CONFERENCE ABOUT FASTING THERAPY

2001 IN ULAN UDE – REPUBLIC OF BURYATIA

We are facing the necessity of discussing together prospects of the introduction of the method of fasting into the public health care and sanatorium-resort system institutions within the Republic of Buryatia. The studies on fasting method have been carried out in Buryatia for several years, and it is time to sum up some preliminary results. It is very important if our guests - experts on fasting from other regions of Russia - would articulate their opinions and share their knowledge and expertise.

Fasting is known to be used as a complimentary method for cleansing the body. Fasting has therapeutic and health-improving potentialities as it purges the body from "residues", namely removing alien antigen materials, allergens, xenobiotics, and other deleterious substances and products of metabolism.

"Fasting for the sake of Health" is likely to be the most ancient method to bodily treatment and health improvement. The history of fasting with healing effect can be traced back to the remote centuries. The interest to this method was increasing and decreasing, what was stipulated by various levels of the development of general culture and dietary hygiene, as well as selective attitude towards other methods, the pharmaco-therapeutic ones in particular. In Russia the history of this method studies cherishes the memory about the prominent enthusiasts, like P. Velyaminov, P. M. Albitsky, V. V. Pashutin, Yu. S. Nikolayev, and many others who contributed a lot to this field.

The medical workers and population in our Republic, which is located in the Eastern region of Russia, have been always more prone to the understanding and practical uses of non-medicamentous methods, referring to natural (traditional) systems of health improvement. In our Republic the Buryat Scientific Centre, the Republic of Buryatia Ministry of Public Health Care, Centre of Oriental Medicine under the latter Ministry have been always supportive and instrumental in the introduction of international and domestic scientific elaborations on fasting in the practical activity of the public health care institutions.

I wish you further success in the scientific and practical development of new medical technologies on the use of natural methods of treatment and health-improvement of Man.

The author, a physician, described several cases of the successful use of short-term fasting and starvation therapy in his out-patient practice for the treatment of various diseases and pathological conditions, like acute respiratory virus infections, rheumatoid polyarthritis, weeping eczema, etc. The Su Jok therapy and hydrotherapy were used for optimisation of the fasting therapy response and elimination of subjective symptoms of acidosis.

Fasting therapy developed by the Research Institute of Pulmonology was applied during 3 years at the Central district hospital on 14 patients with psoriasis (3 patients), neurodermitis (3 patients), eczema (4 patients), and allergic dermatitis (4 patients). The former generally adopted therapy was not effective or had a short-term effect. The fasting lasted from 14 to 24 days. By the end of the fasting therapy, the skin of the patients was reported to have recovered completely in all the patients in case of allergic dermatitis and in psoriasis in 1 patient, in 2 patients — 74%; in neurodermitis all the patients gained the recovery of 50-75% of the skin; in eczema 3 patients had completely recovered their skin and 1 patient — 75% of the skin. In 6 months the skin remained clear in 1 patient with allergic dermatitis; in psoriasis the results were stable in all the patients; in neurodermitis there was 1 relapse; in eczema the akin of 1 patient remained clear. In 2-3 years the good results of fasting were evident in 3 of 4 patients with allergic dermatitis; in psoriasis the skin was clear in 1 patient, the same for neurodermitis. The instable results of the therapy were due to the impact of risk factors, stresses, and improper diet.

The author administered a course of fasting therapy to 250 patients at the medical-rehabilitation centre «Zdorovye» (Health) during a year. Two main groups of the patients were formed. The ones with clinical manifestations of cardiovascular pathology (mainly arterial hypertension and ischemic heart disease) constituted the first group, fewer in number, and the patients without clinical manifestations of the disease, but with a high bodily weight (I and/or II stage obesity considered to be a risk factor of the cardiovascular diseases) constituted the second group, more abundant. The first group underwent fasting therapy for 3 weeks, the second one 7 10 days. No side effects were reported. In all cases the treatment resulted in the improvement of the clinical manifestations, reduction and/ or normalization of the bodily weight, and improvement of the patients' general condition.

 In this work the authors attempted to evaluate the influence of fasting therapy on some parameters of antioxidant defence and uric acid level (below as the UA) in blood serum of patients with bronchial asthma (below as BA) as well as to find possible ways of optimisation of the results of fasting therapy. There were observed 12 women with BA treated with fasting and 11 women with acute BA, treated with generally adopted medications.

The serum levels of glutathione, glutathione-reductase, glucoae-6-phoa-phatdehydrogenase and the UA were tested. Both groups did not show statistically significant changes of serum glutathione concentrations. During the fasting the highly reliable increase of the UA level occurred on the 5-9 day of the fasting, exceeding the normal indices (0.28 ± 0.095 and 0.458 ± 0.034 mmol/1; p < 0.001); during the period of the restorative diet the serum UA level did not plausibly differ from the initial level (0.329 ± ± 0.028 mmol/1; p > 0.05).

Though statistically insignificant, the tendency towards the moderate increase of the levels of glutathione-reductase (0.362 ± 0.02 and 0.383 ± ±0.013 mmol/1) and glucose-6-phosphatdehydrogenase (0.258 ± 0.03 and 0.293 ± 0.018 mmol/1) was reported.

No reliable changes of the parameters studied were noted in the group treated with medications. The authors assume that in fasting the antioxidant system functions with some effort, in particular the latent deficit of glutathione due to the intensive expenditure of lipid peroxydes in the inactivation reactions ffi possible. In this connection, fasting therapy is recommended to be combined with medications improving antioxidant defence.

During the research, biologically active points in 99 patients administered with fasting therapy were studied following the diagnostic method by Nakatani. The course duration ranged from 7 to 25 days. During the fasting in the group of practically healthy individuals there was revealed the so called fasting pattern when plausible divergence of the indices of electric conductivity of some meridians from their initial values was observed: lower values for the meridians of the lungs (L), heart (H), vascular system (VS), small intestines (SI), and higher ones for the meridians of the pancreas and the spleen (PS), and the urinary bladder (UB). Among characteristic features of the fasting pattern in the patients with arterial hypertension are the increased indices of the meridians of the heart (H) and vascular system (VS), as compared with the similar indices in the group of practically healthy individuals; in the patients with benign and malignant disorders — the lower indices of the meridians of the UB and PS. It is likely that the superposition of the patterns occurs namely when in the pattern of a patient with a certain nozological form signs of the fasting patterns and signs of the pattern, typical for this nozological form are present.

