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A condition, in which a vein becomes dilated, elongated and tortuous, this is said to be "Varicose. There are primary as well as secondary causes of varicose veins. The superficial and the deep veins are involved in varicose veins. Modern science provides only symptomatic relief for pain and swelling. The contemporary treatment for varicose veins includes ligation, ligation with stripping, sclera therapy, radial surgical approach and bypass surgery. But these treatments cause reoccurrence of this disease. In Ayurveda, Varicosity is mainly Vatajvyadhi. Pitta and Raktaare also involved in this condition. In Ayurvedic texts Siravyadha venesection , raktamokshan bloodletting , jalaukavacharan , veshtana Wrapping of cloth or crepe bandaging , various panchkarma procedures like Abhyang, Swedanetc and herbs like Guggulu, Ashwagandha, Kanchnar are available which can help in reducing the symptoms and cure varicose veins.` Dr. Rajeev Kumar | Dr. Gayatri | Dr. Neelam Sajwan | Dr. A. K. Gupta "Varicose Veins Treatment And Prognosis In Ayurveda Ascompared To Modern" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-2 | Issue-6 , October 2018, URL: https://www.ijtsrd.com/papers/ijtsrd18462.pdf Paper URL: http://www.ijtsrd.com/medicine/other/18462/varicose-veins-treatment-and-prognosis-in-ayurveda-ascompared-to-modern/dr-rajeev-kumar<br>
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International Journal of Trend in International Open Access Journal International Open Access Journal | www.ijtsrd.com International Journal of Trend in Scientific Research and Development (IJTSRD) Research and Development (IJTSRD) www.ijtsrd.com ISSN No: 2456 ISSN No: 2456 - 6470 | Volume - 2 | Issue – 6 | Sep 6 | Sep – Oct 2018 Varicose Veins Treatment Veins Treatment And Prognosis In Ayurveda Ascompared To Modern Ayurveda Ascompared Sajwan Dr. Rajeev Kumar Assistant Professor, Department Shalyatantra Gurukul Campus, Uttarakhand, India Dr. Neelam Sajwan Consultant, Department Of Harrawala Campus,UAU, Uttarakhand, India epartment Of Assistant Professor /Consultant Shalyatantra Harrawala Uttarakhand UAU, Gupta Dr. A. K. Gupta Department Of Shalyatantra Campus, UAU, Uttarakhand, India Dr. Gayatri Professor, Department Rishikul Campus, Uttarakhand P.G. Scholar, Department Of Shalyatantra Patanjali Bhartiya Ayurvigyanevam Anusandhan Sansthan Haridwar, UAU, Uttarakhand Shalyatantra Anusandhan Uttarakhand, India ABSTRACT A condition, in which a vein becomes dilated, elongated and tortuous, this is said to be There are primary as well as secondary causes of varicose veins. The superficial and the deep veins are involved in varicose veins. Modern science only symptomatic relief for pain and swelling. The contemporary treatment for varicose veins includes ligation, ligation with stripping, sclera therapy surgical approach and bypass surgery. But these treatments cause reoccurrence of this disease. In Ayurveda, Varicosity is mainly Vatajvyadhi. Pitta and Raktaare also involved in this condition. In Ayurvedic texts Siravyadha (venesection), (bloodletting), jalaukavacharan , veshtana of cloth or crepe bandaging ), various panchkarma procedures like Abhyang, Swedanetc and herbs like Guggulu, Ashwagandha, Kanchnar which can help in reducing the symptoms and cure varicose veins. Keywords:Varicose vein, jalaukavcharan INTRODUCTION Varicose veins is common disease in present era. This is mainly a life style disorder. The common site of varicosity is lower limbs. The basic cause of varicose veins is incompetency of perforating valves of lower limbs. The predisposing factor of varicose veins is prolong standing and increased abdominal pressure like pregnancy, abdominal tumors. Varicose veins have been desc It was first described by AcharyaSushruta Samhita1. He has mentioned it as described siragranthi with etiology, pathology, clinical features and treatment. He has considered vata (vyanavayu) as causative factor. Pathogenesis according to Ayurveda Varicose veins are primarily a by an imbalance in VyanaVayu, increased pressure that affects the valves