Mineral water inhalations for bronchial asthma: a meta-analysis
https://doi.org/10.4081/ejtm.2023.11460
Accepted: 15 June 2023
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Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. Purpose of the study was to assess the generalized effect power of the course of inhalations of mineral waters on the disease progress in patients with BA. A search of randomized clinical studies in data bases Pubmed, EMBASE, ELibrary, MedPilot amd CyberLeninka, according to PRISMA strategy, published between 1986 and July 2021. Standardized difference of mean values and their 95% of CI were employed for calculation using the random effects model. The meta-analysis drawing on 1266 sources included 14 studies, with 2 of them being randomized controlled clinical studies, including the results of the treatment of 525 patients. All 14 articles contain a conclusion that the inhalation of mineral water has a positive effect on the course of the disease in patients with BA. The analysis demonstrated that the group of patients after mineral water inhalations, compared with the control group, showed improvement of forced expiratory volume (FEV1), expressed both in % of the norm and in liters. The standardized difference of mean values FEV1 (%) (Hedge's g) was 8.2 (95% CI: 5.87 – 10.59; 100%), FEV1 values (liter.) (Hedge's g) was 0.69 (95% CI: -0.33-1.05). A significant heterogeneity of the results of individual studies was found (Q=124.96; tau2 = 14.55, I2 = 69.13%, p<0.0001 and Q=2.35; tau2 = 0, I2 = 0%, p<0.0001). Patients with mild, moderate, and hormone-dependent BA with a controlled and partially controlled disease course, after mineral water inhalations, compared with the control group, demonstrated a statistically significant decrease in the frequency and intensity of the cardinal symptoms of BA and improvement of FEV1.
Global strategy for asthma: management and prevention. Revised 2017. Available online: www.ginasthma.com. (accessed on 29 May 2022)
Chuchalin AG. Pul'monologiya. Nacional'noe rukovodstvo. Kratkoe izdanie [Pulmonology. National leadership. Short edition]. GEOTAR-Media, 2020. Russian
Chuchalin AG, Khaltaev N, Аntonov N. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. International Journal of COPD. 2014; 9: 963–74. Russian. DOI: https://doi.org/10.2147/COPD.S67283
Krahn MD, Berka C, Langlois P, Detsky AS. Direct and indirect costs of asthma in Canada, 1990. CMAJ. 1996 Mar 15; 154(6): 821-31. PMID: 8634960; PMCID: PMC1487808.
Weber EJ, Silverman RA, Callaham ML, Pollack CV, Woodruff PG, Clark S, Camargo CA Jr. A prospective multicenter study of factors associated with hospital admission among adults with acute asthma. Am J Med. 2002 Oct 1; 113(5): 371-8. PMID: 12401531. DOI: https://doi.org/10.1016/S0002-9343(02)01242-1
Braman SS, Kaemmerlen JT. Intensive care of status asthmaticus. A 10-year experience. JAMA. 1990 Jul 18; 264(3): 366-8. PMID: 2362333. DOI: https://doi.org/10.1001/jama.264.3.366
Salmeron S, Liard R, Elkharrat D, Muir J, Neukirch F, Ellrodt A. Asthma severity and adequacy of management in accident and emergency departments in France: a prospective study. Lancet. 2001 Aug 25;358(9282):629-35. PMID: 11530150. DOI: https://doi.org/10.1016/S0140-6736(01)05779-8
Nenasheva NM. Bronhial'naya astma. Sovremennyj vzglyad na problemu. [Bronchial asthma. A modern view of the problem]. GEOTAR-Media, 2018. Russian.
Khai Vu Do, Mitsunobu F. Spa Therapy for Bronchial Astma. Alternative and Complementary Therapies. 2004; June: 144-50.
Barabash EYu, Kalinina EP, Gvozdenko TA, Stepanova OP. Vliyanie kompleksnoj reabilitacionnoj terapii na sostoyanie interferonovogo statusa u pacientov s bronhial'noj astmoj [Influence of complex rehabilitation therapy on the state of interferon status in patients with bronchial asthma]. Byuleten' fiziologii i patologii dyhaniya. 2015; 57: 25-9. Russ.
Tanizaki Y, Kitani H, Okazaki M, Mifune T, Mitsunobu F, Okuda H, Takatori A, Ochi K, Harada H. Clinical effects of spa therapy on bronchial asthma. 1. Relationship to clinical asthma type and patient age. J Jpn Assoc Phys Med Baln Clim. 1993; 56: 143-50.
