Bulletin of Rehabilitation MedicineBulletin of Rehabilitation MedicineВестник восстановительной медицины2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology70535010.38025/2078-1962-2026-25-4-96-104ArticlesСтатьиReview ArticleNatural healing factors: a systematic analysis of the evidence base and prospects for application in pediatric practiceПриродные лечебные факторы: систематический анализ доказательной базы и перспективы применения в педиатрической практикеhttps://orcid.org/0000-0002-1034-2640PrilipkoNina S.ПрилипкоНина Станиславовна
Russian Federation

D.Sc. (Med.), Leading Researcher of the Scientific Research Laboratory

доктор медицинских наук, ведущий научный сотрудник лаборатории научных исследований

mokinana@mrik-fmba.ruhttps://orcid.org/0000-0001-5009-1623MokinaNatalia A.МокинаНаталья Александровна
Russian Federation

D.Sc. (Med.), Professor, Deputy Director General for Science

доктор медицинских наук, профессор, заместитель генерального директора по науке

mokinana@mrik-fmba.ruhttps://orcid.org/0000-0001-9047-4311NikitinMikhail V.НикитинМихаил Владимирович
Russian Federation

D.Sc. (Med.), D.Sc. (Econ.), Deputy Director General

доктор медицинских наук, доктор экономических наук, советник генерального директора

mokinana@mrik-fmba.ruMachulaNatalia V.МачулаНаталья Владимировна
Russian Federation

Head of the Branch Coordination Department

руководитель управления по координации филиалов

mokinana@mrik-fmba.ruhttps://orcid.org/0000-0001-9895-5048NikitinaAnfisa M.НикитинаАнфиса Михайловна
Russian Federation

PhD (Med.), Head of the Department of Organization of Medical Care and Quality Control

кандидат медицинских наук, начальник управления организации медицинской помощи и контроля качества

mokinana@mrik-fmba.ruFederal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency of RussiaФедеральный научно-клинический центр медицинской реабилитации и курортологии ФМБА РоссииNational Medical Research Center for Rehabilitation and BalneologyНациональный медицинский исследовательский центр реабилитации и курортологии Минздрава России25082026254961040204202610082026Copyright ©; 2026, Prilipko N.S., Mokina N.A., Nikitin M.V., Machula N.V., Nikitina A.M.Copyright ©; 2026, Прилипко Н.С., Мокина Н.А., Никитин М.В., Мачула Н.В., Никитина А.М.2026Prilipko N.S., Mokina N.A., Nikitin M.V., Machula N.V., Nikitina A.M.Прилипко Н.С., Мокина Н.А., Никитин М.В., Мачула Н.В., Никитина А.М.https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2078-1962/article/view/705350

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.

ВВЕДЕНИЕ. Природные лечебные факторы (ПЛФ) — минеральные воды, лечебные грязи, климат, солевые растворы — имеют многовековую историю применения в педиатрии. Однако до настоящего времени отсутствует систематизированный анализ доказательной базы эффективности ПЛФ при различных заболеваниях детского возраста с градацией уровней доказательности по критериям GRADE (Grading of Recommendations Assessment, Development and Evaluation — система оценки и градации рекомендаций).

ЦЕЛЬ. Провести систематический анализ современных научных данных эффективности применения ПЛФ у детей, структурировать доказательную базу по нозологическим группам и определить перспективные направления развития педиатрической курортологии.

ОСНОВНОЕ СОДЕРЖАНИЕ ОБЗОРА. Выполнен поиск публикаций в базах данных PubMed, Cochrane Library, Embase, eLIBRARY.RU за 2000–2025 гг. Отобраны систематические обзоры, метаанализы, рандомизированные контролируемые исследования и когортные исследования. Оценка уровня доказательности проводилась по критериям GRADE. В анализ включено 42 исследования, из них 8 систематических обзоров с метаанализом, 12 рандомизированных контролируемых исследований, 22 обсервационных исследования. Показано, что наиболее убедительная доказательная база (уровень А–В) имеется для применения минеральных вод и солевых ванн при заболеваниях органов дыхания (бронхиальная астма, рецидивирующие респираторные инфекции), болезнях кожи (атопический дерматит, псориаз) и патологии опорно-двигательного аппарата (ювенильный артрит). Уровень доказательности С–В установлен для применения лечебных грязей и климатотерапии при заболеваниях нервной системы, органов пищеварения, мочеполовой системы. Выявлен высокий потенциал экстраполяции данных исследований на взрослых в педиатрическую практику, что соответствует современным подходам к разработке лекарственных средств для детей.

ЗАКЛЮЧЕНИЕ. ПЛФ обладают доказанной эффективностью при широком спектре заболеваний детского возраста. Наиболее высокий уровень доказательности установлен для бальнеотерапии при респираторной, дерматологической и ревматологической патологии. Ключевыми ограничениями доказательной базы являются неоднородность протоколов лечения, малый размер выборок в ряде исследований и недостаточная валидация педиатрических шкал оценки эффективности. Требуются дальнейшие рандомизированные контролируемые исследования с унифицированными протоколами для повышения уровня доказательности и расширения показаний к применению ПЛФ в педиатрии.

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