This case study describes the use of Ayurvedic medicine and leech therapy to treat a 47-year-old male patient with deep vein thrombosis (DVT) in his left leg. Over the course of 30 days of treatment, which included oral medications, abdominal oil massages, leg compressions, and weekly leech therapy applications, the patient experienced significant relief from pain and swelling in his leg. Quantitative scales were used to measure improvements in the patient's pain level, walking ability, and swelling over the course of the 4-week treatment period. The case study concludes the Ayurvedic treatments successfully managed the patient's DVT symptoms.
This case study describes the use of Ayurvedic medicine and leech therapy to treat a 47-year-old male patient with deep vein thrombosis (DVT) in his left leg. Over the course of 30 days of treatment, which included oral medications, abdominal oil massages, leg compressions, and weekly leech therapy applications, the patient experienced significant relief from pain and swelling in his leg. Quantitative scales were used to measure improvements in the patient's pain level, walking ability, and swelling over the course of the 4-week treatment period. The case study concludes the Ayurvedic treatments successfully managed the patient's DVT symptoms.
This case study describes the use of Ayurvedic medicine and leech therapy to treat a 47-year-old male patient with deep vein thrombosis (DVT) in his left leg. Over the course of 30 days of treatment, which included oral medications, abdominal oil massages, leg compressions, and weekly leech therapy applications, the patient experienced significant relief from pain and swelling in his leg. Quantitative scales were used to measure improvements in the patient's pain level, walking ability, and swelling over the course of the 4-week treatment period. The case study concludes the Ayurvedic treatments successfully managed the patient's DVT symptoms.
This case study describes the use of Ayurvedic medicine and leech therapy to treat a 47-year-old male patient with deep vein thrombosis (DVT) in his left leg. Over the course of 30 days of treatment, which included oral medications, abdominal oil massages, leg compressions, and weekly leech therapy applications, the patient experienced significant relief from pain and swelling in his leg. Quantitative scales were used to measure improvements in the patient's pain level, walking ability, and swelling over the course of the 4-week treatment period. The case study concludes the Ayurvedic treatments successfully managed the patient's DVT symptoms.
Kaur Rimpaljeet et al. Journal of Biological & Scientific Opinion · Volume 3 (2).
2015
Available online through
www.jbsoweb.com ISSN 2321 - 6328
Research Article ROLE OF AYURVEDIC MEDICINE AND LEECH THERAPY IN MANAGEMENT OF DEEP VEIN THROMBOSIS: A CASE STUDY Kaur Rimpaljeet1*, Chhabra Shailly1, Singh Amitabh2 1 MD Scholar (Ay.), Department of Kayachikitsa, P.G. School of Ayurveda and Research, DBU, Mandigobindgarh, Punjab, India 2 Professor, Department of Kayachikitsa, P.G. School of Ayurveda and Research, DBU, Mandigobindgarh, Punjab, India *Corresponding Author Email: dr.rimpal@gmail.com
Article Received on: 26/02/15 Accepted on: 08/04/15
DOI: 10.7897/2321-6328.03218
ABSTRACT
Panchakarma is a therapeutic way of eliminating toxic elements from the body. According to Sushruta, Panchakarma include five Shodhana (purification) process or therapies in which Raktamokshana (bloodletting) is one among them. Jalaukaavcharana (Leech therapy) is Shodhana type of treatment under raktamokshana. In Ayurveda, raktamokshana has been mentioned mainstay of treatment for raktapradoshajavikara. Deep vein thrombosis, or deep venous thrombosis, (DVT) is the formation of a blood clot (thrombus) within a deep vein, predominantly in the legs. Non-specific signs may include pain, swelling, redness, warmness, engorged superficial veins. D.V.T. formation typically begins inside the valves of calf veins where the blood is relatively oxygen deprived which activates certain biochemical pathways.The lifestyle of an individual can increase the risk for venous diseases. If a person is obese, or smoker, drinks excessive amount of alcohol, or consume fatty foods, it can lead to blood thickening and obstruction of the vessels by fatty deposits or plaque formation. This is the case presentation of 47 years old male patient had a history of D.V.T., having complaints of pain and numbness in left leg since 8 months. A Colour Doppler Ultrasound was positive for D.V.T. The Jalaukaavcharana was done weekly along with oral medication for total duration of 30 days with continuation of the previous medication. The patient got relief in clinical sign and symptoms of D.V.T.
Keywords: Panchakarma, Raktamokshana, Deep vein thrombosis, Jalaukaavcharana.
