The application of mineral water in the treatment of chronic obstructive pulmonary disease: a meta-analysis

INTRODUCTION: A review of literature data and meta-analysis was performed, which showed the effectiveness of inhaled use of natural mineral water in patients with chronic obstructive pulmonary disease.EVIDENCE ACQUISITION: Randomized clinical trials were searched in Pubmed, Embase, ELibrary, MedPilot, and CyberLeninka databases, according to the PRISMA strategy, published between 1990 and July 2020. For the calculation, a standardized difference of average values and their 95% confidence intervals using a random effects model we used.EVIDENCE SYNTHESIS: 1510 scientific publications were analyzed. The meta-analysis included 7 studies, including 5 randomized controlled clinical trials, including the results of treatment of 1068 patients. All 7 articles concluded that treatment (inhalation) with mineral water has a positive effect on the course of chronic obstructive pulmonary disease. Analysis of the data obtained showed that in the group of patients with chronic obstructive pulmonary disease after inhalation of mineral water compared with the control group, there is an improvement in FEV1, as the main indicator of respiratory function. The standardized difference between the average FEV1 (%) values (Hedge’s g) was 0.4 (95% CI: 0.1-0.7), and the FEV1 (l) values (Hedge’s g) were 0.1 (95% CI: -0.1-0.3). There was significant heterogeneity in the results of individual studies (Q=25.0; df=4, P<0.001 and Q=29.0; df=3, P<0.001).CONCLUSIONS: The review of literature data showed that mineral water inhalation improves the course of chronic obstructive pulmonary disease by reducing the activity of inflammation and lipid peroxidation in the airway mucosa, improves mucociliary clearance and bronchial drainage. A meta-analysis showed that mineral water inhalation contributes to a statistically significant increase in FEV1.