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A randomized controlled study protocol to determine the safety and efficacy of Sivanarvembu Kuzhithailam in the management of Psoriasis (Kalanjagapadai) 确定Sivanarvembu kuzhithailand治疗银屑病(Kalanjagapadai)安全性和有效性的随机对照研究方案
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-09-01 DOI: 10.1016/j.jaim.2025.101191
Rathinamala Rathinam , Gayathri Gunalan , Lavanya Alagusolaiyan , Vinu Bharathi Balasubramaniam , Rajendra Kumar Arumugam , Sathiyarajeswaran Parameswaran

Background

Psoriasis is a chronic skin disorder with a substantial global burden, affecting over 100 million people worldwide. Conventional treatments, including topical and systemic therapies, have their own limitations and side effects. Siddha medicine, deeply rooted with comprehensive principles, offers an alternative approach in Psoriasis management. This randomized controlled trial aims to explore the safety and efficacy of Sivanarvembu Kuzhithailam, a classical Siddha medicine in the management of Psoriasis.

Objectives

The primary objective of this RCT is to determine the safety and efficacy of Sivanarvembu Kuzhithailam (SVK) and Vetpalai thailam and to reduce the PASI score in Psoriasis patients significantly. The secondary objective involves validating the biochemical changes in the study participants and determining enhancements in their quality of life before and after treatment. As a result, specific inflammatory markers, proteins, antioxidants, and assessments of oxidative stress have been undertaken in this clinical trial to provide deeper insights into the extent of inflammation, disease severity, and the mechanisms of action of the trial drug.

Methods

This is a single center, open-label, parallel group, exploratory randomized controlled trial with a sample size of 90 and with the objective of determining the safety and efficacy of Sivanarvembu Kuzhithailam in the management of psoriasis. This study protocol followed the SPIRIT 2013 guidelines.

Result

The primary outcome is to measure the reduction in the Psoriasis Area and Severity Index (PASI) score from baseline to 91 days and safety parameters. Secondary outcomes include the evaluation of enhancements in participants' quality of life through the assessment of the Dermatology Life Quality Index, as well as the examination of antioxidant levels, inflammatory markers, biochemical markers, in blood samples of trial participants.

