芳香療法精油嗅吸改善失智症精神行為症狀之成效－系統性文獻回顧與臨床應用

目的：精神行為症狀是大多數失智症病人所面臨的問題，臨床上已開始運用芳香療法精油嗅吸改善失智症精神行為，但未有一致性臨床操作，且缺乏系統性文獻回顧探討其成效，本文旨在探討芳香療法精油嗅吸對改善失智症精神行為症狀之成效。方法：採系統性文獻回顧法，於Embase、Medline OVID及Cochrane電子資料庫中搜尋2021年4月前發表之相關研究文獻，經篩選、評讀並整合文獻發展出臨床實務應用流程。結果：符合納入條件之文獻共4篇隨機控制試驗，Joanna Briggs Institute（JBI）證據等級1.c，均以神經精神評估量表（neuropsychiatric inventory, NPI）記錄各症狀的出現頻率及嚴重度，三項研究所使用的介入措施對整體精神行為症狀具顯著改善成效，另一項研究改善程度雖未達統計上顯著性，但針對病人易怒感或肢體非攻擊性行為使用薰衣草精油（Lavandula angustifolia）仍有改善成效；結果顯示利用薰衣草精油或甜橙精油（Citrus sinensis）（或同時使用）進行一般嗅吸至少連續14日或霧化薰香機輔助連續至少7日的療程，每次約1－2小時，可改善病人整體精神行為症狀。結論：芳香療法精油嗅吸對改善失智症精神行為症狀為具實證基礎、非侵入性、安全及有效的非藥物療法，可作為失智症病人出現精神行為症狀時的優先選擇，有助於症狀控制，減少病人因多重使用精神行為藥物交互影響加重副作用並提升生活品質。

關鍵字

失智症；精神行為症狀；芳香療法；系統性文獻回顧

並列摘要

Purpose: This study aimed to evaluate the effects and clinical application of olfactory aromatherapy to improve the BPSD of dementia. Methods: A systematic review was used. Relevant articles published prior to April 2021 were retrieved from the Embase, Medline (OVID) and Cochrane electronic databases. After screening the eligible studies and performing critical appraisals, we integrated the systematic review into a protocol for clinical application. Results: A total of 4 eligible randomized controlled trials were extracted. The JBI evidence level was 1.c. The neuropsychiatric inventory (NPI) was used to record the frequency and severity of BPSD in all studies. The interventions used in the three studies had significant improvement on overall BPSD. One study did not achieve statistically significant improvement, but there was improvement when using a lavender essential oil (Lavandula angustifolia) for irritability or nonaggressive physical behavior. The results revealed that the use of lavender essential oil or sweet orange essential oil (Citrus sinensis) (or both) smelling for at least 14 consecutive days or an atomized aromatherapy machine assisted for at least 7 consecutive days of intervention, each approximately 1-2 hours, can improve BPSD in dementia patients. Conclusions: Olfactory aromatherapy is an evidence-based, noninvasive, safe and effective nonpharmacological therapy to improve BPSD. This intervention can be used as the first choice for dementia patients with BPSD, which is helpful for symptom control. It may reduce the aggravation of side effects due to interactions with BPSD medication use and improve patients' quality of life.

並列關鍵字

dementia ； psychological and behavioral of dementia (BPSD) ； aromatherapy ； systematic review

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