The role of essential oils
May 18, 2021
[Essential Oil Science] The rigorous clinical application of essential oils will certainly promote the development of the pharmaceutical industry and the aromatic medicine industry
Essential oils of traditional Chinese medicine, also known as volatile oils, are aromatic substances obtained by steam distillation, squeezing, organic solvent extraction and other extraction processes from traditional Chinese medicines containing volatile components. They are mainly composed of terpenes, aromatics, aliphatics, and nitrogen and sulfur. Category consists of 4 major categories. The molecular structure of essential oils is small and easily penetrates the skin barrier and is absorbed into the blood, lymphatic and other circulatory systems. Ancient people have used wormwood, ageratum, woody, musk and other aromatic medicines to prevent and cure diseases and strengthen their bodies through fumigation and natural inhalation. As one of the most classic and traditional clinical application methods, aromatherapy is often used to regulate anxiety, relieve stress, assist in the treatment of cancer, improve cognitive dysfunction and relieve pain, etc., and is widely used in clinical practice. However, essential oils have safety issues such as irritation, phototoxicity, and sensitization. In order to ensure safe clinical use, risk control has become the top priority in clinical applications. Starting from clinical practice, this article sorts out the application of essential oils in systemic diseases, systematically outlines the risks in its application and proposes control strategies, in order to provide a reference for the follow-up research and clinical application of essential oils.
Clinical application fields of essential oils
Clinically, essential oils can be used to prevent and treat diseases through oral, aromatherapy, aromatherapy, moxibustion and other application methods. They enter the blood and lymph through the olfactory system and skin and mucous membranes, and then affect the body’s nervous system, digestive system, and respiratory system. The system, skin system, urinary system, immune system and cardiovascular system play a regulatory role to enhance immunity and promote cell regeneration, so as to achieve the corresponding effects of relieving dampness, promoting qi and resuscitation, promoting blood circulation and removing blood stasis.
Applied to the nervous system
Nervous system diseases often occur in the central, peripheral, and autonomic nervous systems, mainly manifested as sensory, motor, and autonomic nervous system dysfunctions. Due to various pressures in life, work, and study, modern people have been in a state of mental tension for a long time, leading to frequent neurological diseases, usually manifested as restlessness, difficulty falling asleep, and prone to anxiety. In "Suwen·Ju Pain Theory", it is said that "all illnesses are born in qi." The aromatic medicine, Xin Wen, can regulate the body's qi, soothe the liver and regulate the qi, warm the meridians, disperse blood stasis and relieve pain, and can enter the heart channel to calm the mind and calm the mind, relieve depression and help sleep. Hajibagheri et al. sampled 60 inpatients in the coronary intensive care unit and randomly assigned them to the experimental group (routine care plus rose essential oil aromatherapy) and the control group (routine care). The study showed that rose essential oil aromatherapy can significantly improve the sleep quality of inpatients. . Kasper et al. conducted a randomized, double-blind, placebo-controlled trial on 221 adults with clinically-diagnosed anxiety disorder. Patients were given lavender oil preparations (80 mg/d) or placebo, and Hamilton was administered every 2 weeks. Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) assessments, the test results show that the assessment scores showed a downward trend 10 weeks ago, which has a significant impact on the patient's sleep quality and duration. The aromatic gas is absorbed by the nasal mucosa, and the odor molecules are converted into chemical signals and move to other parts of the limbic system, affecting brain waves and causing behavior changes. Such as lavender, geranium and bergamot in proportion to the compound essential oil aromatherapy touch care to assist the elderly with Alzheimer's disease comprehensive ability training, and obtain good curative effects.