Conclusion

The outcome of the study can be extrapolated to the next level of clinical trials with larger populations to provide robust scientific evidence for this traditional Siddha formulation for global acceptance.
牛皮癣是一种慢性皮肤病,是一种严重的全球负担,影响着全球超过1亿人。常规治疗,包括局部和全身治疗,有其自身的局限性和副作用。悉达医学,深深植根于综合原则,提供了银屑病管理的另一种方法。本随机对照试验旨在探讨经典释迦药Sivanarvembu kuzhithailand治疗银屑病的安全性和有效性。目的:本RCT的主要目的是确定Sivanarvembu kuzhithailand (SVK)和Vetpalai thailand的安全性和有效性,并显着降低银屑病患者的PASI评分。次要目标包括验证研究参与者的生化变化,并确定治疗前后他们生活质量的提高。因此,在本临床试验中进行了特定的炎症标志物、蛋白质、抗氧化剂和氧化应激评估,以更深入地了解炎症程度、疾病严重程度和试验药物的作用机制。方法采用单中心、开放标签、平行组、探索性随机对照试验,样本量为90例,目的是确定Sivanarvembu kuzhithai治疗银屑病的安全性和有效性。本研究方案遵循SPIRIT 2013指南。结果主要观察指标为银屑病面积及严重程度指数(PASI)评分从基线到91天的减少情况及安全性参数。次要结果包括通过评估皮肤病生活质量指数来评估参与者生活质量的改善,以及检查试验参与者血液样本中的抗氧化水平、炎症标志物、生化标志物。结论本研究的结果可以外推到下一阶段的临床试验中,在更大的人群中为这种传统的Siddha配方的全球接受提供强有力的科学证据。
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引用次数: 0
Hashimoto's thyroiditis and hypothyroidism, treated with Shamana Chikitsa principles of Panduroga – A case report 用潘氏法治疗桥本甲状腺炎和甲状腺功能减退1例
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-30 DOI: 10.1016/j.jaim.2025.101172
P.K.V. Anand, Vaishali Deshpande
Hypothyroidism as a sequel to Hashimoto's thyroiditis is a very common thyroid illness. The conventional treatment is replacement of thyroid hormone to compensate insufficient production from the gland. The clinical features manifested is of widely variable intensity and may not be proportionate always to the blood levels of hormones. The disease does not have a direct mention in Ayurvedic classics. In such instances, treatment principle is adopted from the principles of treatment mentioned for those diseases which holds a similarity in etiopathogenesis, based on the clinical presentations and Dosha-Dooshya analysis. Thus, treatment principles of various diseases such as Galagandam, Agnimandyam, Sthoulyam etc., are being used for the treatment of thyroid diseases. A case of hypothyroidism presented with clinical features similar to Pandurogam was managed with the medicines described in the context of Pandurogam and Sopham. Higher TSH levels were brought to normal limits and high anti thyroid peroxidase level was reduced with a set of Ayurvedic medicines for a longer duration. Keeping away from the popular translation of Pandurogam as Anemia, a symptom oriented diagnostic work up based exclusively on the Ayurvedic classics, followed by symptom-oriented selection of medicines suited to the diagnosis is effective in reducing both symptoms and blood values. This gives the hope of managing hypothyroidism with alternate treatment methods other than supplementation of hormone for lifelong.
甲状腺功能减退症是桥本甲状腺炎的后遗症,是一种非常常见的甲状腺疾病。传统的治疗方法是更换甲状腺激素,以弥补腺体分泌不足。所表现的临床特征的强度变化很大,可能并不总是与血液中的激素水平成比例。阿育吠陀经典中并没有直接提到这种疾病。在这种情况下,根据临床表现和Dosha-Dooshya分析,采用的治疗原则是针对那些在发病机制上具有相似性的疾病所提到的治疗原则。因此,诸如Galagandam、Agnimandyam、Sthoulyam等各种疾病的治疗原则被用于治疗甲状腺疾病。一例甲状腺功能减退症的临床特征与Pandurogam相似,用Pandurogam和Sopham中描述的药物进行治疗。较高的TSH水平被控制在正常范围内,高抗甲状腺过氧化物酶水平通过一组阿育吠陀药物持续较长时间而降低。避免将Pandurogam翻译为贫血,以症状为导向的诊断工作完全基于阿育吠陀经典,然后以症状为导向选择适合诊断的药物,有效地减少了症状和血液值。这给了管理甲状腺功能减退的希望与替代治疗方法,而不是补充终身激素。
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引用次数: 0
Addressing clinical practice variability in Ayurveda: An urgent need for developing clinical practice guidelines 解决阿育吠陀临床实践的可变性:迫切需要制定临床实践指南
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-30 DOI: 10.1016/j.jaim.2025.101201
V. Ashwathykutty , Unnikrishnan Payyappallimana , V. Rakesh Narayanan
Clinical practice guidelines (CPGs), which incorporate current evidence with the pondered judgment of experts, represent a promising approach to reducing unwarranted practice variation and promoting the application of research findings in clinical settings.
Globally, CPGs are developed by numerous local, national, and international organizations, and their production has significantly increased in the last two decades. In the realm of Traditional and Complementary Medicine (T&CM), CPGs are gaining popularity, offering evidence-based recommendations for implementing T&CM interventions in clinical practice.
While Korean medicine, Traditional Chinese medicine, and Kampo medicine have established robust CPGs guiding their healthcare practices and research in selected areas, the utilization of CPGs in any of the Ayush (term that represents the traditional and complementary systems of medicine, namely Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy) systems of medicine remains largely unexplored. This paper advocates for investigating the feasibility of CPGs as a promising research program, outlining areas where they could be implemented and the benefits they could bring. It represents one of the initial studies exploring the potential of CPGs in Ayurveda.
The authors argue that it is crucial for stakeholders to provide the necessary momentum to develop robust and effective CPGs that integrate research with clinical practice to enhance patient care.
临床实践指南(CPGs)结合了现有证据和专家的深思熟虑的判断,代表了一种有希望的方法,可以减少无根据的实践变化,促进研究成果在临床环境中的应用。全球范围内,cpg由许多地方、国家和国际组织开发,其产量在过去二十年中显着增加。在传统和补充医学(T&;CM)领域,CPGs越来越受欢迎,为在临床实践中实施T&;CM干预提供了基于证据的建议。虽然韩国医学、传统中医和汉布医学已经建立了强大的CPGs,在特定领域指导他们的医疗实践和研究,但CPGs在任何Ayush(代表传统和补充医学系统的术语,即阿育吠陀、瑜伽和自然疗法、乌纳尼、西达、索瓦Rigpa和顺势疗法)医学系统中的应用仍然很大程度上未被探索。本文主张调查CPGs作为一个有前途的研究计划的可行性,概述了他们可以实施的领域和他们可以带来的好处。它代表了探索阿育吠陀CPGs潜力的初步研究之一。作者认为,至关重要的是,利益相关者提供必要的动力,以发展强大而有效的CPGs,将研究与临床实践相结合,以加强患者护理。
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引用次数: 0
Characterization and potential novel applications of zinc-based traditional medicine, Yashad Bhasma 锌基传统药物的表征和潜在的新应用
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-30 DOI: 10.1016/j.jaim.2025.101188
Guruprasad C. Nille , Monisha Bhuyan , Laxmi Narayan Gupta , Mohd Ali , Chandra Shekhar Pati Tripathi , Omkar S. Nille , Shardendu Kumar Mishra , Anuja Vibhute , Pranoti Kamble , Himanshu Ranjan , Amaresh Kumar Singh , Arpita P-Tiwari , Anand Kumar Chaudhary

