Ponomarenko G.N.

Medical Military Academy, St.-Petersburg, Russia

ponomarenko_g@mail.ru

In XX century the spa-medicine was generated as a science, having united in itself the various isolated directions of medical use of natural physical factors. Representations about essence of the pathological process covering a complete organism, and unity of patho-and sanogenesis stimulated development of new concepts — medical rehabilitation, preventive medicine, in which among other nonspecific effects of medical physical factors are realized. In XX a century have been developed and approved more than 80% of physical methods of treatment available today which in Russia and other countries are included into programs of spa- treatment. Achievements of information computer technologies have allowed entering into medical process of technology of biooperated physiotherapy. In 70th years for treatment of patients began to use the physical factors of low intensity possessing specific action. The revealed strengthening of medical effects of natural and artificial physical factors has defined advantage of their complex use.

Prospects of development of modern balneology are directed on optimization of the organization of spa- treatment and increase of its efficiency.

Optimization of spa-treatment in Russia spent by introduction of reports of spa-treatment on the basic classes of diseases which include natural and artificial physical factors. It is proved, that clinical efficiency of treatment under reports it is significant above, than in patients whom physical methods of treatment appointed empirically.

Among new approaches to an estimation of efficiency of spa-treatment it is necessary to note development of concepts of the evidence based and personalized spa- therapy.

Evidence based spa-therapy — the section of evidence based medicine connected with application in treatment of those physical methods only, which efficiency is proved in good-quality researches. The personalized spa therapy — the section of the personalized medicine based on administration to the patient of physical methods of treatment on the basis of factors, defining (limiting or essentially modulating) their medical effects — a determinants of their efficiency. It is shown, that the reasons of dissociations in medical effects of physical factors are caused not only a level of the base functions broken at concrete patients, but also numerous associated with them clinical conditions, such as genetic polymorphism, metabolism disorders, defeat of the organs-"targets".

Among achievements in basic researches of modern spa- therapy it is necessary to note opening of phenomena of genetic determination of mechanisms of medical action of medical physical factors (made a basis of its new section — physiogenetics). Now in spa- medicine the innovative technologies including hi-tech methods, marketing and consulting of spa- services roughly develop.

The analysis of facts currently available allows concluding, that the basic directions of scientific researches of modern balneology are:

— Development of reports of spa- treatment in patients with various diseases;

— A scientific substantiation of methods of adequate batching air and solar baths and sea bathings;

— Approbation of new combinations of natural and artificial physical factors — modelling of parameters of a medical climate (the organization of branches bioclimatotherapy);

— Development of new techniques of drinking treatment by mineral waters and applications of mud-save technologies.