O efeito da aromaterapia sozinha ou em combinação com massagem na dismenorreia: Uma revisão sistemática e meta-análise

Najafi, Mona Najaf; Najafi, Neshat Najaf; Fakari, Farzaneh Rashidi; Moeindarbary, Somayeh; Abdi, Fatemeh; Hoseini, Zeinab Sadat; Ghazanfarpour, Masumeh

doi:10.1055/s-0041-1740210

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Review Article, Gynecological Endocrinology • Rev Bras Ginecol Obstet. 43 (12) • Out 2021 • https://doi.org/10.1055/s-0041-1740210 linkcopiar

O efeito da aromaterapia sozinha ou em combinação com massagem na dismenorreia: Uma revisão sistemática e meta-análise

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo O objetivo desta revisão sistemática-metanálise é avaliar o efeito da estimulação olfatória na redução da dismenorreia.

Métodos Pesquisa sistemática foi realizada em várias bases de dados, como PubMed, Web of Science, Cochrane e Scopus para identificar pesquisas relevantes até 26 de outubro de 2019. Os estudos identificados foram avaliados com base em uma escala de Jadadmodificada. A intervenção envolvearomaterapiasozinhaouem combinação com óleos essenciais. Não houve restrição para o grupo de controle, como um grupo de placebo ou outros tratamentos comuns. O Comprehensive Meta-Analysis Version 2 (Bio stat, Englewood, NJ, EUA) foi usado para meta-análise. Os testes Q e I2 de Cochran foram utilizados.

Resultados Os resultados da nossa meta-análise, que continha 13 ensaios (15 dados), mostraram que a dismenorreia diminuiu significativamente no grupo que recebeu aromaterapia com ervas em comparação com o grupo de controle (diferença média padronizada [DMP] = -0,795; intervalo de confiança [IC] de 95%: -0,922 a- 0,667; 17 ensaios O <0,001); heterogeneidade; I2 = 19,47%; p = 0,236). Além disso, quatro estudos com dados insuficientes não foram incluídos em nossa meta-análise. Os resultados de todos os estudos sugeriram que a aromaterapia com o grupo de fitoterápicos em comparação com o grupo de controle é eficaz.

Conclusão A aromaterapia com fitoterapia diminuiu a dismenorreia. Este tratamento foi particularmente eficaz quando o óleo aromático foi combinado com massagem ou quando uma mistura de óleo aromático foi usada para o tratamento da dismenorreia.

Palavras-chave
dismenorreia; fitoterapia; óleo de aroma; aromaterapia

	Registration code	Randomization mention	Random sequence generation	Blinding of participants and personnel	Blinding of outcome assessment	Description of withdrawals and dropouts	Clear description of the inclusion and exclusion criteria	Description of the method used to assess adverse effects	The method of statistical analysis	Tota l score
Apay et al. (2012)²²	–	1	0	1	0	1	1	1	1	6
Amiri Farahani et al. (2012)²⁴	IRCT138902153869N13869	1	0	1	0	1	1	1	1	6
Ataollahi et al. (2015)²¹	IRCT201311216807N10	1	1	1	1	1	1	1	1	8
Azima et al. (2015)¹⁰	IRCT2013022611945N2	1	1	0	1	1	1	0	1	6
Bakhtshirin et al. (2015)¹⁵	–	1	0	1	1	1	1	0	1	6
Beiranvand et al. (2015)³¹	IRCT201310297697N2	1	1	1	1	1	1	0	1	7
Davari et al. (2014)²³	–	1	0	1	1	1	1	1	1	7
Raisi Dehkordi et al. (2014)⁴⁷	IRCT201105086412N1	1	1	1	1	1	1	1	1	8
Kim et al. (2011)¹⁸	–	0	0	0	0	1	1	1	1	4
Marzouk et al. (2013)²⁵	–	1	1	1	1	1	1	1	1	8
Ou et al. (2012)²⁶	–	1	1	1	1	1	1	0	1	7
Uysal et al. (2016)³	–	1	1	0	0	1	1	0	1	5
Hur et al. (2012)¹	–	0	0	0	0	1	1	1	1	4
Nikjou et al. (2016)⁴⁸	IRCT201470616252N2	1	1	1	1	1	1	1	1	8
Rizk (2013)²⁷	–	1	0	1	0	1	1	0	1	5
Sadeghi Aval Shahr et al. (2015)²⁰	–	1	0	1	0	1	1	1	1	6
Sajjadi et al. (2018)²⁸	IRCT2017013132329N1	1	0	1	1	1	1	0	1	6
Han et al. (2006)¹⁶	–	1	0	1	0	1	1	1	1	6