The automated system TAIS aimed towards fasting therapy management and its software have been developed. The system was designed based on the analysis of the model of the therapeutic and diagnostic process at the special fasting therapy department, it also includes the information and algorithm software.

Providing intellectual support to physicians when they seek therapeutic decisions, the system makes notes in the case history, conclusions for a doctor about the fasting course (period, terms, modification, etc), gives tactical recommendations, as well as recommendations on the repeated course of fasting, prescribes examinations, therapies, diets with due account of individual features of a patient and vitamin therapy during the rehabilitation period.

Data on patients' questioning and examination, results of laboratory and instrumental methods of examination serve an input information. The clinical evaluation of the system was conducted on 43 case histories.

One of the ways of pharmaco-correction of the bodily endogenic intoxication syndrome is a complex administration of medicinal means of plant origin meant for gradual and staged cleansing of the interior medium of the body. The detoxification method includes administration of cholagogic, liepatoprotective, nephroproteetive, and diuretic means, as well as vitamins, adaptogenes, and antioxidants. In this connection, on the basis of a Tibetan formula we have developed new medicinal means of plant origin, like rozobtin, polyphytocliol, nephrophyt, rantakrin, pentafrussen, cladocent, tanton, etc. part of them already allowed for clinical practices, and others being under expertise at the Pharmaceutical Committee of the Russian Federation Ministry of Public Health Care.

The 76-year-old amateur historian of local lore, history and economy provides interesting data regarding the use of periodical fasting as a traditional method of health improvement among the representatives of the indigenous population of the nomadic peoples in Zabaikalye, like Buryats and Mongols.

The authors applied fasting therapy following the method developed by the Research Institute of Pulmonology to treat 52 patients with sarcoidosis of the lungs (below as the SL). The duration of the fasting period was 14 days in average. By the end of the fasting improved general state was reported for 75% of patients, they ceased to complain about weakness, coughing, short breath, and artliralgia. In the one third of the SL-1 patients without prescription of corticesteroids, the sizes of the lymph nodes of the mediastinum were visible as reduced at the roentgenograms. For the half of the SL-2 patients, the lungs outline on the roentgenograms became more distinct, the dissemination of the seats and sizes of lymph nodes in the mediastinum decreased. The comprehensive roentgeno-functional and radio-nuclide investigation testified to the positive dynamics of the indices of the regional ventilation and pulmonary perfusion in 61% of SL-2 patients and 19% of SL-3 patients after the fasting. After the treatment was over, in 6 and 12 months this above positive dynamics was retained. The majority of the patients (68%) displayed a marked tendency towards the normalisation of the indices of the immune homeostasis. The remote results of the fasting were traced in 17 (from 52) patients: in a year positive dynamics was marked in 14 (from 17) (82%); the stabilisation of the pathology took place in 2 more patients, and in one patient only the SL recurrence was noted. The authors think that fasting is recommendable in the SL-1 as a monotherapy, in the SL~2 as a monotherapy or combined with further usage of corticosteroids, in the SL-3 it can be used to diminish side effects due to cortico steroids and to stimulate their endogenic synthesis. The attendant pathologies, like obesity, peptic ulcer and hypertension, serve as additional indications for fasting therapy.

The patient was a 60-year old man suffered from chronic gout, which resulted in the multiple injured joints and their limited functioning. The annual treatment at a hospital with medicamentous therapy was not a success; he was treated with indometacine in a supportive dose of 100 mg a day. Fasting therapy was started during incomplete clinical remission. After the 10-day course of fasting therapy resulting in the pronounced improvement, the patient stayed on a fasting diet from time to time, took the Russian «banya* once a week in order to maintain the effect of bodily «cleansing». Two repeated courses of fasting therapy were undertaken in a year. During the treatment there were noticed the signs of monoarthritis with moderately painful syndrome. The period of clinical remission became longer, and during the exacerbation periods the symptoms of gout became slight.

 The aim of the work was to evaluate the efficiency of treatment of bronchial asthma involving different complexes of the resort factors along with fasting therapy. 70 patients with bronchial asthma (16 men and 54 women) aged from . 10 to 63 were under observation. The patients were grouped according to the methods used for the treatment: the 1st group (25 patients) was treated only with resort factors, the 2nd group (30 patients) was treated with the combination of resort factors and fasting therapy; the 3rd group (15 patients) — only with fasting. The duration of the fasting period was 10 -14 days. All groups were quite comparable according to the gravity stage of the disease. The comparison of the results showed that the combination of fasting therapy with natural resort factors was the most effective.

Fasting therapy has been used at the Goryachinsk resort since 1994. During this period 975 patients have been prescribed this therapy. Among them there were 139 men and 836 women; 678 patients (71.1%) were natives of Buryatia, 277 persons (28.9%) were from other regions of Russia, including 3 foreigners. The subsequent courses of fasting therapy were carried out in 134 patients (13.6% ). The structure of the pathology included cardiovascular diseases (arterial hypertension, heart ischaemia, etc) — 79 cases (8.1%); bronchial-pulmonary diseases (bronchial asthma, chronic bronchitis with obstruction, etc) — 207 (21.2%); osteochondrosis. reumatoid arthritis, gout and others — 456 (46.8%); skin diseases (psoriasis, neurodermitis, allergic dermatitis, eczema — 40 (4.1%); gastrointestinal diseases (chronic cholecystitis, ulcer of the stomach and duodenum, chronic colitis) — 76 (7.8%); obesity — 88 (9.0%); other, rarely occurring forms of pathology — 29 (3.0%). The patients have been suffering from the diseases from 6 months to 22 years- The course of the fasting period was 10-14 days. During this period the patients were taking distilled boiled water, wild rose decoction in amount of 2-2.5 l a day, every day they were given cleansing enemas, and 3-4 times a week — hygienic douche, sauna. If there were no contraindications, the balneological therapy was prescribed (hydromassage, circular or Charcot's douche, mud poultice applications). If needed, acupuncture, the Su-Jok, and manual therapy were prescribed. The restorative nutrition was carried out according to the general principles, 20 vegetarian and fish dishes were included in a dietary menu. The positive effect of the fasting was observed in 86-91% cases of different pathologies.

