E-ISSN:2456-3110

Case Report

Panchakarma therapy

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 3 March
Publisherwww.maharshicharaka.in

Role of Ayurvedic medicines with Panchakarma therapy in SLE w.s.r. to Aamvata

Yadav V1*, Sharma S2, Meshram R3
DOI:10.21760/jaims.9.3.36

1* Veenu Yadav, Post Graduate Scholar, PG Department of Kayachikitsa, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

2 Shraddha Sharma, Assitant Professor, Department of Kayachikitsa, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

3 Rajesh Meshram, HOD and Associate Professor, Department of Kayachikitsa, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.

Background: Autoimmune disorders occur when the body’s immune system is working hard to defend against potentially precarious substances our bodies such as allergens, toxins, infection or food but does not identify the difference between the invaders and own body cells. SLE is an autoimmune disease in which organs, tissues and cells undergo damage, mediated by tissues binding auto antibodies and immune complexes. SLE affects heart, joints, skin, lungs, blood vessels, liver, kidney and nervous system. Due to Piita Pradhantwa in SLE it can be correlated with Pitta Anubandhi Amavata as both are systemic autoimmune disease having involvement of mainly Pitta Dosha. Materials and Methods: A male patient with complaints of pain in multiple joints with swelling, recurrent mouth ulcers, weakness all over the body and erythematous rashes on both hands with some discharge came to OPD of PTKLS Hospital and diagnosed as Amavata and admitted in IPD of the Hospital and treated according to Ayurveda Protocol including oral medications and Panchakarma therapy. Result: Patient got symptomatic relief. Details of this will be discussed in full paper. Discussion: In Ayurveda, symptoms of Vata Kapha Anubandhi Amavata can be correlated with RA and symptoms of Pitta Anubandhi Amavata can be correlated with SLE as there is involvement of Pitta Dosha and Rakta Dhatu in SLE.

Keywords: Systemic lupus erythematosus, SLE, Pitta, Autoimmune, Panchakarma therapy, Aamvata

Corresponding Author How to Cite this Article To Browse
Veenu Yadav, Post Graduate Scholar, PG Department of Kayachikitsa, Pt Khushilal Sharma Government Ayurveda College and Hospital, Bhopal, Madhya Pradesh, India.
Email: 		Yadav V, Sharma S, Meshram R, Role of Ayurvedic medicines with Panchakarma therapy in SLE w.s.r. to Aamvata. J Ayu Int Med Sci. 2024;9(3):227-230.
Available From
https://jaims.in/jaims/article/view/3160

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-01-11 2024-01-21 2024-01-31 2024-02-10 2024-02-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 23.96

© 2024by Yadav V, Sharma S, Meshram Rand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2024;9(3)227
Veenu Yadav et al. Role of Ayurvedic medicines with Panchakarma therapy in SLE

Introduction

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder characterized by the development of autoantibodies and immune complexes in association with a wide variety of clinical manifestations and tissue damage. Several defects of multiple immunological components play a role in the pathogenesis of SLE.[1]

The cause for SLE is unknown but there some factors like hereditary, genetics, sex hormone status, UV lights, and some drugs are responsible for manifestation of the disease.

Symptoms of SLE are arthritis, myalgia, malaise and tiredness, fever, butterfly rash, skin eruptions, Raynaud’s phenomena, renal disease, weight loss, lymphadenopathy etc.[2] Due to Piita Pradhantwa in SLE it can be correlated with Pitta Anubandhi Amavata.[3] Symptoms of Pitta Anubandhi Amavata can be correlated with SLE as there is a great involvement of Pitta Dosha and Rakta Dhatu in SLE. and Pitta Dosha lies within Rakta Dhatu in body. I.e. Ashrayashrayi Sambandha.

Symptoms of Pitta Anubandhi Amavata are Atidaha, Pipasa, Jawar, Murcha, Rakitima.

Preventive measures are like Langhana, Deepana-Pachana, Shodhana, Shaman and Rasayan have been described for the management of Amvata are actually more effective.

Aim and Objective

To assess the role of Ayurvedic Medicines with Panchakarma therapy in SLE w.s.r. Aamvata.