INTRODUCTION aspirin etc.6 As per Ayurveda, there is no direct reference of any
such disease, but causes, sign and symptoms of DVT resemble Deep vein thrombosis (DVT) is a silent killer.1 It is the third various conditions in Ayurveda. One of them is siragata vata in most common vascular disease, after ischemic heart disease and which there is pain in the region of sira along with narrowing or stroke.2 The mechanisms underlying DVT, known as Virchow’s obstruction in the lumen of sira.7 Another condition called traid, are venousstasis, hypercoagulability and endothelial raktaavritta vata has been described with symptoms of pricking injury.3 Mainly two types of venous thrombosis are seen, pain, hyperaesthesia and numbness of the area affected.8 As far superficial vein thrombosis (Thrombophlebitis) and deep vein as aetiology of the disease is concerned many factors mentioned thrombosis (Phlebothrombosis). Out of two, DVT is of more in nidana of vatarakta like achankramansheelinam (prolonged importance as this can result in life threatening condition like sedentary period), abhigata (trauma), sthulata (obesity) etc9 are pulmonary embolism due to dislodgement of thrombus loosely also predisposing factors for DVT. In such condition of vata attached to vessel wall.4 affecting the sira, Acharya Sushruta has exclusively mentioned Known risk factors for development of DVT during medical and the treatment regime which includes raktamokshana.10 Acharya surgical hospitalizations include congenital factors (i.e. Vagbhatta has mentioned that leech can be applied in the area hereditary thrombophilia like Factor V Leiden, prothrombin where blood is clotted.11 Acharya Charka has enumerated blood deficiency) and acquired factors (advanced age, obesity, surgery, related disorders and their treatment by various type of trauma, neoplasm, heart, kidney and bowel diseases, estrogen bloodletting.12 As these are basically raktapradoshajavikaras so hormone therapy, pregnancy and postpartum period, tamoxifen, raktamokshana was planned for this patient. dehydration, immobilization).5 Venous thrombosis is often asymptomatic and is clinically manifested in 40 % or less cases. Case Report It mainly represent as aching pain which is aggravated by muscular activity at the site of thrombus. Swelling is minimal at A male patient of 47 years of vatapittaja prakruti, Sikh by dependant part along with tenderness in the region of the vein. religion, living in Mandigobindgarh, Punjab, India approached The calf is most frequent site of thrombosis. Treatment of DVT OPD of DBACH and registered with Cr.NO.-3556/459 on Feb is mainly aimed at reduction the propagation of thrombus, to 4th 2013. Patient was asymptomatic8 months ago.8 months back, limit the damage to the venous valves and to reduce the he developedpain in the left leg. He consulted a nearby physician probability for pulmonary embolism. Modern treatment of but had no relief. Later, his condition get worsened and he was established cases of DVT include bed rest, elevation of legs, not able to bear weight on the left leg and unable to walk for elastic stockings and use of drugs like heparin, coumarin which he visited Government Rajindera Hospital Patiala, India derivatives (warfarin), fibrinolytic drugs (streptokinase) and and he was suggested to go for colour Doppler study for both
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legs. The colour Doppler suggestive of Ac. Thrombosis in left External medications was femoral vein and partial recanalization of thrombus in right femoral vein (Jan 19th 2013). Tab. Warfarin 2 mg 1BD, Tab. · Abhyanga with Vishgarbh Tail. Monotrait 20 mg 1BD, Tab. Dolo-650 mg 1BD for 20 days was · NadiSawedana with Rasanasaptak Kawath. given to patient but he did not get any relief with this treatment. · Jalaukaavcharana- started on Feb 13th 2013 and repeated Hence, he approached to DBACH, Mandigobindgarh, Punjab, after every 7th day. India for better management. He come to us with complaints of Pain in left leg since 8 months, Numbness in both legs since 8 Total treatment period was four weeks. On the basis of visual months, not able to walk properly, Slight swelling over the left analogue scale (VAS), patient was assessed weekly. Pain lower leg. According to patient statement, it was found that pain gradation was as follow was constant, severe aching in nature, not radiated to any other part, aggravated on standing for long time and relieved by 0-1 No Pain elevation of left leg. He had no history of Hypertension, diabetes 2-3 Mild mellitus, trauma, previous surgery. On examination, in upper 4-5 Uncomfortable thigh and calf region tenderness was present, in left lower leg 6-7 Distressing redness and oedema was present. Homan’s Sign (dorsiflexion of 8-9 Intense foot may cause pain in calf region) was positive. Moses’ sign 10 Worst Possible (when the calf muscle is compressed forwards against the tibia, but not when the calf muscle is compressed from side to side) As we observed in VAS, before treatment pain grade was 8. was positive. All the laboratory investigations were normal After 7 days of treatment pain grade comes down 6, further on excluding Prothrombin time-15 sec, Prothrombin Ratio-1.07, the completion of 2nd week, 3rd week and 4th week pain grade I.N.R.-1.16. In Urine examination, albumin was traceable. The was 5, 3 and 1 respectively (Chart 1). Before treatment patient patient was treated with both internal and external medications was having swelling on left leg which later completely subsided for four weeks. The details of treatment are given below:- in two weeks. Gradual improvement in walking distance of patient was as following i.e. initially he was not able to walk, Internal medications was after the treatment of one week he was able to walk of the distance 25 meters and later after the treatment second, third · Ekangaveer Rasa 150 mg 1 Tab. BD, week and four weeks he was able to walk up to the distance 70 · Mahayograjj guggulu 325 mg 1 Tab. BD, meters, 90 meters, 200 meters respectively (Chart 2). Patient was · Maharasnaadi Kwatha 60 ml. BD. suggested to continue treatment and advise to attend the OPD after one month. Patient was observed that he has no problem in walking up to any extent.
B e fo re T t A fte r 1 w e e k A fte r 2 w e e k s A fte r 3 w e e k s A fte r 4 w e e k s
Charts: Observations of different parameters before and during treatment
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RESULT Jalaukaavcharana (hirudotherapy) is safe and effective method in
management of D.V.T. than modern treatments.18 After the completion of therapy patient was in supervision up to 3 months without intervention follow up and it was observed CONCLUSION that the patient is symptomless and cured. In present study, the leech application in case of DVT is found to DISCUSSION be effective. Leech therapy is beneficial in reduction of pain, swelling, tenderness in the patient of DVT. With the help of The purpose of Ayurveda is to maintain the health of healthy leech therapy we can improve the quality of life of the DVT individual and treat the patient.13 Basically the Ayurveda is the patients. We can avoid the hazards of prolong use of heparin like complete science of life, which has various drugs and techniques drugs by using leech therapy. In addition to these benefits, this for treatment of mankind. 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Source of support: Nil; Conflict of interest: None Declared
