Research,Progress,of,Aromatherapy,in,the,Treatment,of,Obesity

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Xiaochao GANG, Yang CHEN, Mingjun LIU, Jie LIU, Xiaobo JIANG, Hanrong QU, Qijue LIANG, Jiashu ZHOU, Yuening DONG

College of Acupuncture-Moxibustion and Tuina, Changchun University of Chinese Medicine, Changchun 130117, China

Abstract Obesity is a common clinical disease, in order to take a healthy and simple way to treat it, the volatile properties of traditional Chinese medicine play a role in lifting weights. Aromatherapy uses the four qi and five flavors of traditional Chinese medicine as a typical representative. In order to explore the mechanism of action of aromatherapy in depth, through the etiology and pathogenesis of obesity, the historical origin of modern times, related organs, pathogenesis, and the research progress of aromatherapy in the treatment of obesity, the classification of aromatherapy, and the related research of aromatic drugs, it is found that aromatherapy has a large number of significant clinical effects in modern times. It can be used to treat obesity independently under the guidance of the basic theory of Chinese medicine, and can also be combined with other Chinese medicines to form prescription drug treatment, and in combination with other ways to treat obesity. However, at present, this method of treating obesity has not received widespread attention, and it still needs to be studied and promoted by scholars.

Key words Aromatherapy, Obesity, Research progress

Modern people’s living standards have improved significantly, and then the quality of life and diet structure have also changed greatly. The number of obese patients has increased year by year, and the diagnosis and treatment of obesity have also received more and more attention. According to the 2016 report issued by theLancetMedicalWeekly, 90 million people are obese in China. Therefore, based on the rising population obesity rate, the prevention and treatment of obesity is particularly important, and it has become a consensus to find convenient, economical and effective weight loss methods. In this paper, the research progress of obesity is summarized, refined and summarized, and the treatment of obesity is discussed from the perspective of aromatherapy, so as to provide new ideas for the prevention and treatment of obesity.

2.1 Ancient studies

2.1.1Historical origin. Obesity is recorded inSuwen(Plain Questions), and personal physical factors are associated with obesity: People in the area do not wear silk cotton, but use fur and straw mats; since they like to eat fattening food with fat body, external evil is not easy to harm their body, and most of their diseases are internal injury diseases.Lingshu(Miraculous Pivot) recorded the relationship between constitution classification and obesity, and proposed that according to the five elements of wood, fire, earth, metal and water, as well as five colors and five notes of the pentatonic scale, they could be divided into "twenty-five people" according to constitution. Among them, earth-shaped man is described as "round face", "big head", fleshiness and "big abdomen, which are consistent with the clinical manifestations of modern obesity. InLingshu·Nishunfeishou, people are divided into five types, namely fat people, thin people, ordinary people, strong people and babies. InLingshu·Weiqishichang, obese people are divided into "fertile people", "flesh people" and "fat people". Liu Yanjiaoetal.[1]studied the theories of physicians of all dynasties on the phlegm and dampness constitution of obese people, and found that related descriptions of pulse condition and pathological characteristics of such obese people could be found in ancient Chinese medical books, indicating that ancient Chinese physicians had fully realized that obesity was related to individual constitution. It also laid a solid theoretical foundation for the theory of obesity-related traditional Chinese medicine physique.

2.1.2Related viscera. The spleen governs movement and the stomach governs intake. Intemperate diet and indulgence in a richly fatty and sweet diet will injure the spleen and stomach, thus impairing the transport and absorption function of the spleen and stomach. It is recorded inSuwenShiyi(Annotated Plain Questions)[2]that richly fatty diet leads to stagnation of qi, resulting in internal thermal; eating sweet food makes qi flow slowly and easy to stay, resulting in abdominal distension. Therefore, richly fatty and sweet diet will lead to qi stagnation and failure in distribution to the extremities, resulting in internal thermal; sweet can relieve spasm, but indulgence in sweet diet will lead to slow flow of qi in middle energizer of the spleen and stomach, unsmooth flow of spleen qi, disordered transport function, and abdominal distension and qi stagnation, which will all become important causes of obesity.

The liver is an organ like the jiangjun, which mainly governs free coursing and regulates qi movement of the human body. Traditional Chinese medicine believes that internal damage due to seven emotions can affect the functions of the spleen, stomach, liver and other viscera of the human body, and cause abnormalities in qi, blood, phlegm, fire, dampness and appetite, resulting in the dysfunction of the five viscera and six entrails of the human body, and ascending and descending disorder of qi movement. It is recorded inATreatiseonBloodTroubles[3]that the nature of wood governs free coursing, and the food qi entering the stomach depends entirely on the qi of liver wood for free coursing, to digest water and food; if the lucid yang of the liver does not rise, it is impossible for free coursing of water and food, and the syndrome of eliminating wetness and abdominal flatulence is inevitable. When the function of human liver is normal, the free coursing function is adjusted smoothly, and water and food transport is normal; when the function of the liver is abnormal, it can not regulate qi movement and excrete bile, so the liver qi fails to flow freely, resulting in qi stagnation; long term qi depression will transform into fire, exuberance of fire heat can refine liquid into phlegm, and phlegm and blood stasis block collaterals, which will also lead to body obesity.

