Aromathérapie

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Définition

Aromathérapie : Usage des huiles essentielles à des fins thérapeutiques

  • Terme créé par René-Maurice Gattefossé, [1] repris et développé pour l'usage médical par le docteur Jean Valnet [2]
  • L'aromathérapie moderne impose :
    • De nommer la plante sous son nom botanique international (dénomination latine binominale), espèce, sous-espèce et variété éventuellement
    • De préciser le chémotype (profil chimique ou chimiotype) retenu pour l'usage thérapeutique
    • D'indiquer l'organe de plante dont est issue l'huile essentielle
    • De détailler la forme galénique et sa voie d'administration
    • De spécifier le dosage et la durée de traitement [3]
  • Attention :
    • En langue anglaise, le terme « Aromatherapy » désigne les produits de soins corporels, de massage et de cosmétologie à base d' huiles essentielles. Elle peut être pratiquée par des non-médecins
    • En France, l' « Aromathérapie clinique », pratiquée par des médecins aromathérapeutes, désigne une « aromathérapie médicalisée » qui utilise les HE par voie interne :
      • Voie orale
      • Voie rectale
      • Voie vaginale
      • Voie aérienne : aérosols et inhalations
      • Voie cutanée

Effets anti-infectieux

  • Effet anti-infectieux général [4], [5], [6]
    • Activité antibactérienne [7], [8], [9], module l'activité bactérienne [10],[11], interactions avec les membranes bactériennes [12]), même vis-à-vis de bactéries résistantes [13] telles que Staphylococcus multirésistant MRSA [14], le mode d'action passe par différents processus tels que l'interaction avec les membranes bactériennes, avec la production d’ATP, la synthèse protéique, l’équilibre acido-basique, des modifications cytoplasmiques et de l’ADN, la communication intercellulaire des bactéries (quorum-sensibilité) [15]
    • Activité antibactérienne contre Listeria monocytogenes, Salmonella typhimurium, Escherichia coli O157: H7, Shigella dysenteria, Bacillus cereus, Staphylococcus aureus, entre autres, grâce à divers principes actifs antibactériens : carvacrol, thymol, eugénol, perillaldéhyde, cinnamaldéhyde, acide cinnamique, à des concentrations minimales inhibitrices (CMI) allant de 0,05 à 5 microl ml (-1) in vitro. Dans les aliments, il faut une concentration plus élevée, de l’ordre de 0,5 à 20 µol g (-1). Les organismes à Gram négatif sont légèrement moins sensibles que les bactéries à Gram positif. Leur mode d'action implique plusieurs cibles dans la cellule bactérienne, en raison d’un grand nombre de composants. L'hydrophobie des HE leur permet de se répartir dans les lipides de la membrane cellulaire et des mitochondries, de les rendre perméables et de provoquer des fuites du contenu cellulaire. Une synergie a été observée entre le carvacrol et son précurseur, le p-cymène, et entre le cinnamaldéhyde et l’eugénol [16]
    • Activité antibactérienne contre Clostridium perfringens [17] (thym > basilic et marjolaine > romarin, menthe poivrée et anis vert
    • Activité antivirale [18], activité in vitro sur des virus à ARN et ADN, tels que les herpès simplex virus type 1 et type 2 (HSV-1 and HSV-2), le virus de la dengue type 2, de la grippe Influenza virus, des adénovirus type 3, des poliovirus, du virus Junin, des virus coxsackies B1 [19], [20], [21], vis-à-vis d’Herpes simplex virus type 1 (HSV-1) in vitro [22], [23], divers composants d’huiles essentielles ont une affinité importante vis-à-vis des protéines de surface du virus de la dengue : (-)-α-copaène, (+)-α-copaène, β-bourbonène, (-)-germacrène D, (+)-germacrène D, (+)-spathulénol, (-)-spathulénol, β-caryophyllène, caryophyllène oxide, (+)-épi-bicyclo-sesquiphellandrène [24]
    • Activité antifongique [25], [26], activité sur Aspergillus [27] (Cinnamomum zeylanicum (écorces et feuilles), Cinnamomum cassia, Syzygium aromaticum, Cymbopogon citratus vis-à-vis de Aspergillus niger), activité sur Candida albicans (carvacrol, eugénol, géraniol, linalol, terpinène-4-ol) [28], même sur Candida spp. résistants au fluconazole [29], inhibition des biofilms des Candida sp (carvacrol, géraniol, thymol) [30]
  • Effet dans les pathologies du tractus respiratoire [31], [32]
  • Effet dans les pathologies gynécologiques et urologiques [33], [34]
  • Effet dans les pathologies infectieuses dermatologiques dues à Staphylococcus, Streptococcus pyogenes, Propionibacterium acnes, Haemophilus influenzae, Brevibacterium species [35]
  • Effet sur Helicobacter pylori [36]