Applied to the digestive system
The basic physiological function of the digestive system is to ingest, transport, digest food and excrete waste. According to relevant survey statistics, the prevalence of constipation in my country is about 20% to 40%, and it is more common in elderly patients. "Materia Medica Zhengyi" records that "aroma can help Zhongzhou clear qi", so aromatic medicine can wake up the spleen and appetite, help the spleen to move and transform, and is good at treating spleen and stomach stagnation of qi and damp turbidity. Compound essential oils have been clinically effective in the treatment of various symptoms caused by functional dyspepsia. A large number of clinical trials have proved that the compound clove appetizer is widely used in pediatric and adult departments. In the treatment of acute pancreatitis, Jiang Juan used peppermint oil in a wet and hot compress on the abdomen to activate the intestinal flora, stimulate intestinal peristalsis, and reduce the occurrence of intestinal paralysis. Lu Qin et al. mixed peppermint oil and raw rhubarb, and used peppermint oil's aroma divergence to directly transmit the laxative function of rhubarb to target cells via Shenque acupoint. The effect was significant and the curative effect was definite. Under the guidance of the theory of Chinese medicine, the new pure Chinese medicine preparation Jinghua Weikang capsules developed by combining modern technology and practice contains the volatile oil of water ball flower and nepeta sinensis. It has been used in 470 cases of duodenum. The efficacy and safety of patients with ulcers were investigated experimentally. The test showed that the cure rate of peptic ulcer and the negative conversion rate of Helicobacter pylori in the treatment group of the TCM symptom curative effect evaluation were significantly higher than that of the control group.
Applied to the skin system
The skin is the body's largest organ, which has the functions of defense, regulation of body temperature and immunity. "Shen Nong's Materia Medica" records: "Lithospermum erythrorhizophyllum controls five jaundices, nourishes the middle and nourishes qi, helps the nine orifices, and opens water channels." Such as compound prescriptions.
Lithospermum oil can be used clinically in herpes skin diseases, infectious skin diseases, papules and scaly skin diseases, superficial traumatic skin diseases, allergic skin diseases, etc. Research by Kim et al. showed that the acne grading index, pore index, and erythema index of the experimental group applied with myrtle essential oil were significantly reduced, and the microbial index was significantly reduced and was statistically significant. Huang Linxue et al. took 60 patients with uremia as the research object and randomly divided them into observation group and control group. The study showed that the observation group treated with moisturizing cream containing thorn fruit oil significantly reduced the symptoms of skin itching, and the dry skin was significantly improved, which helped the patients improve their skin. Barrier function.
Applied to the urinary system
The urinary system is the main excretion pathway of human metabolites. It can also regulate water and salt metabolism and acid-base balance, and produce a variety of biologically active substances to maintain the stability of the body's internal environment. "Blood Argument·Blood Stasis" says: if blood stasis is between the meridians and viscera, the knot is a symptom. The traditional Chinese medicine turmeric to dispel blood and remove blood stasis. Clinical studies have shown that turmeric oil combined with Tripterygium wilfordii can treat refractory nephropathy in children. The turmeric oil uses this effect to improve microcirculation, improve immunity, and significantly shorten the time for the disappearance or reduction of urine protein and reduce recurrence. Most of the elderly suffer from deficiency of lung, spleen and kidney, triple energizer and bladder qi-transformation, leading to frequent prostatic hyperplasia. Lin Juze used traditional Chinese medicine zedoary oil and brucea javanica oil to treat benign prostatic hyperplasia through vascular intervention, and achieved good results. Clinical studies have proved that Coix seed oil can promote cell apoptosis in the urogenital system, cooperate with tumor chemotherapy, increase the effectiveness of chemotherapy drugs, reduce toxicity, improve pain, improve immunity, resist cachexia and improve the quality of life of patients.
Applied to the immune system
The immune system has the functions of immune monitoring, defense, and regulation. With the advancement of relevant basic research, it has been discovered that many Chinese medicine volatile oils have immunomodulatory effects, which can enhance the body's immunity while treating diseases, regulate the body's balance, and correct immune dysfunction. Brucea javanica oil emulsion injection is a medicine for treating digestive system tumors. It has the effects of clearing away heat, removing dampness, and suppressing cancer. Clinical studies have reported that Brucea javanica oil emulsion injection has a certain curative effect on non-small cell lung cancer, reduces the incidence of toxic and side effects, and can effectively protect the immune system function and improve cellular immune indicators. It has high clinical value. Li Huyu and others used compound comfrey oil to treat children's eczema, regulate the body's immune system, strengthen the body's immunity of children, fundamentally solve the problem of recurrent eczema, and promote the recovery of patients.
