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AYURVEDIC MANAGEMENT OF DYSLIPIDEMIA - A CASE STUDY

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ejbps, 2018, Volume 5, Issue 1 906-908. Case Study SJIF Impact Factor 4.382

European Journal ISSN 2349-8870

Ram et al. Europeanof Biomedical
Journal of Biomedical and Pharmaceutical Sciences
Volume: 5
AND Pharmaceutical sciences Issue: 1
906-908
http://www.ejbps.com Year: 2018

AYURVEDIC MANAGEMENT OF DYSLIPIDEMIA - A CASE STUDY

*1Dr. Data Ram, 2Dr. Ajai Kumar Pandey and 3Dr. Neeru Nathani
1
Junior Resident – 3rd Year, Department of Swasthavritta and Yoga, Faculty of Ayurveda, I.M.S., BHU, Varanasi, UP,
India
2
Assistant Professor, Department of Kayachikitsa, Faculty of Ayurveda, IMS, BHU, Varanasi, UP, India.
3
Associate Professor and Head, Department of Swasthavritta and Yoga, Faculty of Ayurveda, IMS, BHU, Varanasi,
UP, India.

*Corresponding Author: Dr. Data Ram

Junior Resident – 3rd Year, Department of Swasthavritta and Yoga, Faculty of Ayurveda, I.M.S., BHU.

Article Received on 21/11/2017 Article Revised on 12/12/2017 Article Accepted on 01/01/2018

ABSTRACT
The prevalence of Dyslipidemia is 79% in Indian population. Hyperlipidemia is one of the major modifiable risk
factors for cardiovascular diseases, pancreatitis, fatty liver and many other diseases. According to Ayurveda
Dyslipidemia is the corresponding output of medovaha srotodushti (micro channel disturbances). Nidan Privarjan
(elimination of causes) and advice of specific Pathya measures are useful in the management of Dyslipidemia. In
present case we applied the principle of medovaha srotodushti chikitsa(aptarpana chikitsa) for Dyslipidemia. The
lipid lowering therapy in modern medicine including statin and fibrate is well tolerated with less side effects (2%).
But this therapy in most of the cases is used lifelong and adds large financial burden in developing countries like
India. In this context Ayurveda provides cost effective therapy for Dyslipidemia without any side effects. The
authors tried to share their experiences through this case study to state that given Ayurvedic measures in the form
of specific Pathya Ahara-Vihara are effective in the management of Dyslipidemia. As a single case is not enough
to prove the efficacy, the further extended research is recommended.

KEYWORDS: Dyslipidemia, Medovaha Srotodushti, Nidan Privarjan, Specific Pathya Measures.

INTRODUCTION In large number of cases the hyperlipidaemia may be

Dyslipidemia is a disorder of disturbed lipid metabolism diagnosed when lipid profile of the patients have been
involving abnormality in any or all of the lipoproteins in done who are associated with risk factors, or on random
blood. According to ICMR-INDIAB study, the basis.
prevalence of Hypercholesterolemia was 13.9%, of
hypertriglyceridemia was 29.5%, of low HDL-C was Causes of Secondary Hyperlipidemia[6]
72.3%, and of high LDL-C levels was 11.8%.[1] The Causes of Secondary Hypertriglyceridaemia
metabolic consequences associated with changes in diet • Diabetes mellitus (type 2)
and lifestyle are responsible for increased number of • Chronic renal disease
hyperlipidaemia individuals. Lipoproteins are complex • Abdominal obesity
lipids that are essential for transport of cholesterol, • Excess alcohol intake
triglycerides and fat soluble vitamins. The level of LDL • Hepatocellular disease
cholesterol is most directly associated with coronary
heart disease while VLDL shows association with Causes of Secondary hypercholesterolaemia
premature atherosclerosis.[2] The ratio between Total Hypothyroidism Nephrotic syndrome
Cholesterol:HDL<3.5 has been recommended as clinical Pregnancy Anorexia nervosa
goal for prevention of CHD.[3] Coronary Heart Diseases Cholestatic liver disease Hyperparathyroidism
contribute 25-30% of deaths in most of industrial Drugs (diuretics, corticosteroids)
countries and originated by several risk factors, out of
them Dyslipidemia is most important.[4] Clinical According to Ayurveda a person following apathya like
manifestations of hyperlipidemia are xenthelasma, Avyayama, Achinta, Diwaswapna Atisnigdha, Madhura,
corneal aurcus, prepatellar xanthomas but most of the Adhyashan, atimatra ahara in diet and Beeja swabhavaj
time Dyslipidemia may remain hidden clinically.[5] leads to medovaha srotodushti.[7] In due course of time
blockage of medovaha srotasa propagates defective
tissue metabolism which leads to medoroga and its

