Loading ...
IJTSRD
Education
Volume 4 Issue 5
7
0
Try Now
Log In
Pricing
International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 5 Issue 6, September-October 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD47715 | Volume – 5 | Issue – 6 | Sep-Oct 2021 Page 1754 Ayurvedic Management of Ankylosing Spondylitis: Single Case Study Dr. Kavya J H 1 , Dr. Rajesh Sugur 2 1PG Scholar, 2Associate Professor, 1,2Department of PG Studies in Panchakarma, TGAMC&H, Bellary, Karnataka, India ABSTRACT Ankylosing spondylitis is a chronic inflammatory disease commonly affecting young male individuals. Ankylosing Spondylitis presents with pain and stiffness of joints of axial skeleton especially the sacro- iliac joints. Sacroiliitis is the earliest recognized manifestation of Ankylosing spondylitis. Along with it, peripheral joints and extra articular structures may also get affected. In Ayurveda, Ankylosing Spondylitis can be understood as Amavata based on classical symptoms and can be treated accordingly. Intervention of Virechana Karma and Matrabasthi in ankylosing spondylitis markedly reverse the pathology of ankylosing spondylitis. KEYWORDS: Ankylosing spondylitis, Amavata, Virechana, Matrabasthi How to cite this paper: Dr. Kavya J H | Dr. Rajesh Sugur "Ayurvedic Management of Ankylosing Spondylitis: Single Case Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456- 6470, Volume-5 | Issue-6, October 2021, pp.1754- 1756, URL: www.ijtsrd.com/papers/ijtsrd47715.pdf Copyright © 2021 by author (s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION Ankylosing Spondylitis is an auto immune disease. It is a rare chronic systemic disease more common in male compared to female and affects the young individuals1. Ankylosing Spondylitis is characterised by a progressive inflammation of joints, with a predilection for the joints of axial skeleton, especially the sacroiliac joints. Sacroiliac joints get affected first followed by the spine from lumbar to cervical region. In Ayurvedic parlance, we can understand and analyse this condition as Amavata as most of the clinical features get closely resembled. Amavata is a disease of Rasavaha and Asthivaha Srotas. It is mainly caused due to Ama and Prakupita Vata. The Ama formed due to Mandagni is carried by Prakupita Vata and gets deposited in Shleshma Sthanas resulting in features like Angamarda, Aruchi, Alasya, Sandhiruk, and Sandhishotha2,3. Though, Amavata is a disease of Madhyama Rogamarga, and it is said to be Yapya or Kricchrasadhya, Ayurvedic managements with Panchakarma plays an important role in reversing the pathology of Ankylosing Spondylitis. METHODOLOGY: This is a single case study of 18 years old male patient, who was apparently healthy 2 years ago; gradually he developed pain in low back region with mild stiffness. After few days pain got exacerbated and patient was feeling difficult to walk due to severe stiffness. Pain was severe in early morning and gets reduced after a few steps of walk. Patient visited to an Allopathic Hospital and diagnosed as ankylosing spondylitis. Treated accordingly, the patient didn’t get any relief. Thereafter, the patient visited Panchakarma OPD of TGAMC&H Ballari, for Ayurvedic management. Patient was thoroughly examined and detailed history was taken and admitted for the management of the condition appropriately. Chief Complaint: Patient complains of severe pain and stiffness in lowback region since 2 years. Paient was unable to walk properly due to severe stiffness and unable to bend forward, backward and sidewise. IJTSRD47715 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD47715 | Volume – 5 | Issue – 6 | Sep-Oct 2021 Page 1755 Associated complaints: The condition was associated with Constipation and loss of appetite. General Examination: Vital readings of the patient were within the normal limits. Systemic examination had not shown any abnormal findings. Jihva was Lipta, Mala was constipated, rest of the findings of Ashtavidha and Dashavidha Pariksha were within the normal limits. Local Examination: On inspection, the shape of spine was normal. On palpation, tenderness was present at posterior superior iliac spine. The lateral movements were restricted, Patient was unable to do forward and backward flexion. SLR test: Positive for both the legs, Gaenslen’s test: Positive, Fle’che test: Negative. Radiographic investigations: MRI report showed there is Bilateral Sacro-ilitis, Left side is more than right. Blood investigations done: Hb-14%, ESR-19mm/1hr, CRP- 15.3, RA- 21.9, S. Calcium- 8.4mg/dl Diagnosis: Case was diagnosed as Amavata based on the symptoms explained in Ayurveda classics. TREATMENT: Kaya Shodhana: Pachana-Deepana Snehapana Abhyanga-Sweda Virechana Chitrakadi Vati 1-1-1 before food for 4 days Guggulutikthaka Ghritha - Arohana Matra for 5 days Mahanarayana Taila f/b Bashpa sveda Trivruth Lehya with Ushnodaka Anupana Virechana Karma was planned in this condition. Pachana - Deepana was achieved with Chitrakadi Vati administered for 4 days. Followed by Snehapana was given with Guggulutikthaka Ghritha in Arohana Matra according to Agni and Kosta for 5 days. Sarvanga Abhyanga with Mahanarayana Taila f/b Baspha Sveda with Dashamoola Kwatha was done. Virechana