Background

Yashad Bhasma (YB), the incinerated metal ash of zinc, has been used for centuries in Ayurveda to address a variety of conditions, including eye diseases, diabetes mellitus, anemia, respiratory illnesses, etc.

Objective

This research aimed to synthesize and characterize YB and to evaluate its potential antimicrobial, antioxidant, and anti-angiogenic activities.

Materials and methods

In this study, YB is synthesized by optimizing the traditional method. Morphological and physicochemical characterization are performed using XRD, XPS, SEM, TEM, EDAX, DLS, TGA-DSC, and FTIR. The antimicrobial activity of YB is assessed using the well diffusion technique against the gram-positive bacterium Staphylococcus aureus (S. aureus) and the gram-negative bacterium Escherichia coli (E. coli). The antioxidant potential is evaluated using the 1,1-Diphenyl-2-Picrylhydrazyl (DPPH) radical scavenging assay and Nitric oxide (NO) radical scavenging assay. A chick chorioallantoic membrane (CAM) assay is performed on fertilized chick eggs to study the anti-angiogenesis potential of YB.

Results

The XRD patterns of YB showed the presence of cubic and hexagonal phases of ZnS having average crystallite size of 32.66 nm. XPS data supports the formation of ZnS phase of YB. SEM and TEM data confirmed the size of YB NPs in a range of 250–350 nm. The EDAX analysis confirmed the presence of Zn (37.2 %) and S (21.18 %). The mean particle diameter was 361 nm in DLS. TGA-DSC findings verified that the synthesized material is stable up to 435.80 °C. The FTIR confirms the presence of organic moieties in YB along with ZnS phase. YB effectively inhibited the growth of S. aureus and E. coli. The ability of YB to scavenge DPPH and NO radicals is found to be concentration dependent (50–250 μg/mL). The study also demonstrated that YB has notable antioxidant activity. The disappearance of blood vessels beneath the sample-loaded disk after 7 days indicated the effective anti-angiogenic properties of YB.

