Rodríguez-Ramallo Héctor, Báez-Gutiérrez Nerea, Prado-Mel Elena, Alfaro-Lara Eva Rocío, Santos-Ramos Bernardo, Sánchez-Fidalgo Susana
Pharmacy Department, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain.
Department of Preventive Medicine and Public Health, Universidad de Sevilla, 41009 Seville, Spain.
Healthcare (Basel). 2021 May 13;9(5):581. doi: 10.3390/healthcare9050581.
The association between anticholinergic burden and constipation is not well defined and documented; for this reason, a systematic review was carried out in five databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and Scopus), including studies assessing the correlation between anticholinergic burden, and constipation between January 2006 and December 2020. Data extraction was conducted independently by two researchers. Abstracts and titles were reviewed to determine eligibility for review with eligible articles read in full. From 2507 identified articles, 11 were selected for this review: six cross-sectional studies, four retrospective cohort studies, and a post hoc analysis of a randomized clinical trial. Overall, nine studies reported at least one statistical association between anticholinergic burden and constipation, finding 13 positive results out of 24 association measurements. A total of 211,921 patients were studied. The association between constipation and anticholinergic burden could be demonstrated in studies including 207,795 patients. Most studies were not designed to find differences in constipation prevalence and did not adjust the results by confounding factors. Our findings suggest that a correlation between anticholinergic burden and constipation exists. Higher quality-evidence studies are needed, including analysis that considers confounding factors, such as other non-pharmacological causes of constipation.
抗胆碱能负担与便秘之间的关联尚未得到明确界定和充分记录；因此，我们在五个数据库（医学文献数据库、荷兰医学文摘数据库、考科蓝对照试验中心注册库、护理学与健康领域数据库和Scopus数据库）中进行了一项系统综述，纳入了2006年1月至2020年12月期间评估抗胆碱能负担与便秘之间相关性的研究。数据提取由两名研究人员独立进行。对摘要和标题进行审查以确定是否符合综述标准，对符合条件的文章进行全文阅读。从2507篇已识别的文章中，筛选出11篇进行本综述：6项横断面研究、4项回顾性队列研究和1项随机临床试验的事后分析。总体而言，9项研究报告了抗胆碱能负担与便秘之间至少一种统计学关联，在24次关联测量中发现了13个阳性结果。总共对211,921名患者进行了研究。在纳入207,795名患者的研究中，可以证明便秘与抗胆碱能负担之间的关联。大多数研究并非旨在发现便秘患病率的差异，也未对结果进行混杂因素调整。我们的研究结果表明，抗胆碱能负担与便秘之间存在相关性。需要开展更高质量的证据研究，包括考虑混杂因素（如便秘的其他非药物性原因）的分析。
