our research and practice of aromatherapy in japan...2018/10/08 · •the odor of bedsore, body...
TRANSCRIPT
Eri WatanabeKyoto Prefectural University of Medicine
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Our Research and Practice of Aromatherapy in Japan
• The essential oil is obtained through plant's scent and flavor.
• Essential oil can be absorbed by human body, and it can have impact to our body, heart, and soul. It can relieve various symptoms.
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Aromatherapy
• Essential oil is often used in aromatherapy, which is a form of alternative medicine.
• Essential oil is obtained from various plants which have strong scent
3Rose Lavender Peppermint Orange Cypress
Aromatherapy
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Aromatherapy
Medical Aromatherapy • Aromatherapy is used in clinical circumstances in France• Essential oil is a type of prescription • Essential oil is on sale in the pharmacy • Medical school offers the courses of “Aromatherapy”
• Both essential oil and medicine are used in clinical circumstances in France
• Contagious diseases and wounds (replace antibiotics)• Relieve pain and itching• Hypnotics · Antidepressant • Hormone
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How is essential oil absorbed through our bodies?
③Oil
②Water6
①Air
①Air
• Drop it on the tissue to inhale • Drop it on the sanitary mask to inhale• Spray in the air • Use essential oil diffuser to diffuse in the
air
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• Essential oil can fight against influenza virus, and various bacteria
• To prevent nursing home’s influenza • Be careful with the concentration and selection of the
essential oil in order to feel comfortable
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②Water• Pour the essential oil into the bathing tub, half tub,
or foot tub• Pour the essential oil into hot water or water, use
the towel to apply hot packing
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Foot tube
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• Medical effect• Hot water improves
the circulation of blood
• Relax• Improve the quality of
sleep• Relieve pain, swelling,
and itching of leg joint
• For long-term bedridden • Add drops of essential oil into the tub, soak the
towel, for body wiping or compressing• Sterilizing and anti-inflammatory for skin• Nerve sedation • Relax the body• Relieve pain• “Hot compressing” joint pain・nerve pain ・
sprain• “Ice compressing” bruise・swelling・
inflammation 11
Body wiping and Compressing
③Oil• Apply oil (base oil) on the skin after
diluting with the water• Aromatherapy treatment
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• Apply the diluted oil on the skin directly,
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• Most ingredients of the essential oil are absorbed by the skin
• Since essential oil can be dissolved in fat, it can be absorbed by the cutaneous plexus in the subcutaneous fat
• Sometimes we use massage and other techniques, they have stronger effect
The Average Life Expectancy of Japanese
14Life period increased from 50 years to over 80 years.
1947 2015
The Average Life Expectancy of Japanese
•Currently, Japan is in the stage of increased aging population
15
5.0%
24.1%
39.9%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
1950年 2012年 2060年
Over ages 65%
The demand of long-term caring is increasing in Japan • People who need nursing care under nursing-
care system in 2010• Age 65 – 74 3%• Over age 75 21%The main reason for nursing care• Ulcer disease 21.5%• Dementia 15.3%• Elderly weakness 13.7%• Joint disease 10.9% 16
• Does Aromatherapy really work?• Specific Symptoms • Dementia• Bedsores• Immune Deficiency • Sleeping Disorder/depression• Lumbago/arthralgia• Decline in sensory function • Aromatherapy is good at alleviating the
symptoms comprehensively17
Not only a single symptom, but several symptoms
→Overdose of medicine
Aromatherapy for bedridden people
• Under the condition of bedridden• Blood circulation deterioration →• Bedsores • Immune deficiency • Joint stiff/swelling/pain
• hard to excrete / bath→• It is difficult to keep body clean →
infection18
Cleansing for bedridden person• Using essential oil that has the function of
degermation when cleaning the body.• It can keep body clean.Example• Tea tree oil 2 drops ( degermation/ deodorization)• Cypress oil 2 drops ( degermation / deodorization)• Lemongrass oil 1 drop ( degermation /
deodorization)+relaxing effect
• Pour hot water and essential oil into washbowl (50-300ml) and use wet towel...etc. to dry off body. 19
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Within the facilitie that is a place of group living:• Immune deficiency due to aging• Various fungi and virus is easy to spread→Infection may become life-threatening
Indoor air deodorization and disinfection • Grapefruit 2 drops ( degermation/ deodorization)• Rosemary 2 drops ( degermation/ deodorization)
• Spray in the space • Use a diffuser
• In addition to the prevention of infectious diseases• The odor of bedsore, body odor and bowel
smell…etc. can be suppressed during nursing care.• Degermation of facilities, bedding…etc.• Effectiveness to refresh your mood.
