Licorice Root (Glycyrrhizin)

INTRODUCTION: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabridin (≥3.5% w/w), and others viz., glabrol, eicosanyl caffeate, docosyl caffeate, and total flavonoids (≥10% w/w) with glycyrrhizin (≤3.0% w/w) as glycyrrhizin causes electrolyte imbalance, hypertension, and water retention. Hence, the objective of the current study was to assess the efficacy, safety, and tolerability of GutGard® in managing gastroesophageal reflux (GER)-related symptoms when compared to placebo. METHODS: It was a double-blind, parallel group, randomized, placebo-controlled trial with participants randomized in a 1:1 ratio to either the placebo group or GutGard® group. The duration of the interventions/treatment was for 28 days and the follow-up visits were done at day 7, day 14, day 28, and day 35. A telephonic follow-up was also done on day 21. The primary outcome measures studied was the change in the Gastroesophageal Reflux Disease-Health-Related Quality of Life and the Gastroesophageal Reflux Disease Symptom Assessment Scale. RESULTS: We screened a total of n = 296 participants and enrolled n = 200 participants and obtained written, informed consent from them. Participants in the GutGard® group reported a significantly better quality of life at the end of the intervention period (p = 0.014). They also reported earlier resolution of symptoms of GER as against the placebo group, especially the symptoms of heartburn (p = 0.017 on day 14 and p = 0.005 on day 28) and regurgitation (p = 0.025 on day 7, p = 0.029 on day 14, and p = 0.022 on day 28). CONCLUSIONS: The GutGard® group showed better and earlier resolution (within 2 weeks) of symptoms of GER as against the placebo group, especially heartburn and regurgitation. INTRODUCTION: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabr

Licorice extract (glycyrrhizin), a potent antiviral, anti-inflammatory, and antioxidant remedy, is a potential therapeutic option for COVID-19. We evaluated the efficacy and safety of licorice in patients with moderate COVID-19. In this study, 60 patients with confirmed COVID-19 were randomly assigned in a 1:1 ratio to receive licorice (at a dose of 760 mg three times a day for seven days) or control groups. The primary outcomes were SPO2, body temperature, and respiratory rate (RR) after the end of the intervention. The findings indicated that SPO2, body temperature, and RR had no significant difference between the groups at the end of the intervention. However, CRP and ALT improved in the licorice group toward the baseline. The number of patients with worse prognoses, LOS, mortality, and the incidence of adverse events were not different between the groups at the end of the study. Licorice had no beneficial effect on the clinical symptoms of COVID-19. Moreover, this intervention demonstrated a safe profile of adverse events. The confirmation of the results of this preparatory trial requires more detailed multiple-center trials with a larger sample size. © 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

ETHNOPHARMACOLOGICAL RELEVANCE: Glycyrrhiza glabra L. (Fabaceae), commonly known as liquorice, has been valued for millennia in Ayurveda, Traditional Chinese Medicine (TCM), Persian medicine, and European folk practice. Across these cultures, liquorice root decoctions and formulations are employed to reduce joint pain, curb inflammation, restore systemic balance, and serve as a harmonising "guide herb" in polyherbal prescriptions. AIM OF THE REVIEW: To provide an integrated review of G. glabra in rheumatoid arthritis (RA) management, linking its traditional therapeutic roles with modern pharmacological evidence and exploring its synergistic potential with other agents. MATERIALS AND METHODS: A systematic literature review was conducted using PubMed, Scopus, Springer, ScienceDirect, and Google Scholar. Ethnobotanical, phytochemical, in vitro, in vivo, in silico, and integrative medicine studies were included. RESULTS: Traditional preparations such as roasted, honey-fried, crude root decoctions are reflected in modern bioassays confirming anti-inflammatory, antioxidant, immunomodulatory and cartilage-protective activities. Bioactives, including glycyrrhizin, glycyrrhetinic acid, isoliquiritigenin, liquiritin, and licochalcone A, modulate NF-κB, MAPK, COX/LOX, JAK/STAT and angiogenic pathways, restore Th17/Treg balance, and regulate gut microbiota. Synergistic effects are reported with methotrexate, triptolide, mangiferin, Boswellia serrata extract, and platelet-rich plasma. CONCLUSIONS: The convergence of ancient ethnomedical use and robust modern pharmacology positions G. glabra as a promising adjunctive therapeutic for RA. Future directions should focus on community-based clinical trials, sustainable cultivation, benefit-sharing with knowledge holders, and the development of standardised extracts.

