Laboratorio di Statistica Medica ed Epidemiologia Clinica, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126, Parma, Italy.
CdLM Medicina e Chirurgia, University of Parma, Parma, Italy.
Int J Biometeorol. 2018 Jun;62(6):913-924. doi: 10.1007/s00484-018-1504-8. Epub 2018 Feb 18.
Balneotherapy and spa therapy are well-known practices, even though limited evidence has been produced about their biological effects. This systematic review primarily aims at assessing if balneotherapy, mud/peloid therapy, and spa therapy may influence cortisol levels. Secondarily, it aims at understanding if these interventions may improve stress resilience. PubMed/Medline, Embase, and Cochrane Library were searched for relevant articles in English or Italian about studies involving healthy and sub-healthy subjects or patients with a diagnosed disease about effects of balneotherapy, mud/peloid therapy, and spa therapy on serum and salivary cortisol levels. Fifteen studies involving 684 subjects were included. Five studies investigated biological effects of balneotherapy alone. Two of them reported significant changes of cortisol levels in healthy participants. The other three studies reported no significant variations in patients with rheumatic conditions. No studies investigated biological effects of mud/peloid therapy alone. Ten studies investigated biological effects of spa therapy with or without included mud/peloid therapy, and in all but two studies, significant variations of cortisol levels were reported. Our main findings suggest that balneotherapy may have the potential to influence cortisol levels in healthy subjects, in such a way as to improve stress resilience. Spa therapy with or without included mud/peloid therapy demonstrated the same potential to influence cortisol levels also in sub-healthy subjects and in patients with a diagnosed disease. Therefore, balneotherapy and spa therapy may be considered as useful interventions for the management of stress conditions. Further investigation is needed because of limited available data.
水疗和温泉疗法是众所周知的实践，尽管其生物学效应的证据有限。本系统评价主要旨在评估水疗、泥/淤泥疗法和温泉疗法是否可能影响皮质醇水平。其次，旨在了解这些干预措施是否可以提高应激弹性。检索了英文或意大利文的有关健康和亚健康受试者或诊断疾病患者的水疗、泥/淤泥疗法和温泉疗法对血清和唾液皮质醇水平影响的研究的 PubMed/Medline、Embase 和 Cochrane Library 相关文章。共纳入了 15 项涉及 684 名受试者的研究。五项研究调查了水疗的生物学效应。其中两项研究报告了健康参与者皮质醇水平的显著变化。另外三项研究报告了风湿性疾病患者无显著变化。没有研究调查泥/淤泥疗法单独的生物学效应。十项研究调查了温泉疗法（包括或不包括泥/淤泥疗法）的生物学效应，除了两项研究外，其余研究均报告了皮质醇水平的显著变化。我们的主要发现表明，水疗可能有潜力影响健康受试者的皮质醇水平，从而提高应激弹性。温泉疗法（包括或不包括泥/淤泥疗法）也显示出同样的潜力，影响亚健康受试者和诊断疾病患者的皮质醇水平。因此，水疗和温泉疗法可以被认为是管理应激条件的有用干预措施。由于可用数据有限，需要进一步研究。
