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Journal of Natural & Ayurvedic Medicine Research Article 8 min read

Mainstreaming Evidence Based Ayush in Integrative Palliative Care

Singh A* and Mishra J*
* Corresponding author
ISSN: 2578-4986  10.23880/jonam-16000258  Received: July 17, 2020  Published: August 25, 2020
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Keywords
AYUSH Ayurveda Palliative Healthcare Panchkarma Sirodhara
Abstract

AYUSH collectively defines several system of medicine including Ayurveda, Unani, Siddha and Homeopathy. AYUSH interventions and modalities have been widely used in treatment of certain chronic and life-style diseases. Detoxification therapies and Panchkarma procedures have been targeted for possible application in therapeutics. The systemic review examines the outcome of scientific studies in the field of AYUSH and possible mainstreaming in integrative palliative care. Major and authentic search engines were used to extract the clinical data.

Introduction

Documentation and scientific validation of Ayurvedic drugs is mandatory for quality evaluation and acceptance at global level [1]. The ministry of AYUSH in India has taken several initiatives for integration of Ayurveda in the healthcare system [2]. The possible integration of AYUSH in palliative care has been discussed [3]. The review is aimed at role of drug less AYUSH therapies in the integrative palliative care. Mainstreaming of AYUSH health care practices in palliative care is significant but has some ethical limitations [4]. For the purpose of availability and affordability of AYUSH systems of medicine, implementation of the strategies at the level of policymaker and apex bodies is an absolute must [5].

Material and Methods

Reputed national and international search engines were used to extract data. As discussed under eligibility criteria, due to scarcity of quality research and review data on AYUSH interventions and modalities for possible integration in palliative healthcare, several reputed national as well as international databases like Pub Med, Annotated Bibliography of Indian Medicine, AYUSH Research portal and journals related to Integrative Medicine, Ayurvedic Medicine and Alternative and Complementary Medicine were consulted for obtaining authentic information.

Results

Sirodhara

Sirodhara is a classical and a well-established ayurvedic procedure of slowly and steadily dripping medicated oil or other liquids on the forehead. A clinical study reported efficacy of sirodhara and sirovirecana in selected cases of chronic headache. Patients having history of headache associated with migraine, eye-diseases, temporal arteritis and cervical spondylosis were excluded from the study group. Patients having confirmed diagnosis of frontal sinusitis, scalp myalgia and stress headache participated in the study. Although, number of patients has not been specified in the study but positive impact on remission of headache episodes was reported in frontal sinusitis, scalp myalgia and stress headache [6].

Changes in physiological parameters have been reported in patients treated with sirodhara [7]. A study evaluated the physiological and psychological effects of sirodhara in healthy volunteers. Rating of mood, stress-levels, electroencephalogram and biochemical markers of stress were assessed. Significant improvement in above mentioned parameters was observed by a standardized sirodhara protocol [8]. An open trial in ten patients reported efficacy of sirodhara (with Dhanvantaram taila) in progressive degenerative cerebellar ataxia. However, more randomized placebo-control double blind studies are warranted for possible us in pharmacotherapy of cerebellar ataxia [9].

Integration of various Ayurvedic modalities and physiotherapy was utilized in the management of Erb’s paralysis. Favorable results were reported in reduction of disparity in length and mid-arm circumference of right upper limb in comparison to unaffected left limb. The muscle tone improved significantly from 0 to 4 [10].

A case study reported efficacy of sirodhara in conjunction with other Ayurvedic therapies in the management of Guillain-Baree syndrome. Marked improvement in muscle tone and speech was observed and positive findings were observed in deglutition and various postures [11].

Panchkarma

The therapeutic value of panchkarma has been highlighted by a few studies [12]. Panchkarma is very popular among masses with a notion of curing the diseases from the root cause [13]. Efficacy of the procedure has been reported in the treatment of colicky pain [14]. Vamana (therapeutic vomiting) is a major step of panchkarma. Physiological and biochemical changes with therapeutic vomiting have been studied in healthy volunteers [15]. Vamana along with Ayurvedic formulations have has been reported to have mild to moderate degree of response in patients suffering from major depressive illness [16]. A clinical trial in 19 patients diagnosed with obesity reported efficacy of Lekhana Basti in the management of hyperlipidemia [17]. Panchkarma combined with balance exercises has been reported to improve balance and disability in cases of supranucler palsy [18].

Promising results have been reported in the management of rheumatoid arthritis with diet and virechanakarma [19]. Vaman and virechana have been reported to be effective in certain cases of psoriasis [20]. A standard controlled clinical study evaluated the effect of virechanakarma and Lekhana Basti in the management of dyslipidemia. Virechanakarma was found to be effective in reducing of triglycerides levels, whereas Lekhana Basti was reported to be effective in reducing cholesterol levels [21]. Further, efficacy of panchkarma in the treatment of post partum rheumatoid arthritis, skin diseases and cervical spondylotic myelopathy has been reported [22, 23, 24].

Ksharasutra (Medicated saton)

A published study demonstrated usefulness of ksharasutra in 3586 cases of hemorrhoids [25]. Efficacy of ksharasutra in the management of pilonidal sinus and axillary hidradenitis suppurativa has been reported [26, 27]. A multicentric randomized controlled clinical trial conducted by Indian Council of Medical Research suggested ksharasutra as an effective and safe alternative treatment of fistula-in- ano [28]. The conclusion was based on comparison with surgical treatment of fistula-in-ano. A study reported efficacy of ksharasutra in 114 patients diagnosed with fistula-in-ano. No recurrence was reported over a follow-up of 6 months to 2 years [29]. The study also elaborated the cost effectiveness of the procedure in the treatment of fistula-in-ano.

Conclusion

AYUSH systems of medicine have gained momentum in the recent times and people are open to these diverse systems of medicine for achieving optimal health care. However, it is premature to say that integration of AYUSH systems of medicine with conventional healthcare may yield expected results [30]. Innovation in AYUSH systems of medicine is an absolute must and need of the hour in era of cut-throat competition and tremendous scientific advancement [31]. Seasonal Ayurvedic procedures like Panchakarma, Shirodhara and Ksharasutra (Medicated saton) have yielded encouraging results in management of certain diseases and cost effectiveness have been the major highlight of the ancient therapies [32, 33, 34, 35, 36, 37].

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@article{singh2020,
  title   = {Mainstreaming Evidence Based Ayush in Integrative Palliative Care},
  author  = {Singh A* and Mishra J},
  journal = {Journal of Natural & Ayurvedic Medicine},
  year    = {2020},
  volume  = {4},
  number  = {3},
  doi     = {10.23880/jonam-16000258}
}
Singh A* and Mishra J (2020). Mainstreaming Evidence Based Ayush in Integrative Palliative Care. Journal of Natural & Ayurvedic Medicine, 4(3). https://doi.org/10.23880/jonam-16000258
TY  - JOUR
TI  - Mainstreaming Evidence Based Ayush in Integrative Palliative Care
AU  - Singh A* and Mishra J
JO  - Journal of Natural & Ayurvedic Medicine
PY  - 2020
VL  - 4
IS  - 3
DO  - 10.23880/jonam-16000258
ER  -