was administered with Trivruth Lehya with Ushnodaka as Anupana. Pateint attained Madhyama Shuddhi. Samsarjana Krama was advised for 5 days. After 7 days of gap Matrabasthi with Guggulutikthaka Ghritha (36ml) and Chandanabalalakshadi taila (36 ml) was administered for 15 days . Shamanoushadhis were advised during Parihara Kala : Kaishora Guggulu 1-1-1 (A/F) Rasna Erandadi Kwatha 15ml BD (A/F) RESULTS: Pain and stiffness got reduced after Virechana. Patient can walk normally. Pain is completely absent after completion of Bastikarma. Haematological reports showed marked changes after Parihara Kala i.e Hb- 15gm%, ESR-10 mm/ 1hr, CRP- negative, RA- negative, Calcium- 9.4mg/dl Haematological criteria Before treatment After treatment Haemoglobin % 14g% 15g% Erythrocyte Sedimentation Rate 19 mm/1hr 10 mm/1hr C-reactive protein 15.3 Negative RA-Factor 21.9 Negative Calium 8.4mg/dl 9.4mg/dl DISCUSSION: Ankylosing Spondylitis is chronic inflammatory disease with Severe Pain and stiffness in joints. This disease can be understood as Amavata. Here there will be formation of Ama due to Mandagni and also there will be Vata Prakopa2. Prakupita Vata carries Ama and gets settled in Shleshmasthana leading to the symptoms like Angamarda, Aruchi, Alasya, Sandhiruk, Sandhishotha3. According to Acharya Chakradatta4, Langhana, Swedana, drugs having Tikta rasa, Deepana, Virechana, Snehapana and Anuvasana are the principles of treatment in Amavata. Keeping this in mind, as the condition was in Bahudoshavastha5, Shodhana was administered. Kayashodhana yields good results as it removes the Prakupita Dosha inside the body by cleansing. Though Virechana is the main line of treatment in Pitta Dushti, but at the same time it is also useful in Vata and Kapha Dushti6. Mrudu Samshodhana is also the line of treatment of Vata Dosha7. Shodhana is contraindicated in Samavatha8, hence Deepana Pachana are must till the attainment of Niramavasta. After Shodhana, the aim was to treat Prakupita Vata. Snehana is the main line of treatment in International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD47715 | Volume – 5 | Issue – 6 | Sep-Oct 2021 Page 1756 Vataprakopa9. After Virechana Karma a gap of 7 days10 was given and on 8th day, started with Matrabasthi with Guggulutikthaka Ghritha(36ml) and Chandanabalalakshadi Taila (36ml) administered for 15 days . Chitrakadi Vati11 is Deepaka, Pachaka, Rochaka, Anulomaka, Shulahara, Shothahara, Arochaka, Vibhandhahara, good in Athiparva Ruk. Guggulutikthaka Ghritha12 is best in diseases of Asthi, Sandhi, Majja and it has got Tridoshahara properties. Trivruth is Sukhavirechaka13, Mrudu Rechaka, indicated in Bahudoshavasta. Chandanabalalakshadi Taila is an antinflamatory, indicated in Vatavyadhis and Shreshta Sapthadhatu Vivardhaka. Yamaka Sneha yields better results rather than single Sneha Yoga, as there will be a combined effect of two Snehayogas. Internally, Kaishora Guggulu was administered as majority of the ingredients are Amapachaka, Shothaghna, Shoolaghna, Amavatahara properties, Tridoshahara and Sarvamayaghna. This reduces the clinical manifestation of symptoms of Amavata, helping in Samprapti Vighatana. CONCLUSION: Ankylosing Spondylitis as Amavata can successfully be managed with Ayurvedic principles of Treatment. REFERENCES: [1] J. Maheshwari. Essential orthopaedics. Jaypee brothers medical publishers (P) LTD, 4th edition. 2011. 34th chapter. 282pp [2] Acahrya Vangasena. Vangasena Samhitha. Amavthaadhikara verse 1-4, 399pp [3] Acahrya Vangasena. Vangasena Samhitha. Amavthaadhikara verse7, 400 pp [4] Chakrapanidatta. Chakradatta. with hindi commentary Bhavaarthasandeepini. edited by Bhishagratna PT. Brahmashankar Mishra. Varanasi:Choukhambha Sanskrit series office. Amavata Chikitsa verse 1, 225pp [5] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Sutra sthana 16th chapter, verse 13-19, 97pp. [6] Vagbhatta. Asthanga Hridaya. Sarvanga sundara teeka of Arunadatta and Ayurveda Rasayana of Hemadri. Edited by Pandit Harishastri Paradkar Vaidya. 9th Edition. Varanasi:Chaukhambha orientalia; 2005. Sutra Sthana, 27 chapter, verse1, 260pp. [7] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Chikitsa sthana 28th chapter, verse 83-84, 620pp. [8] Vagbhatta. Asthanga Hridaya. Sarvanga sundara teeka of Arunadatta and Ayurveda Rasayana of Hemadri. Edited by Pandit Harishastri Paradkar Vaidya. 9th Edition. Varanasi:Chaukhambha orientalia; 2005. Sutra Sthana23 chapter, verse28, 217pp. [9] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Sutra sthana 20th chapter, verse 213, 114pp. [10] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Siddi sthana 1th chapter, verse 26, 682pp. [11] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Chikitsa sthana 25th chapter, verse 96-97, 520pp. [12] Vagbhatta. Asthanga Hridaya. Sarvanga sundara teeka of Arunadatta and Ayurveda Rasayana of Hemadri. Edited by Pandit Harishastri Paradkar Vaidya. 9th Edition. Varanasi:Chaukhambha orientalia; 2005. Chikitsa Sthana, 21chapter, verse57-61, 726- 727pp. [13] Agnivesha, Charaka Samhita, Edited by Yadavaji Trikamji Acharya, Ayurveda Deepika Commentary of Chakrapani Datta, Varanasi: Chaukhambha Sanskrit Samsthan;2015. Sutra sthana 25th chapter, verse 40, 131pp.
