Clinical trial of deglydyrrhizinized liquorice in gastric ulcer.

Abstract

Inthepasttwenty years evidence hasaccumulated that liquorice andrelated compounds accelerate the rateofhealing ofgastric ulcers. Powdered succus liquiritiae (Revers, 1948) and glycyrrhiza extract (Schulze, Franke, andKeller, 1954; Ferenbach, 1954; Ohrt, 1955) wereshownto bebeneficial inpatients withgastric ulcer but adequately controlled clinical trials ofliquorice extracts werenotavailable until 1962withthe result thatlittle attention waspaidtothis formof treatment. Interest inliquorice asatherapeutic agent was revived withthesynthesis ofcarbenoxolone sodium fromglycyrrhizinic acid, aglycoside extracted from liquorice. Carbenoxolone sodium hasbeenshown inanumberofcontrolled clinical trials (Doll, Hill, Hutton, andUnderwood, 1962; Doll, 1964; Doll, Hill, andHutton, 1965;Doll, Langman, and Shawdon, 1968;HorwichandGalloway, 1965; Bank, Marks, Palmer, Groll, andVanEldick, 1967) topromote thehealing ofgastric ulcers. However, treatment witheither carbenoxolone sodiumor succus liquiritiae wasoften complicated byretention ofwaterandelectrolyte imbalance. Thefrequency andseverity ofsideeffects occurring inpatients receiving carbenoxolone sodium havebeenemphasized bymanyauthors (Doll etal,1962; Turpie and Thomson, 1965; Mohamed, Chapman, andCrooks, 1966). Themainsideeffects notedhaveincluded frank oedema, elevation ofdiastolic blood pressure, hypokalaemia, andparesis ofmuscles. Langman(1968) stated that avariant ofcarbenoxolone whichisdevoid ofside effects onfluid and electrolyte balance isclearly needed. Borst, Blomhert, Molhuysen, Gerbrandy, Turner, anddeVries (1950) found that theglycyrrhizinic acid moiety ofliquorice wasresponsible forthefluid retention andelectrolyte imbalance. This view wasconfirmed byRevers (1952). Thereisnowavailable apreparation ofliquorice whichdoesnotcontain glycyrrhizinic acid; itis foundintheproprietary preparation, Caved-(S) Eachtablet ofCaved-(S) contains: