Content uploaded by Ashok Kumar Panda
Author content
All content in this area was uploaded by Ashok Kumar Panda on Jan 14, 2020
Content may be subject to copyright.
REVIEW ARTICLE
Nov-Dec 2019
Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6
1
Ayurvedic treatment outcome for Chronic Liver
diseases
Dr. Ashok Kumar Panda,
1
Dr. K. K. Rath
2
1,2
Research Officer (Ayurveda), Central Ayurveda Research Institute of Hepatobiliary disorders, Bharatpur, Near
Kaliga Studio, Bhubaneswar, Odisha, INDIA. A unit of CCRAS, M/O AYUSH, GOI.
I
NTRODUCTION
Chronic liver diseases are disease process of liver
which involves progressive destruction and
regeneration of liver parenchyma leading to
functional and structural changes in form of fibrosis
Address for correspondence:
Dr. Ashok Kumar Panda
Research Officer (Ayurveda), Central Ayurveda Research Institute
of Hepatobiliary disorders, Bharatpur, Near Kaliga Studio,
Bhubaneswar, Odisha, INDIA.
E-mail: akpanda_06@yahoo.co.in
Submission Date: 17/11/2019 Accepted Date: 22/12/2019
Access this article online
Quick Response Code
Website: www.jaims.in
Published by Maharshi Charaka
Ayurveda Organization, Vijayapur,
Karnataka (Regd) under the license CC-
by-NC-SA
and cirrhosis. Chronic liver disease refers to diseases
of the liver which lasts over a period of six months. It
consists of a wide range of liver pathologies which
includes inflammation ( chronic Hepatitis), reduction
of size (Liver cirrhosis), Polycystic liver disease, and
Hepato cellular carcinoma.
[1]
It leads to various
complications to end stage liver disease and hepatic
failure. Ayurveda is traditionally skill full and treating
liver diseases since centuries and the drug toxicity
appears to be less as compared to conventional
medicine. Yakrit is the root of Rakta vaha srotos and
pitta is the mala (by product) of Rakta dhatu. Excess
intake of Madya (Alcohol) said to be increase pitta
and vitiate rakta dhatu and alter the architecture
rakta vaha srotas.
[2]
Ayurveda literature found Yakrit
suska which may be compaired with Cirrhosis of liver.
Pandu, Kamala, Asmari, Yakrit vidradhi (Liver Abcess),
Yakrit granthi ( Liver cyst), Yakrit dalludara (Hepatitis
A B S T RA C T
Currently available medical therapies for liver disorders have more systemic toxicity
, cost
effective
and liver transplantation was advised to many cases. So many patients want to take ayurveda
medication as last choice or as a choice due to poverty. We have documented more than 200 cases
and found 40% cases are Non Alcoholic Fatty liver diseases followed by Cirrhosis of liver. There are
more than three hundred herbo-mineral preparations in Ayurveda system of medicine for the
treatment of jaundice and chronic liver diseases. More than 50% people of our country relay on
Ayurveda and herbal medicine for liver diseases. Ayurveda medicine could represent a promising tool
to postpone the need of liver transplantations, increase the QoL of patients with cirrhosis, and reduce
overall treatment costs of Chronic liver diseases. Ayurveda also delivered sodhana ( Purificatory
treatment) by means of Panchakarma treatment. Rasayana therapy is very helpful in CLD. Diet has a
integral role in Outcome of a CLD patient. Evidences are coming for remission of hepatao-cellular
carcinoma and reversal of fibrosis of liver with high life expectancy. So public participation as well as
awareness for Ayurveda treatment in Chronic liver diseases are required. Proper training and modern
skill development should be mandatory for of Ayurveda Physicians treating liver diseases . More
evidences in terms of Ayurveda outcome studies are the need of the hour to create a hope for CLD
Patients.
Key words: CLD, Cirrhosis, ALD, DILI, NAFLD, NASH, Kamala, Halimaka, Panaki, Yakrit Suska, Yakrit
Vidradhi
(Liver Abcess), Yakrit
Granthi
( Liver cyst), Yakrit
Dalludara
, Krimija
Yakruit Roga
.
Dr. Ashok Kumar Panda et al. Ayurvedic treatment outcome for Chronic Liver diseases
ISSN: 2456-3110 REVIEW ARTICLE
Nov-Dec 2019
Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6
2
or hepato megaly), Jalodara, and Krimija yakruit roga
are the various diseases described in Ayurveda
literature. Kamala, Halimaka and Panaki are different
stages of liver diseases. Ayurveda Practitioners have
been practicing and claimed cure Chronic liver
diseases successfully.
[3]
Recent times Ayurveda
medication induced liver cirrhosis publications
[4]
are
also came to purview of many Ayurveda Practitioners.
It is interesting to note that Ayurveda Liver tonic
(Livomyn) also reported induce liver injury by the
same author.
[5]
The author may be published the data
without analyse the cause properly or to suprees the
poularity of Ayurveda in CLD.
Currently available medical therapies for liver
disorders have more systemic toxicity therefore
physicians hesitate to administrate modern medicine
for long term use.
