芳香疗法对老年痴呆患者精神行为症状和生活质量影响的系统评价和meta分析

doi:10.3969/j.issn.1004-583X.2025.11.001

摘要/Abstract

摘要：

目的系统评价芳香疗法对老年痴呆患者精神行为症状和生活质量的影响。方法计算机检索中外文献数据库,搜集有关芳香疗法干预老年痴呆患者的随机对照试验。采用Cochrane偏倚风险评价工具对纳入研究进行方法学质量评估,并应用RevMan 5.4软件对主要结局指标进行meta分析。结果最终纳入14篇文献,涉及730例老年痴呆患者,Meta分析显示:神经精神科问卷评分[MD=-5.96, 95%CI (-10.02, -1.90), P=0.004], 科恩-曼斯菲尔德躁动量表评分[MD=-6.13, 95%CI (-11.13, -1.14), P=0.02],阿尔茨海默病生活质量量表评分[MD=1.83, 95%CI(0.36, 3.31), P=0.02],差异均有统计学意义(P<0.05)。结论现有证据表明,芳香疗法可有效改善老年痴呆患者精神行为症状和生活质量,且安全性较高。

关键词: 痴呆, 芳香疗法, 精神行为症状, 生活质量, Meta分析

Abstract:

Objective To systematically evaluate the effect of aromatherapy on behavioral and psychological symptoms of dementia and quality of life in the elderly with dementia. Methods Randomized controlled trials investigating aromatherapy interventions for the elderly with dementia were retrieved by searching Chinese and international literature databases. The Cochrane Risk of Bias tool was used to assess the methodological quality of the included studies. Primary outcome measures were explored by a meta-analysis using RevMan 5.4 software. Results A total of 14 studies involving 730 elderly patients with dementia were included. The meta-analysis showed significant differences in the following outcomes: the Neuropsychiatric Inventory score (MD=-5.96, 95%CI=-10.02, -1.90, P=0.004), the Cohen-Mansfield Agitation Inventory score (MD=-6.13, 95%CI=-11.13, -1.14, P=0.02), and the Quality of Life in Alzheimer's Disease score (MD=1.83, 95%CI=0.36, 3.31, P=0.02)(all P<0.05). Conclusion Current evidence indicates that aromatherapy can effectively improve behavioral and psychological symptoms of dementia and quality of life in elderly patients with dementia, with a high safety profile.

Key words: dementia, aromatherapy, behavioral and psychological symptoms of dementia, quality of life, meta-analysis

中图分类号:

R749.16

陈梓琼, 康雅红, 刘芳, 陈秋华. 芳香疗法对老年痴呆患者精神行为症状和生活质量影响的系统评价和meta分析[J]. 临床荟萃, 2025, 40(11): 965-972.

Chen Ziqiong, Kang Yahong, Liu Fang, Chen Qiuhua. Effect of aromatherapy on behavioral and psychological symptoms of dementia and quality of life in the elderly with dementia: A systematic review and meta-analysis[J]. Clinical Focus, 2025, 40(11): 965-972.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2025.11.001