Triple negative breast cancer(TNBC) has generated growing interests due to its aggressive biologic behavior and absence of targeted therapy approach. Glycyrrhizin(GL) from licorice root and its metabolite, glycyrrhetinic acid(GA) have shown extensive bioactivities in clinic. Here, we demonstrate that GL and GA have contrary anti-cancer effect on TNBC MDA-MB-231 cells. Beside its inhibition of cell proliferation, GA at non-cytotoxic concentration showed synergistic effect in combination with anti-cancer drug, etoposide(VP-16). Specifically, GA enhanced cytotoxicity through regulating topoisomerase IIα(TOPO 2A) targeted by etoposide. GA sensitized the cells to etoposide through elevating TOPO 2A with a 2.4 fold rate at 12h. From 12 to 48h, GA halved the expression of TOPO 2A and stimulated apoptosis, which exhibited its antineoplastic effect. Our experiments showed that GSH depletion, modulation of MAPK and AKT pathways accounted for the regulation of topoisomerase IIα and apoptosis. However, GL showed protection and detoxication by decreasing reactive oxygen species generation, maintaining GSH and differentially modulating apoptosis, AKT pathway, ERK and JNK of MAPK pathway. Collectively, our results demonstrate that GA, instead of GL, is a better candidate for TNBC treatment because of its anti-cancer effect and sensitization of topoisomerase IIα inhibitor.

ETHNOPHARMACOLOGICAL RELEVANCE: Triptolide (TP), a major active component of Tripterygium wilfordii, possesses various pharmacological activities with narrow therapeutic window and severe toxicities. Glycyrrhizin (GL), the principal bioactive ingredient of licorice root extract, has been reported to be concomitantly administered with TP in treatment of rheumatoid arthritis with the aim of potentiated efficacy and reduced toxicity. The aim of the study is to investigate the effect of GL on the pharmacokinetic profiles of TP and related mechanisms. MATERIALS AND METHODS: Male and female Wistar rats were randomly divided into two groups: Control group and GL group (pretreated with GL at 100 mg/kg/day for seven consecutive days). After oral administration of TP at a single dose of 450 μg/kg, plasma concentrations of TP were determined using HPLC-MS/MS and pharmacokinetic parameters were calculated by non-compartmental analysis using Phoenix WinNonlin 6.3 software. Since CYP3A is the primary isoform of cytochrome P450s responsible for the metabolism of TP, we further determined to what extent ketoconazole (KCZ), a potent CYP3A inhibitor, could influence the effect of GL on the pharmacokinetics of TP by comparing the pharmacokinetic profiles of TP in GL group (pretreated with GL) and GL+KCZ group (pretreated with both GL and KCZ), as well as verified whether pretreatment of GL could induce the activity of hepatic CYP3A by comparing the AUC parameters after intravenous administration of midazolam (MDZ), a typical probe drug for CYP3A, in rats pretreated with vehicle or GL. RESULTS: Our study revealed marked differences in pharmacokinetic profiling patterns of TP between male and female rats in the Control group; the plasma level of TP in males was far lower than that in females. After pretreatment with GL, the pharmacokinetic profiles of TP were significantly altered in both male and female rats; a remarkable decrease was found in the value of AUC∞, MRT∞ and t1/2 in the GL group, compared with the Control group. But such a decrease was reversed by KCZ; compared with the GL group, the values of AUC∞, MRT∞ and t1/2 were significantly increased in the GL+KCZ group. Pretre

Liquorice (root of Glycyrrhiza uralensis FISCH) is an ingredient of candies and used as a popular medicine in Europe and oriental countries. Cyclosporine (CsA), an immunosuppressant with narrow therapeutic window, is widely used in transplant patients. The absorption and disposition of CsA were associated with P-glycoprotein (P-gp) and cytochrome P450 3A4 (CYP3A4). This study investigated the effects of liquorice extract (LE) and its major ingredient, glycyrrhizin (GZ), on CsA pharmacokinetics in rats. The results indicated that LE and GZ significantly decreased the peak blood concentration and the areas under the curves of CsA in rats. Mechanism studies revealed that glycyrrhetic acid (GA), the major metabolite of GZ, significantly activated the functions of P-gp and CYP3A4. In conclusion, liquorice significantly reduced the oral bioavailability of CsA through activating P-gp and CYP3A4.