Conclusion

Altogether, YB exhibited significant antimicrobial, noteworthy antioxidant, and anti-angiogenic activities, indicating its potential as a promising therapeutic agent.
在阿育吠陀中,焚烧锌的金属灰烬(YB)已被用于治疗多种疾病,包括眼病、糖尿病、贫血、呼吸系统疾病等。目的合成和表征YB,并评价其潜在的抗菌、抗氧化和抗血管生成活性。材料与方法本研究通过对传统方法的优化,合成了YB。采用XRD, XPS, SEM, TEM, EDAX, DLS, TGA-DSC和FTIR进行了形态和物理化学表征。采用孔扩散法测定了YB对革兰氏阳性菌金黄色葡萄球菌(S. aureus)和革兰氏阴性菌大肠杆菌(E. coli)的抗菌活性。采用1,1-二苯基-2-苦味酰肼(DPPH)自由基清除试验和一氧化氮(NO)自由基清除试验评估其抗氧化能力。采用鸡绒毛膜-尿囊膜(CAM)试验研究了YB对受精卵血管生成的抑制作用。结果YB的XRD谱图显示ZnS存在立方相和六方相,平均晶粒尺寸为32.66 nm。XPS数据支持YB中ZnS相的形成。SEM和TEM数据证实了YB NPs的尺寸在250-350 nm之间。EDAX分析证实了Zn(37.2%)和S(21.18%)的存在。DLS的平均粒径为361 nm。TGA-DSC结果验证了合成材料在435.80℃下是稳定的。FTIR证实了YB中有机组分的存在以及ZnS相的存在。YB能有效抑制金黄色葡萄球菌和大肠杆菌的生长。YB清除DPPH和NO自由基的能力呈浓度依赖性(50 ~ 250 μg/mL)。研究还表明,YB具有显著的抗氧化活性。7天后样本盘下血管消失,表明YB具有有效的抗血管生成特性。结论YB具有显著的抗菌、抗氧化和抗血管生成活性,是一种有前景的治疗药物。
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引用次数: 0
Complete healing of a Dooshivishajanya non-healing wound with Jalaukavacharana - A case report 用Jalaukavacharana完全治愈Dooshivishajanya未愈合伤口1例报告
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-29 DOI: 10.1016/j.jaim.2025.101187
Praveen Balakrishnan, Emy S. Surendran, G.N. Sree Deepthi, A. Abhayadev, Lisha S. Raj
A 35-year-old male patient, who is non-diabetic, non-dyslipidemic, normotensive, and euthyroid, and works as a hotel manager, visited our outpatient department with complaints of two ulcers on the inner side of his right lower leg, which developed rapidly after intense itching for about a week due to scratching. The ulcers were clean, had granulation tissue, caused mild pain, showed no discharge, and were surrounded by dark discolouration. The patient's history indicated that he had experienced severe itching in that area for four to five years, along with recurrent fevers, which began after being bitten by an unidentified type of black ant. The Bates Jensen wound assessment tool scored 33 for the larger wound and 27 for the smaller wound. Initially, the patient received some Ayurvedic treatments aimed at promoting healing for approximately 40 days, but these did not improve. A venous Doppler ultrasound of his right leg indicated chronic venous insufficiency. Given the persistent nature of the ulcers despite medical treatment, the condition was diagnosed as Dooshi Vishajanya Vrana over chronic venous insufficiency. Therefore, a single session of Jalaukavacharana was performed using three Jalaukas on the ulcer site, which healed within one week of the treatment. After the treatment, the Bates Jensen wound assessment scores improved to 18 for the larger wound and 17 for the smaller wound. Follow-up evaluations conducted after four months and one year revealed no recurrence of the ulcers. The dark discolouration of the leg began to diminish from the fourth month of the follow-up period.
患者男,35岁,无糖尿病,无血脂异常,血压正常,甲状腺功能正常,酒店经理,就诊于我门诊,主诉右小腿内侧两处溃疡,因抓挠引起剧烈瘙痒约一周后迅速发展。溃疡干净,有肉芽组织,引起轻度疼痛,无分泌物,周围有深色变色。病人的病史表明,他在被一种不明类型的黑蚂蚁咬伤后,该区域出现了4到5年的严重瘙痒,并伴有反复发烧。Bates Jensen伤口评估工具对较大的伤口评分为33分,对较小的伤口评分为27分。最初,患者接受了一些旨在促进愈合的阿育吠陀治疗,持续了大约40天,但并没有改善。右腿静脉多普勒超声显示慢性静脉功能不全。尽管进行了药物治疗,但溃疡仍持续存在,病情被诊断为慢性静脉功能不全。因此,在溃疡部位使用三个Jalaukas进行一次Jalaukavacharana,溃疡在治疗一周内愈合。治疗后,大创面的Bates Jensen创面评分为18分,小创面评分为17分。四个月和一年后的随访评估显示溃疡没有复发。从随访的第四个月开始,腿部的深色变色开始减少。
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引用次数: 0
Long-term disease-free survival of a patient diagnosed with peri-ampullary carcinoma treated with adjunct Ayurvedic treatment – A case report 经辅助阿育吠陀治疗的壶腹周围癌患者的长期无病生存-一例报告