[6]
Clinical and animal research in
this century has confirmed the efficacy of several
medicinal plants and herbo-mineral compounds
described in Ayurveda in the treatment of liver
disease, it may be cause for patients with chronic liver
disease seek primary or adjunctive herbal treatment
and it is a common occurrence observed all over the
globe. Chronic Liver diseases are the serious ailments
and the medical treatment scenario is worsened day
by day for lack of proven precise therapeutic
regimens. There are many plants and their extracts
that have been shown to possess hepato-protective
activities. There are more than three hundred herbo-
mineral preparations in Indian system of medicine for
the treatment of jaundice and chronic liver diseases.
More than 50% people of our country relay on
Ayurveda and herbal medicine for liver diseases.
Undoubtly Ayurveda herbs and products having
defined biochemical active component can protect
liver from oxidative stress, promote virus elimination,
block fibrogenesis, anti inflammatory, immune-
modulating, liver regenerating and inhibit tumour
growth in vitro and in vivo studies. Ayurveda also
delivered sodhana ( Purificatory treatment) By means
of Panchakarma treatment. Rasayana therapy is very
helpful in CLD.
Central Ayurveda Research Institute of Hepatobiliary
disorders, Bhubaneswar is premier Institute of
CCRAS, Ministry of AYUSH where various researches
of liver has been growing and Researchers are
working hard to generate evidences. We have
documented more than 200 cases and found 40%
cases are Non Alcoholic Fatty liver diseases followed
by Cirrhosis of liver. So many case study and case
series were reported regarding the efficacy of
Ayurveda drug in Chronic Liver Diseases. The
observation found that Fatty liver and NASH can be
corrected within six months to one year of treatment
along with lifestyle modification. Viral hepatitis is well
managed with Ayurvedic herbs and sometimes
patients are using antiviral therapy along with
Ayurveda medication. Ayurveda treatment for Auto
immune liver disease can block fibro genesis and
regenerate the hepatocyte of liver by immune
modulating herbs. Ayurveda treatment for
Thrombocytopenia has back through a new treatment
modality.
[7]
Ayurveda treatment could be a potentially
safe and effective complement in these cases of
Alcoholic liver cirrhosis. It can be presume that
Ayurveda treatment modalities block the fibro genesis
of liver and regenerate the hepatocytes. It needs
animal experiment. If replicated in clinical trial then
Ayurveda medicine could represent a promising tool
to postpone the need of liver transplantations,
increase the QoL of patients with cirrhosis, and reduce
overall treatment costs of ALD patient. Ayurveda can
well manage hyperbilirumia and hyponatrimia arised
due to Liver cirrhosis. Ayurveda treatment and
Lifestyle modification is a very successful treatment
strategy for NAFLD and NASH.
[8]
Evidences are
generated for Herbal treatment for Hepatis B
infection.
[9]
Many cases of advised liver transplant
can managed well by Ayurveda and survival outcome
is more than five years in our initial reports. Regading
Hapato cellular carcinoma( HCC), Complete remission
of HCC can be achieved by Ayurveda treatment and
strict dietary schedule. Evidences are coming for
better survival outcome with good quality of life in
HCC.
[10],[11]
Liver tumor markers like alpha feto protein
(AFP) and organ specific auto immune markers like-
antinuclear antibody (ANA)-HEp-2 are also reducing in
Ayurveda medication as per our primary observation.
Ayurveda has been using to treat several liver
Dr. Ashok Kumar Panda et al. Ayurvedic treatment outcome for Chronic Liver diseases
ISSN: 2456-3110 REVIEW ARTICLE
Nov-Dec 2019
Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6
3
ailments, but its efficiency is poorly documented by
means of scientific studies. High number of Ayurveda
liver tonics has been prescribing for chronic liver
diseases and G.I. disorders by all systems of doctors.
Thirteen classical Ayurveda formulations and eight
medicinal plants mostly used by Ayurveda were
reviewed along with scientific studies. Arogyavardhini
vati is highest prescribing medicine in liver disorders.
Liv 52 has own place in CLD with high number of
publications. Haridra, Katuki, chireeta, punnanava,
kiratatikta, Bhumi amalaki are commonest single herb
used by the herbalist and Ayurveda physician in the
treatment of Jaundice and other liver disorders.
[2]
Lokanth rasa, Gomutra Haritaki, Tapyadi lauha, Sidhha
Makaradwja, Sarbeswar rasa, Bruhat sutasekhar,
kamadudha rasa, Potola katu rohinyadi kasaya,
punnavadi kasaya, are the common prescribed
medicines of Ayurveda for CLD. Diet plays an
important role in the outcome of CLD. Takra (home
made butter milk), Cow ghee (emulsified fat), milk,
Mamasa Rasa (mutton juice), Lajja, potala, snake
guard with moderate protein , low salt diet for six
times a day shows better result in our practice. Water
intake restricted to 800-1000ml depending on patient
and concomitant diseases conditions. Sodium
depletion, oesophageal bleeding, hypo albumin,
ascites, sacropenia, portal hypertension, peritonitis,
Infection and encephalopathy are most serious
complications observed in our practice of CLD.