The rhizome of Glycyrrhiza glabra L. (licorice) is used very widely in Indian and Chinese traditional medicine, and it is a popular flavor ingredient of drinks, sweets and candies. Its medicinal uses include treating bronchitis, dry cough, respiratory infections, liver disorders and diabetes. Glycyrrhizin is normally considered to be its biologically active marker, so a rapid RP-HPLC method was developed for the quantitative estimation of glycyrrhizin in the extract. The effect of the standardized extract and its marker on drug metabolizing enzymes was evaluated through CYP3A4 and CYP2D6 inhibition assays to evaluate the safety through its drug interaction potential. The inhibition of CYP3A4 and CYP2D6 isozymes was analysed by the fluorescent product formation method. In the CYP450-CO assay, the interaction potential of the standardized extract and pooled microsomes (percentage inhibition 23.23 ± 1.84%), was found to be less than the standard inhibitor. In the fluorimetric assay, G. glabra extracts showed higher IC(50) values than their positive inhibitors, ketoconazole and quinidine for CYP3A4 and CYP2D6, respectively. Furthermore, the interaction potential of the plant extract was greater than the pure compound. The results demonstrate that G. glabra and its principle bioactive compound, glycyrrhizin, when co-administered with conventional medicines showed only a weak interaction potential with drug metabolizing enzymes.

The liquorice plant has long been used in both Eastern and Western cultures. Glycyrrhizin is the major triterpenoid saponin in liquorice root, and glycyrrhetinic acid (GA) is its predominant metabolite and a pharmacologically active form of glycyrrhizin. We have assessed the ability of GA to inhibit the enzyme cytochrome P450 3A (CYP3A). A Lineweaver-Burk plot showed that GA was a mixed inhibitor of CYP3A, with an IC₅₀ of 7.25 μmol/l, a K(m) of 4.3 μmol/l and a K(i) of 6.4 μmol/l by non-linear regression analysis. CYP3A activity was also affected by intragastric administration of GA, which resulted in increases in area under the plasma concentration-time curve (AUC)(₀-t) and in apparent elimination half-time (t₁/₂) and significant decreases in body clearance, as well as in the formation of 1-hydroxy-midazolam after intragastric or intravenous administration of midazolam (p < 0.05). An increase in C(max) after intragastric administration (p < 0.05) was also observed. These results suggest the likelihood of an interaction between GA and CYP3A-metabolised drugs in humans and indicate that liquorice root should be used with caution when taken concomitantly with other drugs that interact with CYP3A.

Glycyrrhizin (GZ) and licorice (root of Glycyrrhiza uralensis) are worldwide food additives and important oriental phytomedicines. This study investigated the biological fate of GZ by orally giving GZ and licorice decoction (LD) to rats. The serum concentrations of GZ and glycyrrhetic acid (GA) were determined by high performance liquid chromatography. The results showed that GZ was not detected and GA was present in serum until 3 days postdosing of GZ and LD. To evaluate the effects of GZ and licorice on the pharmacokinetics of methotrexate (MTX), an important immunosuppressant with a narrow therapeutic window, rats were orally given MTX with and without GZ and LD in different dosage regimens. The serum MTX concentration was determined by fluorescence polarization immunoassay. The results revealed that the AUC and MRT of MTX were significantly increased by GZ and LD. In conclusion, the concurrent use of GZ or licorice with MTX should be with caution.

This study aimed to evaluate the effects of licorice root supplementation on liver enzymes, hepatic steatosis, metabolic and oxidative stress parameters in women with nonalcoholic fatty liver disease (NAFLD). In this randomized double-blind, placebo-controlled trial, 60 women with NAFLD were selected and randomly assigned into 2 groups to take 1,000 mg/day powder of licorice root extract or placebo for 12 weeks. In addition, all the patients were advised to follow a weight loss diet and healthy lifestyle. The plasma levels of liver enzymes, glycemic indices, lipid profile, oxidative stress parameters, as well as hepatic steatosis were measured at the beginning and end of the study. Through the 12-weeks period of supplementation, women who received powder of licorice root experienced a statistically significant improvement in alanine aminotransferase (p < .001), insulin (p = .002), insulin resistance (p = .003), malondialdehyde (p < .001) serum levels, and ultrasonographic findings of liver steatosis (p < .001), compared to the placebo group. In conclusion, licorice root supplementation in addition to gradual weight loss and lifestyle modification is superior to lifestyle modification alone for the treatment of NAFLD. © 2022 John Wiley & Sons Ltd.

Since ancient times, licorice, the root of Glycyrrhiza glabra, has been known to have a wide spectrum of therapeutic effects. Glycyrrhizin is cleaved to glycyrrhizic acid, which is subsequently converted to glycyrrhetic acid by human intestinal microflora. Glycyrrhetic acid is a potent inhibitor of 11β-hydroxysteroid dehydrogenase (11β-HSD) and performs a range of corticosteroid-like activities. The pharmacologic effects of licorice contribute to its anti-inflammatory, antioxidative, anti-allergenic, and antimicrobial properties. Licorice has been used to treat liver disease, gastrointestinal disorders, oral disease, and various skin disorders and has been used in gum, candy, herbs, alcoholic beverages, and food supplements. Licorice and its extracts, especially glycyrrhizin, can be taken orally, through the skin (in the form of gels and oils), and intravenously. Licorice demonstrates mineralocorticoid-like activity not only by inhibiting 11β-HSD2, but also by binding to a mineralocorticoid receptor, leading to potentially adverse risks of mineralocorticoid-like overactivity. Chronic use of licorice can lead to hypokalemia and hypertension, and some people are more sensitive to licorice exposure. Based on clinical trials, this review summarizes the positive effects of licorice and other reported side effects.

The aim of the present study was to evaluate the effect of dietary integration with dried licorice root on the chemical-nutritional qualities of goat milk and cheeses. The study was conducted for 60 d, during which 30 Saanen goats were divided into 2 groups: a control group (CG) that received a standard diet and an experimental group (LG+) whose diet was supplemented with licorice. At the end of the study, milk samples were collected to determine chemical-nutritional compositions and fatty acid (FA) profiles. Cheeses produced with CG and LG+ bulk milk were analyzed for chemical-physical parameters after 3 (T3) and 30 (T30) d of ripening. A different FA profile and a significant increase in protein and casein were observed in LG+ milk samples compared with CG milk. Regarding cheeses, an increase of proteins and fat was found in LG+ cheeses, which also were harder, more elastic, and more gummy than the CG samples after both 3 and 30 d of ripening. A different protein profile was detected in the 2 groups without significant variations in casein fractions (αS2-casein and β-casein) during ripening. Moreover, greater oxidative stability was found in LG+ cheeses at both T3 and T30. Different families of volatile compounds were detected in T30 cheeses obtained from both groups. A significant reduction of octanoic acid and an increase in nonanal and ketones were found in LG+ T3 cheeses, whereas the LG+ T30 cheeses were characterized by a significant decrease of hexanoic acid an increase of 3-methyl-1-butanol and acetoin. We concluded that it is possible to assert that dietary integration with dried licorice root modified chemical and technological properties of goat cheeses, reducing lipid oxidation during ripening and inducing changes in texture that could improve consumer acceptability, although further studies are needed from this point of view.