The author prescribed fasting therapy to 26 patients, aged from 20 to 60 years, at the hospital of the Eastern Medicine Center. They suffered from various somatic pathologies and skin diseases. The fasting period lasted from 5 to 13 days. The average weight reduction was 1 kg a day. There was observed the improvement in the clinical course of the diseases, vitality enhancement in all patients. Many of them wished a repeated course of fasting therapy in 6-8 months. Oe patient became less (by 4.6 times). The author considers fasting therapy to be recommended against digestive organs pathologies, like functional disturbances of this system, esopliagitis, chrome gastritis, duodenitis, chronic cholecystitis, acute and chronic pancreatitis, enteritis, and chrome colitis.

The authors elaborated a variant of fasting therapy for out-patients, which was approved in the treatment of patients with itching dermatosis (191 cases of neurodermitis, 192 — eczema) and bronchial asthma (60 cases). The findings show that the short-term starvation periodically repeated in every 1.5 or 2 months can be used for out-patient treatment of numerous diseases and prophylaxis due to regular «cleansing» of the body.

The generation of the active oxygen forms in the whole blood by using the method of luminal-dependent hemiluminescence (below as HL) was studied in 60 patients with bronchial asthma. The hemiluminescence intensity in patients depended on the manifestation of the inflammatory process. The patients were grouped as the ones with high and the ones with low HL of the blood. In the complex therapy 7 patients of the first and 18 patients of the second group underwent fasting therapy. In the patients which were treated with the use of fasting, in contrast to those who received the generally adopted basic therapy, the indices of free radical oxidation were normalized and the remission was more prolonged.

The authors used fasting therapy in patients suffering from arterial hypertension with a "missing" phenomenon and this method allowed them to normalize blood pressure in short terms without using medications.

The authors used the fasting methods elaborated by Yu. S. Nikolayev and modificated at the Research Institute of Pulmonology. 30 patients with bronchial asthma aged from 36 to 60, predominantly women, underwent fasting. 21 patients had been suffering from bronchial asthma for 5 years;

11 patients had the severe course of the disease; and 6 patients had been taking corticosteroids for a long time. The fasting lasted 14-28 days. The treatment was successful for all the patients, without complications. The body weight loss was up to 11-18% from the initial weight. The maximum weight loss occured during the first week of the fasting before the acidotic crisis. Attacks of asphyxia ceased in 20 patients on the 3rd-5th day of the fasting. in the others — by the end of the treatment. The corticosteroid intake was cancelled for all the patients. The plausible increase of the speed indices of the spirogram and vital capacity of the lungs was reported. During the period of the rehabilitation, few attacks of asphyxia and dry rales occured in 5 patients, 3 of them had been treated with corticosteroids for a long time. The remote results were observed for the next 2 years, no clinical effect was reported in 6 patients out of 30. The authors consider that fasting in bronchial asthma is recommendable, first of all, in case of insusceptibility to the generally adopted drug therapy, and in case of combined pathology (hypertension, fat and mineral metabolism disturbance). Among the contraindications are: the negative attitude of a patient to fasting therapy, marked inflammatory process (the 3rd stage) of any localization, endocrine pathology (thyrotoxicosis, diabetes mellitus).

The medical community and local populace of the Republic of Buryatia have been deeply familiarizing with method since 1994 when Prof. Yu. S. Nikolayev (Moscow) visited Ulan-Ude. The introduction of the method was started at the initiative of the group of patients with bronchial asthma, who had personally and successfully experienced the effect of this method after reading the scientific and popular book "Fasting for the Sake of Health" by Yu. S. Nikolayev. As a response to the proposal submitted to the Republic of Buryatia Ministry of Public Health Care about the introduction of fasting therapy into therapeutic practice and its spreading within the territory of Buryatia was the organisation of the cycle of lectures on fasting therapy by Prof. Yu. S. Nikolayev in numerous public health care institutions in Buryatia, which appeared of interest for many physicians, though some of them treated it with skepticism. The health resort «Goryachinsk» was the first in Biiryatia to introduce this method, as four of its staff physicians had attended Yu. S. Nikolayev's lectures in Moscow. The successful application of fasting, particularly for patients with bronchial asthma and hypertension, facilitated relatively fast emergence of the significant marked demand by more and more new groups of willing patients.

The second edition of the book on fasting by Yu. S. Nikolayev was printed in Ulan-Ude. Its presentation at the Ulan-Ude city hospital attracted representatives of the municipal and republican level public health care organs, authorities, and general public. In 1996 the public health care administration of the City of Ulan-Ude issued the first printed order on the introduction of fasting therapy at the in-patients' department of the rehabilitation facility Zdorovyeo located in the village of Sotnikovo in the vicinity of Ulan-Ude; for its implementation Prof. A. N- Kokosov at Saint-Petersburg State Medical University named after the Academician I. P. Pavlov trained three physicians who started practicing this method. The next stage was the organization of the workshop in Ulan-Ude entitled "The use of fasting therapy in the internal pathology", with Prof. A. N. Kokosov among the honored participants (Republic of Buryatia Ministry of Public Health Care order No 271, November 25. 1998). The workshop participants articulated the opinion about the necessity of training qualified staff able to conduct fasting therapy to willing patients in compliance with the indications and contraindications of this method, as well as professional monitoring and consulting to these patients.

