甘草酸在體內(nèi)水解成甘草次酸，甘草次酸的化學(xué)結(jié)構(gòu)類似于甾體激素，因此甘草酸是甘草次酸的前體藥物。甘草酸和甘草次酸是甾體激素代謝失活酶（尤其是Ⅱ型11β-羥化甾體脫氫酶）抑制劑，可提高內(nèi)源性和外源性皮質(zhì)激素的活性。甘草酸和甘草次酸又可作為配體，與皮質(zhì)激素受體結(jié)合呈現(xiàn)出糖皮質(zhì)激素、鹽皮質(zhì)激素樣作用。因此長期使用甘草或甘草酸類藥物產(chǎn)生的鹽皮質(zhì)激素樣作用可用于艾迪生病的治療，但用于其他疾病治療時，鹽皮質(zhì)激素樣作用就有可能成為不良反應(yīng)（主要表現(xiàn)為假性醛固酮增多癥或高血壓），約占甘草和甘草酸類藥物不良反應(yīng)的50%以上；并對其引起假性醛固酮增多癥或高血壓的機(jī)制進(jìn)行了討論。

Glycyrrhizic acid is hydrolyzed to glycyrrhetic acid in vivo, so glycyrrhizic acid is a prodrug of glycyrrhetic acid. Chemical structure of glycyrrhetic acid is similar to steroid hormone. Glycyrrhetic acid and glycyrrhizic acid are the inhibitors of enzymes (especially 11β-hydroxy-steroid dehydrogenase type 2) in steroid hormone metabolism, therefore they can enhance effects of inactivation endogenic and exogenic corticosteroids. Glycyrrhetic acid and glycyrrhizic acid, as ligands, can combine with corticoid receptor, and show glucocorticoid-like and mineralocorticoid-like effects. Mineralocorticoid-like effect induced by long-term application of licorice or glycyrrhizic acid derivatives can be used for treatment of Addison’s disease. But, for the treatment of other diseases , this effect may become the side effect (major manifestations: pseudoaldosteronism or hypertension), the incidence was more than 50% of their all adverse reactions, and their mechanisms of pseudoaldosteronism or hypertension were discussed in this paper.