BACKGROUND: Many people with asthma use herbal medicines to help reduce symptoms and improve asthma control. OBJECTIVE: To update the systematic review and meta-analysis of randomised controlled trials of herbal medicine for adult asthma. DATA SOURCES: Nine English and Chinese databases were searched (PubMed, Embase, CINAHL, CENTRAL, AMED, CBM, CNKI, CQVIP, Wanfang). STUDY SELECTIONS: Herbal medicines combined with routine pharmacotherapies compared with the same pharmacotherapies alone or placebo. Cochrane Risk of Bias Tool and GRADE Summary of Findings tables were used to evaluate methodological quality. RESULTS: Twenty-nine (29) studies involving 3,001 participants were included. Herbal interventions used multi-ingredients such as licorice root, crow-dipper, astragali, and angelica. Compared with routine pharmacotherapies alone, herbal medicines as add-on therapy improved lung function (FEV1: MD 7.81%, 95% CI 5.79, 9.83, I(2) = 63%; PEFR: MD 65.14 L/min, 95% CI 58.87, 71.41, I(2) = 21%); asthma control (MD 2.47 points, 95% CI 1.64, 3.29, I(2) = 55%); reduced salbutamol usage (MD -1.14 puffs/day, 95% CI -2.20, -0.09, I(2) = 92%); and reduced acute asthma exacerbations over one year (MD -1.20, 95% CI -1.82, -0.58, one study). Compared with placebo plus pharmacotherapies herbal medicines as add-on therapy improved lung function (FEV1: MD 15.83%, 95% CI 13.54, 18.12 and PEFR: MD 55.20 L/min, 95% CI 33.41, 76.99). Other outcomes were not reported in these placebo studies. Included studies were low to moderate quality. Adverse events were rare. CONCLUSIONS: Herbal medicines combined with routine pharmacotherapies improved asthma outcomes greater than pharmacotherapies alone. Included studies did not blind participants therefore more studies that address such weaknesses are warranted.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common ovarian dysfunction. Recent studies showed the effectiveness of licorice on metabolic profiles with inconsistent findings. So, we investigated the effect of licorice on obesity indices, glycemic indices, and lipid profiles in women with PCOS. METHODS: This randomized, double-blind, placebo-controlled trial was performed on 66 overweight/obese women with PCOS. The participants were randomly assigned to receive either 1.5 gr/day licorice extract plus a low-calorie diet (n = 33) or placebo plus a low-calorie diet (n = 33) for 8 weeks. Participants' anthropometric indices and body composition were assessed using standard protocols. Fasting blood sugar (FBS), insulin levels, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C) were measured using enzymatic kits. The homeostasis model assessment-insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-B) were calculated using valid formulas. RESULTS: Between-group comparisons demonstrated significant differences between the groups in terms of obesity indices (body weight, BMI, and body fat), lipid profiles (TG, TC, LDL-C, and HDL-C), FBS and insulin levels, HOMA-IR, and HOMA-B at the end of the study (P < 0.05). Supplementation with licorice plus a low-calorie diet was also more effective in improving all parameters than a low-calorie diet alone after adjusting for confounders (baseline values, age, weight changes, and physical activity changes) (P < 0.05). CONCLUSION: The findings showed that licorice consumption leads to improvements in obesity indices, glucose homeostasis, and lipid profiles compared to placebo. Due to possible limitations of the study, further research is needed to confirm these findings. © 2024. The Author(s).

ETHNOPHARMACOLOGICAL RELEVANCE: Due to the known side effects of many synthetic drugs, the use of herbal and natural substances in treating diseases such as burns has been considered. licorice is a herbal medicine whose stem and underground roots are used in traditional medicine in many countries, including Iran, for anti-inflammatory, stomach ulcer healing, and antimicrobial purposes. AIM OF THE STUDY: This study investigated the healing effect of hydroalcoholic extract of licorice root on the wound healing process caused by second-degree burns. METHODS: The hydroalcoholic extract of licorice was prepared in ethanol solvent, and then the licorice hydrogel product was designed using gelling compounds. Then, in a double-blinded randomized clinical trial, 50 patients with second-degree burns were selected based on inclusion criteria from the patients referred to Yazd Hospital and Isfahan Hospital. Participants were randomly divided into two groups: the control group receiving hydrogel without extract and the intervention group receiving hydrogel containing licorice root hydroalcoholic extract. The intervention lasted for 15 days, and during this period, the wound-healing process was evaluated on days 1, 3, 6, 10, and 15. Data were analyzed using SPSS software with independent T-test and Mann-Whitney U tests with a maximum error of 5 %. RESULTS: The rate of inflammation (From the 3rd day to the 10th day), redness (From the 6th day to the 15th day), pain (on the 3rd day), and burning (From the 3rd day to the 15th day) of the wound in the group that used the hydrogel-containing hydroalcoholic extract of licorice root was significantly lower than in the control group (P < 0.05), and the healing process was significantly faster than the control group. CONCLUSION: Hydroalcoholic extract of licorice root can accelerate the healing process of second-degree burns.

ETHNOPHARMACOLOGICAL RELEVANCE: Licorice preparations are used as neuroprotective remedies in Persian ethnomedicine, in order to prevent from disabilities in neurodegenerative conditions like Parkinson's disease (PD). AIM OF THE STUDY: This study was designed to determine the licorice (root of Glycyrrhiza glabra L.) effectiveness as an adjunct treatment in the PD management. MATERIAL AND METHODS: In this double-blinded trial, 128 patients were assessed for eligibility criteria. Seventy-eight patients were ineligible and 11 of them refused from participating. Thirty-nine PD patients (YAHR staging ≤ 3) were divided into two groups by random. The patients received oral licorice or placebo syrups with a dose of 5 cc, twice a day for 6 months. High-performance liquid chromatography and spectrophotometric instruments determined licorice syrup constituents. The patients' situation for Unified Parkinson's rating scale (UPDRS) was assessed every 6 weeks for the duration of six months. In addition, patients' blood pressure, blood glucose, sodium and potassium levels, quality of life and dizziness were determined. RESULTS: Six weeks after intervention, total UPDRS, daily activities and tremor were significantly improved with a considerable effect size. A significant better motor test and rigidity scores were observed 4 months after licorice intake (p > 0.05). No electrolyte abnormality, significant changes in blood pressure or blood glucose levels were observed during the study. Each 5cc of syrup contained 136 mg of licorice extract with 12.14 mg glycyrrhizic acid, and also 136 μg of polyphenols. CONCLUSION: The licorice intake could improve the symptoms in PD patients without serious adverse events.

