• Journal of Korean Medicine for Obesity Research
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• v.7 no.1
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• pp.23-29
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• 2007

Background : Mahuang (Ephedra sinica) has been used widely to treat respiratory disease in traditional medicine for over thousands years. Mahuang preparations contain approximately $0.75{\sim}1%$ ephedrine alkaloids. Recently in North America, the Eephedra alkaloids has aroused a controversy due to its adverse effects in those using whole extracts as "dietary supplements" for weight loss or athletic performance enhancement. Objective : To discuss the need for clinical practice guidelines on the use of Mahuang. Results and Conclusion : It is widely assumed that Mahuang is one of the useful medicines and is safe for human body. Most of scientific literatures support that the safety of Mahuang prescription in common dosage. However, it has been claimed that there were some warnings and apprehensions about the harmfulness of Mahuang as dietary supplements. This article does not negate the fact that it is necessary to pay more attention for use of Mahuang in clinical situations. We assert that the establishment of clinical practice guideline on the use of Mahuang, which is based on scientific materials and consensus, is required in traditional medicine.

• Journal of Korean Medical classics
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• v.37 no.1
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• pp.1-24
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• 2024

Objectives : The objective of this study is to compare the properties of Mahuang and Shigao based on their similar effects and how they are manifested in formulas that include these medicinals. Methods : Descriptions of Mahuang and Shigao as written in the Shennongbencaojing, Mingyibielu, Bencaogangmu, Benjingshuzheng were analyzed to determine their similar traits. Formulas in which these medicinals were both used for their similar effects were analyzed. Results & Conclusions : Mahuang and Shigao, through their interaction, both communicate fluids, relieve stagnation, and draw out heat or Yang qi from the Yin part. These similarities influence each other, which is related to their common meridian tropism, the Lung Channel, to diffuse, purify and descend. The ten formulas that include the two medicinals were similar in that Yin and Yang were interactive. Of these, those that relieved stagnation were Maxingganshitang and Daqinglongtang. Those which communicated fluids and relieved stagnation were Yuebitang, Yuebijiabanxiatang, Yuebijiashutang, Xiaoqinglongjiashigaotang, Houpumahuangtang, and Wengetang. Those that drew out heat or Yang qi from the Yin part through interaction between Yin and Yang were Guizhieryuebiyitang and Mahuangshengmatang. Previous studies stated that Mahuang and Shigao are different and using both medicinals in the same formula would repress each other or balance each other out-this study focused on their common properties which resulted in the above-mentioned findings.

• The Journal of Korean Medicine
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• v.38 no.3
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• pp.170-184
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• 2017

Objectives: The objective of this study was to summarize randomized clinical trials (RCTs) that have assessed efficacy and safety of mahuang and ephedrine on treatment of obesity and to propose better process of study. Methods: NLM Medline (pubmed), the Cochrane library, Scopus, Science Direct, RISS, KISS were systemically searched for clinical trials investigating the efficacy, safety of mahuang and ephedrine on treatment of obesity from 2000 to 2017. Results: 16 RCTs met all the inclusion criteria. In most reports, mahuang and ephedrine significantly reduced body weight, body fat mass. There were no serious adverse events associated with mahuang and ephedrine in all studies. Conclusions: In appropriate dose of mahuang and ephedrine for healthy adult was safe, and weight loss effect of mahuang and ephedrine was better than control group. Improved clinical practice guidelines should be developed for safe use of mahuang and ephedrine.

• Journal of Korean Medicine for Obesity Research
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• v.21 no.2
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• pp.95-104
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• 2021

Objectives: The purpose of this study is to analyze the adverse events and safety of Mahuang used as anti-obesity treatment in Korean medicine. Methods: PubMed, EMBASE, Cochrane, KoreaMed, Oriental Medicine Advanced Searching Integrated System (OASIS) and SCIENCE-ON were used as searching for randomized controlled trials investigating the safety of Mahuang for treating obesity from January, 2000 to July, 2021. Results: Total 6 studies were included for analyzing. In most studies, heart rate was higher in experimental group than in placebo group with statistically significant difference. Both systolic and diastolic blood pressure had no significant differences between both groups, but systolic blood pressure got lower in experimental group. Most adverse events reported in experimental group were dry mouth, constipation, diarrhea, palpitation and insomnia, but serious adverse events were not reported. Conclusions: This study provides the evidence about the safety of Mahuang for treating obesity. However, increase of heart rate and minor adverse events could be occurred. Further study is needed to confirm the safety of Mahuang.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.63-71
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• 2007