Hyponatrimea can be manageable by rock salt mixed
with butter milk. Elderly Alcoholic cirrhosis patients
have worst outcome compared to other Cirrhosis
patients. Alcohol obstinate is the prime factor for ALD.
Knowledge of modern haematological and
radiological investigations, Fibroscan, Prognostic
scoring like Child–Pugh score, MELD score are very
essential for Ayurveda doctors. Ayurveda doctor
should manage the complications with help of
hepatologist and gastroentrologist. Primary
prevention, secondary and tertiary prevention should
undertake individually and properly. Yogic exercise
has significant role in Primary prevention, secondary
and tertiary prevention of CLD. Panchakarma and
Rasayana therapy has good outcome in RCT. The
ayurveda treatment outcome in CLD is better
compared to modern system of medicine. It needs
integration for better outcome. So public
participation and awareness for Ayurveda treatment
in Chronic liver diseases are required along with
proper training and skill development of Ayurveda
Physicians.
[12],[13]
More evidences will create a hope
for CLD Patients.
R
EFERENCES
1. Mukherjee PS, Vishnubhatla S, Amarapurkar DN, Das K,
Sood A, Chawla YK, et al. (2017) Etiology and mode of
presentation of chronic liver diseases in India: A multi
centric study. PLoS ONE 12(10): e0187033.
https://doi.org/10.1371/journal.pone.0187033
2. Panda AK, Bhuyan GC, Rao MM (2017) Ayurvedic
Intervention for Hepatobiliary Disorders: Current
Scenario and Future Prospect. J Tradit Med Clin Natur
6: 210.
3. Philips C A, Augustine P, Paramaguru R, et al. (February
22, 2019) Ayurveda Herbal Medicine-induced Liver
Cirrhosis. Cureus 11(2): e4122.
doi:10.7759/cureus.4122
4. Philips CA, Paramaguru R, Joy AK, Antony KL, Augustine
P. Clinical outcomes, histopathologic patterns and
chemical analysis of ayurveda and herbal medicine
associated with severe liver injury—a single center
experience from South India. Indian J Gastroenterol.
2018; 37: https://doi.org/10.1007/s12664-017-0815-8.
5. Luper S (1998) A review of plants used in the treatment
of liver disease: part 1.Alter Med Rev 36: 410-421.
6. Del Prete A, Scalera A, Iadevaia MD, Miranda A, Zulli C,
et al. (2012) Herbal Products: Benefits, Limits, and
Applications in Chronic Liver Disease. Evid Based Compl
Alter Med 2012
7. Panda, Ashok Kumar et al. Phyto Extracts of Carica
Papaya and Tinospora Cordifolia can correct
Thrombocytopenia In Alcoholic Decompensate Liver
Cirrhosis : Case Series. Journal of Ayurveda and
Integrated Medical Sciences (ISSN 2456-3110),
http://www.jaims.in/index.php/jaims/pages/view/Cita
tion, v. 3, n. 1, p. 99 - 101, apr. 2018. ISSN 2456-3110.
8. Ravirajsinh Jadeja, Ranjitsinh V. Devkar, and Srinivas
Nammi, “Herbal Medicines for the Treatment of
Nonalcoholic Steatohepatitis: Current Scenario and
Future Prospects,” Evidence-Based Complementary
Dr. Ashok Kumar Panda et al. Ayurvedic treatment outcome for Chronic Liver diseases
ISSN: 2456-3110 REVIEW ARTICLE
Nov-Dec 2019
Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6
4
and Alternative Medicine, vol. 2014, Article ID 648308,
18 pages, 2014. https://doi.org/10.1155/2014/648308.
9. Panda AK, Das D, Dixit AK, Hazra J (2015) Rapid
clearance of HbsAg and liver transaminase in hepatitis
B infection with classical Ayurvedic formulation: case
study. Asian J Phytomed Clin Res 3: 1-5.
10. Panda AK, Rath KK, Barik LD (2016) Survival outcome in
the patients with advanced hepato-celluar carcinoma
treated with Ayurveda medication: Case series.
Proceeding of World Ayurveda congress.
11. Ashok Kumar Panda , Fiboscan evidence of Reversal of
Liver fibrosis by Ayurveda Medication: Case series,
Journal of Clinical and Experimental Hepatology,
Volume 8,
12. Poornima P, Efferth T (2016) Ayurveda for Cancer
Treatment. Med Aromat Plants (Los Angel) 5: e178.
doi: 10.4172/2167-0412.1000e178
13. Nishanta Shukla , Ayurvedic approach for management
of liver parenchymal disease: A case study,5th World
Congress on Hepatitis & Liver Diseases Proceeding ,
August 10-12, 2017 London, UK.
*******************************
How to cite this article:
Dr. Ashok Kumar Panda, Dr. K.
K. Rath. Ayurvedic treatment outcome for Chronic Liver
diseases. J Ayurveda Integr Med Sci 2019;6:1-4.
Source of Support: Nil, Conflict of Interest: None
declared.
Copyright © 2019 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access
article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