Tanizaki Y, Kitani H, Mifune T, et al. Ten-year study of spa therapy in 329 patients with bronchial asthma. J Jpn Assoc Phys Med Baln Clim. 1994; 57: 142-50.
Тanizaki Y, Kitani H, Okazaki M, et al. Clinical effects of spa therapy on bronchial asthma. 2. Relationship to ventilatory function. J Jpn Assoc Phys Med Baln Clim.1992; 55: 82-6.
Mitsunobu F, Mifune T, Hosaki Y, et al. Improvemant of forced vital capacity (FVC) by spa therapy in patients with bronchial ashma. J Jpn Assoc Phys Med Baln Clim. 1996; 59: 218-24.
Mitsunobu F, Mifune T, Hosaki Y, et al. Effects of spa therapy on asthmatics with low ventilatory function. Relationship to asthma type, patient age, and airway inflammation. J Jpn Assoc Phys Med Baln Clim. 1997; 60: 125-32.
Tanizaki Y, Kitani H, Okazaki M, et al. Clinical effects of spa therapy on bronchial asthma. 9. Suppression of bronchial hyperresponsiveness. J Jpn Assoc Phys Med Baln Clim. 1993; 56: 135-42.
Mifune T, Mitsunobu F, Hosaki Y, et al. Spa therapy and function of adrenocortical glands in patients with steroid-dependent intractabla asthma (SDIA). Relationship to clinical asthma type, and clinical efficacy. J Jpn Assoc Phys Med Baln Clim. 1996; 59: 133-40.
Tanizaki Y, Mifune T, Mitsunobu F et al. Rehabilitation for patients with respiratory disease Spa efficacy in relation to pathophysiological characteristics of bronchial asthma Acta Medica Okayama. 1998: 80-93.
Tanizaki Y, Kitani H, Okazaki M, et al. Clinical effects of spa therapy on bronchial asthma. 5. Efficacy of inhalation with iodine salt solution. J Jpn Assoc Phys Med Baln Clim. 1992; 55: 179-84.
Kitani H, Mitsunobu F, Mifune T, et al. Clinical effects of spa therapy on bronchial asthma. 3. Efficacy of fango therapy. J Jpn Assoc Phys Med Baln Clim. 1992; 55: 127-33.
Mitsunobu F, Kitani H, Okazaki M, et al. Clinical effects of spa therapy on bronchial asthma. 6. Comparison among three kinds of spa therapies. J Jpn Assoc Phys Med Baln Clim. 1992; 55: 185-90.
Mitsunobu F, Kitani H, Mifune T, et al. Clinical effects of spa therapy on bronchial asthma. 12. Effects on asthma with hypersecretion. J Jpn Assoc Phys Med Baln Clim. 1993; 56: 203-10.
Tanizaki Y. Improvement of ventilatory function by spa therapy in patients with intractable asthma. Acta Med Okayama 1986; 40 (1): 55-9.
Okamoto M, Ashida K, Mitsunobu F, et al. Effects of spa therapy combined with dietary supplementation with n-3 fatty acids on bronchial asthma. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 171-9.
Ashida K, Mitsunobu F, Hosaki Y, et al. Decrease in low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) by long-term spa therapy in patients with asthma. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 115-22.
Tanizaki Y, Kitani H, Okazaki M et al. Spa therapy improves ventilatory function in the small airways of patients with steroid-dependent intractable asthma (SDIA). Acta Med Okayama. 1992; 46(3): 175-8.
Tanizaki Y, Sudo M, Kitani H, Araki H. Spa therapy for bronchial asthma. Clinical effects of inhalation of iodine salt solutions. Paper of the Institute for Environmental Medicine, Okayama University Medical School. 1989; 60: 19-24.
Tanizaki Y, Kitani H, Okazaki M et al. Clinical effects of complex spa therapy on patients with steroid-dependent intractable asthma (SDIA). Arerugi. 1993; 42 (3 Pt 1): 219-27.
Ashida K, Mitsunobu F, Mifune T et al. Clinical effects of spa therapy on patients with asthma accompanied by emphysematous changes. J Jpn Assoc Phys Med Balneol Climatol. 2000; 63: 113-9.
