For the first time, medical research study in field conditions was organized in Tuva at the remote arzhaan "Choigan". The medical team consists of eight practicing specialists from various therapeutic-prophylactic health care centers of the republic. The team includes a physiotherapist, neuropathologist, surgeon, a specialist in clinical laboratory diagnostics, otolaryngologist physician's aide-laboratory technologist, and one student of Republic medical College.
The study was performed during the summer season of active visiting by vacationers seeking healing at medicinal springs of arzhaan Choigan, from 9 to 23 July 2012. This research used instructions for examining patients, tests, questionnaires, worked out by I.N. Smirnova, the head of the therapeutic department of Tomsk institute of balneology and physiotherapy. Medical-clinical studies of all parameters of function were performed on 93 patients twice: when they arrived at the arzhaan, before beginning therapy, and just before departure (after the course of therapy. Consequently, varying periods of therapeutic procedures were noted, but in most cases the vacationers came for a week's stay.
The patient studies began with the first examination with taking of medical history and chief complaints, calculation of body mass index, detailed blood analysis and urinalysis. The degree of chief complaint expression was evaluated on a 3-point scale. After that, functional analysis of cardiovascular system by measuring arterial pressure and pulse, evaluation by electrocardiogram, stress-test for level of adaptive response reserves of the cardiovascular and respiratory system, which limits the physical potential of the organism.
Then the levels of oxygen saturation were measured. Every patient was evaluated for external respiration including measurements of volume and frequency of respiration, as determined by peak frequency of exhalation with use of peak flow-meter, evaluation of homeostasis during hypercapnia and hypoxia the general condition of oxygenation system was performed by functional stress by breath-holding after inhalation or after exhalation.
The ophthalmologic study involved examination of the vision acuity and internal ocular pressure. The functional condition of the nervous system was examined by express-diagnostics of nervous system by psychomotor indices, calculation of Cerdeau index and coefficient of strength of the peripheral nervous system, etc. .to characterize the psycho-emotional condition, degree of anxiety and depression on HADS scale was evaluated, asthenic syndrome was evaluated, and the level of psychological stress, by m questionnaire. Making allowances for the fact that during the first examination, patients with problems of skeletomotor system are diagnosed persons with complaints of joint pain were also evaluated for joint function - range of motion. Strength of separate muscle groups was measured with a hand dynamometer.
After all the examinations, the results were entered in a chart of effectiveness of the therapy. The physiotherapist calculated the integral indices of adaptive potential and made conclusions as to the general somatic health of the patient, which allowed to come to conclusions about the therapeutic effectiveness of the procedures. In this way, evaluations of functional condition of cardio-respiratory and nervous system were performed, as well as psychological status of each patient before and after therapy.
The charts of therapy effectiveness of each patient will still have to be subjected to thorough analysis as well as statistical work-up for comparative study of curative action of the arzhaans. This is what will show the therapeutic action of the spring waters of arzhaan Choigan. The results of the research should be presented this November. The research subjects - arzhaan patients were extremely interested in the research carried out in field conditions (at the arzhaan, in a yurt), many of them were happy to undergo the full course of medical examinations, and expressed thanks for its organization. They wanted to know if this research will continue next year, and if their charts will be at the arzhaan.
Therapy at the medicinal natural springs in the summer is one of Tuvan traditions. At the same time, there are no data about the effectiveness of the use of local arzhaans, with an exhaustive proof, in medical and official sources. It has to be noted that in the 1990's medical research was carried out at a number of Tuvan arzhaans, but these were of a sociologic character: conclusions of the effectiveness were evaluated on the basis of subjective symptom reporting by the patients. This circumstance became the basis for the clinical medical study in July 2012 at the natural arzhaan complex "Choigan mineral springs", i.e. arzhaan Choigan or Izig-Sug, as natives of Todzha call it.
The research was carried out in the framework of Complex expeditionary studies, organize3d by OOO "Laboratory of arzhaanology and tourism" with the support by Russian Geographic Society.
Scientists from Scientific research institute of medical-social problems and administration of RT, as well as various centers of Ministry of Health of Tuva participated in the project.