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-23 DOI: 10.1016/j.jaim.2024.101111
Sadanand Sardeshmukh, Vineeta Deshmukh, Swapna Kulkarni, Vasanti Godse, Vinita Awalkanthe, Shreenivas Datar, Shweta Gujar, Sandeep Chavan
This is a case of a female Indian patient diagnosed as Peri-Ampullary Carcinoma, with metastasis to regional lymph nodes, and reported 5-year disease free survival rate of 20–50%, treated with integration of personalized Ayurvedic treatment along with conventional treatments viz., surgery and adjuvant chemotherapy.
The patient was diagnosed with adenocarcinoma through biopsy from the ampulla of Vater during registration at our Centre in May 2010. She had yet to start her conventional treatment which was advised viz., surgery and adjuvant chemotherapy. In June 2010, she underwent Whipple's resection. Histopathology report showed moderately differentiated adenocarcinoma of the periampullary region with metastasis to regional lymph nodes — Completely resected (R0). According to TNM (Tumor Node Metastasis) Staging System as per Union for International Cancer Control (UICC- 6th edition) patient was staged as pT3N1- Stage IIB. After completion of conventional treatment (surgery and chemotherapy) in October 2010, she continued with Ayurvedic treatment and follow-ups till date. Her tumour marker CA19.9 and sonography – abdomen, pelvis after 12 years revealed no evidence of malignancy. In May 2017, she was hospitalized for hematemesis and melena, diagnosed as mild gastritis with clean base ulcers at the surgical anastomosed (Gastrojejunostomy) site. She was treated accordingly with Ayurvedic medicines and her follow-up report showed the resolution of ulcers by September 2017. In May 2014, her mildly raised blood sugar (Fasting 138 mg/dL; Post-Prandial 146 mg/dL) was managed by a healthy lifestyle but in 2019, her blood glucose levels were moderately raised (Fasting 153 mg/dL, Post-Prandial 187 mg/dL) hence she was started on oral hypoglycemics which are continued till date.
Though the pancreaticobiliary subtype is associated with poor prognosis, it was possible to achieve 12 years and 6 months of disease-free survival with adjunct Oral Ayurvedic Medicines (OAM) possessing antioxidant, immune-modulatory, anti-cancer, and hepato-protective action. She could tolerate chemotherapy with minimal side effects. Her quality of life improved. Her blood sugar levels have been maintained by lifestyle changes and oral hypoglycemics.
本文报告一例印度女性壶腹周围癌,伴有局部淋巴结转移,5年无病生存率为20-50%,采用个性化阿育吠陀治疗结合常规治疗,即手术和辅助化疗。患者于2010年5月在我中心登记时通过壶腹活检被诊断为腺癌。她还没有开始她的常规治疗,即手术和辅助化疗。2010年6月,她接受了惠普尔切除手术。组织病理学报告显示壶腹周围中度分化腺癌伴局部淋巴结转移-完全切除(R0)。根据国际癌症控制联盟(UICC-第6版)TNM(肿瘤淋巴结转移)分期系统,患者分期为pT3N1- IIB期。在2010年10月完成常规治疗(手术和化疗)后,她继续接受阿育吠陀治疗和随访至今。12年后,她的肿瘤标记物CA19.9和腹部、骨盆超声检查均未发现恶性肿瘤。2017年5月因呕血、黑黑住院,诊断为轻度胃炎伴手术吻合(胃空肠吻合术)部位清洁底溃疡。她接受了阿育吠陀药物的治疗,她的后续报告显示,到2017年9月,溃疡已经消退。2014年5月,她的血糖轻度升高(空腹138毫克/分升,餐后146毫克/分升),通过健康的生活方式得到了控制,但在2019年,她的血糖水平中度升高(空腹153毫克/分升,餐后187毫克/分升),因此她开始服用口服降糖药,一直持续到现在。虽然胰胆管亚型与预后不良相关,但口服阿育吠陀药物(OAM)具有抗氧化、免疫调节、抗癌和肝保护作用,有可能达到12年零6个月的无病生存期。她能忍受化疗,副作用很小。她的生活质量提高了。她的血糖水平一直通过改变生活方式和口服降糖药来维持。
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引用次数: 0
Unravelling AYUSH providers’ perspectives on healthcare choices of people residing in urban areas of Puducherry, India- A concurrent mixed method study 解开AYUSH提供者对居住在印度普杜切里城市地区的人们的医疗保健选择的观点-一项并行混合方法研究
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-22 DOI: 10.1016/j.jaim.2025.101180
Anusha Seelamantula , Premarajan K C , Mahalakshmy Thulasingam