Khaltaev N, Solimene U, Vitale F, Zanasi A. Balneotherapy and hydrotherapy in chronic respiratory disease. J Thorac Dis. 2020 Aug;12(8):4459-4468. PMID: 32944359; PMCID: PMC7475532. DOI: https://doi.org/10.21037/jtd-gard-2019-009
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009 Oct;62(10):e1-34. Epub 2009 Jul 23. PMID: 19631507. DOI: https://doi.org/10.1016/j.jclinepi.2009.06.006
Moher A, Liberati J, Tetzlaff J, Altman DG Preferred reporting elements for systematic reviews and meta-analysis: a PRISMA statement. Annals of Internal Medicine. 2009; 151 (4): 264–9. DOI: https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Rebrova OYu, Fedyaeva VK. Meta-analyzes and assessment of their methodological quality. Russian version of the AMSTAR questionnaire. Meditsinskie tekhnologii. Otsenka i vybor. 2016; 1: 10−6. Russian
Ressing M, Blettner M, Klug SJ. Systematic literature reviews and meta-analyses: part 6 of a series on evaluation of scientific publications. Dtsch Arztebl Int. 2009 Jul;106(27):456-63. Epub 2009 Jul 3. PMID: 19652768; PMCID: PMC2719096.
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996 Feb;17(1):1-12. PMID: 8721797. DOI: https://doi.org/10.1016/0197-2456(95)00134-4
Zajak D. Inhalations with thermal waters in respiratory diseases. J. of Ethnopharmacology. 2021; 281: 114505. DOI: https://doi.org/10.1016/j.jep.2021.114505
Zając D, Russjan E, Kostrzon M, Kaczyńska K. Inhalations with Brine Solution from the 'Wieliczka' Salt Mine Diminish Airway Hyperreactivity and Inflammation in a Murine Model of Non-Atopic Asthma. Int J Mol Sci. 2020 Jul 7;21(13):4798. PMID: 32645931; PMCID: PMC7370210. DOI: https://doi.org/10.3390/ijms21134798
Romeyke T, Nöhammer E, Scheuer HC, Stummer H. Integration of naturopathic medicine into acute inpatient care: An approach for patient-centred medicine under diagnosis-related groups. Complement Ther Clin Pract. 2017 Aug;28:9-17. Epub 2017 Apr 13. PMID: 28779943. DOI: https://doi.org/10.1016/j.ctcp.2017.04.004
Zaripova TN, Smirnova IN, Antipova II. Nemedikamentoznaya aerozol'terapiya v pul'monologii. [Non-drug aerosol therapy in pulmonology]. STT, 2014. Russian
Gete NA. Ingalyacionnaya nebulajzernaya terapiya zabolevanij respiratornoj sistemy u detej: Prakticheskoe rukovodstvo dlya vrachej [Inhalation Nebulizer Treatment of Respiratory System Disorders in Children: A Practical Guide for Physicians]. Color – Studio, 2008. Russian
Zaripova TN, Smirnova IN, Moskvin VS, Antipova II. Nemedikamentoznaya aerozol'terapiya kombinirovannym gryazevym preparatom «Tonus plyus» v pul'monologii [Non-drug aerosol therapy with the combined mud preparation "Tonus plus" in pulmonology]. Byulleten' sibirskoj mediciny. 2003; 3: 80-9. Russian DOI: https://doi.org/10.20538/1682-0363-2003-3-80-86
Smirnova IN, Zaripova TN, Antipova II et al. Vliyanie aerozol'terapii mineral'nymi vodami na sostoyanie funkcii vneshnego dyhaniya u bol'nyh bronhial'noj astmoj i hronicheskoj obstruktivnoj bolezn'yu lyogkih.[Influence of aerosol therapy with mineral waters on the state of the function of external respiration in patients with bronchial asthma and chronic obstructive pulmonary disease] Sibirskij medicinskij zhurnal. 2012; 7: 42-5. Russian
Ivashchenko NS, Patutin VN. Preimushchestva metodiki kombinirovannogo primeneniya mineral'noj vody 1-L BiS v sostave kompleksnogo sanatornogo lecheniya bol'nyh bronhial'noj astmoj [Advantages of the methodology for the combined use of mineral water 1-L BiS as part of the complex sanatorium treatment of patients with bronchial asthma] Novye tekhnologii. 2010; 4: 147-52. Russian
Zaripova TN, Smirnova IN, Antipova II, Cherno VA. Obosnovanie ispol'zovaniya mineral'nyh vod Kuzbassa v pul'monologicheskoj praktike [Justification of the use of Kuzbass mineral waters in pulmonary practice]. Medicina v Kuzbasse. 2014; 13(1): 16-21. Russian.
