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A CLINICAL EVALUATION OF RAKTA MOKSHANA IN THE MANAGEMENT OF SANDHIGATA VATA WSR TO LUMBAR
SPONDYLOSISrdquo
DRFORAM JOSHIFinal Year MS (AYU SCHOLAR)
DEPARTMENT OF SHALYA TANTRAINSTITUTE FOR POST GRADUATE TEACHING amp RESEARCH IN AYURVEDA
GUJARAT AYURVEDA UNIVERSITY JAMNAGAR 1
Sandhigata Vata is an articular disorder mentioned under
Vatavyadhi mainly occurs in Vriddhavastha (elderly people) due to
Dhatukshaya
Kaphavrita Vyana Vayu also plays important role for its
manifestation by obstructing the circulation of Rasa amp Rakta Dhatu
Katishula Katistambha Akunchana Prasarana Pravruttischa
Savedna are the cardinal features of Sandhigata Vata
INTRODUCTION
Agnivesha krita Charaka Samhita editor Shastri KN edition reprint 2012 published by Chauhamba Bharti Acadamy Varanasi Chikitsa
Sthana Vatavyadhi chikitsa 28 228 p 811
Lumbar spondylosis is a degenerative
disorder characterized by insidious onset of
pain stiffness etc in low back with restricted
joint movements
This condition is correlated with
Sandhigata Vata due to its clinical
menifestation amp pathophysiology where
structural as well as functional changes are
manifested
Now a days Patients of lumbar spondylosis are bound to choose
analgesics anti-inflammatory drugs physiotherapy amp spinal
surgeries as treatment to improve the quality of life
These procedures are not fulfilling the goal of patients because of
very high cost adverse effects and their therapeutic limitations
Raktamokshana is a non-pharmacological and result oriented
therapy recommended in Ayurveda to manage painful conditions
Keeping this view the study had been planned to evaluate the
efficacy of Raktamokshana in the management of Sandhigata Vata
(Lumbar spondylosis)
JUSTIFICATION FOR SELECTION RAKTAMOKSHANA
SnavsiN2israpaPte Snehdahopnahnm |
tElm sNkuicteDWyDge maxsEgt2vsai2tm ||
Aagar2UmlvnteElleRp sltteAsltij |
suPteyene ve3 yuKte tu ktRVymupnahnm || (AHChi1222-23)
Raktamokshana has been recommended for the treatment of
Snayu Sandhigata Vata and for Vednashamanartha (acute
inflammatory conditions)
Shringa Yantra is specially recommended to let out the Vata
Dosha vitiated blood present in Twaka level or deeper to the Twaka
5
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
Sandhigata Vata is an articular disorder mentioned under
Vatavyadhi mainly occurs in Vriddhavastha (elderly people) due to
Dhatukshaya
Kaphavrita Vyana Vayu also plays important role for its
manifestation by obstructing the circulation of Rasa amp Rakta Dhatu
Katishula Katistambha Akunchana Prasarana Pravruttischa
Savedna are the cardinal features of Sandhigata Vata
INTRODUCTION
Agnivesha krita Charaka Samhita editor Shastri KN edition reprint 2012 published by Chauhamba Bharti Acadamy Varanasi Chikitsa
Sthana Vatavyadhi chikitsa 28 228 p 811
Lumbar spondylosis is a degenerative
disorder characterized by insidious onset of
pain stiffness etc in low back with restricted
joint movements
This condition is correlated with
Sandhigata Vata due to its clinical
menifestation amp pathophysiology where
structural as well as functional changes are
manifested
Now a days Patients of lumbar spondylosis are bound to choose
analgesics anti-inflammatory drugs physiotherapy amp spinal
surgeries as treatment to improve the quality of life
These procedures are not fulfilling the goal of patients because of
very high cost adverse effects and their therapeutic limitations
Raktamokshana is a non-pharmacological and result oriented
therapy recommended in Ayurveda to manage painful conditions
Keeping this view the study had been planned to evaluate the
efficacy of Raktamokshana in the management of Sandhigata Vata
(Lumbar spondylosis)
JUSTIFICATION FOR SELECTION RAKTAMOKSHANA
SnavsiN2israpaPte Snehdahopnahnm |
tElm sNkuicteDWyDge maxsEgt2vsai2tm ||
Aagar2UmlvnteElleRp sltteAsltij |
suPteyene ve3 yuKte tu ktRVymupnahnm || (AHChi1222-23)
Raktamokshana has been recommended for the treatment of
Snayu Sandhigata Vata and for Vednashamanartha (acute
inflammatory conditions)
Shringa Yantra is specially recommended to let out the Vata
Dosha vitiated blood present in Twaka level or deeper to the Twaka
5