Materials and Methods

Selection and source of patient

For this study, patient was taken from the IPD of Pt Khushilal Sharma Govt. Ayurveda College and Institute, Bhopal, MP.

Case Study

A male patient IPD No. 54468 age 45years with complaints of pain in multiple joints with swelling, recurrent mouth ulcers, weakness all over the body and erythematous rashes on both hands with some discharge.

History of past illness - No

Surgical history - No

Personal History

Diet - Mixed diet, prefers - spicy.

Appetite - Decreased

Bowel - Clear

Bladder - Normal

Sleep - Disturbed due to pain and itching

Allergy and addiction - Nil.

Examination

Ashtavidha Pariksha

  • Nadi (Pulse) - Vata-Kapha, 80/ min.
  • Mootram (Urine) - Normal
  • Malam (Stool) - Normal
  • Jivha (Tongue) - Upalipta
  • Shabdam (Voice) - Normal
  • Sparsham (Touch) - Normal but warmth all over body.
  • Drika (Eyes) - Normal
  • Aakriti (Built) - Moderately, no deformities

Local examination

  • Tenderness on B/L wrist joints and Knee joints.
  • Restricted range of motion of the joints.
  • Rashes are ill defined, scaly on both the hands.
  • Photosensitive rash present on face and some area of neck.
  • Itching increases on both hands during evening time with some watery discharge.
jaims_3160_01.JPG
Fig 1: Hands

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Veenu Yadav et al. Role of Ayurvedic medicines with Panchakarma therapy in SLE
jaims_3160_02.JPG
Fig. 2: Neck Region

Investigation

Diagnosis of the disease on the basis of SLICC criteria[4]

The SLICC criteria for SLE classification require: 1) Fulfilment of at least four criteria, with at least one clinical criterion AND one immunologic criterion OR 2) Lupus nephritis as the sole clinical criterion in the presence of ANA or anti-dsDNA antibodies.

Clinical Criteria

1. Acute cutaneous lupus

2. Chronic cutaneous lupus

3. Oral ulcers: palate

4. Nonscarring alopecia (diffuse thinning or hair fragility with visible broken hairs)

5. Synovitis involving two or more joints, characterized by swelling or effusion OR tenderness in two or more joints and thirty minutes or more of morning stiffness.

6. Serositis

7. Renal

8. Neurologic

9. Haemolytic anaemia

10. Leukopenia (< 4000/mm3 at least once)

11. Thrombocytopenia (<100,000/mm3) at least once

Immunological Criteria

1. ANA above laboratory reference range

2. Anti-dsDNA above laboratory reference range, except ELISA: twice above laboratory

3. Anti-Sm

4. Antiphospholipid antibody: any of the following

5. Low complement

6. Direct Coombs test in the absence of haemolytic anaemia

Treatment Regimen

Shamana Drugs

1. Swarna Guggulu 1 BD twice a day

2. Panchtikta Ghrita Guggulu 1 BD

3. Avipattikar Churna (3gm) + Godanti Bhasma (125mg) BD before meal

4. Haridrakhand powder 5gm BD with milk

5. Khadiradi Vati 1qid

6. Mahamarichyadi Taila for Local application

Panchakarma Therapy

1. Panchtikta Ksheer Basti for 16 days (Kala Basti)

2. Sarvang Patra Pinda Swedana

DayBastiDoseTime of Basti AdanakalaTime of Basti Pratyagamana Kala
1.K200ml10:15am2:00pm
2.K200ml11:15am4:00pm
3.K200ml10:40am2:50am
4.K200ml10:30am4:10pm
5.K200ml10:15am4:15am
6.K200ml11:00am4:45pm
7.K200ml10:45am4:30am
8.K200ml11:15am3:00pm
9.K200ml10:30am3:00pm
10.K200ml11:15am2:00pm
11.K200ml11:30am3:00pm
12.K200ml10:15am2:40pm
13.K200ml11:15am3:30pm
14.K200ml10:45am2:00pm
15.K200ml11:45am4:00pm
16.K200ml11:30am2:45pm

Discussion and Conclusion

SLE is an autoimmune disease in which organs, tissues and cells undergo damage, mediated by tissues binding auto antibodies and immune complexes. SLE affects heart, joints, skin, lungs, blood vessels, liver, kidney and nervous system.