and elasticity of the veins. In fact, the type of Vata, which is responsible for transporting oxygenated blood from the heart to the through the arteries. It also governs the flow of deoxygenated blood from the body's cells back to the heart through the veins. Veins have surrounding muscles to push blood back to the heart. They are one way valves. These valves direct blood to upwards direction and then close to prevent backflow of blood. When VyanaVayu excessive dryness results in hardening an elasticity of veins and valves. Increase in blood pressure causes dilatation of the vein, and then valves are not locked properly for a long time. It makes difficult for the muscles to push the blood in upward direction to the heart. It causes ba Now blood collects in the superficial veins of lower limbs, which have weaker muscular support than deep veins. This results in varicosity of veins just beneath the skin surface. Because of this, the blood gets the skin surface. Because of this, the blood gets A condition, in which a vein becomes dilated, elongated and tortuous, this is said to be “Varicose”. There are primary as well as secondary causes of Varicose veins have been described in ayurvedic text. AcharyaSushruta in Sushruta . He has mentioned it as siragranthi. He has with etiology, pathology, clinical features and treatment. He has considered ative factor. the deep veins are involved in varicose veins. Modern science provides only symptomatic relief for pain and swelling. The veins includes therapy, radial surgery. But these Ayurveda2: Varicose veins are primarily a Vata disorder, caused VyanaVayu, which creates increased pressure that affects the valves and elasticity of the veins. In fact, VyanaVayu is one of responsible for transporting oxygenated blood from the heart to the whole body through the arteries. It also governs the flow of deoxygenated blood from the body's cells back to the heart through the veins. Veins have valves and surrounding muscles to push blood back to the heart. They are one way valves. These valves direct blood to upwards direction and then close to prevent backflow VyanaVayuis imbalanced, then excessive dryness results in hardening and loss of elasticity of veins and valves. Increase in blood pressure causes dilatation of the vein, and then valves are not locked properly for a long time. It makes difficult for the muscles to push the blood in upward direction to the heart. It causes backflow of blood. Now blood collects in the superficial veins of lower limbs, which have weaker muscular support than deep veins. This results in varicosity of veins just beneath treatments cause reoccurrence of this disease. In Ayurveda, Varicosity is mainly Vatajvyadhi. Pitta and condition. In Ayurvedic (venesection), jalaukavacharan , veshtana (Wrapping of cloth or crepe bandaging ), various panchkarma texts Siravyadha raktamokshan raktamokshan Swedanetc and herbs like are available which can help in reducing the symptoms and cure Varicose vein, jalaukavcharan Varicose veins is common disease in present era. This is mainly a life style disorder. The common site of limbs. The basic cause of varicose veins is incompetency of perforating valves of lower limbs. The predisposing factor of varicose veins is prolong standing and increased abdominal pressure @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 489
International Journal of Trend in Scientific Research and International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 Development (IJTSRD) ISSN: 2456-6470 accumulated in those veins. It causes ulcers in varicose veins due to imbalance in Ranjaka Pitta Pitta dosha is ushna and tikshna in nature and it maintains metabolic and hormonal functioning. Ranjaka pitta is one of the subdoshas purifies the blood. Ranjaka Pitta is present in liver and spleen and it is responsible for composition of blood and for distribution of nutrition to the cells and the tissues through the blood. If Ranjaka Pitta imbalanced, the blood getsimpured when associated with Ama (metabolic toxins), thereby becoming thick and sluggish, thus contributing to ulcers in