Glycyrrhizic Acid in the Treatment of Liver Diseases: Literature Review

Table 1

Clinical trials using compound glycyrrhizic acid injection.

Experimental drugs	Dose and course of treatment	Combined medication	Case/control	Disease type	Indications and symptoms	Efficacy	Positive control	Side effect	Reference
Glycyrrhizin	200 mg + NaCl; 100 mL, i.v., q.d., 4 weeks	Prednisolone; (20–60 mg)	31/14	Acute onset autoimmune hepatitis (AIH)	Fever, general malaise, fatigue, nausea, vomiting, and right upper quadrant discomfort	Recovery rate was higher in the SNMC group than in the SNMC + CS group (𝑃=0.035)	Glycyrrhizin and corticosteroids (CS)	None	[21]
Glycyrrhizin	200 mg, i.v., q.d., 52 weeks	None	374/129	Chronic hepatitis C	Inflammatory effect	The proportion of patients with ALT reduction ≥50% after 12 weeks was significantly higher with 5×/week glycyrrhizin (28.7%, 𝑃<0.0001) and 3×/week glycyrrhizin (29.0%, 𝑃<0.0001) compared with placebo (7.0%).	Placebo-controlled	None	[22]
Glycyrrhizin	200 mg + NaCl; 100 mL, i.v., 6c/week, 4 weeks	None	69/13	Chronic hepatitis C	HCV and HCV-RNA positive; serum ALT at least 1.5 times; liver fibrosis or cirrhosis	The mean percentage ALT decrease from baseline at the end of treatment was 26% and 47% for the three times per week and six times per week treatment group, respectively (both 𝑃<0.001 versus placebo)	Placebo-controlled	None	[23]
Glycyrrhizin	200 mg + NaCl; 100 mL, i.v., q.d. for 8 weeks, then 2–7c/week for 2–16 years	None	453/109	Hepatocellular carcinoma (HCC) occurs in patients with hepatitis C virus-RNA positive chronic liver disease	Inflammatory effect after HCC	Patients treated with SNMC; the 10-year HCC appearance rates in histologic Stages I, II, and III were 3%, and 13%, respectively	Other herbal medicines	None	[24]
Glycyrrhizin	200 mg + NaCl; 100 mL, i.v., q.d., 0.1–14.5 years	None	1249/796	Interferon-resistant hepatitis C	Chronic hepatitis effect	Crude carcinogenesis rates in the treated and untreated group were 13.3%, 26.0% at the fifth year and 21.5% and 35.5% at the 10th year, respectively (𝑃=0.021)	Others without glycyrrhizin therapy	Hypertension skin rash without itching	[25]
Diammonium glycyrrhizinate	150 mg + 5–10% glucose injection liquid 250 mL, i.v., q.d., 1 month, 1-2 cycles	None	629/127	Chronic hepatitis, liver cirrhosis	Fatigue, gastrointestinal symptoms, and discomfort in liver area	After 17-day therapy, there are 93.3% patients with ALT normal level in treating group, but 73.3% in contrast group (𝑃<0.05). At day 10, the patient’srecovered normal SB were 86.7% in treatment group, but that was 40% in contrast group (𝑃<0.01)	Compound ammonium glycyrrhetate injection	Headache, facial edema, and blood pressure increased	[26]
𝛽-glycyrrhetinic acid	80 mg + 10% glucose injection liquid 250 mL, i.v., q.d., 4 weeks, 100 mg, p.o. tid, 12 weeks	None	80/40	Chronic Hepatitis B	Chronic hepatitis effect	Compared with control group, the TBil, ALT, AST, HA, and IVC are significantly ameliorated in treatment group (𝑃<0.01)	𝛼-glycyrrhizic acid	Edema, blood pressure increased, and serum potassium mildly low	[27]
Magnesium isoglycyrrhizinate	80 mg + 10% glucose injection liquid 250 mL, i.v., q.d., 4 weeks	Hepatoprotective drugs	80/40	Chronic Hepatitis B	Fatigue, gastrointestinal symptoms, and discomfort in liver area	Compared with control group, the TBil, ALT, AST are significantly ameliorated in treatment group (𝑃<0.05)	Diammonium glycyrrhizinate injection	Headache,and blood pressure increased	[28]
Magnesium isoglycyrrhizinate	150 mg + 5–10% glucose injection liquid 250 mL, i.v., q.d., 4 weeks	None	60/30	Chronic severe hepatitis	Fatigue, gastrointestinal symptoms, discomfort in liver area, and yellow urine	Compared with control group, the TBil, PTA, ALT, and AST are significantly ameliorated in treatment group (𝑃<0.01)	Hepatocyte generation drugs	None	[29]
Magnesium isoglycyrrhizinate	150 mg + 5–10% glucose injection liquid 250 mL, i.v., q.d., 2 weeks	None	56/28	Liver lesion induced by chemotherapy in cancer	Liver injury effect	Compared with control group, the TBil, PTA, ALT, and AST are significantly ameliorated in treatment group (𝑃<0.01)	Diammonium glycyrrhizinate injection	None	[30]

GA: glycyrrhizic acid; TBil: total bilirubin; IVC: type IV collagen; ALT: alanine aminotransferase; AST: aspartate transaminase; PTA: prothrombin time activity.