According to the implementation of Republic of Buryatia Ministry of Public Health Care order No 56, March 16, 1999, to further develop fasting therapy, Prof. A- N. Kokosov was invited to conduct the first training session cycle "Fasting therapy in the internal pathology". As a result, 30 physicians of various specialities were trained. Subsequently, two more similar training cycles for physicians were held. Recently in the Republic of Buryatia there has been formed the corps of specialists trained and skilled in fasting therapy -They can be found within the formal (state) network of the public health care system, and any resident of Buryatia can rely on their qualified consultations and relevant assistance, with due regard to the indications and contraindications of this method. Throughout Russia fasting therapy was introduced into the state system of public health care bodies in the Republic of Buryatia only.

Public health care bodies in Buryatia, like the Department of Medical and Prophylactic Aid and the Republican Centre of Medical Prophylaxis and Information have accumulated a large amount of analyticalal material on the ways and experience concerning the optimization of the fasting therapy introduction into practice of in- and out-patient institutions of the Republic-In this connection, the fasting therapy information field creation, i. e. informational introduction, as well as practical introduction of fasting therapy into hospitals and polyclinics is emphasized.

The authors stress the point that this experience of the organization has no analogues within the Russian Federation and abroad.

The authors discuss the possibility and prospects of the use of fasting. On the examples of an integrated use of this method in bronchial asthma, their complex application is recommended for aged patients. Brief clinical observations are given.

Optimization of tolerance to medications in patients with bronchial asthma, antibiotics in particular, remains a significant objective. The authors observed and investigated three groups of patients (10 persons in each group) comparable by their age and sex composition and disease severity degree. All the patients suffered from an acute condition of endobronchitis. In the control group the patients were administered the generally adopted (orthodox) medicinal therapy without corticosteroids.

Another group was prescribed fasting therapy following the method developed at the Research Institute of Pulmonology, and the third one — fasting combined with phytotherapy.

Tolerance to antibiotics was investigated when the patients in each group studied were administered them in infectious aggravation of endobronchitis; there were used methods of investigation of medicinal intolerance in vitro.

The comparison of the results of the antibiotics usage in the above three groups showed that the generally adopted/medicinal therapy did not effect tolerance to antibiotics in the patients with bronchial asthma, whereas fasting therapy and its combination with phytotherapy increased it by 2-2.5 times in average.

Fasting seems to be one of the oldest methods of health improvement and therapy, though for many people fasting remains a threat to their health. The authors attempted to consider psychological criteria and behavioural motives of individuals, who volunteered to undergo fasting therapy being aware of safety and advisability of therapy if methodologically accurately conducted. The object of the study was social interviewing of Ulan-Ude residents who did not experience fasting therapy and those who did undergo it. They formed two groups of comparison (at, random selection). The aim of the study was to reveal social and psychological factors influencing the personality before taking the decision to use this method. Having analysed the material obtained, the authors came to the conclusion that the effectiveness of the method was directly related to the conscience of the person, his or her willingness and deeply motivated demand for better personal health. Accompanying factors (for example, the impact of the surrounding and associates) make the main obstacle in fasting usage. After fasting patients demonstrate obviously improved general state and psychic tone; the life aspects are perceived more fully, self-confidence and assurance of ability to control oneself are restored, both one's life mode and conscience change positively.

Since the early 1990's the unfavourable demographic situation, characterized by the decrease of birth-rate and increase of the general mortality of the population, emerged in Buryatia, the situation being the same throughout the whole Russian-Federation, the health of the nation worsening. Such situation demanded taking prompt measures directed towards the reforms of public health care in the Republic. Due to the presence of traditional medicine our region is considered to be unique. Eastern methods of treatment are very popular among the population, they are successful against many diseases, provided that definite conditions and the precise indications are followed. At the same time, it is possible to decrease or discontinue the intake of medications in severe chronic diseases when a patient has to take high doses of medications resulting in side-effects. The medical community and population of the Republic familiarized with fasting therapy in 1994 when Prof. Yu. S. Nikolayev, the author of the well-known popular-and-scientific book «Fasting for the Sake of Health», visited Ulan-Ude.

The introduction of fasting therapy into medical practice was initiated by the patients who had successfully experienced this method. The Goryachinsk health resort was the first medical institution to introduce fasting therapy in the Republic after one of its physicians had been trained in fasting therapy in Moscow. Successful results after fasting therapy, especially in patients with bronchial asthma and hypertension, gave an impetus to the activity of the Ministry of Public Health Care and the emergence of several regulations. At the clinic of Saint-Petersburg State Medical University named after I. P. Pavlov a group of physicians was trained by Prof. A. N. Kokosov and became proficient in fasting therapy. During the subsequent workshops held in Ulan-Ude, Prof. A. N. Kokosov trained more groups of doctors. Today in Buryatia there is a wide circle of proficients in fasting therapy working in polyclinics and hospitals, and any patient, who wants to undergo fasting therapy, can rely on their consultations. During 1994-1999 more than 2,500 patients underwent fasting therapy in Buryatia. This experience of the institutional introduction of fasting therapy is unique for the Russian Federation as well as outside the country.

64 patients with different pathologies, like blood hypertension, bronchial asthma, skin allergy, chronic gastritis and gastroduodenitis, metabolic arthropathy, among them 50 females and 14 males aged from 18 to 50 were observed. All these patients were divided into 2 groups; their grouping according to age, sex, forms of pathology was approximately equal. One group was treated with fasting, another — with 1-3 days starvation followed by fasting, i. e. with combined therapy. The results of the treatment were compared. The average duration of the treatment was 12.8 ± 0.9 days, and the restoration diet period — 7.3 + 0.5 days. The use of short-term starvation at the initial stage of the treatment allowed the authors to obtain the bodily weight reduction in the patients with obesity, earlier normalization of the blood pressure indices; the clinical effect was comparatively more marked in the cases of bronchial asthma, asthmatic bronchitis, skin allergy, chronic gastritis and gastroduodenitis, metabolic arthropathy. The early keto-acidotic crisis (on the 2nd — 3rd day of the starvation) made it possible for the body to complete its endocrine-metabolic switch over towards the endogenic nutrition and shorten the terms of the patients' stay in the hospital.

