Saturday, 22 April 2017

Re: Aromatherapy with Ravensara, Frankincense, and Sandalwood Reduces Symptoms of Perennial Allergic Rhinitis

  • Ravensara (Cryptocarya agathophylla syn. Ravensara aromatica, Lauraceae)
  • Frankincense (Boswellia carteri, Burseraceae)
  • Sandalwood (Santalum album, Santalaceae)
  • Perennial Allergic Rhinitis
Date: 04-14-2017HC# 081654-566

Choi SY, Park K. Effect of inhalation of aromatherapy oil on patients with perennial allergic rhinitis: A randomized controlled trial. Evid Based Complement Alternat Med. 2016;2016:7896081. doi: 10.1155/2016/7896081.

Perennial allergic rhinitis (PAR) is triggered by exposure to allergens in the environment and is characterized by sneezing, runny nose, stuffy nose, and consequent sleep disruption. Aromatherapy is used to treat a number of inflammatory conditions; however, there is a lack of scientific studies evaluating the effect of aromatherapy on reducing symptoms of PAR. Essential oils of ravensara (Cryptocarya agathophylla syn. Ravensara aromatica, Lauraceae) leaves and frankincense (Boswellia carteri, Burseraceae) gum resin have anti-inflammatory and immunomodulatory effects. Essential oil of sandalwood (Santalum album, Santalaceae) heartwood produces relaxation or sedation. The purpose of this double-blind, randomized, controlled study was to evaluate the effect of aromatherapy with a blend of ravensara, frankincense, and sandalwood essential oils on PAR symptoms, quality of life, sleep quality, and fatigue in patients with PAR.
Patients (n = 62, aged 20-60 years) with chronic symptoms of PAR (as confirmed with a skin prick test and/or other physician assessment) participated in this study conducted in Seoul, South Korea, from June to July 2015. Included patients had no previous experience with aromatherapy, no history of psychiatric illness, no current treatment for allergic rhinitis (including medication, surgery, and immunotherapy), no disturbance of olfactory acuity, and had no allergies related to aromatherapy oils.
Patients were treated with almond (Prunus dulcis, Rosaceae) carrier oil as the control or a blend of sandalwood, frankincense, and ravensara at a concentration of 0.2% (per volume) in almond oil (all oils were obtained from Neumond GmbH; Raisting, Germany). The 2 oils appeared similar in color and were dispensed in identical 1-mL bottles. The study protocol was as follows: at 10 am and 10 pm each day for 7 consecutive days, patients were instructed to pour the contents of 1 bottle onto a fragrance pad, sit in a comfortable place, position the pad 30 cm away from the nose, and inhale the fragrance for 5 minutes with normal breathing. At baseline and on day 8, the symptoms were assessed using the Total Nasal Symptom Score (TNSS) questionnaire (primary efficacy measure), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) (primary efficacy measure), Verran Snyder-Halpern (VSH) scale evaluating sleep quality, and the Chalder Fatigue Scale. The TNSS assesses the following 4 symptoms: sneezing, rhinorrhea, itchy nose, and nasal obstruction. RQLQ evaluates the following domains: practical problems, sleep problems, nose symptoms, activity limitations, emotional function, eye symptoms, and non-nose/eye symptoms.
There were no significant differences between groups at baseline. A total of 54 patients (27 in each group) completed the study; 2 patients in each group were lost to follow-up, and 2 patients in each group were excluded from the analysis due to protocol violationsAfter 8 days of treatment, the blend group had a significantly greater improvement in TNSS compared with the control group (P = 0.022). Of the 4 symptoms evaluated with the TNSS, only the score for nasal obstruction was significantly more improved in the blend group (P = 0.035) compared with placebo. While the scores for the other 3 symptoms were numerically greater in the blend group, the difference between groups was not statistically significant.
Compared to the control group, the blend group had significantly greater improvement in total RQLQ score (P = 0.002) and scores for the domains practical problems (P = 0.020), sleep problems (P = 0.021), nose symptoms (P = 0.001), activity limitations (P = 0.008), and emotional function (P = 0.031). There were no significant differences between groups for the domains eye symptoms and non-nose/eye symptoms. VSH sleep quality score did not significantly differ between groups; however, the blend group had significantly greater improvement in the Chalder Fatigue Scale score than the control group (P = 0.021).
In summary, the blend group had significantly greater improvements in TNSS, RQLQ, and Chalder Fatigue Scale scores compared to the placebo group. The authors conclude that aromatherapy with a blend of "ravensara, frankincense, and sandalwood alleviated subjective symptoms, improved the disease-specific quality of life, and reduced fatigue among adult patients with PAR." Limitations of the study include the small sample size, very short study duration given the chronic nature of PAR, and lack of objective measures. Although these results are promising, larger and longer-duration studies using objective measures are needed to confirm these findings. The authors declare no conflict of interest.
—Heather S. Oliff, PhD