慢性膵炎の痛みに抗酸化物質が有効な可能性

　慢性膵炎の痛みの緩和に抗酸化物質が有効な可能性があると、インドのグループがGastroenterology（136:149-159）に論文"A Randomized Controlled Trial of Antioxidant Supplementation for Pain Relief in Patients With Chronic Pancreatitis"（慢性膵炎患者の疼痛緩和に対する抗酸化剤投与効果に関する無作為化対照試験）を発表した。

ABSTRACT
Background & Aims
　Oxidative stress has been implicated in the pathophysiology of chronic pancreatitis (CP). We evaluated the effects of antioxidant supplementation on pain relief, oxidative stress, and antioxidant status in patients with CP.

Methods
　In a placebo-controlled double blind trial, consecutive patients with CP were randomized to groups that were given placebo or antioxidants for 6 months. The primary outcome measure was pain relief, and secondary outcome measures were analgesic requirements, hospitalization, and markers of oxidative stress (thiobarbituric acid-reactive substances [TBARS]) and antioxidant status (ferric-reducing ability of plasma [FRAP]).

Results
　Patients (age 30.5 ± 10.5 years, 86 male, 35 alcoholic, and 92 with idiopathic CP) were assigned to the placebo (n = 56) or antioxidant groups (n = 71). After 6 months, the reduction in the number of painful days per month was significantly higher in the antioxidant group compared with the placebo group (7.4 ± 6.8 vs 3.2 ± 4, respectively; P < .001; 95% CI, 2.07, 6.23). The reduction in the number of analgesic tablets per month was also higher in the antioxidant group (10.5 ± 11.8 vs 4.4 ± 5.8 respectively; P = .001; 95% CI, 2.65, 9.65). Furthermore, 32% and 13% of patients became pain free in the antioxidant and placebo groups, respectively (P = .009). The reduction in the level of TBARS and increase in FRAP were significantly higher in the antioxidant group compared with the placebo group (TBARS: placebo 1.2 ± 2.7 vs antioxidant 3.5 ± 3.4 nmol/mL; P = .001; 95% CI 0.96, 3.55; FRAP: placebo −5.6 ± 154.9 vs antioxidant 97.8 ± 134.9 μMFe+2 liberated, P = .001, 95% CI 44.98, 161.7).

Conclusions
　Antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP.

　慢性膵炎の病態生理に酸化ストレスが関係している可能性があることから、同グループは慢性膵炎の痛みに対する抗酸化物質の有効性を検討した。対象は127例で、６か月間にわたり抗酸化物質のサプリメントを服用する71例とプラセボを服用する56例にランダムに割り付けた。

　その結果、プラセボ群と比べ抗酸化群では６か月後の１か月間の疼痛日数の減少と、鎮痛薬錠剤数の減少がともに有意に大きかった（それぞれP＜0.001、P＝0.001）。痛みが消失した割合は抗酸化群32％、プラセボ群13％であった（P＝0.009）。
　また、プラセボ群と比べ抗酸化群では酸化ストレスマーカーと抗酸化能の有意な改善が認められた。

タグ：慢性膵炎　抗酸化剤