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If you are bedridden for a long time,The blood circulation of the body‘s bottom part will deteriorate, and it will cause necrosis of surrounding tissues.
Bedsore (pressure ulcer)(Wound and necrosis of bedridden people )
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At present, there is no way to prevent pressure ulcers besides the changing of physical location and disinfection in the affected areas.
Hind Brain
Elbow Sacrum 踝骨部Ankle
Ear ShellShoulder
FemurJoint
內踝部LateralMalleolus
Oracle Bone
Rib CageGut
Supine
Side
Prevent / improve bedsore (pressure ulcers )• Dilute essential oil with base oil and apply it to the
skin• Myrrh (preservative) 2 drops• Pure lavender ( to sterilize and to calm the
inflammation) 1 drop• Tea tree (sterilization) 1 drop• Almond oil 20ml
• To rub into the ulcers of the surrounding skin and the areas that is likely to cause.
• Ointment, poultice, spray 24
Dementia • People with dementia usually have crazy circadian rhythms and
most of them have insomnia.• Use wake-up effects oil in the morning• Sweet orange ( to improve blood flow and wake you up) 2 drops• Rosemary (Wake up by tangy smell) 1 Drop• Palmarosa (To get your brain in gear) 1 Drop
• Use asleep effects oil in the evening • Pure lavender ( to make you fall asleep and calm down ) 2 drops
• Sandalwood ( To get relaxation) 1 drop
• Lemon (Nerve sedation ) 1 drop
25Full body and limbs massage (sweet almond oil 20ml), bath
Melancholia• Elderly people get stressful easily, and the incidence of
depression is high.
• For depression, use essential oils to improve blood flow and rejuvenate your body and mind.
• Rosemary ( to increase blood flow and activate sympathetic nerves) 2 drops
• Sweet orange ( to improve blood flow, refresh feeling) 2 drops• Lemongrass ( refresh feeling) 1 drop
• Mix these essential oils with 20ml almond oil and apply it to the whole body. Full bath, foot bath, and aromatic bath are also available.
• Essential oil with sedative effect (lavender, etc.)
→Do not use for depression 26
Aromatherapy Research
The psychological stress relieving effect of bergamot essential oil
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【Purpose】• Bergamot oil• (Citrus aurantium var.bergamia)
• It is used to eliminate psychological stress and anxiety, but scientific evidence is lacking.
• Main Ingredient:Limonene (to improve blood flow), Linalool, linalyl acetate (sedation effect)
• The purpose of this research is to confirm theendocrine effects and the effects of physiology and psychology when the subjects inhaled the mist with bergamot essential oil.
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【Subject】• Subject consisted of 42 healthy adult
women (Average age is 21.3 ± 1.02, 20-23 years old)
• I fully explained the research content and agreed to take the test in written form.
• I conducted it with the approval of the Medical Ethics Review Committee of Kyoto Prefectural University.
