We read with interest the study by de la Iglesia-Garcia et al 1 The authors present a detailed, well-conducted meta-analysis of the efficacy of pancreatic enzyme replacement therapy (PERT) in patients with chronic pancreatitis (CP) who also have evidence of exocrine pancreatic insufficiency (EPI). Using level 1 evidence studies, the primary endpoint of fat absorption is shown to increase with PERT, with additional improvements shown in GI symptoms and quality of life. The authors should be commended for their work clarifying the beneficial use of PERT in this group of patients, but they and the preceding commentary by Windsor2 highlight the heterogenicity of the criteria used to diagnose CP and the greater need for a clear consensus to help target and guide dosing of PERT. Although a recent consensus to produce a mechanistic definition for …

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改进慢性胰腺炎的未来研究：我们理解的范式转变？

我们饶有兴趣地阅读了 de la Iglesia-Garcia 等人的研究 1 作者对胰酶替代疗法 (PERT) 对慢性胰腺炎 (CP) 患者的疗效进行了详细的、进行良好的荟萃分析，这些患者也有证据外分泌胰腺功能不全（EPI）。使用 1 级证据研究，显示脂肪吸收的主要终点随着 PERT 增加，胃肠道症状和生活质量显示出额外的改善。作者的工作阐明了 PERT 在这组患者中的有益用途，应该受到赞扬，但他们和 Windsor2 之前的评论强调了用于诊断 CP 的标准的异质性以及更需要明确的共识来帮助靶向和治疗指导 PERT 的剂量。尽管最近达成共识，为……制定机械定义