Крашеница Г. М. Курортное лечение больных алиментарным ожирением (1971)

Krashenitsa G. M. Kurortnoe lechenie bolnykh alimentarnym ozhireniem (1971)

Resort treatment of patients with alimentary obesity

Genre of the source

автореферат докторской диссертации

Evidence class

первичное исследование

Original language

ru

Pages cited

5, 6, 7, 13, 24, 26, 27, 28

OCR quality

среднее — фамилия автора на титуле искажена (КРАШЕН ИЦА, КРАШЕНПЦА), нумерация страниц читается

Date extracted

2026-08-24

Identifier

work:krashenitsa-1971-obesity

Direct answer

Author’s abstract of a doctoral dissertation carried out at the Pyatigorsk State Research Institute of Balneology and Physiotherapy. 567 patients with alimentary obesity were observed at the Essentuki health resort. Four drinking regimens of differing composition were compared. Principal finding: waters of different chemical composition act differently, and the difference is consistent — the greatest weight loss with water of source No. 20, the best lipid-metabolism dynamics with Essentuki No. 4, while Lysogorskaya water (лысогорская вода) raised cholesterol.

Bibliography

Крашеница Г. М. Курортное лечение больных алиментарным ожирением (№ 14.754 — Внутренние болезни): автореф. дис. … д-ра мед. наук. — М.: Центральный научно-исследовательский институт курортологии и физиотерапии Министерства здравоохранения СССР, 1971. — 33 с. — На правах рукописи. — Тираж 300 экз. — Типография Минздрава РСФСР, подписано 24.05.1971.

The work was carried out at the Pyatigorsk State Research Institute of Balneology and Physiotherapy (Пятигорский государственный научно-исследовательский институт курортологии и физиотерапии; director — Candidate of Medical Sciences Е. А. Смирнов-Каменский).

• Scientific consultants: Prof. А. С. Вишневский, Prof. И. С. Савощенко.
• Official opponents: Prof. Ф. К. Меньшиков, Prof. С. М. Лейтес, Doctor of Medical Sciences А. Ф. Ткаченко.
• Appraisal of scientific and practical value: Research Institute of Balneology and Physiotherapy of the Armenian SSR.

Requires verification against the scan: the author’s surname on the title page was recognised as «КРАШЕН ИЦА» and «КРАШЕНПЦА» — Крашеница.

Sample and method

• 567 patients with alimentary obesity under observation (p. 7).
• Age predominantly 31–60 years; obesity 2,2 times more frequent in women.
• Degrees: I — 31 %, II — 42,6 %, III — 24,3 %, IV — 2,1 %. Progressive stage — 67 %.
• Subgroups for individual methods: cholesterol fractions — 122 patients, glucocorticoid function of the adrenal cortex — 150, incretory function of the pancreas — 140, dosed walking (дозированные прогулки) — 90 (pp. 5, 13).

Comparison of waters — 176 patients, four groups (pp. 6–7):

The bulk of the sample — 437 people — took Ессентуки № 4.

The drinking method in groups 1–3 was identical: 180–200 ml 3 times a day, at an interval of 30–90 minutes before meals.

There is no control group without treatment. The comparison runs between regimens, not against the absence of intervention. This is a substantial limitation: the effect of the resort regime itself and the effect of the water cannot be separated.

What the author reports

From the section «Выводы» (Conclusions, pp. 26–28):

• weight loss averaging 5,61 kg;
• reduced function of the insular apparatus in 75 %, improved glucocorticoid function of the adrenal cortex in 72 %;
• improvement of initially altered lipid-metabolism indices in 57,3–85,8 %;
• in 50 % of patients, signs of insular hyperfunction at baseline;
• comorbidities: hypertensive disease or symptomatic hypertension — 26,6 %, coronary atherosclerosis — 11,3 %, diseases of the digestive organs — 39 %.

The key difference between the waters

«Динамика клинических проявлений основного и сопутствующих заболеваний в результате курсового лечения с применением различных минеральных вод (ессентуки № 17, 4, 20 и лысогорской) во всех группах была примерно одинаковой. Наиболее выраженные потери веса наблюдались у больных, получавших мало минерализованную сульфатно-гидрокарбонатно-кальциево- магниевую воду источника № 20. Улучшение или нормализация показателей липидного и электролитного обменов чаще отмечалась при приеме минеральной воды ессентуки № 4, несколько реже — ессентуки № 17 и лысогорской.» — с. 28

«Прием 200 мл минеральной воды ессентуки № 17 или 4 оказывает воздействие на биохимические показатели липидного и электролитного обмена у больных ожирением, что проявляется в достоверном снижении уровня холестерина и фосфолипидов, повышении содержания неэстерифицированных жирных кислот и уровня натрия в сыворотке крови. Подобных сдвигов при использовании воды ессентуки № 20 не наблюдалось, а прием лысогорской воды приводил даже к повышению холестерина, общих липидов и натрия сыворотки крови.» — с. 28

In the corpus copy before the repair of 31.08.2026 the text here read «Наиболее выраженные потери, веса» — with a comma after «потери». On paper (checked by the owner against the scan, 31.08.2026): «Наиболее выраженные потери веса наблюдались у больных…». Under rule 8 the comma is left inside the quotation rather than corrected on the author’s behalf. Whether it came from character recognition or from the printed original is settled by checking the scan.

This is a negative result, and it is worth more than the positive ones: one of the waters studied worsened the lipid indices. The author explains the divergence by the difference in chemical composition and total mineralisation.

What the source does not contain

• there is no control group without health resort treatment;
• the intervention is complex — water, diet, baths, underwater shower-massage, exercise, walking — the contribution of any single factor is isolated only indirectly;
• long-term results are reported, but in aggregated shares: studied in 243 patients, duration of the positive effect up to 6 months in 28,3 %, from 7 to 11 months in 20,5 %, a year or more in 51,2 % (p. 25). What stands behind «положительный эффект» and how it was measured is not stated in the author’s abstract. An earlier revision of this record asserted that no long-term results existed; that was wrong and was corrected on 01.09.2026 under rule 12;
• by genre the author’s abstract is a condensed account; the full text of the dissertation is absent from the corpus.

How this record may be misquoted

«Lysogorskaya water raised cholesterol» does not mean the water is harmful. This is one biochemical index, in one group, in one 1971 study; by the clinical manifestations of the principal and concomitant diseases the groups barely differed from one another (p. 28). No conclusion about harm to health follows from it — what follows is that on lipid indices this water behaved differently from the rest.

And the opposite distortion. «Essentuki No. 4 improves lipid metabolism in obesity» does not follow from the work in that form either: there is no control group without health resort treatment, four regimens are compared against each other, and this work does not allow the action of the water to be separated from diet, baths, exercise and daily regime.

What remains to be done

• verify the surname and the extent against the scan;
• if possible, locate the full text of the dissertation;
• scientific review by a human;
• review of the Chinese translation by Louis.