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The
Results of the Approbation of the 'BBL' Method in the Department of
Children's Diseases in the First Moscow Medical Institute of E. M.
SechenovK.
P. Buteyko, V. A. Genina
The BBL method was tested and approved by the Medical Institute
of E. M. Sechenov between February 27, 1981 and May 21, 1981.The method
is based on a conscious decrease in deep breathing and specifically
designed for patients suffering from bronchial asthma. It is based
on the fact that clinical results show improvement proportional to
the decrease in lung ventilation. Clinical Characterisations
of Patients with Bronchial Asthma The experiment was based
on patients suffering from regular asthma attacks (once a day or more)
during the previous month. Some of the patients had severe asthmatic
conditions leading to asphyxia. The purpose of the experiment was
to demonstrate the relationship between the major symptoms of the
disease (bronchospasm, cough, nasal blockage and so on) and hyper
ventilation. The patients were asked to undergo a three stage hyper
ventilation test (developed by Professor Buteyko in 1968).
- The test was
conducted in a sitting position. The patients were asked to use
the BBL method. Correctly followed instructions yielded the following
results:
In 1 to 5 minutes there was a decrease or disappearance in the symptoms
of asthma: the patients experienced relief from asphyxia, wheezing,
cough or rhinitis.
- The second
stage involved a reverse process:
The patients were asked to breath deeply for 15 to 60 seconds until
the first symptoms of an attack.
- The patients
were asked to repeat the BBL and thus prevent the onset of the attack
independently.
If the patients did
not understand the relationship between the hyper ventilation and the
disease, the test was repeated. The test was not conducted if the patients
took a bronchodilator 1.5 to 2 hours prior to the test. Fifty-two patients
between the ages of 3 and 15 were treated according to the BBL method:
36 boys (69%) and 16 girls (31%) (qv Table I). Of the 52 children, 34
(65%) were hospitalised, 18 (35%) were outpatients. Twenty-four (46%)
had atopic bronchial asthma, 22 (42%) had mixed bronchial asthma and
6 (12%) had bacterial allergy bronchial asthma. The majority of the
patients (36) had been suffering from this condition for up to 5 years,
12 for between 6 to 10 years and 4 from 11 to 15 years. The patients
were divided into three categories: mild, severe and very severe (qv
Table II).
Table
I: Age and sex distribution of patients
|
|
Sex
|
Age
|
|
Group
|
Number
|
M
|
F
|
3
- 5
|
6
- 10
|
11
- 15
|
|
Hospital
|
34
|
24
|
10
|
2
|
18
|
14
|
|
Ambulatory
|
18
|
12
|
6
|
5
|
12
|
1
|
|
Total
|
52
|
36
|
16
|
7
|
30
|
15
|
Table II: Patient distribution according to degree of asthma
| |
Degree/Duration
of Illness
|
| |
Mild
|
Severe
|
Very
severe
|
|
Group
|
Number
|
Test
|
%
|
Test
|
%
|
Test
|
%
|
|
Hospital
|
34
|
0
|
0
|
24
|
70.6
|
10
|
29.4
|
|
Ambulatory
|
18
|
1
|
5.5
|
13
|
72.2
|
4
|
22.0
|
|
Total
|
52
|
1
|
1.9
|
37
|
71.1
|
14
|
26.9
|
According to patients' histories, 41 cases (79%) had pneumonia 1 to
7 times. Four (8%) were taking corticosteroids (prednisolone tablets)
prior to the BBL treatment. Six (11%) were physically handicapped, 9
(17%) were obese; all the children had bad posture. 11 (21.2%) had chest
deformity. Most of the children (33 or 64%) had allergic reactions to
medication. 34 (65%) allergic reactions to food and 25 (48%) allergic
reactions to dust. Twenty-seven (52%) suffered from rhinitis, 18 (34.6%)
had Quinke's oedema. 47 (90%) had a predisposition to colds and flu.
All had problems with breathing through the nose. 36 (69%) chronic tonsillitis,
11 (21%) sinus problems. 23 (44%) had frequent headaches, all had palpitations
and 13 (25%) had unstable body temperature. Acute periods of their condition
were accompanied by the following symptoms: 31 (59%) had sleeping problems,
16 (31%) had loss of appetite and 13 (25%) constipation. Of the 52 children
47 (90%) were regular hospital patients and only 5 (10%) did not require
hospitalisation. Prior to the BBL treatment, all children had antibiotic
treatment, all had to use bronchodilators, 37 (71.2%) were using Intal
over prolonged periods, 15 (29%) were taking antihistamines. All these
treatments were having little effect. The course of the BBL treatment
consisted of a daily training of 40 to 90 minutes exercise in the mornings
under the supervision of the specialist: self training included 3 to
5 hours under the supervision of the instructor or the parents. The
majority of the children mastered the method in 5 to 10 minutes; they
were eager, disciplined and enthusiastic. After 1 to 5 days of the BBL
treatment, the patients were able to stop their asthma attacks, coughs,
blocked noses and wheezing. The patients were encouraged to use the
BBL method rather than their medication to overcome their attacks. Thirty-eight
(73%) discontinued their medication as soon as they commenced the BBL
method. Eight (15%) cut down on their medication after 3 to 4 days.