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
Lumbar spondylosis is a degenerative
disorder characterized by insidious onset of
pain stiffness etc in low back with restricted
joint movements
This condition is correlated with
Sandhigata Vata due to its clinical
menifestation amp pathophysiology where
structural as well as functional changes are
manifested
Now a days Patients of lumbar spondylosis are bound to choose
analgesics anti-inflammatory drugs physiotherapy amp spinal
surgeries as treatment to improve the quality of life
These procedures are not fulfilling the goal of patients because of
very high cost adverse effects and their therapeutic limitations
Raktamokshana is a non-pharmacological and result oriented
therapy recommended in Ayurveda to manage painful conditions
Keeping this view the study had been planned to evaluate the
efficacy of Raktamokshana in the management of Sandhigata Vata
(Lumbar spondylosis)
JUSTIFICATION FOR SELECTION RAKTAMOKSHANA
SnavsiN2israpaPte Snehdahopnahnm |
tElm sNkuicteDWyDge maxsEgt2vsai2tm ||
Aagar2UmlvnteElleRp sltteAsltij |
suPteyene ve3 yuKte tu ktRVymupnahnm || (AHChi1222-23)
Raktamokshana has been recommended for the treatment of
Snayu Sandhigata Vata and for Vednashamanartha (acute
inflammatory conditions)
Shringa Yantra is specially recommended to let out the Vata
Dosha vitiated blood present in Twaka level or deeper to the Twaka
5
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
Now a days Patients of lumbar spondylosis are bound to choose
analgesics anti-inflammatory drugs physiotherapy amp spinal
surgeries as treatment to improve the quality of life
These procedures are not fulfilling the goal of patients because of
very high cost adverse effects and their therapeutic limitations
Raktamokshana is a non-pharmacological and result oriented
therapy recommended in Ayurveda to manage painful conditions
Keeping this view the study had been planned to evaluate the
efficacy of Raktamokshana in the management of Sandhigata Vata
(Lumbar spondylosis)
JUSTIFICATION FOR SELECTION RAKTAMOKSHANA
SnavsiN2israpaPte Snehdahopnahnm |
tElm sNkuicteDWyDge maxsEgt2vsai2tm ||
Aagar2UmlvnteElleRp sltteAsltij |
suPteyene ve3 yuKte tu ktRVymupnahnm || (AHChi1222-23)
Raktamokshana has been recommended for the treatment of
Snayu Sandhigata Vata and for Vednashamanartha (acute
inflammatory conditions)
Shringa Yantra is specially recommended to let out the Vata
Dosha vitiated blood present in Twaka level or deeper to the Twaka
5
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
JUSTIFICATION FOR SELECTION RAKTAMOKSHANA
SnavsiN2israpaPte Snehdahopnahnm |
tElm sNkuicteDWyDge maxsEgt2vsai2tm ||
Aagar2UmlvnteElleRp sltteAsltij |
suPteyene ve3 yuKte tu ktRVymupnahnm || (AHChi1222-23)
Raktamokshana has been recommended for the treatment of
Snayu Sandhigata Vata and for Vednashamanartha (acute
inflammatory conditions)
Shringa Yantra is specially recommended to let out the Vata
Dosha vitiated blood present in Twaka level or deeper to the Twaka
5
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
SHRINGAVACHARANA
Many Modified Shringa Yantras (MSYs) are
available in the market for purpose Raktamokshana
worldwide
The principles for application MSYs is also parallel
to ancient Shringa Yantra
So in this study Modified Shringa Yantra has been
selected for the purpose of Raktamokshana
6
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
MATERIAL amp METHODS
Modified Shringa Yantra
Disposable Sterile Needle No24
Kidney Trey
Madhu (Honey)
Tila Taila (Sessamum Oil)
Moist heat
bull Intervantion-ShringaAvacharna
bull Site ndash Lumbar Spine
bull Sitting ndash 2 sittings On 15 Days Interval
bull Follow Up Period- 1 Month
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
8
INCLUSION CRITERIA
1Patients suffering from
Sandhigata Vata (lumbar
Spondylosis)
2 Age group 40-70 years from
both of sex
EXCLUSION CRITERIA
1 Age below 40 years and above 70 years
2 Patients of uncontrolled Diabetes Mellitus
3 Other diseases psoriasis tuberculosis rheumatoid artheritisSevere Anemia Malignancy4 Pregnancy
Total 16 diagnosed cases of Sandhigata Vata were registered for the Study
