Department of Biotechnology, Sinhgad College of Engineering, University of Pune, Pune, Maharashtra, India.
Department of Dravyaguna,Tilak Ayurved Mahavidyalaya, Pune, Maharashtra, India.
J Ethnopharmacol. 2017 Feb 2;197:110-117. doi: 10.1016/j.jep.2016.07.071. Epub 2016 Jul 26.
Over the past few decades, there have been significant scientific advances leading to improved understanding of asthma as a disease and treatment providing immediate relief. However, prevention of recurrent attacks, exacerbations and disease cure remains a challenge. Ayurveda refers to bronchial asthma as Tamaka Swasa and it is well explained in Charaka Samhita. Management of asthma in Ayurveda includes removal of vitiated Kapha through Shodhana, Shamana procedures, herbal and herbomineral formulations in addition to advising a healthy lifestyle and diet. Several clinical trials on Ayurvedic formulations for treatment of asthma are reported, however, whole system management of asthma has rarely been studied in the manner in which it is actually being practiced. Ayurveda therapeutics provides Dosha specific approaches, which needs biological investigation.
The objective of our study was to investigate lung functions and cytokine changes in Asthmatic individuals in response to Ayurvedic intervention.
The study design was approved by the Institutional Ethics Committee of Tilak Ayurveda Mahavidyalaya (TAMV) & Sheth Tarachand Ramnath Charitable Ayurveda Hospital and followed guidelines of the Declaration of Helsinki and Tokyo for humans. It was conducted as a whole system individualized pragmatic clinical trial and written consent of patients was collected before enrollment. One hundred and fifteen patients with mild-to-moderate asthma were divided into 2 sub-groups depending on their disease subsets and administered phenotype specific ayurvedic interventions. Seventy six asthma patients completed the treatment. Serum IgE levels, blood eosinophil counts, spirometry and blood cytokine levels were measured before the start of treatment and six months at the end of treatment. Age and sex matched healthy participants (n=69) were recruited in the study for comparison of cytokines levels.
Significant improvements in FEV1(% predicted) (p<0.0001) and FVC (% predicted) (p=0.0001) was observed in asthmatic patients who underwent Ayurvedic treatment. Circulating levels of IgE (p<0.03) and eosinophil numbers (p=0.001) reduced significantly in the asthmatics after Ayurvedic treatment. This was associated with significant reduction in levels of circulating cytokines. Levels of Th2, Th1 and inflammatory cytokines in the peripheral blood were higher than healthy control participants at baseline (p values <0.0001) and reduced significantly after ayurvedic intervention.
This proof of concept study highlights the potential benefits and possible mechanism of Ayurvedic interventions in patients with mild-to-moderate asthma. The interventions significantly reduced IgE and eosinophil count, also improved lung function and reduced levels of circulating Th2 cytokines.
在过去的几十年中，科学取得了重大进展，这使得人们对哮喘作为一种疾病的认识以及提供即时缓解的治疗方法有了更深的理解。然而，预防复发、加重和疾病治愈仍然是一个挑战。阿育吠陀将支气管哮喘称为 Tamaka Swasa，在《查拉卡·桑希塔》中有详细的解释。阿育吠陀治疗哮喘包括通过净化、缓解程序、草药和草药矿物制剂来清除被扰乱的 Kapha，此外还建议保持健康的生活方式和饮食。有报道称，已经进行了多项关于治疗哮喘的阿育吠陀配方的临床试验，然而，很少有人以实际实践的方式研究哮喘的整个系统管理。阿育吠陀疗法提供了针对特定 Dosha 的方法，这需要进行生物学研究。
我们的研究目的是调查哮喘患者对阿育吠陀干预的肺功能和细胞因子变化。
本研究设计得到了提拉克阿育吠陀玛哈维亚学院（TAMV）和谢思·塔拉克钱德拉·拉姆纳特慈善阿育吠陀医院机构伦理委员会的批准，并遵循了《赫尔辛基宣言》和《东京宣言》的规定。这是一项全系统个体化实用临床试验，在入组前收集了患者的书面同意。根据疾病亚组将 115 名轻度至中度哮喘患者分为 2 个子组，并给予表型特异性阿育吠陀干预。76 名哮喘患者完成了治疗。在治疗开始前和治疗结束后的六个月测量血清 IgE 水平、血嗜酸性粒细胞计数、肺活量和血液细胞因子水平。招募了 69 名年龄和性别匹配的健康参与者（n=69）进行比较细胞因子水平。
接受阿育吠陀治疗的哮喘患者的 FEV1（%预测）（p<0.0001）和 FVC（%预测）（p=0.0001）显著改善。哮喘患者的 IgE（p<0.03）和嗜酸性粒细胞数量（p=0.001）在接受阿育吠陀治疗后显著降低。这与循环细胞因子水平的显著降低有关。哮喘患者外周血中的 Th2、Th1 和炎症细胞因子水平在基线时高于健康对照组（p 值<0.0001），在接受阿育吠陀干预后显著降低。
本概念验证研究强调了阿育吠陀干预对轻度至中度哮喘患者的潜在益处和可能的机制。干预措施显著降低了 IgE 和嗜酸性粒细胞计数，还改善了肺功能并降低了循环 Th2 细胞因子水平。
