Abstract：
Licorice (Glycyrrhiza spp.) has been a cornerstone of traditional Chinese and Japanese medicine. This systematic review and meta-analysis aimed to evaluate the efficacy of licorice formulations, alone or in combination with other herbs, on liver function enzymes in patients with primary liver disease. We systematically searched MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library up to April 2024. Randomized controlled trials (RCTs) comparing the effects of Glycyrrhiza spp. preparations versus placebo or standard of care controls were included. Standard Cochrane methods were used to extract data and appraise eligible studies. A total of 15 RCTs, involving 1367 participants, were included in the analysis. The studies varied widely in geographical location, duration, and licorice preparations used. Licorice significantly reduced alanine aminotransferase (ALT) by 15.63 U/L (95% CI: -25.08, -6.18; p = 0.001) and aspartate aminotransferase (AST) by 7.37 U/L (95% CI: -13.13, -1.61; p = 0.01) compared to control groups. Subgroup analyses revealed that purified glycyrrhizic acid compounds were particularly effective, showing greater reductions in ALT and AST without significant heterogeneity. Although licorice treatment did not significantly impact gamma-glutamyl transferase and total bilirubin (TBIL) levels overall, specific licorice-herb preparations did show a notable reduction in TBIL. The safety profile of licorice was consistent with known side effects, predominantly mild and related to its mineralocorticoid effects. Despite heterogeneity and potential language bias, the findings suggest that licorice can enhance liver function. Further studies should standardize licorice preparations and explore its role in multifaceted herbal formulations to better understand its hepatoprotective mechanisms.
摘要：
甘草（甘草属。）一直是中国和日本传统医学的基石。本系统评价和荟萃分析旨在评估甘草制剂的疗效。单独或与其他草药结合使用，对原发性肝病患者肝功能酶的影响。我们系统地搜索了MEDLINE,Embase,Scopus,WebofScience,和Cochrane图书馆截至2024年4月。比较甘草效果的随机对照试验（RCT）。包括与安慰剂或标准护理对照相比的制剂.使用标准Cochrane方法提取数据并评估合格的研究。共15项RCT,涉及1367名参与者，包括在分析中。这些研究在地理位置上差异很大，持续时间,和甘草制剂使用。与对照组相比，甘草显著降低丙氨酸氨基转移酶（ALT）15.63U/L（95％CI：-25.08，-6.18；p=0.001）和天冬氨酸氨基转移酶（AST）7.37U/L（95％CI：-13.13，-1.61；p=0.01）。亚组分析显示，纯化的甘草酸化合物特别有效，显示更多的ALT和AST的减少没有显著的异质性。虽然甘草治疗并没有显著影响γ-谷氨酰转移酶和总胆红素（TBIL）的整体水平，特定的甘草草药制剂确实显示TBIL显着降低。甘草的安全性与已知的副作用一致，主要是轻度的，与其盐皮质激素作用有关。尽管存在异质性和潜在的语言偏见，研究结果表明，甘草可以增强肝功能。进一步的研究应规范甘草制剂，并探索其在多方面的草药配方中的作用，以更好地了解其保肝机制。