To sum up, the spleen, stomach and liver are the main organs related to obesity.

2.1.3Etiology and pathogenesis. It is recorded inSuwenthat it is a disease caused by richly fatty and sweet diet, and people suffering from this kind of disease must often eat fatty and sweet food. Even the description of dietary characteristics of obese people also accords with the dietary characteristics of modern phlegm-dampness obese people who like to eat fat and sweet food. The original text clarifies that diet preference and improper diet will lead to weak spleen qi, and spleen deficiency will cause cohesion of phlegm turbidity, thus becoming the cause of obesity. It is also recorded inSuwenthat there will be impotence, greatly weakened kidney qi, unfavorable nine orifice, and upper deficiency and lower excess, as well as tears and a runny nose at the age of 60. It shows that one of the causes of obesity is old and weak body, insufficient kidney yang, weak yang qi and weak transportation. It is recorded inRenzhaiZhiZhiFang(Effective Recipes from Renzhai House)[4]that fat people’s qi deficiency produces cold, cold produces dampness, and dampness produces phlegm, so fat people are cold and wet. Therefore, the evil of cold and dampness is also one of the main etiology and pathogenesis of obesity. Chen Nianzu, a famous physician of traditional Chinese medicine in the Qing Dynasty, proposed that phlegm dampness is an important pathological factor leading to obesity. To sum up, ancient literature research reveals that phlegm-dampness and qi deficiency constitution is one of the main pathogenesis of obesity.

The main causes of obesity in traditional Chinese medicine can be summarized as the following aspects.

(i) Improper diet. Ye Tianshi[5]put forward inMedicalRecordsforClinicalGuidancethat "Since dampness is endogenous, he surely drink too much wine of fat and grain, or drink too much tea soup, or eat raw cold fruits and sweet greasy food; he is white and fat, with soft muscles." That is, obesity is related to dietary factors. When drinking tea, soup or eating raw cold, sweet food exceeds a certain limit, pathogenic dampness will be produced in the body, which will lead to obesity.

(ii) Imbalance between work and rest.WangZhenZunJing·JuYangWangFaXiangCan[6]proposed that "The rich have soft and fragile bodies, fat and white skin…Irregular work and rest will easily lead to fat deposition and become fat people." It shows that when the body muscles lack exercise, muscles will be soft, qi and blood movement is slow relative to movement; the functional activity of qi will be unsmooth in the long run, and qi stagnation and stasis will occur in the body, resulting in the occurrence of obesity. Conversely, regular exercise can promote qi-blood circulation and promote body metabolism, thus helping to maintain normal body state and to avoid obesity. With the increasing pressure in modern life, busy work and other reasons, the daily routine of life has changed, and some people do not follow the rules of time, which is also an important cause of obesity.

(iii) Emotional disorder. When a person’s mood changes, the body’s qi will change accordingly, affecting the function of the five internal organs. Anger hurts the liver, joy hurts the heart, sorrow hurts the lung, grief hurts the spleen, and fear hurts the kidney[7]. Anger hurts the liver, and emotional disorders will lead to abnormities in dredging and regulating qi activity, abnormal rise and fall of qi, and unsmooth functional activity of qi. According to the law of mutual generation and restriction of five elements, the liver belongs to wood and restrains spleen soil, which easily leads to dysfunction of spleen and stomach and cause obesity. Grief hurts the spleen, and the spleen governs movement and transformation. Over-anxiety will lead to dysfunction of the spleen in transport, abnormal distribution of cereal essence, so phlegm and dampness will accumulate in the body and cause obesity.

2.2 Modern research

2.2.1Definition of disease. The American Medical Association defined obesity as a disease in 2016[8]. Through the analysis of different BMI indexes and cut-off points of waist circumference[9], the standard body mass index (BMI) ≥24, waist circumference ≥0.85 m for men and waist circumference ≥0.80 m for women are diagnosed as the abdominal fat storage limit. Obesity and its complications not only bring economic burden to patients, but also seriously affect their quality of life. Jiang Yong[10]found in his study on adult obesity in China that when the BMI was equal to or larger than 24, the proportion of overweight and obese people suffering from three highs was significantly higher than that of normal weight people, and the older the age, the higher the risk of disease. When the BMI was equal to or smaller than 24, 45%-50% of risk factors for complications could be prevented. Waist circumference of less than 85 cm in men and less than 80 cm in women may prevent 47%-58% aggregation of risk factors for complications.

