Effectiveness of Sanshman Chikitsa on Amavata w.s.r. to Rheumatoid Arthritis

Pratiksha Sharma; Ravi Sharma

doi:http://dx.doi.org/10.21760/jaims.8.5.43

Amavata occurs when the Ama mixes with the Vata Dosha and occupies the Shleshmasthana (Asthisandhi). Ama and Vata are the two main pathogenic components of Amavata, a Rasa Pradosaja Vikara that primarily affects Sandhi before moving on to Asthi and Majja. Due to similar clinical features, Amavata and rheumatoid arthritis can be co-related. It is an autoimmune condition called rheumatoid arthritis results in persistent symmetrical polyarthritis with systemic involvement. When compared to men, females are more likely to contact this disease. The ratio of male to female is 3:1. It is an extremely painful condition that frequently results in soreness, edema, and inflammation in the joints. The pain, joint stiffness occurs maximum in Mornings, which lasts for over an hour.

Corresponding Author

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Pratiksha Sharma, Post Graduate Scholar, Department of Kayachikitsa, Madan Mohan Malviya Govt. Ayurved College, Udaipur, Rajasthan, India.
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Pratiksha Sharma, Ravi Sharma, Effectiveness of Sanshman Chikitsa on Amavata w.s.r. to Rheumatoid Arthritis. J Ayu Int Med Sci. 2023;8(5):250-253.
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https://jaims.in/jaims/article/view/2395

Manuscript Received

Review Round 1

Review Round 2

Review Round 3

Accepted

2023-03-27

2023-03-29

2023-04-05

2023-04-12

2023-04-19

Conflict of Interest

Funding

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Note

Nil

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Introduction

Asthivaha and Rasavaha Strotas are affected by the condition known as Amavata. It is mostly formed as a result of Ama and Vata Dosha vitiation. The increased Vata transports the Ama and deposits it in Sleshmasthanas (Places of Kapha, like joints, etc.) it includes clinical features like Angamarda (body ache), Aruchi (loss of appetite), Alasya (weakness), Sandhiruk (joint pain), Sandhishotha (joint swelling).^[1]

The characteristics of Amavata were originally detailed by Madhavakara in Madhava Nidana, but Acharya Chakradatta was the first to explain techniques to recover from Amavata. Amavata is a Madhyama Roga-marga disorder, which is why it is also known as Krichrasadhya or Yapya. It is a chronic, progressive autoimmune arthropathy, rheumatoid arthritis is characterized by bilateral symmetrical joint involvement and certain systemic clinical symptoms.^[2] 80% of patients experience the disease's beginning between the ages of 35 and 50, when it occurs most frequently in the fourth and fifth decades of life.^[3]

Material and Methods

Patient’s personal history

Name - XYZ
Age - 18 year
Sex - Female
Occupation - Student

Chief complaints

Morning stiffness in interphalangeal joints of both hands (from 4 months)
Redness, itching and swelling in fingertips of both hands (from 4months)
Pain in interphalangeal joints of both hands (from 4 months)
Appetite - low
Sleep - disturbed
Bowel - constipated

Nadi

Normal in rate and rhythm, Kapha Pradhaan

Mala

Aam

Mutra

Bahu-Mutrata (6 times-Day) (1-2/night)

Jihwa

Coated

Shabda

Samanya

Sparsha

Sheeta

Drika

Shweta

Aakriti

Krisha

Prakriti

Kapha Vaataj

Vikriti

Aamvata

Sara (purest body tissue)

Majjasara

Samhanana (body built)

Krisha

Pramana(body proportion)

Avara

Satmya (homologation)

Madhyam

Satva (mental strength)-

Madhyam

Aharshakti (food intake)

Avara

Vyayamshakti (to carry on physical activities)

Avara

Vaya

Baal

Date

RA Factor

Normal range

Before treatment

30 /01/2023

190.65 IU/ml (elevated)

0-20 IU/ml

After treatment

24/04/2023

9.00 IU/ml (normal)

0-20 IU/ml

Treatment Profile

SN	Medicine	Dose	Anupana	Duration
1.	Giloy Ghan Vati	2 tabs BD	Ushna Jala	First 1 month
2.	Giloy Churna	1 gm BD	Madhu	First 1 month
3.	Kutaki Churna	1 gm BD	Madhu	First 1 month
4.	Trikatu Churna	1 gm BD	Madhu	First 3 months
5.	Haritaki Churna	1 gm BD	Madhu	First 3 months
6.	Chop Chini Churna	1 gm BD	Madhu	First 3 months
7.	Punarnava Mandura	500mg BD	Madhu	1 month
8.	Vaishwanara Churna	3 gm BD	Madhu	1.5 month
9.	Agnitundi Vati	1 tab BD	Ushna Jala	1 month
10.	Eranda Sneha	10 ml	Luke warm milk	1.5 month
11.	Amavatahara Kwath	5 gm		1.5 month

Discussion

Guduchi: Guduchi is having Katu, Tikta, Kashaya Rasa and Ushna Virya, it does Ama Pachana. It also acts as Agni Deepaka and Vatahara. The anti-inflammatory effect Guduchi was mediated via reduction of the pro inflammatory cytokines such as: IL-16, TNF-alpha, IL-6, and IL-17 etc. Due to its Rasayana property it action was expected in micro level by cellular repairing, it may be the reason of its immunomodulator effect. Deepana, Amahara.^[4]

Kutaki: Kutaki is helpful for treating rheumatoid arthritis due to its anti-inflammatory property. It helps reduce joint swelling by inhibiting the production of inflammation causing chemicals.