Background

The rising popularity of alternative medicine positions AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy) systems as valuable tools for providing affordable, culturally appropriate healthcare to low-middle-income countries. However, overcoming the challenges of scaling up these traditional systems is key to gaining broader acceptance of this promising healthcare approach.

Objectives

To determine the prevalence and associated factors of AYUSH utilization. And, to explore the perceptions of AYUSH providers on factors supporting or hindering AYUSH adoption, and its integration with conventional medicine.

Material and methods

A concurrent mixed-method study was employed between September and December 2023. Prevalence of AYUSH utilization was assessed via door-to-door survey using pre-tested questionnaire. Ten key informant interviews were conducted among AYUSH practitioners and analyzed using thematic analysis.

Results

Prevalence of AYUSH utilization was 19.2% (95% CI:16.9% – 21.6%). A significant association among people with comorbidities (aPR: 1.5; 95% CI: 1.0–2.1; P-value<0.05) is observed. Qualitative analysis revealed that growing public interest and government support were key enablers, while limited scientific validation and workforce shortage were major barriers. From the health systems perspective, AYUSH providers spoke about the need for policy and governance reforms to create a more unified healthcare system.

Conclusion

Despite some challenges, the findings suggest that AYUSH is increasingly favoured for its natural approach. A growing acceptance of integrative medicine highlights the need for cohesive care models and improved accessibility. The study emphasizes the importance of addressing state-specific needs and standardizing AYUSH practices to facilitate integration.
替代医学的日益流行使AYUSH(阿育吠陀、瑜伽和自然疗法、乌纳尼、悉达和顺势疗法)系统成为向中低收入国家提供负担得起的、文化上合适的医疗保健的宝贵工具。然而,克服扩大这些传统系统的挑战是获得更广泛接受这种有前途的医疗保健方法的关键。目的了解AYUSH使用率及相关因素。并且,探讨AYUSH提供者对支持或阻碍采用AYUSH及其与传统医学结合的因素的看法。材料与方法于2023年9月至12月采用并行混合方法研究。采用预先测试的问卷,通过上门调查来评估AYUSH的使用率。在AYUSH从业人员中进行了10个关键信息提供者访谈,并使用主题分析进行了分析。结果使用率为19.2% (95% CI:16.9% ~ 21.6%)。观察到合并症患者之间存在显著关联(aPR: 1.5; 95% CI: 1.0-2.1; p值<;0.05)。定性分析显示,日益增长的公众兴趣和政府支持是关键的推动因素,而有限的科学验证和劳动力短缺是主要障碍。从卫生系统的角度来看,AYUSH提供者谈到了政策和治理改革的必要性,以创建一个更加统一的卫生保健系统。结论尽管存在一些挑战,但研究结果表明,AYUSH因其自然方法而越来越受到青睐。越来越多的人接受综合医学,这突出了对有凝聚力的护理模式和改善可及性的需要。该研究强调了解决各州具体需求和标准化AYUSH实践以促进一体化的重要性。
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引用次数: 0
Prakriti elucidates the inter-individual variability in coronary artery disease risk-predicting biomarkers: A tertiary care hospital-based case control study Prakriti阐明了冠状动脉疾病风险预测生物标志物的个体间变异性:一项基于三级保健医院的病例对照研究
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-19 DOI: 10.1016/j.jaim.2025.101178
Pamila Dua , Bhavana Prasher , Sandeep Seth , Shivam Pandey , Subir Kumar Maulik , K.H. Reeta

Background

Several biochemical tests and biomarkers are well-known for the assessment of risk towards coronary artery disease (CAD). However, conflicting results pose a significant challenge probably due to phenotypic heterogeneity. In Ayurveda, individuals are classified into phenotypes- Prakriti, which helps in predicting an individual's susceptibility to disease, its prognosis and selection of therapy. In the present study, an attempt was made to overcome this challenge with an aim to identify the association between different constitution types as mentioned in Ayurveda with biochemical markers for precisely predicting the risks for CAD.

Methods

200 clinically stable CAD patients and 100 healthy controls were recruited from the Cardiology OPD, AIIMS, New Delhi, India. A comprehensive set of tests to incorporate various aspects of CAD pathophysiology was performed. Assessment of Prakriti was done clinically and with AI/ML algorithm based validated questionnaire.

Results

The monocyte-lymphocyte ratio (MLR), fasting blood sugar, urea, creatinine, uric acid, and NT-pro BNP were significantly higher in CAD patients as compared to healthy controls. Prakriti stratification revealed maximum number of patients with Kapha Prakriti. MLR and IL-6 (associated with inflammatory and peripheral endothelial dysfunction) were high in Vata patients; diabetic control (associated with plaque instability and malfunctioned RAAS) was poor in Kapha patients and NT-pro BNP (associated with myocardial hypoxia) was higher in Pitta patients.