• Tested using a random crossover design.29
【Method】• Set the following three conditions, each of them
was about 15 minutes.• R condition: Do nothing• RM condition: Spray distilled water 80ml• RMB condition: spray distilled water 80ml plus
bergamot essential oil 0.4ml
UltrasonicDiffuser
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Rest
15 min
Rest
(R)
Questio
nnaire10 m
in
Rest
10 min
RestSteam
(RM)Q
uestionnaire
10 min
Rest
10 min
RestSteam
Oil(RMB)
Questio
nnaire 10 min
Rest
10 min
Collect saliva
Procedure of the test
Heart rate changesRandom sequence
Collect saliva
Collect saliva
15 min 15 min 15 min(R) (R) (R) (R)(Q) (Q) (Q)
【Measurement item】• Heart rate variability:• Parasympathetic nervous system index High Frequency
(HF)Frequency Domain Analysis of the Salivary Stress-Related Hormone Cortisol Enzyme-Linked Immunosorbent Assay Questionnaire by Fast Fourier Transform
• Saliva:• Mental stress related hormone cortisol• Enzyme-linked immunosorbent assay (ELISA)• Questionnaire• POMS (emotion), Degree of fatigue • Compare measurement items of 3 conditions (R, RM, RMB)
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0
0.05
0.1
0.15
0.2
R RM RMB
saliv
ary
cort
isol
(μg
/dl) ****
Stress Hormone
n=42, mean±S.E. Bonferroni, p<0.001***, p<0.010**, p<0.050*※ R:Rest M:Mist B: Bergamot odor
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-200
-150
-100
-50
0
50
100
150
A) rest B) rest+D C) rest+D+aroma0
100
200
300
400
500
600
700
A) rest B) rest+DC) rest+D+aroma
HF (m
s2 )
R RM RMB R RM RMB
The changes of HF before and after the present of condition.
*** *
*
n=42, mean±S.E. Bonferroni, p<0.001***, p<0.010**, p<0.050*
Parasympathetic nervous system
※ R:Rest M:Mist B: Bergamot odor34
The average of HF after 10 minutes rest which is after the present of condition.
0
5
10
15
T-A D A-H V F C
POM
S (m
oo
d s
core
)
*
n=42, mean±S.E. Bonferroni, p<0.001***, p<0.010**, p<0.050*
R RM RMB
*
*
Tension/anxiety Depression Anger Vitality Fatigue Disorder
Emotion※ R:Rest M:Mist B: Bergamot odor
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0
5
10
15
body mind body+mind
Fatig
ue (s
core
)
*
R RM RMB
n=42, mean±S.E. Bonferroni, p<0.001***, p<0.010**, p<0.050*
Fatigue
Physical fatigue Mental fatigue36
【Consideration】• When inhaling steam containing bergamot
essential oil,
• Decreased cortisol• Parasympathetic innervation• Improve mood
• It shows that the psychological stress could be alleviated.
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Conclusion•Aromatherapy, a complementary alternative medicine, might be useful in a variety of situationssuch as dementia, nursing care andpalliative care.
• In the future, the research would be progressive and it is alsoexpected to be used in the medical sites and the nursing care sites.
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Examples of using Aromatherapy in thegeriatric health services facility.