varicose veins. Primary cause of varicose veins is poor blood circulation (as governed by VyanaVayu are the secondary complication caused by impure blood (as governed by Ranjaka Pitta). According to the ayurvedicsamhitas e.g., Astanga Hrdayam says that ‘if the one who dip their feet in cold water immediately after excessive exercise causes sudden decrease in temperature to the warm legs. As a result, VataDosha imbalance will occur (prakopawastha vatadosha), after which sudden constriction of warm veins occurs, which leads to formation of varicose veins. Sign andsymptoms3, 4: ?Heaviness (Gowrava) , burning sensation (Daha) , aching pain (Toda ), tiredness ( discoloration of veins or skin ( Krishnaraktasira numbness ( Sada) or pain in legs which gets after prolonged standing or sitting . ?Appearance of the spider or tortuous veins ( Grathithasira) ?Swelling in legs and ankle (Padasotha), over the vein (Kandu). ?At later stage Varicose ulcers are varicose vein and usually aren't a sign of serious problem. But in many cases, varicose veins can be a sign of blockage in the deeper veins called DVT (deep vein thrombosis). Ayurvedic approach for varicose veins: In case of any disease first we have to avoid the causes which are responsible for the disease, called as Nidanaparivarjan. In varicose vein the food that lead to impairment of Vata and Pitta in the body are to be avoided like – salty and spicy food, dry and junk food. Prolonged standing must be avoided because it is main cause for this disease. In Ayurveda herbs and herbal formulations changes and lifestyle modification appear to wo changes and lifestyle modification appear to work by It causes ulcers in Ranjaka Pitta. in nature and it trengthening the walls of veins, other vessels and promote an healthy venous circulation in the body. They primarily relieve symptoms like pain, heaviness. The main line of treatment is to pacify aggravated strengthening the walls of veins promote an healthy venous circulat They primarily relieve symptoms The main line of treatment is to pacify aggravated Vata, Pitta dosha and Raktadhatu treatments include internal herbal health supplements and external treatments procedures. Herbs which can be used are pure Commiphoramukul ), Neem Kanchanara (Bauhinia (Mesuaferrea Linn.), Amalaki Bala (Sidacordifolia Linn.), racemosus Willd.), Vidari Arjuna (Terminaliaarjuna), (Centellaasiatica), Daruharidra Ashwagandha ( Withaniasomnifera Common herbal preparations which are effective in varicose veins are Punarnavadiguggulu, Manjishtadivati, Arogyavardhinivati. preparations are tridoshshamak anti -inflammatory, diuretic, b healing which ultimately helps in reducing discomfort of varicose veins. Ayurvedic external treatments ?Abhyanga(Gentle massage or Daily application of medicated oils around the affected part helps to reduce pain, swelling and it improves blood circulation like Pinda oil. Sahachar oil is most effective ?Swedana (giving Patrapindasweda make blood flow s upward direction. ?Upnahaandbasti karma pacify vatadosha. Like guggulu, etc. ?Avagahan karma (Dipping Erandtailaand Dashmoolkwath ?Udvartan karma with the help Ghrita mixed cotton seeds. ?Local application of powdered form of black cumin and kampillak mixed with ?Parasurgical procedures ?Siravedhana (Venesection) engorgement of the pressure blood circulation, and preserves valve competency and elasticity of the vein walls. ?Jaloukavacharana (Leech therapy) is a blood letting therapy with the help of leech application letting therapy with the help of leech application maintains metabolic and hormonal functioning. subdoshas of Pitta, it is present in liver Raktadhatu. Ayurvedic treatments include internal herbal health supplements and external treatments procedures. and spleen and it is responsible for composition of blood and for distribution of nutrition to the cells and Ranjaka Pitta is Herbs which can be used are pure Guggulu ( Neem (Azadirachtaindica), (Bauhinia imbalanced, the blood getsimpured when associated s), thereby becoming thick and sluggish, thus contributing to ulcers in varicose veins. Primary cause of varicose