Evidence-based-balneotherapy-inHungary课件.pptx

Evidence-based balneotherapy in Hungary
Katalin Szendi ., .
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 conditionsKnee 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