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Intervention Effect of Aromatherapy on Depressive Symptoms in Patients With Depression: A Systematic Review and Mechanism Analysis Prospect Based on the Integration of Chinese and Western Aromatherapy



Author(s)

HUANG Yun, PENG Zhu, TANG Jiazhi

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DOI:10.17265/2159-5836/2026.07.007

Yunnan Museum of Aromatics & Incense Culture, Kunming, China Yuxi Normal University, Yuxi, China Zhaotong Qihuang Traditional Chinese Medicine Technology Co., Ltd., Zhaotong, China

Background: Depression is one of the psychosomatic diseases with the heaviest global disease burden. Existing pharmacological and psychological treatments suffer from issues such as slow onset of action, significant adverse reactions, and poor long-term compliance. Aromatherapy has a long history and practical foundation in both Western modern medicine and Traditional Chinese Medicine (TCM). Western aromatherapy centers on essential oil chemistry and neurobiological mechanisms, while traditional Chinese aromatic therapy is based on the theoretical system of “opening orifices with aromatics, regulating Qi to relieve stagnation, calming the heart to tranquilize the mind”. These two systems are highly complementary; however, an integrated Chinese-Western model specifically for depression still lacks systematic evidence-based evaluation and mechanistic integration. Objective: To systematically evaluate the intervention effect of aromatherapy on depressive symptoms in patients with depression, with a focus on analyzing the clinical advantages of integrated Chinese-Western aromatherapy protocols, and to elucidate its antidepressant mechanisms from a combined Chinese and Western medicine perspective, thereby providing high-level evidence for adjuvant therapy and rehabilitation of depression. Methods: Computerized searches were conducted in PubMed, MEDLINE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases from their inception to May 2023 to identify randomized controlled trials (RCTs) on aromatherapy interventions for depression. Following the PRISMA guidelines, literature screening, data extraction, and bias risk assessment were performed. A random-effects model was employed for meta-analysis, subgroup analysis, meta-regression, sensitivity analysis, and publication bias testing. Mechanisms were explored by integrating theories from both Chinese and Western medicine. Results: A total of 27 studies (32 RCTs) were ultimately included. Meta-analysis showed that aromatherapy could moderately and significantly improve depressive symptoms in patients with depression (SMD = -0.56, 95% CI: -0.69 to -0.43, P < 0.001). Subgroup analysis indicated that inhalation was superior to massage, and blended essential oils/aromatic formulas were superior to single oils. Protocols integrating TCM syndrome differentiation, acupoint massage, and emotional regulation showed more stable effects, lower heterogeneity, and higher patient compliance. Perimenopausal women and patients with cardiovascular disease comorbid with depression benefited the most, while evidence for postpartum depression was inconsistent. The overall quality of the included studies was moderate, with limitations in blinding and allocation concealment. Conclusion: Aromatherapy has positive, definite, and safe adjuvant therapeutic value for depression. The integration of Chinese and Western aromatherapy can achieve complementary advantages between modern essential oil pharmacology and TCM’s holistic view and syndrome differentiation/treatment, offering unique benefits in improving mood, alleviating somatic symptoms, and enhancing quality of life. The integrated model centered on inhaled blended aromatic therapy + syndrome-differentiated aromatic selection + acupoint intervention holds the greatest potential for clinical promotion and translation. There is an urgent need for future high-quality RCTs with standardized protocols, large samples, and long-term follow-up to promote the inclusion of aromatherapy into standardized depression rehabilitation systems.

aromatherapy, traditional Chinese aromatic therapy, Chinese-Western integration, depression, depressive syndrome, systematic review, meta-analysis, adjuvant therapy

Journal of Literature and Art Studies, July 2026, Vol. 16, No. 7, 622-630