Fasting therapy is a traditional, natural method of cleansing and purging the human body of accumulated products of vital activity («residues») which promotes improved functioning of every bodily organ and system, increases defensive forces of the body, and is beneficial in protecting the body against numerous diseases, as well as for health conservation and improvement.

Before administering fasting therapy one should identify contraindications (absolute and relative), the number of the relative ones decreasing as the personal experience and expertise of the treating physician grows. Fasting therapy can be prescribed only with the patient consent, his or her willingness and readiness to be treated following this method, which secures intelligent performance of medical recommendations.

Of significance for fasting therapy application are cosy and comfortable conditions and benevolent attitude of patient's associates to tills method of treatment are of signifiance for fasting therapy application. In fasting therapy there are singled out three main periods: preparatory, fasting proper, and recuperative (restorative diet). The duration of the fasting period is dependent upon specific features of the target pathology and therapeutic method applied. The duration of the recuperative period ought to comprise not less than two thirds of the one of the fasting period. The generally adopted method of fasting therapy is complete fasting: food deprivation with water intake if one feels a need for it. Other methods which are becoming more popular in Russia are: starvation with food and water deprivation; combined starvation and fasting, the "stepped" fasting when fasting is several times alternated with restorative diet, fractional fasting with prolonged duration of the "steps". The application of fasting therapy lias good prospects for health improvement of a virtually healthy individual who displays no clinical signs of any pathology.

Non-medicamentous therapeutic methods are divided into; 1) the orthodox (contemporary) and 2) traditional (natural, naturopathic) ones. Traditional methods used in India, Tibet, China, and Russia are considered the most original ones. Fasting therapy refers to the traditional methods of treatment and health improvement. In the pre-revolutionary Russia, Prof. P. Vilyaminov of Moscow University (1889) and Prof. V. V. Pashutin of the Saint-Petersburg Military and Medical Academy (1902) contributed significantly to the fasting therapy development. In the 1950's Professor Yu. S. Nikolayev, psychiatrist by speciality (Moscow), prescribed fasting therapy for treating patients with schizophrenia, observing effect also in accompanying somatic pathologies, including bronchial asthma. In 1973 the former USSR Ministry of Public Health Care commissioned the then All-Union Research Institute of Pulmonology (now the Research Institute of Pulmonology of Saint-Petersburg Medical University named after the Academician I. P. Pavlov) to investigate the possibility of using fasting therapy in allergic bronchopulmonary pathology, including bronchial asthma. This long time research resulted in the development of fasting therapy, including identification of the indications and contraindications, methods, mechanism of the healing effect, possible complications, etc, and was reflected in relevant publications, methodical recommendations and aids for physicians. It was found that in fasting the human body switches over to endogenic nutrition; basal metabolism decreases, so does oxidative processes intensity, with predominant usage of rat resources, low expenditure of carbohydrates, and the minimum waste of proteins. Inevitable stress reaction to fasting reconstructs reactivity of the body and mobilises the mechanisms of sanogenesis. The therapeutic and health improving effect of fasting therapy is based on mortality of non-vital cellular structures, active discharge of final products of metabolism, endotoxins, accompanied with simultaneous stimulation of reparative processes-It is helpful in various pathologies of the internal organs, as well as for treatment of neuroses, everyday toxomania, reactive states. The efferent effect due to fasting may be used for preventive purposes, general health improvement, maintenance of proper efficiency, and creative activity of an individual.

The authors have been using fasting therapy for treating patients with bronchial asthma over 20 years. We have randomly chosen 700 cases among several thousands of patients to analyse in detail (without special selection):

242 men and 358 women aged from 17 to 65. Fasting therapy was prescribed in clinical conditions following the authors' methods: the treatment course lasted 3 weeks. The main indications for fasting therapy in bronchial asthma are as follows: tolerance to the generally adopted medicamentous therapy;

concomitant multiple pathologies: syndromes of drug and food allergy. The main contraindications include negative attitude of a patient to fasting therapy, marked emaciation, the 3rd stage of active inflammation of any localization, active stage of tuberculosis of the lungs, malignant tumours;

marked pulmonary, heart, renal, and liver insufficiency; helminthoses, and some mental disorders. The efficiency of fasting therapy is stipulated by a temporary switch-over from exogenic to endogenic nutrition, resulting in the acidotic crisis as a prolonged stress, which changes or decreases the bodily reactivity involving the emergency mechanisms of sanogenesis. Biologically active cells in bronchi mucosa are degranulated, its hyperreactivity decreases, cortizol secretion increasing by the adrenals; copper and zinc residues diminish thus improving the bronch permeability. The efficiency of fasting therapy does not depend on the age of a patient, it is of seasonal character: higher in spring and summer that is related to the availability of antioxidants in the body. The near results of fasting therapy are following: the positive effect has been found in 90% cases (including the excellent and good ones — 65% and satisfactory ones — 25%); the worsening of the bronchial asthma course due to fasting therapy has not been observed. The remote results are as follows: clinical remission in 50% cases, including medical rehabilitation in 10% and social rehabilitation in 10% cases. Side effects of fasting therapy, such as exacerbation of infection seats, liver and renal colics, cramps caused by hypokaliemia and orthostatic collapse, can be prevented and controlled without interrupting fasting therapy.

The experience of applying fasting therapy against various diseases has been analyzed. The high effectiveness of the given method virtually fully depends on how competently the restorative period is conducted. Its main principles are as follows: the maximum individualization; observation of diet regimen; mechanical, chemical, and thermal protection; gradual diversity of foodstuff balanced according to their chemical composition. The priority directions during the restorative period in fasting therapy are following: to introduce to the dietary various biologically active supplements and foodstuff with higher biological value.

The authors describe in detail the case when a 40-year-old patient suffering from severe blood hypertension of hereditary character, complicated by brain insults and multiple concomitant pathology has been treated with repeated courses of fasting therapy. The treatment facilitated to stabilize his condition and normalise his blood pressure without hypotensive therapy. The results are confirmed with 48-hour monitoring data of his blood pressure and dynamic echocardiography.

