PDF(Pubmed)
Abstract：
Abdominal pain is the most common symptom of chronic pancreatitis (CP) and is often debilitating for patients and very difficult to treat. To date, there exists no cure for the disease. Treatment strategies focus on symptom management and on mitigation of disease progression by reducing toxin exposure and avoiding recurrent inflammatory events. Traditional treatment protocols start with medical management followed by consideration of procedural or surgical intervention on selected patients with severe and persistent pain. The incorporation of adjuvant therapies to treat comorbidities including psychiatric disorders, exocrine pancreatic insufficiency, mineral bone disease, frailty, and malnutrition, are in its early stages. Recent clinical studies and animal models have been designed to improve investigation into the pathophysiology of CP pain, as well as to improve pain management. Despite the array of tools available, many therapeutic options for the management of CP pain provide incomplete relief. There still remains much to discover about the neural regulation of pancreas-related pain. In this review, we will discuss research from the last 5 years that has provided new insights into novel methods of pain phenotyping and the pathophysiology of CP pain. These discoveries have led to improvements in patient selection for optimization of outcomes for both medical and procedural management, and identification of potential future therapies.
摘要：
腹痛是慢性胰腺炎（CP）最常见的症状，通常会使患者衰弱，并且很难治疗。迄今为止,这种疾病没有治愈方法。治疗策略侧重于症状管理和通过减少毒素暴露和避免复发性炎症事件来缓解疾病进展。传统的治疗方案从医疗管理开始，然后考虑对患有严重和持续性疼痛的选定患者进行手术或手术干预。纳入辅助疗法治疗合并症，包括精神疾病，胰腺外分泌功能不全，矿质骨病,脆弱,营养不良，处于早期阶段。最近的临床研究和动物模型已被设计用于改善对CP疼痛的病理生理学的研究。以及改善疼痛管理。尽管有一系列可用的工具，许多治疗CP疼痛的选择提供了不完全的缓解.关于胰腺相关疼痛的神经调节仍有许多发现。在这次审查中,我们将讨论过去5年的研究,这些研究为新的疼痛表型鉴定方法和CP疼痛的病理生理学提供了新的见解.这些发现改善了患者选择，以优化医疗和程序管理的结果，并确定潜在的未来疗法。
