title: Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Chronic pancreatitis is a progressive, inflammatory disease of pancreas characterized by significant abdominal pain, malabsorption, and diabetes mellitus. Antioxidant therapy has been proposed as an effective treatment for painful chronic pancreatitis. We performed a meta-analysis of trials in which antioxidant therapy was compared with placebo in chronic pancreatitis.
  
  
  METHODS
  We searched six databases to identify relevant trials. Results are expressed as risk ratio (RR) or standardized mean difference (SMD) with accompanying 95% confidence intervals (CI). The meta-analysis was performed with the fixed-effects model or random-effects model according to heterogeneity.
  
  
  RESULTS
  Eight studies including 573 patients met the inclusion criteria. A meta-analysis of these studies revealed that the intervention of antioxidants was associated with a significant increase in patients with pain relief (RR, 2.15; 95% CI, 1.72-2.69; P < 0.00001), and a significant decrease in patients' need for analgesics (RR, 0.56; 95% CI, 0.40-0.78; P = 0.0006). For pain score, antioxidants improved pain tolerance in chronic pancreatitis patients (SMD: -0.41; 95% CI: -0.83 to -0.10; P = 0.0005). Additionally, antioxidants may cause some adverse reactions (RR, 4.22; 95% CI: 2.17-8.20; P < 0.0001).
  
  
  CONCLUSIONS
  Based on current evidence, oxidative stress may play an important role in the pathophysiology of chronic pancreatitis, and administration of antioxidants to patients with painful chronic pancreatitis is effective in relieving pain. Antioxidant supplements may be advocated as one medical therapy for chronic pancreatitis patients with low antioxidant capacity in their blood.
authors.affiliation: Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.
authors.forename: Dongkai
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Anorectal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Wei
authors.affiliation: Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China. Electronic address: shusenzheng@zju.edu.cn.
authors.forename: Shusen
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000975:Antioxidants / Q000008:administration & dosage*; D016208:Databases, Factual; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects; D050500:Pancreatitis, Chronic / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000975:Antioxidants
keywords: Antioxidant; Chronic pancreatitis; Meta-analysis; Pain