Mössner J
Medical Policlinic, University of Würzburg, FRG.
Digestion. 1993;54 Suppl 2:35-9. doi: 10.1159/000201101.
According to the theory of negative feedback regulation of pancreatic enzyme secretion by proteases, treatment with pancreatic extracts has been proposed to lower pain in chronic pancreatitis by decreasing pancreatic duct pressure. However, we have demonstrated in healthy volunteers that intraduodenal application of porcine pancreatic extracts does not inhibit but rather stimulates pancreatic enzyme secretion. This is probably due to the high protein content of porcine pancreatic extracts which may overwhelm a potential inhibitory effect of proteases. In a prospective placebo-controlled, double-blind, multicenter study to investigate the effect of acid-protected porcine pancreatic extracts on pain in 43 patients with chronic pancreatitis, pain improved in most patients irrespective of whether they started with placebo or verum. There was no significant difference between the two treatment arms. The pancreatic extract that we have used in our study neither inhibits pancreatic enzyme secretion nor is it very efficient in lowering pain in chronic pancreatitis.
根据蛋白酶对胰腺酶分泌的负反馈调节理论，有人提出用胰腺提取物治疗来降低慢性胰腺炎患者的疼痛，其原理是降低胰管压力。然而，我们在健康志愿者中已证明，十二指肠内应用猪胰腺提取物不会抑制反而会刺激胰腺酶分泌。这可能是由于猪胰腺提取物的高蛋白含量，它可能会掩盖蛋白酶潜在的抑制作用。在一项前瞻性、安慰剂对照、双盲、多中心研究中，为了探究酸保护猪胰腺提取物对43例慢性胰腺炎患者疼痛的影响，大多数患者的疼痛都有改善，无论他们开始时使用的是安慰剂还是真实药物。两个治疗组之间没有显著差异。我们在研究中使用的胰腺提取物既不抑制胰腺酶分泌，在降低慢性胰腺炎疼痛方面也不是非常有效。
