嗅觉牵连障碍（ORD）是一种持久且错误地认为自己身体存在臭味或者其他令人不愉快气味为特征的精神障碍，以导致明显的痛苦和社会功能受损为特征，常伴有牵连性思维，并试图掩盖、改变或避免自认为的气味的重复行为。该疾病的诊断应与多种躯体疾病（如牙周炎、三甲基胺尿症、直肠脓肿、肛瘘、颞叶癫痫）、社交焦虑障碍、强迫症、躯体变形障碍、妄想障碍及其他原发性精神病性障碍、心境障碍、回避型人格障碍和躯体痛苦障碍相鉴别。关于ORD的治疗，目前多为病例报道，缺乏大样本随机对照研究。治疗方式包括抗抑郁药、抗精神病药物、抗精神病药物联合抗抑郁药及心理治疗等。未来应进行多中心、随机对照研究以进一步验证各种治疗方法的疗效。本文系统回顾ORD的临床特征、诊断、鉴别诊断及治疗进展，为ORD的临床诊疗提供科学依据。

Olfactory reference disorder （ORD） is a psychiatric condition characterized by a persistent and false belief that one emits a foul or unpleasant body odour. This belief leads significant distress and impaired social functioning. It is often accompanied by referential thinking and repetitive behaviours aimed at concealing， changing or avoiding the perceived odour. Its diagnosis should be distinguished from various physical diseases （such as periodontitis， trimethylaminuria， rectal abscess， anal fistula， and temporal lobe epilepsy）， social anxiety disorder， obsessive-compulsive disorder， body dysmorphic disorder， delusional disorder， and other primary psychotic disorders， mood disorder， avoidant personality disorder， and bodily distress disorder. Evidence for the treatment of ORD primarily comes from case reports， while large-sample randomized controlled studies are lacking. The treatment for ORD includes antidepressants， antipsychotic drugs， antipsychotic drugs combined with antidepressants， and psychotherapy. Multi-center， randomized controlled trials are needed to further validate the efficacy of these treatments. This paper systematically reviews the clinical characteristics， diagnosis， differential diagnosis and treatment of ORD， providing scientific evidence for the clinical diagnosis and treatment of ORD.