Karagülle Mine, Karagülle Müfit Zeki
Department of Medical Ecology and Hydroclimatology, Istanbul Medical Faculty, Istanbul University, Millet cad 126, Capa, Istanbul, 34093, Turkey,
Clin Rheumatol. 2015 Feb;34(2):207-14. doi: 10.1007/s10067-014-2845-2. Epub 2014 Dec 23.
In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.
在大多数欧洲国家，医生广泛推荐使用浴疗法和温泉疗法，欧洲民众也更倾向于用这些疗法来治疗包括慢性腰痛（LBP）在内的肌肉骨骼问题。我们旨在回顾和评估近期关于浴疗法和温泉疗法对腰痛患者有效性的证据。我们全面检索了2005年7月至2013年12月期间以英文发表的随机对照试验（RCT）数据库。我们确定了所有测试浴疗法或温泉疗法治疗腰痛且报告分配序列为随机的试验。我们最终纳入了总共八项随机对照试验：两项关于浴疗法，六项关于温泉疗法。所有纳入综述的试验均报告，浴疗法在长期缓解疼痛和改善功能方面优于自来水疗法，且将浴疗法与泥敷疗法和/或运动疗法、物理疗法和/或教育相结合的温泉疗法在腰痛管理中有效，在短期和长期内均优于或等同于对照治疗。我们使用Jadad量表对方法学质量进行评分。八项试验中只有三项得分高于3，表明质量良好。随机对照试验的数据表明，关于浴疗法和温泉疗法对腰痛有效性的总体证据令人鼓舞，且与先前证据一致。然而，试验的总体质量普遍较低。需要更好质量的随机对照试验（设计、实施和报告良好）来测试缓解慢性背痛的短期和长期效果，并证明更广泛的有益效果。