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Ram et al. European Journal of Biomedical and Pharmaceutical Sciences

associated disorders like Sthaulya, Premeha, Kustha, PAST HISTORY

disorders of Ama, Napunsakata, Dysuria.[8] The
Ayurvedic methods of lifestyle modification and
aptarpana Ahara prevent Dyslipidemia and provide better
management over allopathic drugs burden.
CASE
Krishna Amar a 50 years old male patient resident of
Rihand Nagar, Sonbhadra, Uttar Pradesh came in OPD
of Kayachikitsa, Indian Medicine Wing, S.S Hospital,
BHU with the complaints of overweight, pain in legs,
skin outgrowth below left eyebrow and lethargicness
(OPD no. Kc7278/2017).
Patient had no history of diabetes, hypertension and
smoking.
DRUG HISTORY
Atorvastatin 20mg and Methylcoblamin 3mcg twice
daily since two months.
AYURVEDIC MANAGEMENT
We have thoroughly examined the case and given
following A yurvedic management for keeping in views
that: “Dietary modification is an important component in
the management of Dyslipidemia”.[8]

PHYSICAL EXAMINATION AND INITIAL 1- Specific Pathya

INVESTIGATIONS Chapatti made up of flour containing 5 ingredients
Physical Examination: (green mudga, yava, chanaka, gehu, sawa chawal).[9]
Blood Pressure -130/90 mmHg
Heart Rate -76/min 2-General Pathya Ahara-Vihara/ life style measures
Height -164 cm a) Intake of food at the time of hunger (in 3 divided
Weight -83 kg doses).
BMI -31.1 b) Use of green vegetables, takra and lashun in their
Laboratory Evaluation: diet.[10b]
Fasting Lipid Profile- c) Minimum 5 min walking after every meal.
Total Cholesterol Level -282 mg/dL d) Strict advice for importance of vyayama on every
Triglycerides -569 mg/dL visit and encourage for daily cycling 30 minutes.[10a]
Very Low Density Lipoprotein (VLDL)-144 mg/dL
Low Density Lipoprotein (LDL) -138 mg/dL 3-Apathya /avoidable life style measures[11]
High Density Lipoprotein (HDL)-30 mg/dL a) Excessive oily fried items, high sugar containing items
Blood Sugar (F) -95 mg/dL b) Non-vegetarian diet.
Blood Sugar (pp)-117 mg/dL c) Sleeping during day time.

CLINICAL FEATURES OBSERVATIONS AND RESULTS

Patient complaints of increased weight, stretching type of
pain in legs, xenthelasma and lethargic since 3 months.
Before 3 months he was asymptomatic, after that he
gradually developed above symptoms and received
modern medicine of statin group with methylcoblamin as
prescribed by modern physician since last two months
but no significant improvement was observed by the
patient. With same complaints and advice he attended
Kayachikitsa OPD for Ayurvedic management.
Patient taken specific Pathya (chapatti of multigrain
flour) and followed lifestyle modification regularly for
three months. 3 Follow-ups were done at every one
month of interval. At every follow-up lipid profile,
clinical Symptoms, signs and other investigations were
evaluated.

Assessment of Lipid Profile

B.T. F.U.1 F.U.2 F.U.3
Parameters
(mg/dL) (mg/dL) (mg/dL) (mg/dL)
Cholesterol 282 222 226 180
Triglycerides 569 365 223 217
VLDL 114 73 45 56
HDL 30 35 39 40
LDL 138 114 152 84
BT-before treatment, FU1-follow-up after 1st month, FU2-follow-up after 2nd month, FU3- follow-up after 3nd month.