Study (year)	Type of study	Participants	Age (mean)	Intervention (n)	Control (n)	Duration of study	Sample drop (%)	Measurement method	Inclusion	outcome
Apay et al.(2012)²²	Quasiexperimental crossover	Midwifery/nursing students	20	Lavender/ abd. Massage, 1st day of menses, 15 minutes, 1 time (n = 44)	Placebo/abd. Massage 1st day of menses, 15 minutes, 11 time	3 cycles	0	VAS-100 points	VAS > 60	Massage is effective. The effect of aromatherapy massage is higher than placebo massage (p<0.001).
Amiri Farahani et al. (2012)²⁴	RCT	Medical university students	21	Massage + mixture of lavender/peppermint essential oil (n = 36) a week before menses up to the presence of pain, onetime, 1 5 minutes, daily	1.almond oil (n = 36) 2.massage alone (n = 36) a week before menses up to the presence of pain, one time, 1 5 minutes, daily	2 cycles	reported	VAS-10points	multidimensional spoken criteria = 2 or 3	Severity of dysmenorrhea decreased in massage and aromatherapy groups(p = 0.014)
Ataollahi et al. (2015)²¹	RCT	Medical student	21	Rosaceous extract (n = 55), First 3 days of menses, two times daily	Placebo (n=55) First 3 days of menses, two times daily	2 cycles	0	VAS-10points	Intermediate/ sever pain	Severity of dysmenorrhea decreased in both groups, but this reduction was more significant in the Rosaceous group (p<0.001).
Azima et al. (2015)⁴⁶	RCT	Non-medical university students	21	Lavender/massage (n = 34) First 2 days of menses, one time daily	1) Reflexology (n = 34), 20 minutes daily, 10 days before menses 2) Control (n = 34)	2 cycles	0	VAS-10points	VAS>5	pain reduction was more in the lavender/ massage group (p<0.001)
Bakhtshirin et al. (2015)¹⁵	RCT, cross over	Midwifery/nursing students	20	Lavender/ massage (n = 40)	placebo/ massage (n = 40)	2 cycles	0	VAS-10points	VAS>6	A significant pain reduction in lavender/massage in comparison with placebo/massage.
Beiranvand et al. (2015)³¹	RCT cross over	Students	21	Lavender/ 48 hours before and after menstruation/ 15 minutes twice a day (n = 30)	Placebo (almond oil)/ 48 hours before and after menstruation/ 15 minutes twice a day (n = 30)	2 cycles	reported	VAS-10points	VAS>5	A significant pain reduction in lavender/massage in comparison with placebo/massage (p<0.001).
Davari et al. (2014)²³	RCT	Students	22	Rosemary (n = 30), Lavender (n = 30), rosemary + lavender (n = 30), first 3 days of menses 15 minutes, twice a day	mefenamic acid (n = 30), placebo (n = 30)	2 cycles	reported	VAS-10points	MDQ	significant reductions in pain in rosemary (p < 0.001 ), lavender, both, and mefenamic acid (p <0.01) compared with placebo.
Raisi Dehkordi et al. (2014)⁴⁷	RCT Crossover	Students	20	Lavender first 3 days of menses, every 6 hours (n = 48)	Placebo first 3 days of menses, every 6 hours (n = 48)	2 cycles	reported	Scoring from 1 to 4 1: none, 2: mild, 3: moderate, 4: severe	VMS: 2 or 3	significant reductions in pain in lavender (p<0.001)
Kim et al. (2011)¹⁸	Non-Random CT	Nurses	25	Aroma1 + self-massage (n = 26) twice a day, 2 days	Placebo (n= 18) No treatment (n= 19)	1 cycle	reported	VAS-10points	VAS>5	significant reductions in pain (p<0.001)
Marzouk et al. (2013)²⁵	RCT Crossover	Nursing students	17-20	Aroma2+ massage (n = 48), once daily, 7 days before menses	Placebo+ massage (n = 47), once daily, 7 days before menses	2 cycles	reported	VAS-10points	VAS>5	significant reductions in pain
Ou et al. (2012)²⁶	RCT	Patients	24	Aroma3 + massage (n = 24) Once daily, 3 days	Placebo+ massage (n = 24) Once daily, 3 days	1 cycle	0	VAS-10points	VAS>5	Duration of pain significantly decreased
Uysal et al. (2016)3	RCT	Patients admitted to the emergency unit	21	rose essential oil + diclofenac, 75 mg ampule (n = 52)	Placebo + diclofenac, 75 mg ampule (n = 53)	continuously spray every 10 minutes [img]	reported	VAS-10points	VAS>5	significant reductions in pain after 30 minute (p = 0.019)
Hur et al.(2012)1	RCT	High school students	?	Aroma4 + massage (n = 32)	acetaminophen (n = 32)	1 cycle	reported	VAS-10points	VAS>5	significant reductions in pain after 24 hour (p< 0.001)
Nikjou et al.(2016)⁴⁸	RCT Triple blind	Students	19-29	Lavender (n = 100) once a day, 30 minutes, 3 days	Placebo (n=100) once a day, 30 minutes, 3 days	2 cycles	0	VAS-10points	Intolerable, limits activities exclude	significant reductions in pain (p<0.001)
Rizk(2013)²⁷	RCT	Nursing students	17-21	Peppermint oil + massage (n = 40) ginger oil + massage (n = 40), once daily, 15 minutes, 5 days before menses	Placebo + massage (n = 40)	2 cycles	reported	VAS-10points	Moderate or severe dysmenorrhea	Significant reductions in severity of pain in Int. groups.
Sadeghi Aval Shahr et al. (2015)²⁰	RCT	Students	18-35	Rose essential oil (n = 25) on the first day of menses, 15 minutes	almond oil + massage (n = 25) massage (n = 25)	2 Cycles	reported	VAS-10points	VAS>5	Significant reductions of pain in rose essential oil comparison to massage only (p< 0.001) or almond oil +massage (p < 0.05)
Sajjadi et al. (201 8)²⁸	RCT	Students	18-35	Geranium essential oil (n = 30) on the first day of menses, 15 minutes	1) Almond oil (n = 30) 2) No treatment (n = 30)	2 cycles	reported	VAS-10points	VAS>5	Significant reduction in Geranium essential oil group comparison to others (p<0.001).
Han et al. (2006)¹⁶	RCT	Students	20	Aromatherapy5 + massage (n = 25) 15 minutes on the first day of menses	1) Almond oil + massage (n = 20) 2) No treatment (n = 22)	2 cycles	0	VAS-10points	VAS>6	The severity was significantly lower in the aromatherapy group than in the other two groups

