Ayurveda Treatment Methods

A Guide Line To Ayurveda Treatments & Principles

EKAKUSHTHA (PSORIASIS) Treatment Protocol by Ayush

 

INTRODUCTION

Ekakushtha is one among eleven Kshudra Kushta with the dominance of Vata and Kapha, which is characterized by silvery plaques like fish scales may be associated with itching and with tendency to spread all over the body. It can be correlated with psoriasis like diseases. Along with faulty dietary habits, psychogenic stress also plays important role in the pathogenesis of Ekakushtha.

Case Definition:

A patient presenting with dry scaling erythematous / maculopapulous patches, covered with adherent silvery white scales which may or may not be associated with itching.

Differential Diagnosis

  1. Sidhma: White colored shiny patches associated with or without itching along with exfoliation in the form of dust.
  2. Dadru: Circular patches with elevated periphery associated with severe itching

Line of Treatment

  • Nidana Parivarjana should be the first line of treatment.
  • Shodhana Chikitsa – Vamana, Virechana, Rakta Mokshana,
  • Shamana Chikitsa – Pachana, Raktashodhana, external applications (Lepa, Taila and Dhara Chikitsa)
  • Rasayana Chikitsa for Rasa – Rakta Prasadana.
  • Treatment according to Doshik involvement
  • General line of treatment prescribed for Kushtha

LEVEL 1: AT SOLO AYURVEDIC PHYSICIAN CLINIC / PHC

Investigations: Nothing specific.

Treatment: In the initial stage when the patient is having mild features of Ekakushta, along with diet restriction, two or more of following drugs may be given as per Doshic predominance: Table 8.1: Medicines at level 1 for Ekakushta

Drugs

Dosage form

Dose

Time of administration

Duration

Anupana

Sariva1

Churna

3-6 gm

After meal /

thrice a day

2-3 weeks

Madhu / Luke warm water

Haridra2

Churna

3-6 gm

After meal /

thrice a day

2-3 weeks

Madhu / Luke warm water

 

Khadira3

Churna

3-6 gm

After meal /

thrice a day

2-3 weeks

Madhu / Luke warm water

Guduchi4

Churna

3-6 gm

After meal /

thrice a day

2-3 weeks

Madhu / Luke warm water

Manjishtha5

Churna

3-6 gm

After meal /

thrice a day

2-3 weeks

Madhu / Luke warm water

Manjisthadi Kwatha6

Kwatha

20-40 ml

After meal /

twice a day

2-3 weeks

-

Mahatiktaka Kwatha

Kwatha

20-40 ml

Before meal / twice daily

2-3 weeks

-

Panchatiktakam Ghrita

Ghrita

15 ml

Before meal

2-3 weeks

Luke warm water

Kaishora Guggulu7

Vati

1-2 Vati

Before meal / twice daily

2-3 weeks

Luke warm water

 

Whenever needed, symptomatic treatment of associated conditions can also been done e.g. if patients complains of constipation, Avipattikara Churna or Swadishta Virechana Churna in empty stomach early morning with luke warm water can be given.

External applications:

Kshalana: Tankan Jala / Triphala Kwatha / Panchavalkala Kwatha

Lepa: Jeevantyadi Yamaka Lepa, Vajraka Taila, Mahamarichadi Taila, Gandhaka Malahara, Karanja Taila, Jatyadi Taila, Adityapaka Taila

Pathya - Apathya (Diet and life style education):

Do’s -

  • Ahara: Laghu Anna (light food), Tikta Shaka (bitter leafy vegetables), Purana Dhanya (seasoned grain), Yava (barley), Godhuma (wheat), Mudga (green gram), Patola,
  • Vihara: Maintain hygiene, follow Dinacharya and Ritucharya properly

Don’t -

  • Ahara: Viruddha Ahara, Adhyashana (eating prior to the digestion of previous meals), excessive sour and salty food, exercise after heavy meal, Masha (black gram), radish, refined flour products, fermented food, curd, fish, jaggery.
  • Vihara: Mental stress / anxiety, suppression of urges especially of vomiting, day-sleeping, excessive exposure to sun, unhygienic condi­tions

Referral Criteria:

  • Patients not responding to above mentioned management.
  • Need further investigations

 

LEVEL 2: CHC’S OR SMALL HOSPITALS WITH BASIC FACILITIES

Clinical diagnosis: Same as level 1 for a fresh case reporting directly.

Investigation: Nothing specific

Treatment: In addition to the management mentioned in Level 1, few of the following drugs may be added as per the requirement and status of the patient. Rasaushadhi (herbo-mineral drugs) can be used at this level. Patient may be kept under observation while prescribing these kinds of medicines:

Table 8.2: Medicines at level 2 for Ekakushta

 

Compound formulation

Dosage form

Dosage

Time of administration

Duration

Anupana

Sarivadyasava8

Asava

10-20 ml

After meal / thrice daily

2-3 weeks

Equal quantity of water

Mahamanjisthadi Kwatha9

Kwatha

20-40 ml

Before meal / twice daily

2-3 weeks

-

Gandhaka Rasayana

Vati

1-2 Vati

(125-250 mg)

After meal / thrice daily

2-3 weeks

Luke warm water / Madhu

Khadirarishta10

Arishta

10-20 ml

After meal / thrice daily

2-3 weeks

Equal quantity of water

Aragwadharishta

Arishta

10-20 ml

After meal / thrice daily

2-3 weeks

Equal quantity of water

Arogyavardhini Vati11

Vati

1-2 Vati

(500 mg)

After meal / thrice daily

2-3 weeks

Madhu / water

Manibhadra Gudam

Lehya

15-30 gm

Every morning

For 1 month

Luke warm water

 

procedures indicated for Ekakushtha can be performed.

Shodhana Chikitsa:

  • Vamana
  • Virechana
  • Raktamokshana: Siravedha, Jalookavacharana

Rasayana - Amalaki, Guduchi, Bhringaraja, Ghrita Bhrishta Haridra, Brahmi, Mandukaparni, Triphala, Khadira, Vidanga, Tuvaraka, Bhallataka, Bakuchi

Pathya - Apathya (Diet and life style education): Same as Level 1.

REFERENCES

  1. Anonymous, The Ayurvedic Pharmaco­poeia of India, Ministry of Health and Family Welfare, Govt. of India, part I, Vol. IV (24).
  2. Anonymous, The Ayurvedic Pharmaco­poeia of India, Ministry of Health and Family Welfare, Govt. of India, part I, Vol. III (30).
  3. Anonymous, The Ayurvedic Pharmaco­poeia of India, Ministry of Health and Family Welfare, Govt. of India, part I, Vol. I (46).
  4. Anonymous, The Ayurvedic Pharmaco­poeia of India, Ministry of Health and Family Welfare, Govt. of India, part I, Vol. I (27).
  5. Anonymous, The Ayurvedic Pharmaco­poeia of India, Ministry of Health and Family Welfare, Govt. of India, part I, Vol. III (52).
  6. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (4:24), 2000.
  7. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (5:2), 2000.
  8. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (1:37), 2000.
  9. Sharangadhara, Sharangadhar Samhita with commentary of Adhamal’s Dipika and Kashiram’s Gudharth Dipika, edited by Pandit Parshuram Shastry, 5th edition, Madhyam Khanda, Varanasi, Chuakhambha Orientalia 2002; 2/137-142.
  10. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (1:14), 2000.
  11. Anonymous, The Ayurvedic Formulary of India, Ministry of Health and Family Welfare, Govt. of India, Part I (20:4), 2000.