Validation of an Integrated Ayurveda- Yoga module for residential treatment of patients with type 2 diabetes mellitus -

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Validation of an Integrated Āyurveda - Yoga module for residential treatment of patients with type 2 diabetes mellitus - A Compilation from Traditional Literature. By- Dr Satyam Tripathi SVYASA University [email protected]
Validation of an Integrated Āyurveda- Yoga module for residential treatment of patients with type 2 diabetes mellitus - A Compilation from Traditional Literature By- Dr Satyam Tripathi SVYASA University [email protected] DIABENOS - FOUNTAINMELLITUS - SWEETMetabolic disorder that is characterizedby high bloodglucoseInsulin resistance [1]Insulin deficiency.[1]1. Robbins and Cotran, Pathologic Basis of Disease, 7th Ed.pp 1194-1195. SWEET URINE FOUNTAIN DISEASE OBJECTIVES To compile all available knowledge about madhumeha 1. In Vedas (Atharvaveda),Puränas(Garuda Puräna, ….……) and Samhitäs (CharakaSamhitä, ……etc). 2.From the Äyurveda commentaries (gayadäsa,..etc) & research studies (done in Äyurveda research institutes 3.To check the content validity. METHODOLOGY INCLUSION CRITERIA For objective 1 and 2: classical texts of Äyurveda For objective 3: Academic staff master’s degree and > 5 year’s experience as clinical practitioners. DM2 Patients (ADA Criteria) between 30-60 years of age and satisfy the Yogya-ayogya assessment Chart. EXCLUSION CRITERIA Patients with complications of DM2 such as CAD, nephropathy, proliferative retinopathy. Patients who are suffering from duodenal or peptic ulcers. Those who are diabetic from childhood and have low BMI (Dhätukshayamadhumehi) are excluded for this protocol. LITERATUREREVIEW Puränicperiod (4000 B.C. to 1000 B.C.) Samhitäperiod [2000 B.C. TO 1900 A.D.] Research institutes- Theses- 91. Research paper-51 Diabetes Mellitus in Äyurveda Can be correlated to madhumeha Paribhäçäof madhumeha: The clinical entity in which patient passes the urine similer with Madhui.e. of KañäyaandMadhurataste, texture becomes Rükña(dry) and body acquires sweetness calledmadhumeha (Ch.Chi 6/55, A.H N.10 madhumehais one of the 20 types of PRAMEHA. àk«òae meh> yiSmn raeget s àmeh>. prakåñöo mehaù yasmina rogeta sa Pramehaù ||(Ch.Su.17) Pra-Excess frequency. Meha – urine. Management Of madhumeha Cikitsäsutra- SwUlàmeihblvainkk«zSwwEkpirÊbRlí, s b&h[< tÇk«zíkayRm! s<zaexn< dae; blaixkSy. Ch.Chi. 6/15 sthülaprameehibalavänikakåçasthathaikaparidurbalaçca | sabåhaëaàtatrakåçaçcakäryamsaàçodhanaàdoñabalädhikasya || TREATMENT OF madhumeha ÊivRRreCya ih mxumeihnae ÉviNt medae=iÉVyaÝzrIrTvat tSmat! tIú[< @ete;a< zaexnm k…vRiNt,………... durrvirecyä hi madhumehino bhavanti medo'bhivyäptaçarératvät tasmät tékkñaëam aiteñäà çodhanam kurvanti | ……… || (Su.Chi.12/6) AsaXya vatjaíEv iv}eya É&zdaé[a>, AvgaýaitsUúmTvaÎya àöv[< ï&tm!. asädhyä vätajäçcaéva vijïeyä bhåçadäruëäù | avagähyätisükñmatväddayä prasravaëaà çråtam || (Bhe. Sa. Chi. 7/29) ........tIú[< c s<zaexn< ÊivRRreCya ih meihnae ÉviNt medaeiÉVyap&deheTvat! |……..|| ………..tékñëaà ca saàçodhanaà durvirecyä hi mehino bhavanti medobhivyäpådehetvät |..........|| (Ast.Sa.Chi.14/21) y½aÉyalaehrjaeink…MÉcU[R ihtm! zkRrya smetm!, )liÇkaya mxuna c lehm! svR àmehe;u ihtm! vdiNt. yaccäbhayäloharajoonikumbhacürëa hitam çarkarayä sametam | phalatrikäyä madhunä ca leham sarva prameheeñu hitam vadanti|| (Ha.Sa. Pram.28/16) TREATMENT OF madhumeha Management (Cikitsä) ähära (Diet) Vihära (Lifestyle) Auñadhi (medicine) Management Principles/CikitsäNidänaparivarjanais told as the primary line of treatment [i] A.H- 12/5,6,10,11,12,13,14) vihära
  • svasthavritta – Yogaas an important content.
  • Alasir B,et al., (2008) & Manjunatha S, et al (2005) concluded the benefits for patients with diabetes may be achieved from practicing Yoga .
  • On the day of pradhäna karma there will be no more physical activity.
  • Patient is asked to sit comfortably and can do self study.
  • No day sleep.
  • No gardening and no long walks.
  • vihära(pürva / päçcät karma) A.H 12/32. Ch.Chi.6/50 ON THE DAY OF ARRIVAL Assess prakruti, vikruti and fitness (Çodhana yogya/ayogya purusha) for treatment sthülaSamÇodhana kåça Assess agni, aama, Kostha SamÇamana Cikitsä dépana & päcana Max. up to 7th day Snehana; 1.Snehapana. 3-7 days 2.Abhyanga. 3 days Virechana. 1 day (Followed by Samasarjan Krama (3-7 days). Total days-7+7+3+1+7=25days (Max) SamÇamana Cikitsä ASSESSMENTS CONTENT & MAX. DURATION OF ÇodhanaCikitsä
  • Dépana & päcana- Trikatucürna. (3-7 days)
  • Snehana
  • 1.Snehapana – Triphalaghåta, Sarshapaoil. (3-7 days)
  • 2.Snehana (Massage oil) Balataila, Tilaoil. (3 days)
  • Swedhan– Ushnajalasnäna.
  • Virechana– trivåtalehya, TriphalaKashaya(1day)
  • Sansarjana karma– 3-7 days. (Total : 7+ 7+3+1+7=25 days)
  • SamÇamanaCikitsä CONTENT VALIDITY Content validity (also known as logical validity) refers to the extent to which a measure represents all facets of a given social construct. Content validity was developed by C. H. Lawshe (1975). The average CVR resultedvwas 0.85. For a total of eleven experts, the critical value of the CVR is 0.58. CVR OF PROTOCOL CONCLUSION First of this type of study using modern scientific methods for validating a protocol. This makes the module acceptable and generalizable LIMITATION & SUGGESSION
  • Different experts from different schools of Äyurveda.
  • Protocol to be used in allÄyurvedacenters in the country and abroad.
  • This validated protocol has to be tested through randomized control studies to prove its efficacy.
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