veins is poor blood m mvariegata), Amalaki (Embelicaofficinalis), Nagakesar (Sidacordifolia Linn.), Shatavari (Asparagus (Puerariatuberosa DC), (Terminaliaarjuna), Daruharidra (Berberisaristata), and ( Withaniasomnifera)5. VyanaVayu) and ulcers are the secondary complication caused by impure Mandukparni ). According to Astanga Hrdayam3which who dip their feet in cold water immediately after excessive exercise causes sudden to the warm legs. As a result, Common herbal preparations which are effective in varicose veins are Triphalaguggulu, Chandraprabhavati, These (prakopawastha of constriction of warm to formation of varicose Arogyavardhinivati. tridoshshamak specially vatashamak, inflammatory, diuretic, blood purifier, wound healing which ultimately helps in reducing discomfort all ) , burning sensation (Daha) , ), tiredness (Ayasa) , Krishnaraktasira ), ) or pain in legs which gets worse treatments6: ssage or Application of oil) Daily application of medicated oils around the affected part helps to reduce pain, swelling and it improves blood circulation like Sahachar oil, oil is most effective oil. (giving spider or tortuous veins ( ankle (Padasotha), Itching steam steam blood flow smoothly in to to body) body)- At later stage Varicose ulcers are common at varicose vein and usually aren't a sign of serious with Vataghnadravya ike nirgundi, dashmool, , varicose veins can be in the deeper veins called DVT (Dipping the the legs legs in) in) Dashmoolkwath. with the help of mudga ash and seeds. Local application of powdered form of black mixed with ghee. Parasurgical procedures (Venesection) the pressure and helps in better , and preserves valve competency walls. (Leech therapy) is a blood- veins: In case of any disease first we have to avoid the causes which are responsible for the disease, called as . In varicose vein the food that lead in the body are to be salty and spicy food, dry and junk food. Prolonged standing must be avoided because it is reduces reduces local local herbs and herbal formulations, dietary @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 490
International Journal of Trend in Scientific Research and International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456 Development (IJTSRD) ISSN: 2456-6470 CONCLUSION: Once the valves are deranged it is very difficult to bring them in natural form. In contemporary medicine they have tried to treat surgically like pass etc. But the reoccurrence is not permanent. As per Ayurveda treatment it not only reduces discomfort, venous insufficiency but also help in healing of varicosity by controlling Ranjaka pitta the main cause. Henceforth treatment regimen can give more promising result for varicose veins. References: 1.Vaidya Jadavaji Trimakji 1, Nibhandhasangraha Choukhamba Surabharati Prakashan. P.311. 2.Ayurveda : A Fruitful remedy for varicose veins , A Fruitful remedy for varicose veins , on the affected part. This procedure improves blood circulation. It declines pressure on veins the surrounding areas, so that elastic recoiling of veins are maintained and over dilatation also prevented. The leech’s saliva has anticoagulant, antibacterial and anaesthetic property. antibacterial and anaesthetic property.7 procedure improves pressure on veins and Once the valves are deranged it is very difficult to bring them in natural form. In contemporary medicine they have tried to treat surgically like stripping, by reoccurrence will occur and the cure the surrounding areas, so that elastic recoiling of veins are maintained and over dilatation also prevented. The leech’s saliva has anticoagulant, Also certain yoga postures such as Sarvangaasana Navasana, Shirasasana and Pawanmuktaasana helpful in restoring normal drainage of blood from the legs. Pathogenesis according to modern9 Varicose veins mostly occur due to incompetence of their valves. It occurs commonly in those whose works demand standing for long hours e.g. conductors, drivers, policeman etc. Varicosity may also be secondary, predisposed by any obstruction which hampers venous return e.g. tumors, pregnancy, loaded colon, retroperitoneal