Conclusion

Though, several biochemical parameters were associated with risks for CAD, Prakriti classification provided more insights into the precise risks. This dual approach may help in guiding personalized treatment options in CAD management.
背景:几种生物化学测试和生物标志物在评估冠状动脉疾病(CAD)风险方面是众所周知的。然而,可能由于表型异质性,相互矛盾的结果提出了重大挑战。在阿育吠陀,个体被划分为表型——Prakriti,这有助于预测个体对疾病的易感性、预后和治疗选择。在目前的研究中,我们试图克服这一挑战,目的是确定阿育吠陀中提到的不同体质类型与精确预测CAD风险的生化标志物之间的联系。方法从印度新德里AIIMS心内科OPD招募临床稳定的冠心病患者200例和健康对照100例。进行了一套综合CAD病理生理学各个方面的测试。临床评估Prakriti,并采用基于AI/ML算法的有效问卷。结果冠心病患者的单核细胞淋巴细胞比(MLR)、空腹血糖、尿素、肌酐、尿酸、NT-pro BNP均显著高于健康对照组。Prakriti分层显示Kapha Prakriti患者最多。Vata患者的MLR和IL-6(与炎症和外周内皮功能障碍相关)较高;Kapha患者的糖尿病控制(与斑块不稳定和功能失调的RAAS相关)较差,而Pitta患者的NT-pro BNP(与心肌缺氧相关)较高。结论:虽然一些生化参数与冠心病的风险相关,但Prakriti分类提供了更准确的风险。这种双重方法可能有助于指导CAD管理中的个性化治疗选择。
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引用次数: 0
Development of an instrument for screening mental health based on Ayurvedic concept of Triguna 开发一种基于阿育吠陀心理健康概念的心理健康筛查工具
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-06 DOI: 10.1016/j.jaim.2025.101175
K.N. Ananda Lakshmy , M.A. Shajahan
<div><h3>Background</h3><div>As the bio-regulatory principles (<em>Dosha</em>) are the essential components of the body, the three attributes (<em>Triguna</em>)-<em>Satva, Raja</em>, and <em>Tamas</em> are the crucial components of the mind that determine an individual's mental status. Though <em>Triguna</em>-based psychological assessment tools are available, there are no standardized tools to evaluate mental health using this unique Ayurvedic approach.So this research was undertaken to create a simple, self-administering instrument for screening mental health based on Ayurvedic concept-<em>Triguna</em>.</div></div><div><h3>Objective</h3><div>To develop a simple, reliable, and valid self-administering instrument based on <em>Triguna</em> concept of Ayurvedic classics for screening mental health.</div></div><div><h3>Methods</h3><div>Standard steps to develop the instrument -Conceptualization, item generation, item selection, item wording, Translation-back translation, pre-test, pilot study, Test-retest were done before the final administration of the draft instrument. Reliability and validity testing were carried out. Reliability assessment included Test-retest and internal consistency. Face, content, construct, criterion and convergent validity were done as part of the validity assessment. Exploratory factor analysis using Principal Component Analysis with Varimax rotation was employed for construct validation and item reduction. A cross-sectional study employing a stratified, multi-stage cluster sampling technique was conducted among 400 participants aged 20–40 years, representing rural, urban and coastal areas of Thiruvananthapuram, Kerala, India. The criterion validity of the newly developed tool was assessed against the WHO Subjective Well-being Inventory(SUBI).The reference standard, evaluated for its diagnostic properties including sensitivity, specificity, predictive values, and likelihood ratios, was administered alongside the draft instrument. After appropriate analyses, a 38-item self-administering instrument was developed and named as Mental Health Assessment Scale with <em>Triguna</em> (MHAS-TG). Hypothesis validation and construct validity were assessed using diverse community samples, comprising 100 individuals from various geographical areas of Kannur District, 100 students from NIT Calicut (Kozhikode) and 50 ex-convicts from Kannur District.</div></div><div><h3>Results</h3><div>The newly developed 38-item Mental Health self-Assessment Scale with <em>Triguna</em> (MHAS-TG) is presented as a discriminating tool that showed high Test-retest (Intra Class Correlation coefficient - 0.8) and Internal consistency reliability (Cronbach's alpha = 0.9). The tool had adequate face validity and content validity (Content validity index- 0.84). Construct validity by Exploratory factor analysis yielded 38 items of 9-factor solution with a cumulative variance of 58.06 %. The self-administering tool with a score range of 0–114 derived a cut-off sc
