Shanti K, R Sarathchandran
Dept of Shalakya Tantra, Amrita School of Ayurveda, Kollam, India.
B.S Ayurveda Vaidyashala (Govt Grant-in-Aid), Harippad, Kerala, India.
J Ayurveda Integr Med. 2023 May-Jun;14(3):100723. doi: 10.1016/j.jaim.2023.100723. Epub 2023 May 25.
Vrana (ulcer), in Ayurveda is defined as a structural deformity in the skin and deeper structures (gaatra avachurnana), associated with ruja (pain), srava (discharge) etc and caused either by the vitiation of the doshas(humuors of the body) or by trauma. Vrana is basically of 2 types- Dushta vrana and Shudha vrana. Shudha Vrana (acute ulcer) is easily treatable, whereas Dushta vrana is a chronic ulcer, mostly unresponsive to any treatment. Acharya Sushruta has described sixty methods for treating such vranas (ulcers). In this case, symptoms like Deerghakalaanubandhi (chronic), Teevra ruja (painful), Teevra puti srava (smelly discharge) etc. were suggestive of Pitta pradhana Sarakta Tridoshaja Dushta vrana on the left leg. Studies from India about the prevalence of venous leg ulcers (VLU) are limited. The chronic wound management strategies include compression therapy and antimicrobial therapy (if infected). However, in unresponsive cases, surgery (skin grafting) is done. A 38-year-old non-diabetic, non-hypertensive female sought Ayurvedic treatment after a wound on her left leg did not respond to the conventional medicines even after 7 months of treatment. The ulcer was painful and foul-smelling, to the extent of disturbing her sleep and restricting her daily activities. Her Ayurvedic treatment comprised of Patoladi kashaya, Kaishora guggulu, Guduchyadi kashaya, Manjishtadi kashaya and Avipathi churna, orally and Vrana prakshalana (wound cleaning) and Vrana lepa (application of medicinal paste) externally. Ayurvedic treatment was effective in healing the Dushta vrana completely in this case. This suggests the efficacy of Ayurveda in the management of chronic ulcers. However, a detailed study of the same with larger sample sizes will help to formulate a treatment protocol for such cases.
在阿育吠陀医学中，溃疡被定义为皮肤及更深层结构（身体组织的破坏）的结构畸形，伴有疼痛、分泌物等症状，由体液失衡（身体的体液）或创伤引起。溃疡主要分为两种类型——恶疮性溃疡和单纯性溃疡。单纯性溃疡（急性溃疡）易于治疗，而恶疮性溃疡是慢性溃疡，大多对任何治疗都无反应。苏什鲁塔阿查里亚描述了六十种治疗此类溃疡的方法。在这种情况下，诸如病程长、疼痛剧烈、分泌物恶臭等症状提示左腿患有以皮塔为主导的三体液失调性恶疮性溃疡。印度关于下肢静脉溃疡（VLU）患病率的研究有限。慢性伤口管理策略包括压迫疗法和抗菌疗法（如果感染）。然而，对于无反应的病例，则进行手术（皮肤移植）。一名38岁的非糖尿病、非高血压女性，在左腿伤口经7个月常规药物治疗仍无反应后，寻求阿育吠陀医学治疗。该溃疡疼痛且有恶臭，严重影响她的睡眠并限制她的日常活动。她的阿育吠陀医学治疗包括口服帕托拉迪药汤、凯肖拉古古卢、古杜奇亚迪药汤、曼吉什塔迪药汤和阿维帕蒂粉，以及外部伤口清洗和涂抹药膏。在这个病例中，阿育吠陀医学治疗有效地完全治愈了恶疮性溃疡。这表明阿育吠陀医学在慢性溃疡管理方面的有效性。然而，对更大样本量进行详细研究将有助于为此类病例制定治疗方案。
