Ma Huang Tang (Ephedra Decoction)

What Is Ma Huang Tang

Ma Huang Tang commonly known as Ephedra Decoction is a well-known Chinese medicine prescription. It initially appeared in <Shanghan Lun> (Treatise on Cold Damage Diseases) in the end of the Han Dynasty (189 AD-220 AD).

Ma Huang means “ephedra”, and Tang means “decoction “. It is a traditional Chinese medicine prescription mainly composed of ephedra.

Traditional Chinese herbal medicines have long played an important role in Asian countries, especially Japan, China, and Korea. Along with cultural exchanges and trade between China and Japan, Ma Huang Tang was also introduced into Japan.

Ma Huang Tang has been improved by Japanese Kampo medicine and is now widely used to treat upper respiratory tract infections and influenza[1]. It is called maoto in Japan.

In traditional Chinese medicine (TCM), Ma Huang Tang is often used to promote sweating and relieve exterior symptoms, ventilate lung qi and relieve asthma, treat fever with anhidrosis, body feeling cold, headache, body pain, asthma, thin and white tongue coating, and tight pulse caused by wind-cold, influenza, acute bronchitis, bronchial asthma, upper respiratory tract infection, acute febrile disease.

With the changes of the times, this prescription has gradually evolved into a variety of traditional Chinese medicine prescriptions based on it. Among them, the representative prescriptions are Da Qing Long Tang, Ma Huang Jia Shu Tang, San Ao Tang, and Hua Gai San.


The dosage of Ma Huang is the largest in this prescription. Its medicinal nature is relatively warm. It can promote sweating, relieve body fever, and ventilate lung qi and relieve asthma.

The medicinal nature of Gui Zhi is relatively warm. It can promote sweating, warm and dredge the meridians. It can be used in combination with Ma Huang to double promote sweating and relieve headaches and body pain caused by wind-cold. Generally, the compatibility of Ma Huang and Gui Zhi is frequent in TCM formulas to relieve wind-cold.

The medicinal nature of Ku Xing Ren is slightly warm with a bitter taste. It can descend lung qi, relieve cough and asthma. It can be used together with Ma Huang to strengthen the anti-asthmatic effect of the prescription.

The medicinal nature of Gan Cao is relatively neutral. In most Chinese medicine prescriptions, it is often used to reconcile the medicinal effects of other Chinese herbal medicines. It can effectively avoid the negative effects caused by the too strong efficacy of other Chinese herbal medicines. In this prescription, it avoids excessive sweating induced by Ma Huang and Gui Zhi.


  • Dispelling cold and dredging the meridians, relieving headaches and body aches.
  • Exciting sympathetic nerves, promoting norepinephrine to enter the skeletal muscle, kidney, heart, and vasculature, constricting blood vessels and increasing blood pressure.
  • Relaxing bronchial smooth muscles, expanding lung ventilation, and relieving bronchial asthma.
  • Promoting urination, treating dysuria and acute nephritis.
  • Relaxing the bladder wall, contracting the inner bladder sphincter, treating neurological disorders caused by hypothalamic-pituitary problems, and severe diabetes insipidus caused by the abnormal internal sphincter.
  • Treating chronic urinary tract infections, enuresis caused by chronic cystitis.
  • Relaxing skeletal vascular smooth muscle, increasing muscle blood supply, and relieving general muscle pain and soreness.
  • Treating colds, influenza, acute bronchitis, upper respiratory tract infections, and acute febrile diseases.
  • Promoting the secretion of sweat glands, treating fever with anhidrosis, body feeling cold, headache, body pain, asthma, thin and white tongue coating, and tight pulse caused by wind-cold.
  • Studies have confirmed that it can regulate Th1/Th2 cytokines and inhibit Th17 cells in ovalbumin-sensitized mice to improve asthma[2].
  • There have been reports that it can inhibit the TLR9 pathway and alleviate the pathological changes of the acute asthma-like syndrome[3].

How to use it

Ma Huang Tang has not been made into Chinese patent medicine, and it can only be made by decoction of Chinese herbal medicines. It should only be used under medical supervision.

When using the ancient Chinese medicine method to make Ma Huang Tang, add water to boil the Ma Huang, remove the foam on the surface of the soup, add other medicines to continue decoction, and then remove the medicine slag after it is cooked. Then it is finished.

Due to the powerful medicinal properties of Ma Huang, doctors now reduce the dosage of Ma Huang when making Ma Huang Tang. They will use water decocting to make it.

When decocting, the doctor needs 9g of Ma Huang without knots, 6g of peeled Gui Zhi, 6g of Ku Xing Ren, and 3g of Zhi Gan Cao to make ephedra soup.

Generally, after taking the prescription, the patient’s symptoms can be relieved. Patients can stop taking it after sweating.

In the short term, if the patient’s condition again, he needs to make Ma Huang Tang again and take it.

If the patient suffers from the described illness and other illnesses, the doctor needs to increase or replace part of the Chinese herbal medicines in Ma Huang Tang according to the illness.

Side Effects

There are almost no side effects when taking Ma Huang Tang as prescribed by a doctor.

Overdosing it may cause excitement, insomnia, or irritability. In severe cases, it can consume Qi and body fluids.

A small proportion of people taking it may cause chest tightness, palpitations, headaches, insomnia, and other adverse reactions.

Precautions and Warnings

  • Ma Huang Tang is limited to the treatment of the diseases described in this article, and should not be used indiscriminately.
  • It has strong medicinal effects, and people with mild wind-cold should not take it.
  • It is not recommended to use iron containers to make Ma Huang Tang.
  • It is not suitable for long-term decocting.
  • During the medication, it is not recommended to drink, smoke, eat spicy or greasy food.
  • People who are allergic to the ingredients of Ma Huang Tang should not take it.
  • People with hyperhidrosis, night sweats, or polyuria should not take it.
  • People with chronic diseases such as diabetes, high blood pressure, heart disease, liver disease, kidney disease should take it under the guidance of a physician.
  • Children, pregnant women, breastfeeding women should not take it.
  • After taking the medicine, if there is an adverse reaction, the patient should stop the medicine in time and go to the hospital for treatment.
  • If you are taking other drugs at the same time, you should consult your doctor to prevent interactions between the drugs and affect the efficacy of the drugs.
  • After using it for 2 days, if the symptoms are not relieved, the patient should go to the hospital in time.