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Case 1- using aromatherapy in the geriatric health services facilityFoot bath10 minutes each time, weeklyHot water is 10cm under the kneeThe temperature of the hot water is based on 40 ℃, ± 3 ℃if needed.• Lavender ( linalool, decyl acetate: sedative) 2 drops• Tea tree ( Pantene: antibacterial, sedation)• Sandalwood ( linyl alcohol: sedation )• Grapefruit ( limonene, blood flow promotion)• Add essential oils into the basin between 14:00 and 16:00 daily.• → To Improve blood circulation of the lower extremities to reduce
edema and dry skin.The elderly people actually feel relaxed. 40
1 drop,if needed
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Improve symptoms through foot bath
Improves cold, bruise, red spots, dry skin
• Dilute essential oil with base oil and apply it into the skin
• Leg treatment for 30 minutes (once a month)• Essential oil is ① or ②• ①sweet orange + pure lavender (during sleep )②lemongrass + tea tree ( after wake up )
• Add sweet almond oil 10ml ① or ②• Add 0.05ml (1 drop) of the two essential oils and
mix together, the concentration is set to Use for legs
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Case 2
• Meanwhile, drop citrus series essential oil such as lemon or sweet orange ( to promote circulation)
• 0.05ml (1 drop) on the cotton pad,• Place on the resident's shoulder and chest
for an aromatic bath.Feedbacks from the residents in 3 months • “The leg movements have improved” • “It’s easier to stand up from my
wheelchair?”• “I was fast asleep slept on the day of
aromatherapy” 43
Fragrance bath (1)• Elderly patient of dementia with Alzheimer's disease• Morning: Rosemary ( refreshment effect)
Lemon ( to promote circulation, strong)Evening: Lavender (sedative effect, sleepy effect)
Sweet orange ( to promote circulation)• They smelled the aroma of essential oils
with a diffuser→ Observed the improvements of cognitive function and life rhythm.
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Case 3
Fragrance bath (2)• The uses from the dementia special care unit• It’s hard to stay focused and often leave seats or fall asleep.• When taking deep breaths or doing rehabilitation exercises
like gymnastics.,• To use diffuser to spread the aroma of essential oil in the
rehabilitation room• Put the essential oil on the gauze pad.• →To use diffuser to spread the aroma of essential oil in the
rehabilitation room.• Rosemary, lemon, mint ( wake up, concentrate)• →combine• To continue for 6 weeks.• The moment that the patients leave seats or fall asleep easily
could be reduced. 45
Fragrance bath (3)• Sweet orange ( to promote circulation) 1 drop• Start to use the diffuser ( unheated ) to spread
it into the air just 10 minutes before sleeping.Impacts on the residents• Can feel things that are interesting or feel
joyful• can be relaxed• feel relief• improve sleeping• Anxiety is relieved before sleeping
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Precautions when using essential oils for the elderly and those in need of nursing care
• Choose 100% organic, physiotherapy grade essential oils• High concentration of essential oils may cause burns and
should be used with care.• Essential oils have strong physiological effects and should be
used with care.• Using from low concentration, and to test and observe the
physical conditions and appearances of the users.• Stop using aromatherapy immediately in case of skin redness,
itching, dyspnea, coughing, nausea, and other symptoms.• Please note that there are different taboo essential oils
according to different kings of diseases.• Users should notice that sometimes the kidney function of the
elderly becomes weak and may not be able to break down in the body and exhaust extra essential oil components. 47
Reference
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Various essential oil can be obtained from one kind of plantFor instance, there are 3 kinds of essential oils are obtained from bitter orange
Bitter orange oil
Neroli
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d-limonene (93%)Petit Grain
Fruit Leaf
Flower
Linalyl acetate (48%)Linalool (28%)Terpineol (6%)
Linalool (37%)β-pinene (11%)Limonene (11%)Linalyl acetate (7%)trans-β-ocimen(7%)
What is essential oil? • The ingredient of the scent of a plant is
concentrated to the factor of ten times to thousand times
• The scent of the essential oil is stronger than the scent of the plant
• Ex,It requires 40kg of flower to obtain 10ml of rose essential oil.
