Spa Therapy for Bronchial Asthma Studies at the Misasa Medical Center

Abstract

Bronchial asthma is usually well-controlled with bronchodilators and antiallergic medication. However, some patients cannot control asthmatic attacks without relying on oral glucocorticoids and their long-term use is associated with side effects of hypertension, diabetes, osteoporosis, and adrenal insufficiency as a result of suppressed adrenal function. These patients, who are diagnosed as having steroid-dependent intractable asthma (SDIA), represent the greatest challenge for physicians, and many attempts to wean these patients to a lower dose of corticosteroid have often been unsuccessful. In light of the prevalent use of alternative and complementary medicine in the United States, many alternative treatments have been explored except one nonpharmacologic therapy widely used in Europe and Japan—spa therapy. There have only been a few studies conducted at the Dead Sea, Israel, for pulmonary diseases and, of those studies, most involved primarily chronic obstructive pulmonary diseases (COPD) and climatotherapy.1,2 But the most extensive research on spa therapy for pulmonary diseases has been conducted at the Misasa Medical Center, at the Okayama University Medical School, Tottori, Japan, for more than 20 years. Although the Japanese balneologists (spa physicians) at the Misasa Medical Center have extensive experience in treating other pulmonary diseases, this review of their research will be limited only to bronchial asthma. At the Misasa Medical Center, spa therapy consists of swimming training in a hot spring pool for 30 minutes; 5 times per week; inhalation of 1.0 mL of iodine salt solution (KI 134 mg/L and NaCl 14.664 g/L), twice per day; and fango therapy. Fango therapy is a treatment involving mud taken from the Ningyo pass and heated to 70–80 C before being packed with cloth (40–43 C) to make compresses. For our research fango was applied to patients’ backs for 30 minutes, 5 times per week. Patients’ responses to therapy was evaluated according to the following guidelines:3 • Marked efficacy—Patients’ asthma attacks clearly disappeared and need for glucocorticoid treatment was reduced. • Moderate efficacy—Asthmatic attacks clearly reduced but patients still had occasional dyspnea with wheezing, or the dose of glucocorticoid could not be reduced, despite relief from symptoms • Slight efficacy—Slight reduction in asthmatic attacks but patients had persistent dyspnea and wheezing and still required glucocorticoid medications • No efficacy—No change in asthmatic attacks without reduction of glucocorticoid medications.