Corradi M, Folesani G, Gergelova P et al. Effect of salt-bromide-iodine thermal water inhalation on functional and biochemical lung parameters. ISRN Pulmonology. 2012: 1–8. DOI: https://doi.org/10.5402/2012/534290
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41. Epub 2010 Feb 18. Erratum in: Int J Surg. 2010;8(8):658. PMID: 20171303. DOI: https://doi.org/10.1016/j.ijsu.2010.07.299
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. PMID: 33782057; PMCID: PMC8005924. DOI: https://doi.org/10.1136/bmj.n71
Higgins JP, Thomas J. Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, 2019. DOI: https://doi.org/10.1002/9781119536604
Samsonova IP. Korrekciya giperreaktivnosti dyhatel'nyh putej u chaste boleyushchih detej I podrostkov s boleznyami organov dyhaniya ingalyaciyami Konstantinovskoj mineral'noj vodoj [Correction of airway hyperresponsiveness in frequently ill children and adolescents with respiratory diseases by inhalation of Konstantinovskaya mineral water] Byulleten' fiziologii I patologii dyhaniya. 2007; 24: 69-70. Russian.
Osina TD. Vliyanie peloidoterapii na mestnye factory zashchity dyhatel'nyh putej u detej [Influence of peloid therapy on local factors of airway protection in children]. Byulleten' fiziologiiipatologiidyhaniya. 2001; 9, 45-48. Russian.
Ivashchenko NS, Patutin VN. Sravnitel'naya harakteristika effektivnosti lecheniya pul'monologicheskih bol'nyh v sanatorii «Laba». [Comparative characteristics of the effectiveness of treatment of pulmonary patients in the sanatorium "Laba"]. Novye tekhnologii. 2010: 2; 145-50. Russian.
Wark P, McDonald VM. Nebulised hypertonic saline for cystic fibrosis. Cochrane Database Syst Rev. 2018 Sep 27;9(9):CD001506. PMID: 30260472; PMCID: PMC6513595. DOI: https://doi.org/10.1002/14651858.CD001506.pub4
Di Marco M, De Novellis AMP, Carluccio V, Bozzelli R, Orlando M, Lanuti P. Short- and long-term beneficial effects of medicinal mineral water administration. Environ Geochem Health. 2020 Feb;42(2):353-364. Epub 2019 Oct 19. PMID: 31630285. DOI: https://doi.org/10.1007/s10653-019-00290-x
Avdeev SN, Arhipov VV. Ingalyacionnaya terapiya [Inhalation therapy]. GEOTAR-Media, 2020. Russian.
Stempel DA, Raphiou J, Kral K, Yeakey A, Buaron K, Emmett A, Prazma ChM, Pascoe S., et al. AUSTRI, a large Randomized Study in Adolescents and Adults with Asthma, Assessing the Safety and Efficacy of Salmeterol in Combination with Fluticasone Propionate Compared to Fluticasone Propionate Alone. The Journal of Allergy and Clinical Immunology. 2016; 137 (2): 389. DOI: https://doi.org/10.1016/j.jaci.2015.12.1208
6-month Safety and Benefit Study of ADVAIR in Children 4-11 Years Old (VESTRI). Available online: https://clinicaltrials.gov/ct2/show/NCT0 1462344 (accessed on 12 May 2022).
Rachelefsky GS, Liao Y, Faruqi R. Impact of inhaled corticosteroid-induced oropharyngeal adverse events: results from a meta-analysis. Ann Allergy Asthma Immunol. 2007 Mar;98(3):225-38. PMID: 17378253. DOI: https://doi.org/10.1016/S1081-1206(10)60711-9
Maccarone MC, Masiero S. Spa therapy interventions for post respiratory rehabilitation in COVID-19 subjects: does the review of recent evidence suggest a role? Environ Sci Pollut Res Int. 2021 Sep;28(33):46063-46066. Epub 2021 Jul 17. PMID: 34273080; PMCID: PMC8286038. DOI: https://doi.org/10.1007/s11356-021-15443-8
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