There is involvement of Pitta Dosha and Rakta Dhatu in the SLE.


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Veenu Yadav et al. Role of Ayurvedic medicines with Panchakarma therapy in SLE

Swarn Guggul - Swarna Bhasma contains nanoparticles of gold that act as a wonderful rejuvenating agent which helps in bringing down the aggravated Vata Dosha in the body especially during old age. Ashwagandha is known for its anti-inflammatory properties that help control joint inflammation. Saffron has the ability to reduce all the vitiated Doshas and eliminate toxins from the body.

Panchatikta Ghrita Guggulu contained following drugs- Nimba, Guduchi, Vasa, Patola, Kantakari, Ghrita, Patha, Vidanga, Devadaru, Gajapippali, Yavakshara, Sarjikakshara, Nagara, Nisha, Mishreya, Chavya, Kushtha, Tejovati etc. Aretikta-Katu Rasa, Laghu Ruksha Guna, Ushna Virya which act on vitiated Kapha Dosha. Tikta Rasa also has the property of Raktaprasadana, Vishaghna, Kushthaghna, Kandughna and Dahaprashamana.[5]

Hadridra Khand - Haridra Goghrita Godugdha Sharkara Shunthi, Maricha, Pippali, Patra, Twak, Ela, Vidanga, Triphala, Trivrit, Nagarmotha, Nagakeshara, Loha Bhasma. It is used widely in the treatment of allergic skin diseases, itching skin diseases and Visphota (blisters).[6]

Panchtikta Tikta Ksheer Basti - Most of ingredients of Panchtikta Ghrita Gugglu have Tikta Rasa, Ushna Virya, Madhura and Katu Vipaka. Further Tikta drugs have Vataghna & Rasayana (Dhatuvardhaka) Guna & increases the Dhatwagni (metabolic fire). It performs Pachan Karma, which destroys Srotorodha (channel obstruction) leading to pacify the Vata Dosha & improves the metabolism. The decoction prepared in Kshira (Milk) has Madhura & Snigdha Guna which helps in balancing the Vatadosa & Pitta Dosa and acts as Brimhana. Due to Sukshmaguna of Saindhava; it reaches deep in the microchannel of the body & helps to improve blood supply to the bone tissue.[7]

Mahamarichyadai Taila - having Maricha, Hartal, Trivrit, Musta, Haridra, Daruharidra, Raktachandan. This formulation mentioned in Sharnagdhar Samhita Madhyam Khand 9/148-152 having properties like antifungal, antiseptic and antioxidant etc. All these factors combinedly showing the tremendous result in symptoms of SLE. Patient got symptomatic relief although it is an autoimmune disorder; we completely cannot cure the disease. But we can decrease the vague symptoms of SLE in our patients for better lifestyle. In Ayurveda

it is related with Aamvata so our main focus to minimize the Aam Dosha in the patients, indirectly we correlate the Aam to the toxins (affecting autoimmunity).

References

1. P. D'Cruz, M. A. Khamashta, and G. R. Hughes, “Systemic lupus erythematosus,” The Lancet, vol. 369, no. 9561, pp. 587–596, 2007.

2. Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD. Manifestations of systemic lupus erythematosus. Maedica (Bucur). 2011 Oct;6(4):330-6. PMID: 22879850; PMCID: PMC3391953.

3. Madhavnidan, hindi commentary by Yadunandan Upadhyay, amavata nidan, chaukhamba prakashan, poorvardha, 509-51

4. SLE Criteria [Internet]. [cited 2024 Apr 16]. Available from: https://sliccgroup.org/research/sle-criteria/

5. Charaka Samhita, Sutra Sthana, Atreyabhadrakapiya adhyaya, 26 /31Available from: http://niimh.nic.in/ebooks/echarak

6. Sanjay Kumar et al. “Review of Haridra Khand and its pharmaceutical preparation.” International Ayurvedic Medical Journal, vol. 11, no. 1, 2023, pp. 2232-2238

7. Dr Raja Singla, Dr Pankaj Sharma,Role of Panchtikta Kshira Basti in Management of Avascular Necrosis : A Case Study, IJRMST, July-December 2021, Vol 12, 115-120.


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