The anti-inflammatory properties of the topical herbal composition VEL-091604 with gentian root, licorice root, and willow bark extract were assessed in a randomized, prospective, placebo-controlled, double-blind ultraviolet (UV)-erythema test study with 42 healthy volunteers in comparison to 1% hydrocortisone acetate. The efficacy and tolerability of VEL-091604 cream 2 times daily over 2 wk was evaluated in an open-label, prospective proof of concept study in 10 subjects with atopic dermatitis using a lesional SCORAD severity score. In the UV-erythema test VEL-091604 cream significantly reduced inflammation compared to placebo and was as effective as 1% hydrocortisone acetate. The clinical study with atopic subjects revealed a significant and rapid reduction of the lesional SCORAD severity score in the test areas after 1 and 2 wk. No adverse events were recorded. It is concluded that the herbal cream VEL-091604 with licorice root, willow bark, and gentian root extract display anti-inflammatory properties in vivo. It is a promising new treatment option for atopic dermatitis that warrants further investigation in controlled studies. Georg Thieme Verlag KG Stuttgart · New York.

BACKGROUND: Lipid-based emulsions can be useful for the management of canine atopic dermatitis (cAD). 18-beta glycyrrhetinic acid (GRA), a component of liquorice root, has anti-inflammatory and anti-pruritic effects. HYPOTHESIS/OBJECTIVES: To evaluate the effects of a topical lipid emulsion containing ceramides, fatty acids and GRA on clinical signs of cAD and skin barrier in a randomized, double-blinded, placebo-controlled trial. METHODS: Client owned (n = 45) dogs with nonseasonal, mild/moderate AD, received either treatment or placebo for three months. Skin lesions, pruritus, transepidermal water loss (TEWL) and global assessment (GA) were evaluated. RESULTS: Fourteen dogs receiving treatment and 14 receiving the placebo completed the study. After one month ≥50% reduction in pruritus was seen in seven of 14 dogs (50%) in the Treatment group, and in two of 14 dogs (14.3%) in the Control group (P = 0.047). After two and three months, significant reduction in pruritus was not seen. For Canine Atopic Dermatitis Extent and Severity Index (CADESI), TEWL and GA, there were no significant findings over time or between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The emulsion had some transient beneficial clinical effects. However, it was not effective in controlling pruritus as a monotherapy. Further studies should examine whether owner compliance was a factor in the steady decline of effect on pruritus scores. Further studies evaluating its role as an adjunctive therapy are indicated. © 2017 ESVD and ACVD.

OBJECTIVE: The aim of our study was to evaluate the efficacy of an herbal lollipop containing licorice root extract on salivary Streptococcus mutans in caries-free and high-caries-risk children. MATERIALS AND METHODS: The study was conducted in caries-free and high-caries-risk children, aged 5-11 years (n = 108). The groups were caries-free children (group A); high-caries-risk children whose dental treatment was completed before lollipop use (group B); and high-caries-risk children who did not comply with dental treatment (group C). The groups were divided into two subgroups: herbal (A-1, B-1, C-1) and placebo lollipops (A-2, B-2, C-2). Saliva samples were taken before dental treatment, before and after consuming lollipops, and at 3 months after consuming lollipops. The results were statistically analyzed with chi-squared test. RESULTS: Only in group C-1 (high-risk, using herbal lollipops) that significant reduction was observed in salivary S. mutans levels after lollipop use (p = 0.033), and only in the same group (C-1), there was significant difference between after lollipop use and third month levels (p = 0.006). CONCLUSIONS: Herbal lollipops could be recommended to children with high-caries risk who do not comply with dental treatment in place of high-carbohydrate snacks. CLINICAL RELEVANCE: The paper provides a perspective on using herbal products in high-risk children for reducing salivary S. mutans counts.

