The benefit of ayurvedic diagnostics in treatment strategies for rheumatoid arthritis

Question

Ayurveda gains greater attention worldwide, but investigations of ayurvedic treatments with participation of ayurvedic physicians are scarce in international literature presumably due to different conceptual frameworks of both medical systems.

We examined which ayurvedic diagnosis corresponds to the diagnosis rheumatoid arthritis (RA) and how patients with RA respond to one line of herbal ayurvedic drug preparations.

Methods

In an open observational study, a team of physicians from western and ayurvedic medicine diagnosed patients according to the ARA criteria (1987) as RA and thereafter according to ayurvedic criteria. One line of routinely used ayurvedic drug preparations based on Semicarpus anarcardium L., Commiphora mukul Hook ex Stocks, Withania somnifera Willd. and Asparagus racemosus Dunal. was given for 10 months in India. The Paulus and Ritchie indices, Steinbrocker classes, ESR, CRP, joint swelling score, morning stiffness, joint pain/tenderness scores and the functional status were monitored monthly.

Results

Forty-four RA-patients were included and subgrouped according to ayurvedic diagnostic criteria as Sandhigatavata srotovarodha (SS) (n=33), Sandhigatavata dhatukseya (SD) (n=6) and Amavata (A) (n=5) with distinct clinical and biochemical features. The treatment course was completed by 26 patients. Eighteen patients left due to improvements (n=3), non-compliance (n=7), relocation (n=1), unknown reasons (n=4), adverse events (n=1) or inflammatory attacks (n=2). The 20% and the 50% Paulus response were achieved by 34% and 15.9% of all patients, respectively. The 50% Paulus response was achieved in 40% of A-, in 33% of SD-, but only in 9% of SS-patients.

Conclusion

The Western diagnosis RA did not correspond to a uniform ayurvedic diagnosis. The treatment response differed between subgroups. Ayurvedic diagnostics may support the search for ayurvedic drugs for RA in India and may be developed to an additional tool for treatment strategies and response predictions to medication in RA in Western medicine.

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