2.2.2Cause of disease. (i) Constitution factors. The causes of obesity are complex. Liu Cuicuietal.[11]showed that obesity is related to a variety of factors. Through analysis of traditional Chinese medicine, obesity not only has external cause, but is related to personal constitution. Zhang Luluetal.[12]studied from the perspective of traditional Chinese medicine and found that constitution is an individual’s unique morphological, physiological and psychological characteristics formed on the basis of innate endowment and acquired exposure to cereal essence. Professor Wang Qi[13]proposed the theory of traditional Chinese medicine physique, which divides the human body into 7 types: balanced constitution (BC), qi deficiency constitution (QDC), yin deficiency constitution (YIDC), yang deficiency constitution (YADC), dampness-heat constitution (DHC), phlegm-dampness constitution (PDC), qi stagnation constitution (QSC), blood stasis constitution (BSC), and inherited special constitution (ISC). Body is the combination of morphological, psychological, and physiological traits exhibited in an individual, based on the individual congenital endowment and acquired exposure to cereal essence. Different characteristics of each organism determine different body constitutions. The difference of individual constitution leads to individual tendency of the disease, so a group of people with similar constitution are more likely to suffer from some similar specific types of disease. Wang Qietal.also clarified the close relationship between individual constitution and health and disease. For example, dialectical analysis from the perspective of traditional Chinese medicine shows that the pathogenesis of obesity is mostly the tendency of deficiency in origin and excess in superficiality[14]. The deficiency in origin mostly is spleen deficiency, and qi deficiency mostly is kidney deficiency. Excess in superficiality mostly refers to qi-stagnation and blood stasis, abundant accumulation of phlegm and dampness, stomach excessive heat.

(ii) Emotional factors. Because of the correlation between emotion and constitution, that is, the relationship between psychology and physiology, and between spirit and material, we should pay attention to the important position of psychological factors in the pathogenesis of obesity. According to individual physical differences and specificity, combined with psychological factors, treatment plan can be effectively adjusted to instruct clinical, that is, inhibiting appetite and improve mood by means of regulating emotions, so as to achieve the effect of reducing weight.

(iii) Dietary factors. Through rat experiment, Xie Lilietal.[15]proved that fructose high-fat diet would cause obesity, and illustrated the influence of dietary factors on the occurrence and development of obesity. Overeating refers to when the diet beyond the normal range of human metabolism, it will cause gastrointestinal damage and lead to obesity in the course of time, that is, if you eat twice as much, your intestines and stomach will be hurt.

(iv) Living habit. With the progress of modern science and technology, transportation is more and more convenient and developed, and a lot of work that requires physical strength is replaced by machinery, too little exercise and lack of exercise will lead to obesity.

(v) Genetic factors. Through epidemiology, Lou Xiaominetal.[16]found that parental obesity has a great impact on childhood obesity, obesity is highly likely to be passed on to future generations, and the location of obesity also has a certain genetic tendency.

(vi) Metabolic factors. Fat metabolism of the human body is closely related to endocrine system. When endocrine regulation is abnormal, obesity will occur. Moreover, with the growth of age, the metabolic function of the human body will gradually decrease, resulting in the accumulation of fat in the body, which will also cause obesity.

Aromatherapy refers to the therapeutic purpose through the aroma and volatile components of traditional Chinese medicine[17]. After these active components are absorbed into the human body, they play the role of four properties and five tastes of drugs in the human body, so as to regulate the rise and fall of zang-fu qi and to adjust the balance of yin and yang. It is recorded inSuwen·Jingmaibielun[18]that it is not the treatment of the viscera, but it can reach the viscera directly, and it is especially valuable to recognize the viscera; the principle of external treatment is exactly the principle of internal treatment, the medicine of external treatment is also the medicine of internal treatment, and the major difference is their usage. All these are traditional Chinese medicine theoretical supports for aromatherapy.

