St. Louis University, MO, USA.
Aliment Pharmacol Ther. 2011 Jan;33(1):149-59. doi: 10.1111/j.1365-2036.2010.04491.x. Epub 2010 Oct 29.
Effectiveness of medical therapies in chronic pancreatitis has been described in small studies of selected patients.
To describe frequency and perceived effectiveness of non-analgesic medical therapies in chronic pancreatitis patients evaluated at US referral centres.
Using data on 516 chronic pancreatitis patients enrolled prospectively in the NAPS2 Study, we evaluated how often medical therapies [pancreatic enzyme replacement therapy (PERT), vitamins/antioxidants (AO), octreotide, coeliac plexus block (CPB)] were utilized and considered useful by physicians.
Oral PERT was commonly used (70%), more frequently in the presence of exocrine insufficiency (EI) (88% vs. 61%, P < 0.001) and pain (74% vs. 59%, P < 0.002). On multivariable analyses, predictors of PERT usage were EI (OR 5.14, 95% CI 2.87-9.18), constant (OR 3.42, 95% CI 1.93-6.04) or intermittent pain (OR 1.98, 95% CI 1.14-3.45). Efficacy of PERT was predicted only by EI (OR 2.16, 95% CI 1.36-3.42). AO were tried less often (14%) and were more effective in idiopathic and obstructive vs. alcoholic chronic pancreatitis (25% vs. 4%, P = 0.03). Other therapies were infrequently used (CPB - 5%, octreotide - 7%) with efficacy generally <50%.
Pancreatic enzyme replacement therapy is commonly utilized, but is considered useful in only subsets of chronic pancreatitis patients. Other medical therapies are used infrequently and have limited efficacy.
在针对特定患者的小型研究中已经描述了医学疗法在慢性胰腺炎中的疗效。
描述在美国转诊中心评估的慢性胰腺炎患者中，非镇痛性医学治疗的频率和感知疗效。
使用前瞻性纳入 NAPS2 研究的 516 例慢性胰腺炎患者的数据，我们评估了医生经常使用（胰腺酶替代疗法 (PERT)、维生素/抗氧化剂 (AO)、奥曲肽、腹腔神经丛阻滞 (CPB)）和认为有用的医学治疗的频率。
口服 PERT 通常被广泛使用（70%），在存在外分泌不足 (EI)（88%比 61%，P < 0.001）和疼痛（74%比 59%，P < 0.002）时更常见。多变量分析表明，使用 PERT 的预测因素包括 EI（OR 5.14，95%CI 2.87-9.18）、持续（OR 3.42，95%CI 1.93-6.04）或间歇性疼痛（OR 1.98，95%CI 1.14-3.45）。PERT 的疗效仅由 EI 预测（OR 2.16，95%CI 1.36-3.42）。AO 的使用频率较低（14%），在特发性和阻塞性与酒精性慢性胰腺炎中更有效（25%比 4%，P = 0.03）。其他治疗方法很少使用（CPB-5%，奥曲肽-7%），疗效通常<50%。
胰腺酶替代疗法通常被广泛使用，但仅在慢性胰腺炎患者的某些亚组中被认为有用。其他医学治疗方法使用频率较低，疗效有限。
