Natural healing factors: a systematic analysis of the evidence base and prospects for application in pediatric practice
TL;DR
The highest level of evidence has been established for balneotherapy for respiratory, dermatological, and rheumatological pathologies, and key limitations of the evidence base include heterogeneity of treatment protocols, small sample sizes in some studies, and insufficient validation of pediatric efficacy assessment scales.
Abstract
INTRODUCTION. Natural healing factors (NHF) — mineral waters, therapeutic mud, climate, and saline solutions — have a centuries-long history of use in pediatrics. However, to date, there is no systematic analysis of the evidence base for the effectiveness of NHF for various childhood diseases, with a gradation of levels of evidence according to GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.
Aim
To conduct a systematic analysis of modern scientific data on the effectiveness of natural healing factors in children, structure the evidence base by nosological groups, and identify promising areas for the development of pediatric balneology. MAIN CONTENT OF THE REVIEW. A search of publications was performed in PubMed, Cochrane Library, Embase, and eLIBRARY.RU databases for the period 2000–2025. Systematic reviews, meta-analyses, randomized controlled trials, and cohort studies were included. Evidence was assessed using the GRADE criteria. The analysis included 42 studies, including 8 systematic reviews with meta-analysis, 12 randomized controlled trials, and 22 observational studies. The strongest evidence base (levels A–B) was found for the use of mineral waters and salt baths in respiratory diseases (asthma, recurrent respiratory infections), skin diseases (atopic dermatitis, psoriasis), and musculoskeletal disorders (juvenile arthritis). Level C–B evidence was established for the use of therapeutic mud and climatotherapy in diseases of the nervous system, digestive organs, and genitourinary system. High potential for extrapolation of these studies to pediatric practice was identified, consistent with modern approaches to developing medicines for children.
Conclusion
Natural therapeutic factors have proven efficacy in a wide range of childhood diseases. The highest level of evidence has been established for balneotherapy for respiratory, dermatological, and rheumatological pathologies. Key limitations of the evidence base include heterogeneity of treatment protocols, small sample sizes in some studies, and insufficient validation of pediatric efficacy assessment scales. Further randomized controlled trials with standardized protocols are needed to improve the level of evidence and expand the indications for the use of NHF in pediatrics.