Variable	Number of RCTs	Sample size (treatment/control)	Test of heterogeneity		P-value	Fixed =effect model
Variable	Number of RCTs	Sample size (treatment/control)	P	I²(%)	P-value	SMD (95% CI)
Types of treatment
Massage + aromatherapy	9	540	0.7	0%	< 0.001	-0.915 (-1.09 to -0.73)
Aromatherapy alone	9	729	0.13	34%	< 0.001	-0.741 (-0.89 to -0.58)
Test for subgroup difference						p<0.001
Types of treatment
A mixture of aroma oils	7	452	0.410	3%	< 0.001	-0.865 (-1.01 to -0.715)
Single oil	11	817	0.273	20%	< 0.001	-0.75 (-0.97 to -0.53)
Test for subgroup difference						p = 0.34

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[TFN1] Abbreviations: MDQ, mood disorder questionnaire; RCT, randomized control trial; VMS, verbal multi-dimensional scoring system.

[TFN2] ¹Aroma: otto (Rosa damascena), clary sage (Salvia sclarea), rose geranium (Pelargonium graveolens), and ginger (Zingiber officinale) in almond, jojoba, and evening primrose oil.

[TFN3] ²Aroma: cinnamon, clove, rose, and lavender in a base of almond oil.

[TFN4] ³Aroma: lavender, clary sage, and marjoram oils, in jojoba cream.

[TFN5] ⁴Aroma: clary sage, marjoram, cinnamon, ginger, and geranium in almond oil.

[TFN6] ⁵Aroma: lavender (Lavandula officinalis), clary sage (Salvia sclarea), and rose (Rosa centifolia) in almond oil.