The problem of paramedics training within the system of the fasting therapy introduction for medical services of the Republic of Buryatia was brought up as soon as physicians who used this method appear in the Republic. Special training of nurses able to work with patients undergoing fasting is of great importance. As they maintain closer contacts with such patients, they ought to render them psychological support during fasting. At the Buryat Post-graduate Training Centre of the Ministry of Public Health Care, a special educational programme for nurses has been developed to provide theoretical training and classes at the clinics where fasting therapy is used, like the Centre of Eastern Medicine, the war and labour veterans hospital, and others.

At the basis of the municipal in-patient clinic the authors have been applying fasting therapy following the method of Prof. Yu. S. Nikolayev since 1994. They have treated 350 patients predominantly with cardiovascular pathology (54%), bronchopulmonary and gastrointestinal pathology (15% and 16% respectively); the pathology of the skin, kidneys. Joints, and the endocrinic pathology comprised 15%, all together. Among the patients, women aged 30-40 were predominant. During the preparatory period vegetarian diet with one hungry day a week was recommended, in descrete cases such preparatory period lasted up to 10 weeks. The duration of the period of fasting proper was from 11 to 15 days for the majority of the patients. During that time the intake of medications was cancelled, with the exception of some cases of supporting therapy; massage, remedial gymnastics, relaxation techniques, and indifferent inhalations were frequently administered. The clinical results of the fasting were as follows: in bronchial asthma, attacks of asphyxia became rarer and disappeared, similarly did short breath; bronchi drainage as well as speed and volume characteristics of spirogram improved. In hypertension, headaches and heart pains disappeared, arterial pressure and bodily weight decreased. In ischemic diseases of the heart, there decreased and disappeared heart pains and short breath; dose of nitrates diminished; the indices of electrocardiogram and echocardiogram, and central and intracardial hemodynamies improved. In gastrointestinal pathology, appetite arose; pain and dyspeptic syndromes vanished. The average loss of bodily weight was 7.07 kg (from 5 to 9 kg).

In general, the positive effect was reported for over 90% of the patients. During the recuperative period, there was recommended predominantly vegetarian diet with hungry day a week, with a repeated course of fasting in 6-12 months, out-patient supervision by a physician familiar with fasting therapy, with one or two examinations a month. 22% of the patients underwent repeated (two times) courses of fasting, 10% — three times repeated courses, and 8% of the patients — four times and more. It allowed the chronic course of the pathologies to be checked, assisting in keeping the patients in a good health state.

The paper deals with methods of oriental medicine used for the bodily cleansing. There are identified methods related to the limited use of discrete food products by practically healthy individuals during relevant seasons, as well as methods with the usage of some certain medications according to the scheme for bodily cleansing to combat diseases, to slow down aging, etc.

58 patients with different forms of hypothyrosis were examined before and after the fasting therapy course combined with acupuncture. After the treatment there was observed a marked decrease of the thyrotropic hormone level, of the antibody level to thyreoglobulin and microsomal fraction in the patients with postoperative hypothyroidism, as well as with autoimmune thyroiditis. No reliable changes of the level of the hormones — triodthyronin and general thyroxine were reported. The decrease of the antibody level to thyreoglobulin and microsomal fraction is assumed to have resulted from the correcting effect of fasting therapy on the immune system. The decrease of the thyrotropic hormone level in the patients with postoperative hypothyroidism was obviously connected with the stimulating effect of fasting therapy and acupuncture on the thyroid gland function. During the rehabilitation period of fasting therapy the prescribed dose of hormone medications was diminished by 3 times in 12% of the cases, by 2 times in 85% of the patients, and 3% remained at the initial dose.

The elaboration and optimization of the non-medicamentous methods of treatment including fasting therapy, as well as the revealing of their mechanisms of action compared with the action of the generally adopted medicamentous therapy, are of great importance. The authors observed and treated 80 patients with bronchial asthma who were divided into 4 groups according to sex, age and the disease gravity. The therapies were different:

25 patients were prescribed antiallergic iminunoglobuline, 18 patients — ronkoleukin, 21 patients — fasting therapy, and 16 — basic medicamentous antiinflammatory therapy. Fasting therapy was carried out following the method developed at the Research Institute of Pulmonology: a complete «wet» fasting. The clinical effect of fasting was manifested in the control of the bronchospastic syndrome, reliable decrease of the sympathomimetics inhalation need, and increase of the spirogram speed indices, decrease of eosinophiles in sputum and diminishment of endobronchitis manifestation; decrease of the IgG and IgM. After fasting therapy, the level of cortizol in the blood plasma has increased by 1.5 times.

The clinical effectiveness of fasting therapy with the period of complete fasting of 14-16 days was studied on 119 patients with alimentary-constitutional obesity. It was found that along with the bodily weight reduction, fasting therapy effectively stops clinical signs of the diseases accompanying obesity, like hypertension, ischemic disease of the heart, chronic gastroduodenitis, chronic cholecystitis, fatty hepatosis.

The complex studies of the functional and morphological state of the small intestine were carried out on 28 patients with obesity before the fasting period, on the 8th and 16th days of complete fasting, and on the 7th and 26th days of recuperative diet. Two characteristic groups of pathogenetic

changes in the mucous membrane were found during the fasting period:

first, its structural reconstruction with inhibition of mitotic activity of the krypt epithelium and development of reversible dystrophic processes, and, second, inflammatory reactions manifested with higher cellular infiltration of the stroma and compensatory-adaptive changes of the microcirculatory channel structure.

The adequate dietary therapy secures complete restoration of tissue parameters of the mucous membrane on the 26th day from the beginning of the food intake. One can consider the above changes as adaptive to the specific features of endogenic diet.

The patients suffering from bronchial asthma and the systems injury of the gastrointestinal tract were treated with fasting combined with hydro-colonotherapy to optimise the therapeutic effect. This combination increased the efficiency of the cleansing and purging procedures that was important especially in the case of food allergy. The treatment was carried out in the out-patients' department. According to the methods elaborated by the author, such treatment is good for patients with mild forms of bronchial asthma. The fasting course lasts to 2 weeks. Hydrocolonotherapy is suggested to be performed during the initial period of fasting and after the acidotic crisis. The complications were not reported. The stable results are dependent on the subsequent regular cleansing procedures.