• Essential oil has strong effects on body50
True Lavender• Lamiaceae, Low evergreen• Strong antimicrobial effects。• It used to prevent “plague” in Europe during
the middle Age • Ingredients:• Linalool, Linalyl acetate• Strong sedative effect• To calm emotion• Fix insomnia 51
★Commonly used essential oil
Grapefruit• A fruit from subtropical citrus tree• Essential oil can be obtained from its peel• Its ingredient has over 90% of d-limonene• d-limonene is from the peel of citrus genus
(orange, lemon)• Improve blood circulation• Inhabit cells of cancer to increase• To calm and have nerve sedation• Improve the function of liver and kidney 52
Peppermint• Lamiaceae Perennial plant• Country of origin: Europe. Scent of cooling
and chilly • Main ingredient: Menthol, Menthone• Relieve pain• Relieve itching • Cooling• Improve the function of body and heart• Brain refreshing • Antimicrobial 53
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Dropper(to adjust the amount)1 drop appox. 0.05ml
On sale in this type of container
Shading bottle
Steam Distillation
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• Through the steam below to separate the ingredient and essential oil
• Cool the steam, use the water to transform it back to the liquid• Collect the essential oil on the upper layer
※The most common method
Steam andEssential oil
IngredientPlant
Cooler
Essential oil
Steam
Water
FireFloral Water)
56Steam Distillation
Expression• Expression is a method to obtain
essential oil from the citrus peel• Orange, grapefruit, lemon,
tangerine, bergamot, yuzu,et• Use machinery or hands to squeeze • Avoid heating the oil, and it can
obtain the pure natural ingredient• However, the catabolic enzyme has
the residues. Therefore, the obtained essential oil is easy to oxidize. 57
• 5ml/10ml • Label on the bottle
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Name
Scientific Name
Content
Origin, Location, Expiration
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Ingredient Percentage
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(1)Nose
(3)Skin(2)Liver
Essential oil is sent to the brain, and it affects the whole body
panorama
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(1)Nose→Olfactory Nerve →Brain
The message of the scent is sent to thebrain directly
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Olfactory Receptor
Olfactory Nerve
Scent Message
Message, Taste area
The message of the scent is sent to the area which controls emotion and memory
Emotion(Amygdala)Memory(Seahorse)
Scent※The pathway for mesaage of visual and
auditory and others are indirect
Detect scent
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The Limbic System
Hippocampus
海馬旁迴
乳頭體
胼胝體
Fornix
Cingulate gyrus
Amygdala
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(2)Inhale from nose andmouth→liver→blood circulation
Essential Oil
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(3)Skin→Blood circulation (apply on skin)
Ingredient & Brain
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Automatic Nervous System, Endocrine System(adjust hormone), Immune systemLimbic System
Hypothalamus
Brain cutaway sideScent message
Pituitary gland
Brain stem
Spinal cord
Cerebellum
Thalamus
memory·instinct
emotion
Cerebral Neocortex
•Aromatic bath•Drop the oil on the tissue, and put it on the bed or in the bedroom
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• Drop the oil on the sanitary mask, peppermint
• By the function of menthol, it can help with nausea and motion sicknessEucalyptus/Rosemary
• Ingredient1、8-Cineole forlaryngeal mucus r
• Sterilization/anti-inflammatory• Treat cough• Prevent cold and pollen allergy 68
• Dissolve essential oil in the ethanol, dilute with the water, fill into the spray to use
• Spray on beddings• Indoor use, for relax, insect repellent, dust
repellent(cupressus/cedarwood)• Sterilization and deodorization
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• A machinery which can make essential oil molecule diffuse into the air
• Ultrasonic Diffuser• Making water fog to diffuse • No need to heat (safe and the oil
won’t have chemical change)• It‘s easy to have chemical change
after combining with the water • Exchange water daily 70
• Ingredient can be absorbed through breathing
•Essential oil is absorbed throughskin while bathing
•Foot bath/half bath are suggested
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• Use base oil apply the diluted oil on the skin
• The function of the diluted oil works after applying it on the skin
• No smell (almost)• Ex, Jojoba, sweet almond, olive, grape seeds, et• Essential oil skin osmosis • Use professional base essential oil
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• Apply the oil on the skin to promote absorption • Essential oil is from the diluted 1% to 5% (3% less
for facial use)of the base oil • The concentration should be less than 1% of the
diluted oil for children and elder• Use more than 1% of the diluted oil for body use• The function of the essential oil uses on the body is
more efficient than uses in the bathing tub• Be cautious with the body while doing
aromatherapy
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