Coccheri S, Nappi G, Valenti M, Di Orio F, Altobelli E, De Luca S
Cardiovascular Department, Division of Angiology, University Hospital St. Orsola, Bologna, Italy.
Int Angiol. 2002 Jun;21(2):196-200.
Chronic venous disorders carry lifelong medical and social burdens. Within conservative approaches, spa hydrotherapy is popular among patients with venous disorders in Europe, but whether the practice is associated with health or social benefits remains controversial.
The present work is a substudy of the nation-wide Italian Naiade Project, a large multicenter observational exercise on spa treatments in different disease groups. The "Chronic Phlebopathies" substudy included 2504 patients with primary or secondary varicosis or non-varicose venous insufficiency. After a first visit and administration of a detailed questionnaire, patients underwent a "thermal cycle" of 15-20 days consisting of underwater active and passive physical therapy with mineral waters. The same procedures were repeated after 1 year on the 1352 patients (54%) who spontaneously returned to the same spa. Primary endpoints of the study were some indicators of the use of health resources related to the year after the first thermal cycle, compared with the same indicators recorded at first visit using appropriate statistical methods.
The occurrence of acute venous episodes, working days missed, number and duration of hospital admissions, consumption of drugs and physical therapies were all significantly reduced in the year after thermal therapy, thus indicating lesser use of health resources.
The study suggests that thermal hydrotherapy in patients with chronic venous disorders is associated with health and social benefits.
慢性静脉疾病带来终身的医疗和社会负担。在保守治疗方法中，温泉水疗在欧洲静脉疾病患者中很受欢迎，但这种疗法是否与健康或社会效益相关仍存在争议。
本研究是意大利全国性奈亚德项目的一项子研究，该项目是一项针对不同疾病组温泉治疗的大型多中心观察性研究。“慢性静脉病”子研究纳入了2504例原发性或继发性静脉曲张或非静脉曲张性静脉功能不全患者。在首次就诊并填写详细问卷后，患者接受了为期15 - 20天的“热循环”治疗，包括使用矿泉水进行水下主动和被动物理治疗。1年后，1352例（54%）自行回到同一温泉的患者重复了相同的治疗程序。该研究的主要终点是与首次热循环后一年相关的一些卫生资源使用指标，使用适当的统计方法与首次就诊时记录的相同指标进行比较。
热疗后的一年中，急性静脉事件的发生率、缺勤天数、住院次数和时长、药物及物理治疗的消耗量均显著降低，这表明卫生资源的使用减少。
该研究表明，慢性静脉疾病患者的热浴水疗与健康和社会效益相关。