Objectives : To provide an objective assessment of the effectiveness for weight loss of Mahuang. Methods : Effects were assessed by measuring changes in body weight, body mass index (BMI), body fat (kg, %),body muscle, and abdominal f3t ratio. The subjects of this study were healthy adults who agreed to participate in this study. Eligibility requirements include age between 20 and 50 and BMI more than 18.5 kg/m2. One hundred subjects were randomly assigned to two groups (control and Mahuang group) in a double-blind manner. Mahuang group subjects took 8g of Mahuang capsule/day for two weeks; control subjects took the same amount of indistinguishable placebo. We analyzed the body weight, body mass index, body fat, abdominal fat, body muscle and BMR (basal metabolic rate) before and after the study. Result After two weeks of clinical trial, body weight and BMI decreased in both groups, but the Mahuang group showed more significant decrease. On body fat, the Mahuang group showed significant decrease. while it increased in the placebo group. Although body muscle, body fat ratio and basic metabolic rate showed differences between the two groups, there was no statistical significance. Conclusion : It is suggested that intake of Mahuang may induce weight loss and body f3f decrease in healthy adults.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.105-116
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• 2007

Objectives : Mahuang (Ephedra sinica), well known as an herbal medicine in the East and West, contains a relatively high percentage of ephedrine known as sympathomimetic alkaloid. We investigated the effects of Mahuang on sympathetic nervous system with heart rate variety (HRV). Time and frequency domain analysis of HRV is a noninvasive technique capable of providing information on autonomic modulation of the sinus node. Methods : We investigated 57 healthy volunteers consisting of 37 subjects in the Mahuang group and 20 subjects in the placebo group. Study form was a randomized, placebo-controlled, double-blind clinical trial. The 37 subjects in the Mahuang group took 3 Mahuang capsules (1 capsule equivalent to 2g herb Mahuang) twice a day at 10 a.m. and 2 p.,., while the 20 subjects in the placebo group took 3 placebo-capsules filled with glutinous rice powder at the same times. Mahuang medicine and placebo medicine were made into opaque capsules. We measured HRV at 3 p.m. 1 or 2 days before medication and at 3 p.m. after medication. Results : Mean-RR and SDNN of the Mahuang group significantly decreased compared with that of the placebo group, but the heart rate of the Mahuang group significantly increased compared with the placebo. HRV-Index, RMSSD and SDSD of the Mahuang group significantly decreased compared with that of the placebo group, but PNN50 of the Mahuang group significantly increased compared with placebo. Ln(TP), Ln(VLF), Ln(LF) and Ln(HF) of the Mahuang group significantly decreased compared with those of the placebo group. There were no significant differences in normalized LF, normalized HF and LF/HF ratio between the Mahuang and placebo groups. Conclusion : The results suggest that Mahuang in healthy adults tends to reduce the autonomic nervous system within the normal range.

• The Journal of Internal Korean Medicine
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• v.28 no.1
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• pp.106-114
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• 2007

Background : Mahuang (Ephedrae Herba, Ephedra sinica $S_{TAPE}$) has been widely used to treat respiratory disease in Asian over the past thousand years. The main ingredient of Mahuang is ephedrine, whose affects on the autonomic nervous system induce some adverse effects like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, etc. Although there were lots of reports about adverse effects of Mahuang, there were no clinical studies which evaluated the adverse effects of Mahuang on the autonomic nervous system by objective numerical value in the past decade. Objectives : The purpose of this report was to provide an objective assessment of state-trait anxiety that is caused by Mahuang, and to identify anxiety of Mahuang according to different Sasang constitution classifications. Methods : The study design was a double-blind randomized placebo-controlled trial. The subjects of this study were 79 adults aged between 20 to 40 who agreed to participate. Because 8 adults dropped out, a total of 71 subjects entered the study. They were allocated through randomization to a Mahuang group (N=50) and placebo group (N=21). Each group took three opaque capsules (every opaque capsule containing 2g of Mahuang or none) twice a day. To compare the state and trait anxiety before and after taking Mahuang, we checked the anxiety by using STAI-KYZ. Results : The following results were obtained. Short-term administration of Mahuang significantly increased state-anxiety, but in the placebo group, there were no significant changes in state-anxiety. In the Mahuang group except females, there was more significant increase in state-anxiety of Soeumin than Soyangin and Taeumin in the 2nd measurement. Conclusion : It is suggested that the ingestion of Mahuang can increase sympathetic activity and induce anxiety. There was a significant difference among Sasang constitution classification. Especially, the response is stronger in Soeumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only minimize the anxiety but maximize the potential curative value.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.836-844
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• 2006

