Balneotherapy for Progressive Systemic Sclerosis

Material and Methods

We addressed the members of scleroderma-self-help-groups in West-Germany and succeeded to get the replies of 411 patients for evaluation, 110 of them had only circumscribed scleroderma (CS)

Table 1 The most frequent complaints of 411 patients with scleroderma. See text for details.

1.)	Deterioration in the patients general condition (physical and psychological)	51.3%
2.)	Deterioration in the patient's general physical strength	59.8%
3.)	Sensitivity in cold	78.6%
4.)	Numbness of fingers (Raynaud's phenomenon)	66.4%
5.)	Feeling of tension in the skin	49.5%
6.)	Aclerema	45.0%
7.)	Arthralgie	46.3%
8.)	Myalgie	34.4%
9.)	Morning Stiffness	39.3%
10.)	Limited flexibility of joints	45.2%
11.)	Xerosis	47.2%
12)	Microstomia	34.6%
13.)	Rigidity of joints	30.6%
14.)	Skin lesions and ulcers	29.7%
15.)	Cutaneous swelling	29.0%
16.)	Sclerema and contraction of the frenulum	28.6%
17.)	Dyspnea	25.1%
*Prof. Dr. med. M. Buhring, Krankenhaus Moabit, IV, Innere Abteilung (Naturheilweisen), Turmstr. 21, D-10559 Berlin, Germany

In table 2 you see the different kinds of balneotherapy that were assessed. At the same time you find the number of responders. Mud and sulphur were ordered most by the doctors and these classic agents were rated best by the patients, especially regarding "sensitivity to cold", which was complained above all.

Table 2: Subjective rating of different treatments regarding different complaints (see table 1). n stands for the number of treated patients. The percentage of responders ("good" and "very good") is mentioned.

	n	Well being	Phys. Strength	Sensit. cold	Scler. skin	Pain	Stiffness	x
Mud	56	39	33	21	19	23	24	26.5
Sulphur	56	50	33	23	18	16	16	26.6
Brine	35	26	13	4	17	13	9	13.7
Co²	32	20	15	4	5	0	0	7.3
Radon	19	24	19	6	16	25	14	17.3
Phyto-Baln	31	38	36	23	12	18	12	23.2
Hyperthermia	55	47	45	26	17	37	32	34.0

Table 3: Subjective rating of different kinds of drug therapies, physical therapies and mud/sulphur baths regarding different complaints. (See table 1; details of the therapeutic procedure see text.) See also text for table 2

	n	well being	Phys. Strength	Sensit. cold	scler. Skin	Pain	Stiffining	x
Pharmacother.	562	21	17	9	14	14	15	15.0
Physical Therapy	933	39	32	15	21	23	20	25.0
Mud, Sulphur	112	44	33	22	18	19	20	26.0

2nd Symposium...Sulfur in Health Resort Medicine, Bad Nenndorf, May 1994

Discussion

The present study has severe methodical deficiencies.

First, it is a retrospective survey, based on subjective data. There is no control group, no stratification, and the patients were neither clinically examined nor the disease objectively staged in a standardized manner as part of the study design. Therefore bias are possible in the way that severely sick patients with a poor prognosis might be primarily treated with drugs, while patients with limited disease with physical or balneological therapies (they still could visit a spa). so the good results could depend on the naturally better earlier stages in the course of the illness. The possible mistake may be less serious comparing physical and balneological treatments exclusively.

To defend our approach one can point out that we put our attention above all to the patients with 'strong' and 'very strong' complaints, even if the statements were subjective. patients suffering from a prolonged, very impairing chronic disease like PSS are able to give a reliable evidence by themselves of their health state in general and in detail, what means a judgement of their quality of life.

As a first step of investigation on this field, the present research made it possible to produce such an extensive data base about treatment effects on syndromes of PSS by a large number of patients. There does not yet exist a comparable publication.

Second, this study has a lack of differentiation within the therapeutic procedures. In sulphur baths e.g., we know neither detail of the substance actually used (sulphide-sulphur in spa-water or colloid sulphur in family baths), nor the frequency or duration of the applications. With a total of already 96 treatments mentioned and 22 symptoms characterizing the degree of illness further subdivision or detailed description would have passed the upper limit of a questionnaire, to be filled in and worked out by anybody.

But, the remarkable effectiveness of mud and sulphur baths does correspond to the overall balneological experience and already described in the ancient and classical literature.

As to carbon dioxide baths, we think that they were ordered for theoretic considerations on their mechanism of stimulating the vasomotricity strongly and consecutively causing cutaneous hyperaemia. The commonly low temperature in CO² baths might have been of disadvantage and explain the poor results,

where as in the contrary the commonly high temperature of mud baths might be one reason for the outstanding benefit the patients reported. In this context we also interpret the very good rating of hyperthermia.

This preliminary study supplies a good deal of orienting data that lead to further research.

Text Book

Disclaimer
Copyright © 1979-2010, by Healing Botanicals, Inc. International All right reserved, including the right of reproduction in whole or in part, in any form. This document or photos can not be reproduced without the written consent of the owner.