OBJECTIVE: To evaluate the clinical efficacy and safety of Qiangji Recipe (QR) in ad- junctive treatment of axial undifferentiated spondyloarthritis (axuSpA) through a four-week open study. METHODS: Fifty-four axuSpA patients of Shen-deficiency Du-channel cold syndrome (SDDCS) in line with inclusive criteria were recruited and assigned to the treatment group and the control group according to random digit table, 27 in each group. Patients in the control group took Celecoxib Capsule (0.2 g each time, twice per day). Patients in the treatment group additionally took QR (consisting of Herba Epimedii 15 g, antler glue 15 g, Cibotium Barometz 15 g, eucommia bark 20 g, dipsacus asper 10 g, two toothed achyranthes root 15 g, drynaria 15 g, Taxillus Chinensis 20 g, ground beetle 10 g, scorpion 5 g, wild celery 10 g, notopterygium incisium 10 g, cow-fat seed 10 g, white mustard seed 6 g, and licorice root 6 g, one dose per day, twice daily). The therapeutic course for all was 4 weeks. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), total body pain and spinal pain, patient and physician global assessment on a four-point scale, the Ankylosing Spondylitis Quality of Life (ASQoL), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before and after 4 weeks of treatment. The primary end point in this study was the proportion of patients with a 20%improvement response accord- ing to the ASAS International Working Group Criteria (ASAS 20 responders) at week 4. RESULTS: Totally 50 patients completed this trial, 26 in the treatment group and 24 in the control group. Improvement of BASDAI, BASFI, BASMI, ASQoL, ESR, and CRP was shown in both groups after treatment. Better effect was shown in the treatment group in all indices except ESR and BASMI after treatment (P < 0.05, P < 0.01). Twenty cases (accounting for 76.92%) in the treatment group achieved ASAS 20 response at week 4, while 12 cases (accounting for 50.00%) in the control group achieved ASAS 20 response at week 4 (P < 0.05). No obvious adverse reaction occurred in the two groups. CONC

OBJECTIVE: To observe the effect of Ningdong Granule (NG) on serum levels of interleukin-12 (IL-12) and tumor necrosis factor-alpha (TNF-alpha) of children patients with Tourette's syndrome (TS). METHODS: Totally 90 TS children patients were randomly assigned to the NG group, the NG + Tiapride group (abbreviated as the combined treatment group), and the Tiapride group, 30 in each group. Besides,another 30 healthy children were recruited as the healthy control group. Patients in the NG group were treated with NG (consisting of all gastrodia rhizome, Codonopsis pilosula, Ophiopogon japonicus, white peony root, Rhinocerotidae, oyster, earthworm, licorice root, etc.), one dose daily, administered by dissolving it in boiled water, taken in two portions in the morning and in the evening respectively. Patients in the Tiapride group took Tiapride Tablet, 50 -100 mg each time, twice daily. The dosage was adjusted according to individual difference and changes of pathogenic conditions. The maximal dosage was 300 mg per day. Those in the combined treatment group were treated with equal dose of NG and Tiapride Tablet in combination. The treatment course was 3 months for all. Changes of pathogenic condition before and after treatment were assessed by Yale global tic severity scale (YGTSS). Serum levels of IL-12 and TNF-alpha were detected by enzyme-labeled immunosorbent assay (ELISA) before and after treatment. RESULTS: (1) The total effective rate of the NG group, the combined treatment group, and the Tiapride group was 79.3%, 83.3%, and 67.9%, respectively. It was the lowest in the Tiapride group (P < 0.05). It was significantly higher in the combined treatment group than in the NG group (P < 0.05). (2) The post-treatment YGTSS score was obviously lower in each group after treatment than before treatment (P < 0.05). The posttreatment YGTSS score was obviously lower in the NG group and the combined treatment group than in the Tiapride group (P < 0.05), but with no statistical difference between the fromer two groups (P > 0.05).(3) Compared with the healthy control group before treatment, serum levels of IL-12 and TNF-alpha (pg/mL) were 124.95 +/- 22.78 and 209.52 +/- 21.69