Trikatu Churna: Contains Shunthi, Maricha, Pippali. Trikatu has an anti-inflammatory effect in RA, similar to piperine, 6-shogaol, and 6-gingerol.

Trikatu has immunomodulatory properties also.

Haritaki: Laghu, Ruksha, Tridoshashamaka, especially Vataanulomaka, Ushna Virya. It has Chebulanic acid, which have antioxidant property, Hyperglycemia promotes auto-oxidation of glucose to form free radicals. The generation of free radicals beyond the scavenging abilities of endogenous antioxidant defenses results in macro and microvascular dysfunction.^[5]

Chopchini: it has anti-rheumatic nature is used to reduce inflammation.it also helps in stimulation of digestive system.^[6]

Vaishwanara Churna: Contains Haritaki, Saindhaw, Yavani, Ajmoda, Shunthi. It is mentioned in Chakrdatta, Amavata Rogadhikar.

Agnitundi Vati

Kajjali (Black sulfide of mercury), Ajwain (Trachyspermum ammi), Sudha Vatsanabha (Aconitum ferox), Harad (Terminalia chebula), Bahera (Terminalia bellerica), Amla (Emblica officinalis), Sajjikshar, Yavakshar, Chitrakmool (Plumbago zeylanicum), Saindhav Lavan (Rock salt), Survarchal Lavan (Black salt), Samudra Lavan (Sea salt), Shavet Jiraka (Cuminum cyminum), Vidanga (Emblica ribes), Shunthi (Zingiber officinalis), Pippali (Piper longum), Marich (Piper nigrum), Sudh Kuchla (Strychnos nuxvomica). Through the digestion of Ama, the primary cause of illness appearance, Agnitundhi Vati strengthens Agni.

Eranda Sneha

Eranda Taila is a combination of Kashaya, Madhur and Katu Rasatmak, Madhur Vipaka, and Ushna Viryatmak, which balances the Doshas Vata, Kapha, and Pitta. It is Anti-inflammatory and has the purgative, or Bhedaniya, function of destroying excrement. Rechana removes excess Doshas, Snehopaga hydrates and treats dryness, and Rechana decreases Vata.

Amavatahara Kwath

It is Hypothetical Kwath, made in pharmacy of Madan Mohan Malviya Govt. Ayurved College, Udaipur (Rajasthan). Contents - Erondmoola, Punarnava Moola, Giloy, Shunthi, Karchur, Haritaki, Pippalimoola, Ashwagandha, Dhanyaka.

All the contents are Agnideepaka, Aam Pachaka, and Mutra Virechak have the anti-inflammatory property.

Before treatment

Conclusion

One of the most common diseases nowadays is Amavata, which presents a difficult problem for medical research. Ama and Vata have characteristics that are at odds with one another and the presence of Uthanadhatu (Rasa) and Gambheradhatu (Asthi) complicates the treatment. As a result, a systematic treatment protocol that is solely based on the principles of Ayurveda is required, as any measures taken will primarily work against one another. As a result, taking a very cautious approach will only be to the patient's advantage. Although the exact origins of RA are still unknown, it is thought that genetically vulnerable individuals are more likely to develop it as a result of their body's immune system reacting to an infectious pathogen. Ayurvedic researchers have also linked RA to Amavata. To avoid abnormalities with effective care, early diagnosis is essential. The diagnosis of Amavata was made in this case because to the characteristic severe pain in small joints, anorexia, bodily aches, and stiffness. Pachak, Tikta, and Katu Drugs called Aahar and Aushadhi, which operate as deepening and pacifying agents and have the flavours Katu

Reference

1. Madhavakara, Madhavanidana, Vimala Madhudhara Teeka by Tripathi Brahmanand, Chaukhambha Surabharati Prakashana, Varanasi, ed. 2010, Poorvardha, Adhyaya 25, Page 571-577.

2. Shah Ankur, E. William St. Clair, Harrison's Principles of Internal Medicine. Volume 2, 18th edition, Chapter 321, Rheumatoid Arthritis, (Pg. 2739).

3. Churchill Livingstone, Davidson’s Principle and Practice of Medicine. 19th ed.: Elsevier Publication; 2002. (pp. 1002–7).

4. Prakash L. Hegde, Harini A, A text of Dravyaguna Vijnana, volume 2nd, 2020 edition.

5. Bha. S. Guduchyadi Varga 6-10

6. Antioxidants and diabetes, Antioxidants and diabetes - PubMed (nih.gov)

7. https://www.planetayurveda.com/library/chopchini-smilax-china-uses-health-benefits/

8. Chakradutta with Ratnaprabha commentary edited by Priyavat Sharma, Swami Jayaram das Prakashana Jaipur, Reprint 2000, Amavata chi.25/1 pg no.423 and Bhaishajya Ratnavali, Edited with Siddhiprada Hindi Commentary by Siddhinandan Mishra, Published by Chaukhambha Surbharati Prakashana, 29/13 Varanasi, Edition, 2007; 198

Case Report

Amavata

Journal of Ayurveda and Integrated Medical Sciences