Abstract :
Alcoholic liver disorder is resulted from chronic alcohol consumption which is characterised by anorexia, easy bruising, increasing weakness and fatigue, progressive jaundice, bleeding from gastrooesophageal varices, ascities and encephalopathy having serious complications. In modern science, the disease has only supportive treatment and sometimes liver transplant surgery. In this article,a case is presented of alcoholic liver disorder in which the patient had responded well to Ayurvedic medications.
Keywords :
Ayurvedic,alcohol, virechan, arogyavardhini, Kutaki
Introduction :
Now a days incidence of alocoholic liver disorders are increasing . There are many effective Ayurvedic drugs for the liver disordes. A.S.S. Arogyashala Hospital, Nashik treated a case of alcoholic liver disorder successfully.The details of the efforts are given in this article.
Clinical record :
A 35 year old male patient having history of alcohol consumption(750 ml X 3 for five years) since ten years presented with complaints of
- P/R bleeding
- Generalised oedema
- Anorexia
- Abdominal pain
- Giddiness since three weeks
Medical History :
Jaundice two years back which was cured completely.
Family History :
Not specific
Surgical History :
Not specific
Drug History :
Not specific
Initially the patient was admitted in private hospital.The authorities had given him emergency management and further supportive treatment to prevent probable severe complication like hepatic encephalopathy in the future.
Then for Ayurvedic treatment he was admitted at A.S.S. Arogyashala Hospital , Nasik for the same complaints as above on 16 July 2009. On examination he had.
- Heart Rate : 110/min
- BP : 110/70 mm Hg
- P/A = Abdominal tenderness and 2 finger Hepatomegaly
- P/R : No hemorrhoids, no fissures
- General Examination: Bipedal pitting oedema
- Icterus ++
- Pallor ++
Investigations :
- Hb = 7.6 gm%
- TLC= 4500/mm3
- Platlet = 70,000/mm3
- Bilirubin (Total) = 23.5 mg%
- Bilirubin (Direct) = 17.7 mg%
- SGOT = 39.9 IU/L
- SGPT = 152.9 IU/L
The Ayurvedic medications were started which are as given below :
- Arogyavardhini Vati 500 mg, t.d.s.
- Gokshuradi Guggulu 500 mg, t.d.s.
- Raktasthambhak Mishran (Mixture of Nagkeshar, Laksha, Lodhra) special Kalpa of Arogyashala Hospital. 3 gms,t.d.s.
- Kumari Aasav 15ml, b.d.
Diet recommended during treatment :
- Kharjuradi Manth
- Mudge Yush (Moongdal soup)
- Godugdh (cow milk)
- Odan (rice)
There was marked improvement in his symptoms, within fifteen days. After fifteen days his symptoms were
- No P/R bleeding
- generalised oedema was also reduced
- improvement in appetite
Examination :
- Pulse: 90/min
- BP: 110/70mm hg
- P/A: No Hepatomegaly
- Mild Icterus
After improvement in general condition he had been given 'Virechana' Karma by using Kutaki(Picrorhiza kurroo) Kwath which is commonly indicated management guideline for Kamala i.e. hepatitis. Sansarjankrama was followed after Virechan.
There was marked improvement in his symptoms and biochemical markers after one month.
He was discharged free of above symptoms on 22 August2009. Then he was given Ayurvedic treatment on O.P.D. basis till 21-09-09.
Improvement found in his biochemical markers is as given below :
Biochemical marker |
Normal range |
14/7/09 |
25/7/09 |
3/8/09 |
14/8/09 |
2/9/09 |
15/9/09 |
21/9/09 |
Bilirubin(Total) mg% |
< or= 1 |
27.8 |
23.5 |
14.9 |
7.5 |
4.5 |
2.0 |
0.9 |
Bilirubin(Direct) mg% |
0.1 to 0.3 |
13.2 |
17.7 |
10.9 |
5.7 |
2.9 |
1.2 |
0.6 |
Bilirubin(Indirect) mg% |
0.7 to 0.9 |
14.6 |
5.8 |
4.0 |
2.2 |
1.6 |
0.8 |
0.3 |
S.G.P.T. IU/L |
0 to 35 |
152.6 |
145 |
76 |
45 |
40 |
39 |
39 |
Biochemical marker |
Normal range |
25/7/09 |
25/08/09 |
Hb gm% |
12 to 16 |
7.6% |
8.7% |
TLC |
4000 to 11000 |
4500/mm3 |
6000/mm3 |
Platelet |
1.5 lakh to 4.5 lakh |
70000/mm3 |
150000/mm3 |
Discussion :
Prognosis of advanced alcohol liver disorder is poor. Most of the patients eventually land up in hepatic encephalopathy, even provided with long term medical supervision and careful management. Complete recovery of these patients is very difficult and most of the times impossible.
But in confirmation with a previous case report,the response to Ayurvedic treatment was dramatic in this patient.
As per Ayurvedic pathophysiological aspects the diagnosis was
Bahupitta Kamala. This is a disease of
'Raktavaha Strotas' (Vascular system) [
Strotas means channel. They are transporters of factors that causes the
prakop or shaman of Doshas].
Yakrit (Liver) and
Pliha(Spleen) are important sites where disease of
Raktavaha Strotas (Vascular system)produce pathological lesion. Hence inflammatory condition of Yakrit(Liver) leads to clinical jaundice and further complications. The symptoms are associated with
Mahastrotas (Alimentary channels ) and
Raktavaha Strotas(Vascular system) dysfunction.
Action of
Arogyavardhini is hapatoprotective, hepatostimulant and useful to regulate the bile secretion and it's flow. It is also useful to regulate bowel physiology by its action on
Pittadhara Kala [a part of
koshta (G.I.Tract) described as
Grahani (small intestine spe. Duodenal end) main function to provide
pachakpitta (bile) for digestion of food).
Arogyavardhini relieves the obstruction and is the drug of choice in hepatic dysfunction.
Action of
Gokshuradi Guguloo is antiinflamatory and diuretic.
Virechana Karma is a process by which
doshas are made to pass through
adhomarga i.e. anus. It is said to be important therapy for evacuation of
pitta dosha. By
virechan the
dushta pitta dosh and
malas are cleard not only from the colon and rectum but also from whole body i.e. at cellular level.
Hence by this case report, it can be suggested that the Ayurvedic line of treatment according to suitable stages of disease will be life saving and can give complete recovery to patient. It also requires attention to conduct a suitable clinical study for testing the benefit of the proposed Ayurvedic Treatment for alcoholic liver disease.