Background: Mahuang (Ephedra sinica STAPF) is well known as an herbal medicine and has been widely used to reduce body weight and increase athletic ability. However, as a result of reporting many cases of adverse effects on the cardiovascular system, use of dietary supplements containing ephedra was prohibited by the FDA. Objectives : The object of this study was to find the effectiveness of ephedra on weight loss without severe adverse effect. Methods : 16 healthy volunteers consisting of an ephedra group (N=8) and a placebo group (N=8) were investigated. Study form was a randomized, controlled, double-blind clinical trial. The ephedra group took 12g of ephedra while the placebo group took 12g of glutinous rice powder. Both groups were measured with BCA (body composition analysis) on weight loss and with HRV (heart rate variability) on its adverse effect before and after medication. Results : The following results were obtained after taking 12g of ephedra for 14 days. In the ephedra group, body weight reduced significantly. In the placebo group, there were no significant differences of body weight between before and after placebo treatment. There was a slight increase of heart beat rate and deactivation of cardiac activity. Parasympathetic nerves were deactivated, but balances of autonomic nervous system were well maintained. Conclusions : The results suggest that ephedra in healthy adults tends to reduce body weight and deactivation of autonomic nervous system and cardiac activity.

• Herbal Formula Science
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• v.27 no.1
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• pp.87-100
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• 2019

Objective : This study's purpose was to review the clinical studies of Mahwang-tang (MHT). Method : We searched ten clinical studies of MHT using KISS, RISS, NAVER, PUBMED, Science Direct. Ten papers were sorted by 4 topics, as influenza, pediatric febrile symptoms, contact dermatitis, and adjuvant for chronic hepatitis C. At last we analyzed if these papers are consistent with the keywords of Shanghanlun provisions about MHT. Results : When summarizing these papers again by topic, there were 4 studies on influenza, 1 study on pediatric febrile symptoms, 1 study on contact dermatitis and 4 studies as an adjuvant for chronic hepatitis C. Conclusion : These studies were consistent with terms such as fever, headache, aversion to wind, body pain, pain in the lumbar, articular pain written in Shanghanlun provisions. In addition to this, research on anti-depressive effects of MHT is proceeding systematically. However, studies on nosebleeds and pulses are still underdeveloped and further studies are needed.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.37-57
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• 2009

Objectives : This study was performed to investigate the effects of fermented Ephedra sinica (FMH) nano-extract compared Ephedra sinica (MH) on 3T3 L1 cell viability, lipid and glycometabolism, Obes rats' behavior and state-trait anxiety. Methods and materials : Each of 6 rats was divided into a normal diet, HFD, MH, and FMH. We fed a HFD group of rats a high fat diet and administered normal saline for 8 weeks. And we fed an experimental group of rats a high fat diet and administered an extract of Ephedra sinica and fermentated Ephedra sinica for 8 weeks. At the end of the experiment, the rats were sacrificed to determine their chemical composition. Ephedra sinica and fermentated Ephedra sinica was examined in effects of 3T3 L1 cell viability, lipid and glycometabolism, rats' behavior and state-trait anxiety. Results : 1. Ephedra sinica and fermentated Ephedra sinica didn't induce cytotoxicity at 3L3 L1 cell. 2. Fermentated Ephedra sinica by Lactococcus confusus inhibit $PPAR-{\gamma}$ activation and promote $TNF-{\alpha}$ activation. 3. In MH and FMH group, the body weight and FER decrease occured significantly than in HFD group. 4. No side effect of Ephedra sinica appeared in FMH group, so fermentated Ephedra sinica have a capacity of anti-anxiety. 5. Serum total cholesterol, triglyceride, HDL-cholesterol and creatine of HFD+Ephedra sinica, HFD+LO group were decreased compared with that of HFD group. Decreasing rates of sample group was significant(p<0.05). 6. In both MH and FMH group serum HDL was increased(P>0.05). 7. In MH group only TG was decreased, but in FMH group total cholesterol, TG, and glucose were decreased(P>0.05). Conclusions : Fermentated Ephedra sinica by Lactococcus confusus was superior to Ephedra sinica in capacity of anti-obesity. Further fermentated Ephedra sinica have no Ephedra sinica's side effect.