K.P.BUTEYKO, V.A.GENINA
The BBL method was tested and approved by the Medical institute of E.M. Sechenov between 27.2.81 and 21.5.81.
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 Characterizations 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 hyperventilation. The patients were asked to undergo a three stage hyperventilation test (developed by Professor Buteyko in 1968).
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.
If the patients did not understand the relationship between the hyperventilation 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 B BL method: 36 boys (69%) and 16 girls (31%) (qv Table I). Of the 52 children, 34 or (65%) were hospitalised, 18 or (35%) were outpatients. Twenty-four or (46%) had atopic bronchial asthma, 22 or (42%) had mixed bronchial asthma and 6 or (12%) had bacterial allergy bronchial asthma. The majority of the patients (36) had been suffering from this condition for up to 5 ywears, 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 V).
| GROUP | NUMBER | SEX | AGE | ||
|---|---|---|---|---|---|
| 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
|
| GROUP | NUMBER | DEGREE / DURATION OF ILLNESS | |||||
|---|---|---|---|---|---|---|---|
| MILD TEST | % | SEVERE TEST | % | VERY SEVERE 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. Twentv-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 wcre 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.
Fifty-two children were observed for between 29 and 84 days. The results were based on the following criteria:
a) no improvement
b) some improvement (the degree of attacks is lessened
together with a considerable reduction in medication).
c) 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.
| 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
breathe 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 39C), 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 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 immunoglobulins 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 +/- 0.3 seconds to 31.4 +/- 4.7 seconds (qv Table V).
| STATE OF ILLNESS | NUMBER | START POINT | 40 MINS. | TIME IN DAYS | ||
|---|---|---|---|---|---|---|
| 7 | 14 | 30 | ||||
| SEVERE | 14 | 37 (+/-8) | 92 (+/-11) | 117 (+/-15) | 159 (+/-16) | --- |
| AVERAGE | 26 | 76 (+/-8) | 121 (+/-8) | 161 (+/-18) | 173 (+/-10) | 139 (+/-9)
|
| STATE OF ILLNESS | NUMBER | START POINT | 40 MINS. | TIME IN DAYS | ||
|---|---|---|---|---|---|---|
| 7 | 14 | 30 | ||||
| SEVERE | 14 | 2.9 (+/-.3) | 12.4 (+/-1.4) | 28.0 (+/-4.9) | 24.5 (+/-4.5) | 31.4 (+/-4.7) |
| AVERAGE | 26 | 5.4 (+/-.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).
| STATE OF ILLNESS | NUMBER | TIME | |||||
|---|---|---|---|---|---|---|---|
| START | 14 DAYS | ||||||
| LC | AR | ES | LC | AR | 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 |