Synergies avec les thérapeutiques conventionnelles

Aromathérapie et maladies nosocomiales

  • L’aromathérapie peut diminuer l’incidence des maladies nosocomiales, une désinfection standard, en combinaison avec une nébulisation d'huiles essentielles, réduit la contamination bactérienne et fongique [50]

Spécificités des traitements en pédiatrie

Effets sur le système nerveux central

  • Effet anxiolytique [52], [53], [54], [55], [56], [57], [58], [59], [60], [61]
    • Une méta-analyse montre que l'aromathérapie inhalée unitaire est efficace pour améliorer l'insomnie, ainsi que le stress, la dépression, l'anxiété et la fatigue, avec une supériorité de l’huile essentielle de lavande vraie [62]
    • Une large méta-analyse comportant un total de 6539 patients montre un effet positif de l’aromathérapie inhalée sur les niveaux d'anxiété dans 70 % des cas, étude souvent obérée par l'absence de données de sécurité, l’imprécision des espèces végétales et du dosage de l'huile essentielle [63]
  • Effet antidépresseur [64], [65]
    • Une baisse de la sensibilité olfactive est remarquée chez les dépressifs [66]
  • L’inhalation d’huiles essentielles (de lavande vraie, Citrus sp., rose) en préopératoire réduit l’anxiété [67]
  • Réduction de l'agitation dans les démences [68], [69], [70], [71], [72], améliore le comportement de motivation [73], [74], [75], en cancérologie [76]
  • Bénéfices de l'olfaction d'huiles essentielles en unités d'hébergement de personnes âgées de type EHPAD [77] et l'olfaction peut même aider au diagnostic de la maladie d'Alzheimer [78]

Effets sur le système nerveux végétatif

  • L'inhalation d'huiles essentielles peut moduler l'activité sympathique chez les adultes en bonne santé : les HE de poivre, d'estragon, de fenouil et de pamplemousse augmentent l'activité sympathique, alors que l’HE de rose ou de patchouli entrainent une diminution de l'activité sympathique, l’HE de poivre augmente la concentration d'adrénaline plasmatique, et l’HE de rose diminue la concentration d'adrénaline [79]

Effets dans la sphère gynécologique

Effet dans l'immunité

Effet dans la sphère cutanée

Effet dans la sphère rhumatologique

  • Anti-inflammatoires par voie topique [106], [107], [108]
  • Antalgiques [109], [110], [111], surtout monoterpènes [112]
    • Effet antalgique, revue d'études et méta-analyse de 2021 [113]
    • Une revue de littérature de 2023 avec méta-analyse montre que l’aromathérapie par voie topique peut réduire la douleur et la raideur dans les troubles musculo-squelettiques [114]
  • Maladies rhumatismales inflammatoires [115]

Effet dans les maladies cancéreuses

Aromathérapie à l'hôpital

  • L'aromathérapie est de plus en plus utilisée en complément dans les services hospitaliers [127]

Effet répulsif, insectifuge

Précautions d'emploi

  • Éviter l'usage des huiles essentielles chez la femme enceinte et l'enfant de moins de 6 ans par voie orale
  • Prudence chez les patients aux antécédents de troubles neurologiques
  • Risques allergiques, surtout par voie topique
  • Les suppositoires contenant des dérivés terpéniques sont contre-indiqués chez les enfants de moins de 30 mois et chez les enfants ayant des antécédents de convulsion fébrile ou d’épilepsie Lettre aux professionnels de santé 14/11/2011

Bibliographie

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  2. Valnet Jean. Aromathérapie. Ed. Maloine. Paris. 1964 et nombreuses éditions ultérieures
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