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Nandita Vijay, Bengaluru October 13 , 2020
There is need to clear the misconception that Ayurveda lacks evidence. Though healthcare in India revolves around modern drugs, there are several attempts to supplement it with ayurvedic therapies.

The release of National Clinical Management Protocol based on Ayurveda and Yoga for COVID-19 by the Union government is laudable. Of the 103 human studies registered between March 1 and June 25, 2020 in the Clinical Trial Registry of India, 61.5 per cent are from Ayush disciplines.

India accounts for over 700,000 registered practicing vaidyas with BAMS or MD Ayurveda qualification. With their qualification, they need not doubt the existence of evidence, said Dr D B Anantha Narayana, chief scientific officer, Ayurvidye Trust.

There is abundant evidence in Ayurveda. For instance, a common grantha recipe, chyawanprash, has been scientifically studied in India, Russia and elsewhere with benefits reported. Many vaidyas undergo an integrated medicine course which includes exposure to use of synthetic molecule-based drugs. Some of the practicing vaidyas also use modern medicine to provide quick relief, he added.

Vaidyas use preparations from the granthas or proprietary ayurvedic medicines (PAM) supplied by manufacturers or in ayurvedic formulary or Materia Medica. There are 57 ayurvedic books recognized as authoritative texts in the First Schedule to the Drugs and Cosmetics Act. It also permits combinations of ingredients listed in the granthas, under PAM category.

Over 80% of PAMs have medicinal plants as their active ingredients. Medicinal plant-based products finding a reference to usage in granthas qualify as ayurvedic medicines. This is where evidence of efficacy and safety becomes pertinent, stated Dr Narayana and scientific literature reviewer Sharanbasappa Durg.

Further, a classical product like Arogyavardhini Vati has been in use for centuries to treat cardiovascular disorders. Researchers from All India Institute of Medical Sciences and Central Council for Research in Ayurvedic Sciences investigated the efficacy and safety of Arjuna powder and Arogyavardhini Vati in 96 dyslipidemia patients who reported significant reduction of total cholesterol, low density lipoprotein, triglycerides, C-reactive protein, and blood glucose.

Recipes documented in the granthas depict a long history of safe usage. However, clinical trials on grantha recipes or traditional ayurvedic treatment are far and few. This is because of high costs involved and inability to own and protect the findings through patents, stated Dr Narayana and Durg in a study titled ‘Ayurveda: Here is the evidence’ published in the Journal of Ayurveda and Integrative Medicine.

Providing more examples of evidence-based Ayurveda drugs, the authors said Arya Vaidya Pharmacy, Coimbatore, in an award-winning research paper compared the safety and efficacy of ayurvedic treatment with methotrexate, a synthetic approved drug for rheumatoid arthritis. The evidence on effectiveness of Ayurveda also extends to therapies like Panchakarma, Abhyangam oleation and Shirodhara. Beyond India, scientists in Japan have studied the neurological benefits of Shirodhara several years ago.

Jaluka, another valuable therapy, uses leeches to suck the venous blood from varicose veins. “This therapy is now approved by the US FDA with operating procedures to breed the right type of leeches,” said the authors.

Kshara sutra medicated thread tying technique for treatment of anal fistula has been accepted by surgeons and extensively studied in Japan and practiced in different hospitals there.

Unfortunately, such evidence in Ayurveda  is not easily accessible through online search, giving one the impression that evidence does not exist. ICMR is working to digitize such data. But granthas are difficult to access online, particularly because many of them are in Sanskrit, said Dr Narayana and Sharanbasappa Durg.

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