Steroid medications however were an exception. They had to be reduced
gradually. The patients were allowed to take their medication in conjunction
with the treatment, only if they were unable to stop the attack after
10 to 15 minutes with the BBL method. For these cases, medication dosage
was reduced by a factor of 2 to 3 and remained sufficient to stop the
attack. The Results of the BBL Method. Fifty-two children
were observed for between 29 and 84 days. The results were based on
the following criteria
- no improvement
- some improvement
(the degree of attacks is lessened together with a considerable
reduction in medication).
- considerable
improvement (cessation of the heavy attacks, slight traces of the
disease or a total disappearance of the symptoms).
The results are Listed
in Table III.
Table
III: Results of the BBL method
|
Group
|
Considerable
Improvement
|
Some
Improvement
|
No
Change
|
Worse
|
|
Hospital
|
28
|
82.4%
|
6
|
17.6%
|
0
|
0
|
|
Ambulatory
|
15
|
83.3%
|
3
|
16.6%
|
0
|
0
|
|
Total
|
43
|
82.7%
|
9
|
17.3%
|
0
|
0
|
Forty-three (83%) of the patients showed considerable improvement and
nine (17%) showed some improvement. There were no cases showing no improvement.
The average period of hospitalisation was 16 days. All the patients
with bronchial asthma (52) improved in the first four days. They could
breath freely through the nose and their coughs and wheezing disappeared.
Fifteen experienced 'sanogenes' (self-cleansing) reactions, manifesting
themselves through nervous excitement, chills, raised temperatures (up
to 39°), headaches, muscular pains, intestinal pains, chest pains, weakness
and hypersecretion of mucus. Some experienced appetite loss, nausea.
vomiting, thirst, excessive salivation (smelling of their medication)
and increased urination and defecation. These reactions lasted from
a few hours to two days and happened 2 to 3 times. The time in the condition
of the patient was relative to the length of the controlled pause. (The
control pause is a measure of the concentration of carbon dioxide in
the alveolar sacs. Clinically defined as the length of lime for which
a patient is comfortable after a normal exhalation through the nose.)The
clinical observations of the dynamics and the functions of the bronchi
were researched simultaneously (using Tiffno tests and Rait scale).
All the patients showed the following results during the first fourteen
days of the BBL treatment. As the control pause increased from 10 to
40 seconds, so did the concentrations of immunoglobins A, M, G &
E. Forced expiration volume (Rait's measuring scale) was raised from
36.7 to 173.2 (qv Table IV). The acid-alkali balance of the blood normalised
(it became less basic), the pCO2 of the arterial blood increased from
24.6 to 36.3 mmHg. Control pause increased from 3.9 to ± 0.3 seconds
to 31.4 ± 4.7 seconds (qv Table V).
Table
IV: Change in lung capacity with the BBL treatment
|
State
of Illness
|
Number
|
Start
Point
|
40
min
|
7
Days
|
14
Days
|
30
Days
|
|
Severe
|
14
|
37
± 8
|
92
± 11
|
117
± 15
|
159
± 16
|
-
|
|
Average
|
26
|
76
± 8
|
121
± 8
|
161
± 18
|
173
± 10
|
139
± 9
|
Table
V: Change in control pause with the BBL treatment
|
State
of Illness
|
Number
|
Start
Point
|
40
min
|
7
Days
|
14
Days
|
30
Days
|
|
Severe
|
14
|
2.9
± 0.3
|
12.4
± 1.4
|
28.0
± 4.9
|
24.5
± 4.5
|
31.4
± 4.7
|
|
Average
|
26
|
5.4
± 0.7
|
12.5
± 1.8
|
24.0
± 3.9
|
28.3
± 6.4
|
31.4
± 4.7
|
Patients with severe
cases of asthma increased their lung capacities by 27%; the allergic
resistance increased by 33% (qv Table VI).
Table VI: Change in allergic resistance (AR). expiration speed (ES)
and lung capacity (LC) with the BBL treatment
| |
Time
|
| |
Start
|
14
Days
|
| State
of Illness |
Number
|
LC
|
AR
|
ES
|
LC
|
AE
|
ES
|
| Severe |
8
|
39.2
|
29.4
|
22.1
|
66.2
|
62.0
|
72.3
|
|
Average
|
15
|
55.3
|
48.0
|
51.0
|
80.0
|
78.3
|
85.3
|
Conclusion
The BBL method
as suggested by Professor Buteyko helps to decrease the number and
severity of attacks as well as the dosage of medication.
- As a result
of this therapy, the indicators of acid-alkali balance and lung
ventilation improved.
- The method
may be taught to children from 3 years of age up either in hospital
or as outpatients.
- This method
is endured by children of any age over 3.
- This method
is most effective in acute periods of bronchial asthma in very ill
patient
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