Problems with different administration routes of essential oils
Aromatic essential oils can be used orally, but the following two problems must be paid attention to. One is the high concentration of essential oils and strong irritation. Oral use is likely to damage the gastrointestinal tract, and the active ingredients are easily destroyed by gastric acid and pancreatic juice. There is a risk of adverse reactions to the combination medication. Essential oils can also be absorbed through the skin, vagina, rectum and respiratory tract. Different essential oils have different administration methods and dosages for different diseases, and their absorption, metabolic processes and biological decomposition products are significantly different. Cash et al. gave the experimental group oral peppermint oil sustained-release capsules to relieve the symptoms of irritable bowel syndrome, while Zhang Yongting used peppermint oil wet and hot compress to promote intestinal peristalsis to improve the constipation of patients after mixed hemorrhoids. These two studies show that the clinical application needs to choose the appropriate route of administration and dosage form according to the purpose of the drug and the drug substance. Comparing various administration methods, inhalation administration is the safest, and oral administration has the greatest potential toxicity. Barocelli et al. studied the analgesic and gastroprotective effects of oral or inhaled lavender volatile oil, and the results showed that both routes of administration have significant effects, but inhaled administration has no sedative side effects.
Risk control strategy for clinical application of essential oils
Promote the standardization of essential oil production and improve the quality evaluation system
On the basis of understanding the efficacy, composition, and compatibility of essential oils, quality control modes such as sensory index evaluation, physical index testing, essential oil component analysis, and microbial testing are adopted to formulate and improve the quality evaluation system of essential oils to ensure stable and uniform quality of essential oils , Thereby ensuring the safety and effectiveness of essential oil products. The essential oil production process is the key to quality control, and standard operating procedures should be formed in every link from plant breeding to essential oil products. In addition, the current Chinese medicine essential oil extraction technology and engineering equipment are relatively backward. Chinese medicine essential oil production equipment should strengthen innovation, promote the volatile oil extraction equipment to gradually move from experience to standardized, refined, green, and intelligent construction, and strengthen technology integration and process innovation to improve The manufacturing level of Chinese medicine essential oil extraction equipment accelerates the standardization and modernization of the essential oil production process.
Application of formulation technology to increase the stability of essential oils
The instability, strong irritation, poor solubility, and low bioavailability of volatile oil hinder its clinical application. In order to increase the stability of its efficacy, volatile oil is often prepared into cyclodextrin inclusion compounds and microemulsions Later, the stability and bioavailability of essential oils can be improved. If it is a liquid preparation, you can directly add auxiliary materials such as solubilizers and emulsifiers to reduce surface tension, increase solubility, and improve bioavailability; if it is a solid preparation, use adsorption or inclusion preparation methods, or make it into soft capsules or microcapsules. Capsules, microspheres, etc. to improve physical properties and achieve the effects of blocking bad odors. Nano-structured lipid carriers have opened up a new path for essential oils in the pharmaceutical field. It not only overcomes the shortcomings of essential oils that are sensitive to light and heat and insoluble during the application of essential oils, but also solves the problems of low encapsulation efficiency and low drug loading of other nano preparations. Carbone et al. developed and optimized lipid nanoparticles of rosemary essential oil, oregano essential oil, and lavender essential oil, and used their potential synergistic effects to prolong the in vitro release of clotrimazole and improve the effectiveness of combating local candidiasis. Pickering milk is a new type of emulsification technology that uses solid particles as a stabilizer. It has simple preparation, high biocompatibility, good stability, and can be further dehydrated, dried and solidified to achieve solid powder. The volatile oil is encapsulated in Pickering milk. An effective way to improve the stability of volatile oil. Zhou et al. used nanocellulose as a stabilizer to prepare oregano volatile oil into Pickering milk by ultrasonic method. The results showed that the emulsion has good stability under the conditions of high stabilizer concentration, high pH value, and low oil-to-water ratio. And can effectively inhibit 4 kinds of bacteria.