While treating patients with bronchial asthma and accompanying pathology of the gastrointestinal tract in the out-patients' department, the authors found that the rational combination of fasting and hydrocolonotherapy provided the comparatively better near and remote results as compared to basis pharmacotherapy. As the authors consider, it can be explained by intensified bodily purgation due to the combined rational application of the two non-medicamentous efferent methods of the traditional (fasting) and the orthodox (hydrocolonotherapy) character.

The authors examined 20 patients with bronchial asthma during their fortnight fasting according to the methods developed at the Research Institute of Pulmonology, in order to determine their antioxidant provision and lipid peroxidation state. The examinations were carried out on the 7th and 14th day of the fasting and on the 7th day of the rehabilitation period. The findings have shown that by the end of the fasting in the patient body the level of ascorbate and tocopherols increased and at the same time the level of the products of lipid peroxidation decreased. This occured due to the "release" of antioxidants out of the tissues into the general blood stream. By the 2nd day of the rehabilitation period of the treatment the content of antioxidants in the patient's body was reduced and at the same time the quantity of initial and final products of lipid peroxidation was increased. The above mentioned data correlate with the decrease of the clinical effect of the fasting.

From the authors' point of view, the prescription of antioxidants during the fasting period optimises the near and remote results of fasting.

Fasting therapy has been used at the balneological resort Arshan for the recent three years. As a rule the classical method of fasting therapy is used combined with mineral water intake (the usual duration of the fasting period is 7-15 days); in few cases the combined method is used: 24-36 hours of starvation followed by fasting therapy. The routine clinical laboratory test was carried out on all patients. The complex of the treatment embraces such therapeutic procedures like massage, sauna, exercise therapy, swimming, and outdoor hiking. 217 patients, predominantly women, aged from 10 to 60, underwent fasting therapy. According to the resort profile there prevailed gastro intestinal pathologies, like cholecystitis, cholangitis, post-chole-cystectomy condition (73; 47.7%); chronic gastritis, duodenitis (50; 32.65); chronic colitis (18; 11,7%); chronic pancreatitis (8; 5.2%); chronic hepatitis (2; 1.3%), etc. Side effects and complications after fasting occurred rarely (1 case of uterine hemorrhage, several cases of grave acidotic crises; chole-cystalgia and renal colics; gout attacks). The above mentioned pain syndromes were controlled with the Su-Jok therapy. The dietary menu during the rehabilitation period includes juices, fruit or cereals decoctions with gradual varying of diet. The findings have shown improvement in 87% cases, 19.6% of the cases — no changes. The remote results were studied in 30 patients (17.6%) who visited the resort once more; the next 6 or 11 months a prolonged remission was observed. The number of relapses decreased from 3-6 to 1-2 cases a year. The patients feel the improved life quality.

The author observed several patients, middle-aged men with pronounced gout, who underwent the repeated fasting therapy (in 6-8 months). Due to the treatment the patients recovered their capacity to work and improved their life quality.

The 48-year-old pharmaceutist, who lived in a remote rural area in Buryatia and suffered from polyorganic somatic pathologies, like chronic pielonephritis, prostatitia, hyperacidic gastritis, osteochondrosis, undertook three periods of fasting therapy of a month duration, each repeated in 6-8 months, after he familiarized with the essence and methods of fasting therapy in popular scientific publications. Due to the treatment conducted in out-patients' conditions, he restored his capacity to work and promoted his vitality and life quality.

The author — 52-years-old therapeutist, was attacked with acute respiratory virus infection (the bodily temperature rose to 37,8"C, with the ca-tarrhal syndrome in the upper respiratory tract). After a two-day starvation (the severe variant) and three-day fasting she completely recovered. It is interesting to note that temperature became normal and the catarrhal syndrome disappeared on the first day of the treatment. The patient did not cease her office duties.

The crisis of public health care in the post-perestroika Buryatia true for the whole Russia, has manifested through the unprecedented decrease of the population quantity. Preventive measures do not require significant investments both from the society and the individuals. The official statistics data on the Russian Federation and foreign data convincingly show that the significant number of cases of non-infectious diseases can be prevented. Natural methods of health enhancement are rooted in the ancient traditions of the people. In Buryatia, the indigenous population professing Buddhism has used for centuries natural methods of healing, among them sporadic abstention from meals occupied a significant part along with intake of herbal compositions, moxabustion, and acupuncture. The statistics shows that the state of health depends on several factors, diet and lifestyle comprising 50%. It is well known that periodical abstention from food, constant bodily weight correction have, even without medications, a positive health improving effect. The growing interest of the populace to the methods of bodily cleansing has its pros and cons. The latter includes the fact that many individuals fast following instructions from publications. In this case side effects, sometimes ruinous for health, happen which naturally discredit the fasting method. At the same time many physicians are hardly familiar with the method. The existing situation requires from the public health care bodies to organize a proper use of fasting for therapeutic and health improving purpose, in compliance with indications. To achieve it there was established the Republican Fasting Centre to coordinate training of physicians on the fasting method and to provide consulting and therapeutic services. The forms of the Centre's activity are diverse and stipulate constant information for medical workers and local public through mass media (press, radio, TV) about the essence and potentialities of fasting, regular meetings of experts on fasting with the community, polls and surveys, talks and the City Society of Physicians.

On the base of the well-known and scientifically proved data on the high efficiency of fasting therapy in the treatment of allergic diseases the authors elaborated the method of the short-term fasting where the quick therapeutic effect concerning the patients' condition and clinical laboratory data is regarded as an important factor of differentiation of the allergic and pseudoallergic nature of the disease.

