composition in obese women. Metabolism. 1992b;41:686-688.   DOI   ScienceOn
57 Astrup A, Lundsgaard C. What do pharmacological approaches to obesity management offer? Linking pharmacological mechanisms of obesity management agents to clinical practice. Exp Clin Endocrinol Diabetes. 1998;106:29-34.
58 Blank HM, Khna LK, Serdula MK. Use of nonprescription weight loss products: Results from a multistate survey. JAMA. 2001;268:930-935.
59 Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, Strauss R, Meredith T. Herbal Ephedra/caffeine for weight loss: A 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord, 2002;26:593-604.   DOI   ScienceOn