OBJECTIVE: The present study was designed to evaluate the in vitro as well as in vivo cariostatic efficacy of aqueous and ethanolic extracts of liquorice and assess their acceptability among child patients. MATERIALS AND METHODS: Minimum bactericidal concentrations of aqueous and ethanolic extracts of liquorice against mutans streptococci were evaluated and their toxicity profiles were tested using the model organism Caenorhabditis elegans. The clinical trial was conducted as a double-blind pilot study where pediatric patients (N = 60), aged 7-14 years, were equally divided by randomization into three groups, namely, Group 1 using aqueous liquorice mouthwash (15%), Group 2 using ethanolic liquorice mouthwash (3.75%), and Group 3 using chlorhexidine gluconate (0.156%) as positive control. A baseline pre-rinse and three post-rinse saliva samples were evaluated for the changes in pH and mutans streptococci colony counts. Palatability of liquorice extracts was assessed through a self-designed questionnaire having structured categorical responses. STATISTICAL ANALYSIS: Parametric evaluations were done using Analysis of Variance (ANOVA) and Dunnett's "t" test. RESULTS: The mean mutans streptococci colony counts in all three groups decreased significantly (P < 0.001) immediately after the oral rinsing. The reduction in colony counts was significant in ethanolic liquorice group as compared to the control (P < 0.01). Liquorice extracts also led to an immediate rise in salivary pH. The results showed an immediate antimicrobial action of liquorice extracts, with limited retentivity. CONCLUSION: The study affirms that both aqueous and ethanolic liquorice extracts are potent cariostatic agents and are found to be palatable by child patients.

This study was performed to investigate the effects of licorice on non-alcoholic fatty liver disease (NAFLD). In this double blind randomized clinical trial, 66 patients were divided into case and control groups. All patients had elevated liver enzymes and had increased liver echogenicity (lipid accumulation) on sonography. The case group was treated with one capsule containing 2 g aqueous licorice root extract per day for 2 months while the control group was treated in the same manner with a placebo. Weight, body mass index (BMI) and liver transaminase levels were measured for each patient before and after the study. In the case group, the mean alanine aminotransferase (ALT) level decreased from 64.09 to 51.27 IU/mL and the aspartate aminotransferase (AST) level decreased from 58.18 to 49.45 IU/mL, which were statistically significant (p < 0.001 and p < 0.001). But in the control group, a drop in the ALT and AST levels was not statistically significant. The BMI difference before and after the study was not statistically significant in both groups. Despite the significant drop in liver enzymes following administration of licorice root extract, it is recommended that further studies that include histological examination are necessary.

This study was conducted to determine the effect of a natural polyphenolic isoflavone antioxidant (Glabridin) on low-density lipoprotein (LDL) oxidation. Determination of the extent of LDL oxidation was done by measuring the formation of Thiobarbituric acid reactive substances (TBARS). After oral administration of licorice-root ethanol extract to healthy subjects for 6 months, the subjects' oxidative stress level as well as plasma LDL oxidation reduced by 20%. We concluded that dietary consumption of glabridin protects LDL from oxidation.

OBJECTIVE: To study the clinical efficacy of Shufeng Liangxue Decoction (SLD) in treating hormone dependence dermatitis (HDD). METHODS: One hundred and sixteen patients with HDD were randomly assigned to two groups. Both were treated with symptomatic Western medical therapy, including oral taken of loratadine 10 mg, and intravenous injection of 10% calglucon 10 mL and vitamin C 3.0 g adding in 20 mL 50% glucose, once per day, and to the test group, one dose of SLD consisting of imperata rhizome 30 g, rehmannia root 30 g, moutain bark 15 g, schizonepeta spike 15 g, divaricate saposhnikovia root 10 g, scutellaria root 15 g, forsythia fruit 15 g, cape-jasmine fruit 10 g, red peony root 10 g, white-stiff silkworm 10 g, broom cypress fruit 15 g, Indian bread 15 g and licorice root 10 g, was given every day by decocting with water. The course of treatment was 4 weeks. Symptoms of patients, including redden-swollen skin, capillary dilatation, inflammatory papula, itching and other discomfort sensation (pain, burning, dry, buckled) were scored before and after treatment according to their severity. The efficacy was evaluated by the change in scores of symptoms, the adverse reactions occurring in the therapeutic course and the relapse rate after treatment were observed as well. RESULTS: The cure-obvious effective rate was 76.32% in the test group and 42.50% in the control group; the total effective rate in them was 94.74% and 77.50% respectively, all showing significant difference (P < 0.05) between groups. In the test group, slight diarrhea appeared in 5 patients and slight nausea with upper abdominal discomfort in 3; while in the control group, slight somnolence appeared in 2, but all these adverse reactions did not affect the treatment. A 3-month follow-up study showed that the relapse rate in the test group was significantly lower than that in the control group (16.00% vs. 42.50% , P < 0.01). CONCLUSION: SLD is effective and safe in treating HDD, with the efficacy better and relapse rate lower than those of treatment with Western medicine alone.