3.1 Classification of aromatherapyLin Huiguangetal.[19]summarized 8 categories of aromatherapy. (i) Incense crown method: Hats are made with aromatic drugs and worn on the head to prevent and treat diseases. (ii) Fragrant pillow method: The drugs with aromatic odor are put into pillow, or the pillowcase is soaked with medicine juice to make it dye the taste, thereby achieving the purpose of preventing and treating disease. (iii) Fragrant method: The aromatic drugs are put in a bag and worn around the body to make the drugs evaporate to prevent and cure disease. (iv) Sachet method: The aromatic drugs are ground into powder, put in a bag and keep indoors to prevent disease. (v) Aromatherapy method: The traditional Chinese medicine with aromatic odor is lighted and fumigated the affected area or the environment to prevent and cure the disease. (vi) Fragrant bath method: When bathing, fragrant Chinese traditional medicine is soaked into water, or fragrant medicine can be decocted to fumigate affected area by hot gas. (vii) Fragrant application method: The prescription of aroma is applied to specific acupoints or affected parts, so as to make use of the characteristics of four properties and five tastes to play a role in different meridians. (viii) Fragrant ironing method: Aromatic drugs are fried and wrapped in cloth to iron muscle surface or affected part of the human body. (ix) Put the potion into the nose method: Aromatic drugs are ground into powder, blown into the nose, or inhaled by the patient himself.

The above 8 kinds of aromatherapy commonly use 8 kinds of dosage forms: original medicament, dispersive agent, decoctum, paste, nasal drop, foggant, fumigant, and refine oil.

3.2 Mechanism of aromatherapy in the treatment of obesity

When aromatherapy is used in the treatment of obesity, the volatile components of aromatic drugs are absorbed through the respiratory tract. In addition to the respiratory tract, the drugs can also be absorbed through the skin, enter the bloodstream and be transported throughout the body for therapeutic purposes. Wang Yaqietal.[20]proposed that these components are mainly volatile oil, glycosides and amino acids. Therefore, although the route of aromatherapy is different from that of prescription for internal administration, the principle of aromatherapy is the same as that of internal prescription for internal administration, which all achieve the purpose of treatment by using its property and flavor. Cui Yingxueetal.[21]studied moxibustion and aromatherapy, and proposed that aromatic components of traditional Chinese medicine, such as volatile oil, can affect the excitability of central nervous system through nasal mucosa, thus affecting the secretion function of digestive gland and the activity of digestive enzymes, and further affecting the spleen and stomach and appetite. Therefore, aromatic drugs can treat obesity caused by emotional factors by regulating human cardiovascular activity, improving patient’s psychological and physiological emotions and relieving emotions. Aromatherapy can be combined with different dosage forms, choose the appropriate way of administration based on syndrome differentiation of patient’s constitution, and cooperate with different prescriptions to improve the treatment of obesity.

3.3 Research on drugs for treating obesity with aromatherapyThrough the analysis and summary of network technology, Jin Yitingetal.[22]found the medication law of some single Chinese medicines with aromatic odor in treating obesity, and extracted heat-clearing and dampness drugs such asPoriarhubarb,tangerinepeel,baishu,zediarrhea, which are the key Chinese medicines for the treatment of simple obesity. Zhao Pengweietal.[23]summarized the effective components and mechanism of traditional Chinese medicine with aromatic odor, and found that drugs such as ginseng, semen raphani, lotus leaf and hawthorn can increase gastrointestinal peristalsis, thus speeding up cholesterol metabolism and reducing fat absorption.

3.4 Aromatherapy for the treatment of obesityModern research has found that the topical application of the smell of traditional Chinese medicine in aromatherapy can be applied to the abdomen of patients with abdominal obesity. After addition and subtraction compatibility, hawthorn, sea-buckthorn, ginseng, fructus momordicae, semen raphani, lotus leaf and other drugs are reduced to powder. According to different syndrome types of patients, media with different characteristics are selected to make paste preparation, which is pasted on the abdominal acupoint, achieving the effect through the volatility of drugs. Perfume pouch wearing method can be adopted as well. Rhizoma acori graminei, ligusticum, rose and bitter cardamom are packed into the bag, which are worn by patients to absorb the volatile components of the drug, so as to regulate cardiovascular activity and central system activity to prevent and cure obesity by improving mood, strengthening spleen and stomach, and suppressing appetite.

Aromatherapy occupies an important position in traditional Chinese medicine and has been playing a significant role in disease treatment and prevention. Aromatherapy has been widely used by scholars both at home and abroad in the prevention and treatment of SARS and COVID-19. However, the current application of aromatherapy is too limited to the traditional treatment concept, and is often limited to the prevention and treatment of respiratory diseases while ignoring the application in other fields, such as the role of aromatherapy in the treatment of obesity. Based on a large number of literatures, this paper sorts out and summarizes the relevant contents of obesity and aromatherapy, and concludes that aromatherapy has the advantages of universality, small side effects, simple operation and good effect in the treatment of obesity. Using aromatherapy to treat obesity can not only achieve the therapeutic purpose, but also relieve patient’s emotions and reduce the mental pressure brought by obesity. Therefore, aromatherapy is an effective and safe treatment for obesity and will become an indispensable treatment in the future. More in-depth research and promotion are needed to explore its better clinical efficacy.

推荐访问:Progress Research Aromatherapy