由于生物调节原理(Dosha)是身体的基本组成部分,三属性(Triguna)-Satva, Raja和Tamas是决定个人精神状态的关键组成部分。虽然基于triguna的心理评估工具是可用的,但没有标准化的工具来评估使用这种独特的阿育吠陀方法的心理健康。因此,这项研究是为了创造一个简单的,自我管理的工具来筛查心理健康基于阿育吠陀的概念- triguna。目的研制一种简单、可靠、有效的基于阿育吠陀经典Triguna概念的心理健康筛查自用药仪。方法在最终发放前,按标准步骤进行量表的编制——概念化、项目生成、项目选择、项目措辞、翻译回译、预试、中试、复试。进行信度和效度检验。可靠性评估包括重测和内部一致性。效度评估包括面、内容、结构、标准和收敛效度。探索性因子分析采用主成分分析和方差旋转进行结构验证和项目缩减。采用分层、多阶段整群抽样技术的横断面研究对400名年龄在20-40岁之间的参与者进行了研究,这些参与者代表了印度喀拉拉邦蒂鲁凡南得普兰邦的农村、城市和沿海地区。根据世卫组织主观幸福感量表(SUBI)评估新开发工具的标准效度。参考标准,评估其诊断特性,包括敏感性、特异性、预测值和似然比,与草案工具一起使用。经过适当的分析,编制了一套38项的自我管理量表,并命名为心理健康评估量表(mahas - tg)。假设验证和结构效度评估采用不同的社区样本,包括来自坎努尔地区不同地理区域的100名个人,来自卡利科特(科日科德)NIT的100名学生和来自坎努尔地区的50名前罪犯。结果新编制的38项Triguna心理健康自评量表(MHAS-TG)具有较高的重测(类内相关系数- 0.8)和内部一致性信度(Cronbach's alpha = 0.9)。该工具具有足够的表面效度和内容效度(内容效度指数- 0.84)。探索性因子分析产生38项9因子解,累积方差为58.06%。评分范围为0-114的自我给药工具根据敏感性和特异性得出了40分和80分的临界值。得分低于40分为心理健康不良,41-80分为心理健康中等,81分以上为心理健康良好。受试者工作特征曲线分析灵敏度为75.36%,特异性为78.18。该工具的平均使用时间为10分钟。对印度喀拉拉邦Thiruvananthapuram地区400人进行心理健康筛查的结果如下:28.25%的人心理健康状况良好,63.5%的人心理健康状况中等,8.5%的人心理健康状况不佳。在坎努尔县进行的再验证表明,17%的人心理健康状况良好,75%的人心理健康状况中等,8%的人心理健康状况较差。在科日科德,16%的人心理健康状况良好,74%的人心理健康状况一般,10%的人心理健康状况较差。在前罪犯中,8%的人心理健康状况良好,67%的人心理健康状况中等,25%的人心理健康状况不佳。独立t检验显示差异有统计学意义(p <;0.05)。弱正相关分析(p <;Satva评分与Rajo Guna评分呈显著负相关(p <;0.01)与Tamo Guna呈正相关(p <;Rajo和Tamo Guna的比值为0.01。结论mhas - tg是一种基于Triguna概念的有效、可靠的38项自我管理工具。该工具具有影响心理健康的风险和保护因素,是一种快速简便的评估心理健康的筛查工具。在Thiruvananthapuram地区的400名参与者中,该工具的管理显示了它识别精神健康状况不佳的人的能力。Satva-Rajo得分之间呈弱正相关,Satva-Tamo得分之间呈强负相关,Rajo-Tamo得分之间呈中度正相关。
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引用次数: 0
Translating Ayurvedic concepts to modern drug structures: A novel paradigm 翻译阿育吠陀概念到现代药物结构:一个新的范例。
IF 1.9 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2025-08-04 DOI: 10.1016/j.jaim.2025.101203
Antonio Morandi , Maria Cristina Minniti , AN Narayanan Nambi
Modern pharmacology faces challenges in fully explaining inter-individual variability in drug efficacy and side effects. This article introduces a groundbreaking approach that applies Ayurvedic principles to interpret modern drug structures and actions, offering a more comprehensive framework for understanding drug behavior. Through the Collaborative Medicine and Science (Co.M.S.) framework, we demonstrate how Ayurvedic epistemology provides a holistic reading of modern pharmaceuticals using fundamental principles of Panchamahabhuta, Tridosha, and Guna. This Ayurvedic interpretation reveals how drug effects (Karma) emerge from the interaction between a substance's inherent qualities (Guna profile) and an individual's constitutional context (Prakriti/Vikriti), explaining inter-individual variability in drug responses. Illustrative examples using antibiotics and antihypertensives demonstrate how this approach can optimize prescription practices, reduce side effects, and lower healthcare costs. While empirical validation will strengthen this approach, it already offers valuable practical insights that complement—not replace—conventional pharmacology, potentially enhancing personalized medicine and patient outcomes.
现代药理学在充分解释药物疗效和副作用的个体差异方面面临挑战。本文介绍了一种开创性的方法,应用阿育吠陀原理来解释现代药物的结构和作用,为理解药物行为提供了一个更全面的框架。通过合作医学与科学(co . m.s.)框架,我们展示了阿育吠陀认识论如何使用Panchamahabhuta, Tridosha和Guna的基本原则提供了对现代药物的整体解读。这种阿育吠陀的解释揭示了药物效应(Karma)是如何从物质的内在品质(Guna profile)和个体的体质环境(Prakriti/Vikriti)之间的相互作用中产生的,解释了药物反应的个体差异。使用抗生素和抗高血压药物的说明性例子说明了这种方法如何优化处方实践、减少副作用和降低医疗保健成本。虽然经验验证将加强这种方法,但它已经提供了有价值的实用见解,可以补充而不是取代传统药理学,潜在地提高个性化医疗和患者的治疗效果。
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引用次数: 0
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Journal of Ayurveda and Integrative Medicine
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