Choosing the appropriate clinical route of administration
The common medication methods of volatile oil of traditional Chinese medicine are "smoke, smell, wash, apply", etc., mainly including the nasal cavity, gastrointestinal tract, skin, etc., to achieve the effect of curing and preventing diseases. In the Qing Dynasty, Wu Shiji systematically expounded the theory and application of aromatic medicine in his "Liping Pianwen". For example, it is recorded in the book that "faintness will heat white sandalwood and those who suffer from heatstroke and deficiency and faintness, agarwood and sandalwood incense will be smoked," Make the aroma fill the room and wake up when it reaches its orifice. It is not possible to take the medicine from the mouth and use the fumigation method." In order to achieve rapid onset, the physical and chemical properties, mechanism of action and route of administration of volatile oils can be comprehensively considered to give full play to the plant volatile oils. Specialties in all aspects. For example, by administering highly volatile essential oils through the nasal cavity and brain targeting/inhalation, the rapid onset of plant volatile oils can be maximized. However, some essential oils need to be released slowly, such as in the treatment of chronic diseases such as insomnia and depression, the appropriate dosage form and route of administration should be selected according to different needs. Before clinical use of essential oils, the patient’s physique should be investigated, allergic history and disease history should be asked, or allergen testing should be performed. Skin irritation or allergic reactions should be closely observed and liver and kidney functions should be tested regularly to ensure the safety of the patient’s medication. Clinically, it is necessary to balance the clinical use method and route of administration according to the type of disease and the purpose of medication to reduce adverse reactions. Due to the small molecules of essential oils, high volatility, good permeability, and easy absorption by the skin and mucous membranes, the recommended dosage and usage principles of essential oils must be strictly followed to reduce the irritation of the skin and mucous membranes.
Theoretical guidance formula essential oil combination medication
Under the guidance of traditional Chinese medicine theory, an optimized compatibility design method is adopted to achieve the compatibility of effective components, and the use of traditional Chinese medicine informatics methods to optimize the formula of essential oils using an overall screening model. Refer to the "Technical Requirements for New Drug Research of Natural Medicines" for compound preparation requirements "to prove the scientificity and rationality of the compatibility; to conduct a study on the compound ratio to prove the best ratio of the compatibility. Compound essential oil preparations composed for the purpose of reducing toxicity and increasing efficiency or Choose other appropriate toxicity experiments for comparative research, and provide supporting basis for the rationality of its formula essential oils." Focus on further in-depth research on compatibility theory, extraction scheme design, curative effect evaluation criteria, selection of optimal compound ratio, safety of compatible essential oils, quality of compatible essential oils, etc., and incorporate the preparation research and clinical application of formula essential oils into reasonable norms standard.
Discussion and outlook
Essential oils of traditional Chinese medicine have the characteristics of rapid efficacy, strong activity and fast metabolism. However, there are still some urgent problems in its clinical application, such as poor stability, unstable efficacy, and occasional adverse reactions. Therefore, the appropriate dosage form should be selected according to the actual situation, on the one hand, the advantages of traditional dosage forms should be used to carry out basic research on the essential oils of traditional Chinese medicine to solve the problems existing in its preparations. When necessary, avoid light and other methods to improve the stability of the preparation. On the other hand, by strengthening the research of new dosage forms of volatile oil of traditional Chinese medicine with targeted and slow-release capabilities, avoiding the risks in the clinical application of volatile oil, reducing toxic and side effects, and developing a series of stable quality, safe and controllable medicines and general health products. In addition, clinical application should also pay attention to the identification of personal physique and the two-way regulation of essential oils. The clinical application of essential oils has a suitable physique type, and at the same time has a two-way regulation effect on many diseases (inhibition and excitement, contraction and expansion). These should be clinically applied. Need to be highly valued. In summary, researchers need to fully explore the treasure house of traditional Chinese medicine, guided by traditional Chinese medicine theory, and through the use of new technologies and methods of modern preparations, in-depth study and exploration of the mechanism of essential oils, avoiding the risks of essential oils, and guiding the clinical rational use of drugs and the development of new drugs. It will certainly promote the development of the pharmaceutical industry and the Chinese medicine aromatherapy industry.
Original article:
1. Jiangxi University of Traditional Chinese Medicine, State Key Laboratory of Innovative Medicines and High-efficiency Energy-saving Pharmaceutical Equipment
2. School of Pharmacy, Jiangxi University of Traditional Chinese Medicine
3. The Key Laboratory of Modern Chinese Medicine Preparation of Ministry of Education, Jiangxi University of Traditional Chinese Medicine
4. Sichuan Orthopedic Technology Co., Ltd. of Sinopharm Group
Xing Liyuan 1, Li Huiting 1, Wan Na 1, 2*, Huang Xiaoying 1, 3*, Yang Fangli 4
Yang Ming 1, 3, Wu Zhenfeng 1, 3