https://www.lchc.cn/CN/Y2025/V40/I11/965

图/表 9

参考文献 37

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纳入文献		国家		诊断标准		年龄(岁)	C/E (例)	C	E		芳香疗法				干预时间		结局指标
纳入文献		国家		诊断标准		年龄(岁)	C/E (例)	C	E		精油		使用方法		干预时间		结局指标
Ting 2023^[9]		中国		① ②		C:81.18±7.21 E:75.53±7.11	16/17	日常活动	日常活动+ 芳香疗法		100%薰衣草精油6滴,100%柠檬香脂精油6滴,3%薰衣草精油1 ml		嗅吸+按摩,bid×5 d/w		4周		CMAI
段然2022^[10]		中国		① ③		C:83.11±6.27 E:85.04±4.51	26/25	安慰剂	芳香疗法		复方精油(薰衣草、甜橙、佛手柑)6滴		嗅吸,1 h×qd×7 d/w		12周		NPI、QOL-AD
王羽2022^[11]		中国		④		C:70.68±2.57 E:70.30±2.86	48/48	常规治疗	常规治疗+ 芳香疗法		复方精油(薰衣草、佛手柑、天竺葵)1.2 ml		嗅吸,第1周:0.5~1h/次×2~3次/d×7 d/w; 第2~12周:1 h/次×qd×7 d/w;按摩,15~30 min/次×2~3次/d×7 d/w		12周		CMAI、QOL-AD
Leach 2021^[12]		澳大利亚		⑤		C:82.65±9.02 E:81.71±7.44	17/21	安慰剂	芳香疗法		个体化精油		涂抹在患者的前臂/面部/颈部/肩部,2~4次/d×7 d/w		8周		CMAI、PAS、QOL-AD
Mascheron 2021^[13]		瑞士		未注明		C:85.43±6.18 E:87.06±6.95	16/16	常规治疗	常规治疗+ 芳香疗法		甜橙精油6滴、薰衣草精油6滴		嗅吸,甜橙精油:1 h/次×tid×7 d/w;薰衣草精油:1 h/次×qd×7 d/w		8天		NPI
Takahashi 2020^[14]		日本		⑥		C:75.8±7.8 E:76.2±9.8	17/19	安慰剂	芳香疗法		雪松叶精油		嗅吸,7 d/w		8周		NPI
Fung 2018^[15]		中国		未注明		C:84.33±7.85 E:84.11±7.33	20/20	认知训练	认知训练+ 芳香疗法		薰衣草精油、向日葵精油		按摩,<20 min/次×1次/2w		12周		CMAI、NPI
Turten Kaymaz 2017^[16]	土耳其		未注明		C:73.79±6.55 E:82.43±5.68		14/14	日常活动		日常活动+ 芳香疗法		柠檬草精油,薰衣草精油6滴	按摩:qd×3 d/w;嗅吸:qd×7 d/w	4周		NPI、CMAI
Yang 2016^[17]	中国		未注明		C:80.67±7.44 E:83.34±6.41		29/27	日常活动		日常活动+ 芳香疗法		薰衣草精油、橙子精油	按摩,30 min/次×1 d/w	8周		CMAI、CSDD
Yang 2015^[18]	中国		⑤		C:81.56±6.79 E:85.3±5.76		57/56	常规治疗		常规治疗+ 芳香疗法		2.5%熏衣草精油	按摩,<15 min×qd×5 d/w	4周		CMAI
Fu 2013^[19]	澳大利亚		⑤		>60		22/23	安慰剂		芳香疗法		薰衣草精油75滴	嗅吸,bid×7 d/w	6周		CMAI-SF
Burns 2011^[20]	英国		⑥		C:83.68±7.79 E:83.99±4.87		31/32	安慰剂		芳香疗法		梅丽莎精油1 ml	按摩,bid×7 d/w	4周		PAS、NPI、 QOL-AD
Fujii 2008^[21]	日本		⑤		C:80±11 E:77±10		14/14	常规治疗		常规治疗+ 芳香疗法		薰衣草精油2滴	嗅吸,tid×7 d/w	4周		NPI
Ballard 2002^[22]	英国		未注明		C:79.6±8.5 E:77.2±7.6		36/35	安慰剂		芳香疗法		梅丽莎精油	涂抹面部和手臂,bid×7 d/w	4周		NPI、CMAI、DCM