Iridological examination which according to publications and personal experience of the authors, can visibly demonstrate cleansing effect of the efferent therapy, was carried out among 80 patients with bronchial asthma (58 men and 22 women), with the average age of 46.8 ± 0.2. They were treated in the in-patients' clinic following the method developed at the Research Institute of Pulmonology. Based on the iridological examination, the control group consisted of practically healthy individuals, comparable with the experimental group by age and sex. The results of the iridological examination of all the patients with bronchial asthma before starting fasting therapy differed plausibly from the ones of the control group persons. For the sick individuals, as compared to the healthy ones, more frequently were found the following:

the radial and lacunar type of the iris, deformed pupils, residued autonoumous ring, dull and faded colour of the iris, presence of pigment spots, and emergence of the adaptation nervous rings. After the fasting therapy the obvious positive dynamics was reported in the patients, particularly as compared with the healthy persons, as well as with their own state before the fasting. Particularly marked changes were noted for the residued autonomous ring; the colour of the iris became clearer; there lessened the number of the adaptation nervous rings and toxico-dystrophic signs. To the opinion of the authors, the changes of the iridodiagnostics indexes of the residueness of the body after fasting therapy can be objectively indicative of the efficiency of this kind of efferent therapy.

The significance of large-scale training of physicians for the organization of introduction of fasting therapy into the public health care system with due regard to the local population ready to accept this method along with other methods of the traditional and Oriental medical systems was stressed in the paper. Interesting findings obtained through surveys and interviews of physicians — fasting therapy practitioners on the relevance and contribution of the method into the alteration of their world outlook and interrelationships with the colleagues who are not familiar with fasting therapy are given. This experience is considered recommendable for other regions where the medical community and locals are interested in traditional medicine and resource sharing medical technologies.

TUYEV A. V., ZHADOVA T. A., MiSHLANOV V. YU., Perm

The aim was to study supplemental prognostication criteria of fasting therapy efficiency in patients with bronchial asthma. Materials and methods used were as follows: 315 patients with asthma and 30 healthy persons were examined. 20 patients with intrinsic asthma were examined before and after the 14th day of the fasting period. The spirometric parameters, immune status, and haemostasis were studied. There was calculated a new criterion of severity of asthma — the index of allergic inflammation (IAI). The IAI formula reflects the relationship between the T- and B-chains of the immune system activity.

The results showed correlation between the clinical data, functional criteria, and degree of immune disbalance reflected by the IAI. The correlation index between the IAI and the forced expiratory volume per 1 second in intrinsic asthma was r = -0.6457 (p < 0.0001). The sensitivity and specificity of the new diagnostic method of bronchial asthma severity were 83.3% and 81.5% respectively when the IAI was more than 0.080.

We revealed some new clinical and laboratory features of asthma in patients with lipid metabolism disturbance: the resistance to basis antiinflamiTiatory and broncholithic therapy, high frequency of polyvalent allergy, increase of lymphocytes and theophylline-resistant T-lympohocytes in venous blood, increase of phagocytic parameters and spontaneous aggregation activity of thrombocytes, high level of the correlation index between the spontaneous aggregation activity of thrombocytes and forced expiratory volume per 1 second, decrease of theophyl line-sensitive and theophylline-resistant T-lymphocytes relatively to the patients with severe bronchial asthma without lipid metabolism disturbance.

The significant improvement of the clinical picture after the fasting therapy was found in the patients with severe bronchial asthma, particularly in ones with lipid metabolism disturbance. Fasting promoted the decrease of eosinophiles, the ESR, spontaneous aggregation activity of thrombocytes and fibrinogen blood level, XII-dependent fibriolisis, and the time of autoco-agulation activity, trend to the IAI decrease, and increase of phagocyte activity.

The authors have come to the conclusion that it is recommendable to identify bronchial asthma in patients with lipid metabolism disturbance as a specific clinic variant of the asthma course, which require the usage of complementary therapeutic methods, like fasting, to the basis antiinflammatory and hroncholithic therapy. The positive additional prognostication criteria of fasting therapy effectiveness lie in the fact that the high levels of spontaneous aggregation activity of thrombocytes and the IAI before fasting decrease in the course of therapy.

After the thorough examination of a large group of patients with different forms of bronchial asthma before and after the fortnight course of fasting therapy, the authors established the relationship between the clinical-and-functional criteria of the bronchial asthma severity and the level of the immunological disbalance manifestation. In the cases of bronchial asthma concomitant with obesity, there were revealed the refractiones to the basic medicamentous therapy of bronchial asthma, high frequency of polyvalent allergy and some specificities of immunological reactiveness. In the cases of bronchial asthma concomitant with the second or third degree obesity, the authors consider fasting therapy as an alternative method of treatment.

The aim of the given research was to analyse fasting therapy efficiency in the treatment of patients with chronic obstructive bronchitis (below as COB) and bronchial asthma (below as BA) at sanatoria and health resorts.

There were observed 32 patients with COB and BA at the stage of subsiding exacerbation, and instable and full remission stages who were prescribed the 6- or 15-days fasting therapy course along with the regular therapies. The near results were evaluated according to the clinical and functional indices.

The usage of fasting therapy within the complex of sanatorium therapy allows the efficiency of COB and BA treatment to be significantly increased. The patients' age and the duration of the disease course did not effect the results of the fasting therapy. If the duration of the therapy is no less than 7 days, then the effect of fasting is much higher. On the other hand, the prolonged fasting does not secure improved results.

The author carried out treatment of bronchial asthma in two groups of patients with concomitant somatic pathologies. One group was administered a common adapted medicamentous therapy, and another fasting therapy. The analysis of the near and remote results of the treatment has shown that fasting therapy is inferior in the near results but excels the drug therapy in the remote results. Besides, fasting therapy has been shown to have a favorable effect on concomitant somatic pathologies.

in the treatment of 267 patients suffering from the moderately grave course of infection-dependent bronchial asthma, among them 117 patients treated with fasting in combination of auto infusions of ultraviolet-irradiated blood (photo hemotherapy) during the fasting proper period. The analysis of the findings obtained has demonstrated that the application of photohemo therapy during fasting therapy increases the efficiency of fasting, manifested in a faster positive clinical dynamics in 100% of patients, more favorable changes in the immune system, 2-timea decrease of the frequency of infectious exacerbation in the respiratory tract, as compared with patients, who were administered fasting therapy only.