fibrosis, ascites. Under normal conditions the blood from the superficial venous system is passed to the deep veins through the competent perforators and from deep veins the blood is pumped up to the heart by muscle pump, competent valves and negative intrathoracic pressure. vein this mechanism breaks down , either due to destruction of the valves of deep veins or of the perforators or of the superficial venous system the blood becomes stagnated in the superficial veins which become the pray of ‘high pressure leaks’ and thus becomes distended and tortuous to become varicose veins. Modern approach for varicose vein 9: Three modes of treatments available: A.Palliative treatment: Avoidance standing, use of crepe bandage or elastic stockings, limb elevation, exercise. B.Operative treatment: Ligation and stripping. C.Fegan’s injection and compression treatment. D.Endothermal Ablation, Endovenous Drawbacks of modern treatment: Stripping damages to the sural nerves, cause numbness and tingling sensation in saphenous vein stripping causes bruising and injury to sensory nerve and in post thrombotic condition more chances of reoccurrences. as Sarvangaasana, Pawanmuktaasana8etcare drainage of blood from the ment it not only reduces venous insufficiency but also help in healing of varicosity by controlling Vyanavata and the main cause. Henceforth Ayurvedic treatment regimen can give more promising result for Varicose veins mostly occur due to incompetence of their valves. It occurs commonly in those whose for long hours e.g. . Varicosity may predisposed by any obstruction Trimakji, Sushrutasamhita Part- Hindi Prakashan. P.311. commentary, which hampers venous return e.g. tumors, pregnancy, loaded colon, retroperitoneal fibrosis, ascites. Under Jaipur national Institute of available on (www.ijapc.com 3.Astanga Hrdayam ,Vidyotinihindi Commentary, Written by Kaviraja Atrideva Gupta , Published by Chaukhambha Prakashan , Varanasi. P 4.CharakSamhita ,Vidyotini Hindi Vyakha by Shastri Pt Kashi Chaukhamba Sanskrita Sansthan, Varanasi. P 5.Dr. P. V. Sharma. Dravyaguna Varanasi: ChaukhambhaBharati 54,195,783,149,537,234,758,562,738. 6.Ayurveda : A Fruitful remedy for varicose veins , : A Fruitful remedy for varicose veins , Jaipur national Institute of Ayurveda, march 2016 www.ijapc.com) p.3-4. from the superficial venous system is passed to the deep veins through the competent perforators and from deep veins the blood is pumped up to the heart by muscle pump, competent valves and negative intrathoracic pressure. In varicose breaks down , either due to destruction of the valves of deep veins or of the perforators or of the superficial venous system the blood becomes stagnated in the superficial veins the pray of ‘high pressure leaks’ and Hrdayam ,Vidyotinihindi Commentary, Atrideva Gupta , Published Prakashan , Varanasi. P-757. CharakSamhita ,Vidyotini Hindi Vyakha, Written Kashinath, Sansthan, Varanasi. P-783. Published by Sharma. Dravyaguna Vigyan: volume -2. Varanasi: ChaukhambhaBharati Academy. P- 54,195,783,149,537,234,758,562,738. tortuous to become Jaipur national Institute of available on (www.ijapc.com 7.Altman, Lawrence K. (February 17, 1981).The Doctor’s World; leeches still uses. The Newyork Times. Pg. 2. 8.Effective Asanas to treat varicose (Home page on internet )Sept. 2017.( www.stylecraze.com 2017 9.Das Somen, A Manual on Clinical Surgery, S. Publication Calcutta, 9th edition. P Jaipur national Institute of Ayurveda, march 2016 www.ijapc.com). P-6. of prolonged of crepe bandage or elastic (February 17, 1981).The leeches still have their medical Ligation and ligation with uses. The Newyork Times. Pg. 2. sanas to treat varicose (Home page on www.stylecraze.com ) Sept. Fegan’s injection and compression treatment. Endothermal Ablation, Endovenous Ablation. A Manual on Clinical Surgery, S. Das edition. P-256,259. nerves, cause limbs. Short saphenous vein stripping causes bruising and injury to sensory nerve and in post thrombotic condition more @ IJTSRD | Available Online @ www.ijtsrd.com www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018 Oct 2018 Page: 491