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Evidence-based-balneotherapy-inHungary课件.pptx

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Evidence-based-balneotherapy-inHungary课件.pptx
文档介绍:
Evidence-based balneotherapy in Hungary
Katalin Szendi M.D., Ph.D.
Department of Public Health Medicine, Universitiy of Pécs, Pécs, Hungary
Introduction
Balneotherapy:
Ancient, traditional treatment
Europe, other parts of the world
Musculoskeletal
Gynaecological
Dermatological conditions (psoriasis)
Peripheral vascular diseases, etc.
Used empirically for centuries
18th century – chemical analyses – anic salts only
Recent decades – studies, clinical trials
Introduction
Balneotherapy defined as the use of:
Natural mineral waters
Natural peloids and mud
Natural sources of different gases (CO2, H2S, Rn222)
Implemented as/by:
Head-out immersion in mineral water
Mud- or peloid-packs to body regions
Exposure to gases during bathing and by inhalation
Drinking mineral water
Introduction
Hungary:
Rich in thermal-mineral waters
> 1300 thermal wells
270 qualified medicinal water, 275 qualified mineral water
Geothermal conditions – geothermal gradient
Pannonian basin – crust 10 km thinner
50 °C / km (world average – 26 ° C / km)
Thermal water underground – 70-80%
Mechanism of action of balneotherapy
Physical:
Cardiovascular
Pulmonal
Renal
Endocrine
Neuromuscular
Hematologic
Water depth
Posture
Buoyancy
Temperature
Chemical:
Absorption through the skin (limited data)
Other:
Antioxidant
Immunologic
Evidence-based balneology research in Hungary
Evidence-based balneology research in Hungary
Started in the 19th century
The Hungarian Balneological Society was founded in 1891
Musculoskeletal conditions Knee osteoarthritis
Trial
Study design
Treatment
Follow-up period
Results
Balint et al. 2007
Double blind RCT
G1: mineral water, 34°C, 30 min, 5 days a week for 4 weeks
G2: heated tap water
3 months
WOMAC activity, pain improved sign. + follow-up sign.
Same in tap water, no improvement end of follow-up
Szucs et al. 1989
Double blind RCT
G1: thermal mineral water, 36°C, daily 20 min, 18x
G2: tap water
3 weeks
Pain, tenderness decreased
Kovacs and Bender 2002
Double blind RCT
G1: thermal mineral water, 36°C, daily 30 min, over 15 days
G2: mixture of tap and thermal
15 weeks
Greater improvement in thermal water group (in all parameters)
Gaal et al. 2008
Prospective study
33°C water, daily 30 min, 15x
10-14 weeks
All parameters improved sign. Effect prolonged for 3 months after treatment
Musculoskeletal conditions Hand osteoarthritis
Trial
Study design
Treatment
Follow-up period
Results
Horvath et al. 2012
Randomised, single-blind, controlled trial
G1: thermal mineral water, 38°C, 20 min, 5x a week for 3 weeks + standard pulsed ic field therapy 3x a week, over 3 weeks
G2: same, but 36°C
G3: pulsed ic field therapy
13 weeks
Stat. sign. improvement in several parameters + follow-up
Kovacs et al. 2012
Randomised, double-blind, controlled trial
G1: thermal mineral water, 37°C, 20 min, 15x, over 3 weeks
G2: tap water, same temperature
6 months
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