Assessment of Clinical Signs and Symptoms

Symptoms B.T. F.U.1 F.U.2 F.U.3
Weight 83 kg 80 77.5 76
Lethargy* Present Relieved 40% Relieved 60 % Relieved 80%
Xenthelasma Present No significant reduction No significant reduction minute reduction in xenthelasma
Legs pain* Present No significant reduction No significant reduction No significant reduction
*clinical symptoms assessed according to patient.

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 Ram et al. European Journal of Biomedical and Pharmaceutical Sciences

Other Investigation
Parameters B.T. F.U.1 F.U.2 F.U.3
Blood glucose (mg/dL)
a) fasting 95 89 75 80
b) Post prandial 117 112 105 115
BMI 31.1 29.98 29.04 28.48

DISCUSSION
In the pathogenesis of dyslipidemia the hypo functioning
of medodhatvagni play key role in the basic matrix of
medovaha-sorotodushti along with vitiation of khapa
dosha.[12] The Ahara and Vihara guidelines used here in
the management of medovaha srotodushti have property
of reducing the kapha and excess medodhatu. Khapa
dosha triggers the derangement of lipid components in
various manners and obstruct the body channels. The
management of dyslipidemia in modern medicine is not
satisfactory because of prolong use of modern drugs &
their side effects, hence researchers are inclined towards
alternative medicine. In this regard variety of drug and
non pharmacological measures are described in
Ayurvedic texts. In Ayurveda Ahara-Vihara are
considered as a part of therapeutic as well as Pathya
measures during treatment. During the management of
dyslipidemia kapha-medohara treatment as well as
dietary measure along with promotion of jatharagni
should be considered on priority basis.[13] The Ahara-
Vihara guidelines used here in the management of
medovaha srotodushti have property of reducing the
kapha dosha and rearrangement of meda and prevention
of further vitiation of kapha dosha & medodhatu.
We advised follow vyayamm in the form of cycling. The
mixture of crude food items contains barley (Hordeum
valgare), wheat (Triticum aestivum), green moong
(Vigna radiate), chana (Cecer arietinum), sava ka chawal
(a variety of rice)= Echinochloa frumentacea). Flour of
these five contents in equal quantity was made by milling
and chapattis were prepared. This and this Flour has
property of tridosha shamana and reduces the kaphameda
because of ruksha, kashaya,laghu and virukhshana
guna.[15] The possible mechanism of action of this Pathya
is to check the intestinal cholesterol absorption and also
normalization of hepatic synthesis of endogenous
lipoprotein formation.
REFERENCES
1. Prevalence of Dyslipidemia in Urban and Rural
India: The ICMR–INDIAB Study, Published: May
9, 2014
https://doi.org/10.1371/journal.pone.0096808
2. McGrew-Hill Harrison’s Principles of Internal
Medicine, Chapter 424, page 2449 Anthony S. Fauci
et al, 19th edition, New York Education.
3. Park’s textbook of Preventive & Social Medicine by
K. Park, Chapter 6, and page 371, 23rd edition.
4. Park’s textbook of Preventive & Social Medicine by
K. Park, Chapter 6 and page 366, 23rd edition.
5. Davidson’s Principles & Practice of Medicine
Chapter 16, page 454, 22nd edition.
6. Davidson’s Principles & Practice of Medicine
Chapter 16, page 453, 22nd edition.
7. Agnivesha, Charaka Samhita-Sutrasthana 21/21,
page 415, by Kashinath Shastri & Gorakhnath
Chaturvedi.
8. Ibid 23/5-7, p 437.
9. Ibid 21/25-27, page 415.
10. a- Ibid 21/25-28, page 415.
b- Ibid 21/25-28, p415.
11. Ibid 21/34, p415.
12. Agnivesh Charak Samhita, Vimanasthana 5/15-16,
page713 By Kashinath Shastri & Gorakhnath
Chaturvedi.
13. Ibid 27/16, 20,22,23,28.

CONCLUSION
We finally concluded that strict Pathya-apathya measures
exert beneficial effect as normalization of deranged lipid
profile, body weight, BMI. The clinical symptoms
subsided and unwanted effects were not observed at the
end of therapy. Thus, we can say that selected measures
are safe & cost effective and may be helpful to the
patients of Obesity, Diabetes, Hypertension, CHD,
Metabolic Syndrome etc. These are easy natural methods
for control and prevention of dyslipidemia thereby
reducing the risk of CHD and other diseases to enhance
the life expectancy.

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