纳入文献		国家		诊断标准		年龄(岁)	C/E (例)	C	E		芳香疗法				干预时间		结局指标
纳入文献		国家		诊断标准		年龄(岁)	C/E (例)	C	E		精油		使用方法		干预时间		结局指标
Ting 2023^[9]		中国		① ②		C:81.18±7.21 E:75.53±7.11	16/17	日常活动	日常活动+ 芳香疗法		100%薰衣草精油6滴,100%柠檬香脂精油6滴,3%薰衣草精油1 ml		嗅吸+按摩,bid×5 d/w		4周		CMAI
段然2022^[10]		中国		① ③		C:83.11±6.27 E:85.04±4.51	26/25	安慰剂	芳香疗法		复方精油(薰衣草、甜橙、佛手柑)6滴		嗅吸,1 h×qd×7 d/w		12周		NPI、QOL-AD
王羽2022^[11]		中国		④		C:70.68±2.57 E:70.30±2.86	48/48	常规治疗	常规治疗+ 芳香疗法		复方精油(薰衣草、佛手柑、天竺葵)1.2 ml		嗅吸,第1周:0.5~1h/次×2~3次/d×7 d/w; 第2~12周:1 h/次×qd×7 d/w;按摩,15~30 min/次×2~3次/d×7 d/w		12周		CMAI、QOL-AD
Leach 2021^[12]		澳大利亚		⑤		C:82.65±9.02 E:81.71±7.44	17/21	安慰剂	芳香疗法		个体化精油		涂抹在患者的前臂/面部/颈部/肩部,2~4次/d×7 d/w		8周		CMAI、PAS、QOL-AD
Mascheron 2021^[13]		瑞士		未注明		C:85.43±6.18 E:87.06±6.95	16/16	常规治疗	常规治疗+ 芳香疗法		甜橙精油6滴、薰衣草精油6滴		嗅吸,甜橙精油:1 h/次×tid×7 d/w;薰衣草精油:1 h/次×qd×7 d/w		8天		NPI
Takahashi 2020^[14]		日本		⑥		C:75.8±7.8 E:76.2±9.8	17/19	安慰剂	芳香疗法		雪松叶精油		嗅吸,7 d/w		8周		NPI
Fung 2018^[15]		中国		未注明		C:84.33±7.85 E:84.11±7.33	20/20	认知训练	认知训练+ 芳香疗法		薰衣草精油、向日葵精油		按摩,<20 min/次×1次/2w		12周		CMAI、NPI
Turten Kaymaz 2017^[16]	土耳其		未注明		C:73.79±6.55 E:82.43±5.68		14/14	日常活动		日常活动+ 芳香疗法		柠檬草精油,薰衣草精油6滴	按摩:qd×3 d/w;嗅吸:qd×7 d/w	4周		NPI、CMAI
Yang 2016^[17]	中国		未注明		C:80.67±7.44 E:83.34±6.41		29/27	日常活动		日常活动+ 芳香疗法		薰衣草精油、橙子精油	按摩,30 min/次×1 d/w	8周		CMAI、CSDD
Yang 2015^[18]	中国		⑤		C:81.56±6.79 E:85.3±5.76		57/56	常规治疗		常规治疗+ 芳香疗法		2.5%熏衣草精油	按摩,<15 min×qd×5 d/w	4周		CMAI
Fu 2013^[19]	澳大利亚		⑤		>60		22/23	安慰剂		芳香疗法		薰衣草精油75滴	嗅吸,bid×7 d/w	6周		CMAI-SF
Burns 2011^[20]	英国		⑥		C:83.68±7.79 E:83.99±4.87		31/32	安慰剂		芳香疗法		梅丽莎精油1 ml	按摩,bid×7 d/w	4周		PAS、NPI、 QOL-AD
Fujii 2008^[21]	日本		⑤		C:80±11 E:77±10		14/14	常规治疗		常规治疗+ 芳香疗法		薰衣草精油2滴	嗅吸,tid×7 d/w	4周		NPI
Ballard 2002^[22]	英国		未注明		C:79.6±8.5 E:77.2±7.6		36/35	安慰剂		芳香疗法		梅丽莎精油	涂抹面部和手臂,bid×7 d/w	4周		NPI、CMAI、DCM