Nema Aditya, Gupta Sanjay Kumar, Dudhamal Tukaram S, Mahanta Vyasadeva
Dept. of Shalyatantra, I.P.G.T. & R.A., Gujarat Ayurved University, Jamnagar, Gujarat 361 008, India.
Dept. of Shalyatantra, I.P.G.T. & R.A., Gujarat Ayurved University, Jamnagar, Gujarat 361 008, India.
J Ayurveda Integr Med. 2017 Apr-Jun;8(2):113-121. doi: 10.1016/j.jaim.2017.01.013. Epub 2017 Jun 7.
Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy. The average Unit Cutting Time and healing (UCTH) was observed 7.86 days/cm. During treatment Panchawalkala Kwatha (decoction of five medicinal plant's bark), Shatdhautaghrita, Jatyaditaila and Erandabhrishtaharitaki Churna were used as adjuvant drugs. To generate quality evidence Transrectal Ultra Sonography (TRUS) was used in pre as well as post-treatment and showed remarkable tool to assess effect of treatment. Substantial clinical result was observed at the end of treatment and all the patients were free of fistula. No recurrence was observed in any case during the 12 follow up of 12 months. The treatment was reported safe and well tolerated in all the patients.
自古代以来，印度医学体系就一直使用药线疗法（一种使用经碱处理的线进行的辅助手术程序）来治疗肛肠疾病；特别是用于治疗肛瘘，而肛瘘通常难以治疗。在本病例系列中，按照《印度阿育吠陀药典》制备了标准药线，并用于治疗不同病例的肛瘘。在本病例系列中，共有6例肛瘘患者接受了药线疗法和部分瘘管切除术治疗。观察到平均单位切割时间和愈合时间（UCTH）为7.86天/厘米。治疗期间，使用了五味树皮汤（五种药用植物树皮的煎剂）、六味酥油、贾蒂迪油和蓖麻仁诃子粉作为辅助药物。为了产生高质量的证据，在治疗前和治疗后均使用经直肠超声（TRUS），结果显示其是评估治疗效果的显著工具。治疗结束时观察到了显著的临床效果，所有患者的肛瘘均已治愈。在12个月的随访期间，未观察到任何病例复发。据报告，所有患者对该治疗的耐受性良好且安全。