from the OPD amp IPD of Shalyatantra department IPGT amp RA Jamnagar
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
9
RAKTAMOKSHANA PROCEDURE
PURVA KARMA
bull Informed written consent was taken
bull Mudga Yusha Paan
bull Local Snehana Swedana
bull Preparation of local part
bull Preparation of instruments and
equipments
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
10
PRADHAN KARMA
bull Site demarcation was done with application
of MSY
bull After proper vasodilatation all MSY were
removed
bull Pricking of skin was done in demarcated
area with help of disposable needleno24
bull Re-application of Modified Shringa Yantras
were done upto complete stoppage of
oozing
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
11
PASCHAT KARMA
bull Aseptic dressing with Haridra dusting was
done amp Madhu and Jal paan were given just
after the procedure
bull Placebo capsules were given in 1 bid dose
after meal with luke warm water during
interval period
bull Patients were advised to avoid
Vatavridhdhikara Ahara and Vihara during
treatment and follow up period
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
CRITERIA FOR ASSESSMENT
OBJECTIVE CRITERIA
bullKatishula
bullKati Stambha
bullKati Suptata
bullAkunchan Prasarne
Pravrutti Savedana
bullRange of movement
bullX ray of lumbar spine(KAL scale)
bullODI scale
bullVA scale
bull Schoberrsquos test
bull SLR Testbull Lassguersquos Sign
SUBJECTIVE CRITERIA
Assessment was done every week on the basis of
subjective and objective criteria for assessment in
specially prepared Performa
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
Routine hematological(Hb TLCDLC ESR) amp FBS
Urine routine amp microscopic examination
Serum calcium amp Ra Qualitative Test
X-ray Lumbo sacral spine AP amp Lateral view
13
INVESTIGATIONS BT ampAT
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
CHIEF COMPLAINTS
100
6250
2813
9688
0
20
40
60
80
100
120
KATISHULA KATI STAMBHA KATI SUPTATA AKUNCHANA PRASARAN PRAVRUTTI SAVEDANA
14
OBSERVATIOS ampRESULTS
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
PERSONAL HISTORY
75
5313
3125
1875
3438
0
10
20
30
40
50
60
70
80
18
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
5313 patients are having irregular sleep (Khandit
Alpa Anindra ) which might have provoked Vata Dosha
and played important role for Dhatu Kshaya
Moreover the emotional disturbances also hamper the
normal sleep and initiate attack of low back pain and
spinal stiffness as per some psychologist
19
DISCUSSION ON PERSONAL HISTORY
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
20
3125 patients were having tobacco addiction where as 1875 patients
were alcohol addicted Due to Ruksha amp Vyavayi Guna Vata Dosha would have
been provoked and might have caused LS ultimately
3438 female were attained menopause Lack of female hormone
(oestrogen) in this period plays important role in calcium binding capacity of
bones This condition can be correlated with Dhatu Kshaya and Vayu Prakop
which might have lead to Sandhigata Vata
Clinical study on Sandhigata Vata wsr to Osteoarthritis and its management by Panchatikta Ghrita Guggulu
Babul Akhtar et al Ayu 2010 Jan-Mar 31(1) 53ndash57
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
25
8750
5938
25
9063
756563
5625
0102030405060708090
100
21
AGGRAVATING FACTORS
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
875 patients were having aggravation of symptoms due to seasonal
changes As it is obvious that in cold weather due to increase of Shita Rukhadi
Guna in atmosphere hamper the Dhatu Poshana and due to Adana Kala
patients feel Balakshaya and unable to bear Vedana
9063 patients have observed aggravated symptoms due to continuous
standing positions for long time 7500 patients aggravated pain due to
walking for long time and 6563 patients aggravated pain due to weight
lifting which are self explanatory
22
DISCUSSION ON AGGRAVATING
FACTORS
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
EFFECT ON SUBJECTIVE PARAMETERS
5405
652260
4643
KATI SHULA KATI STAMBHA KATI SUPTATA AP SAVEDANA
RAKTAMOKSHANA
23
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
16 Katishula 231 106 54054 0774 0196 6455 lt0001
HS
16 Katistambha 23 08 65217 0707 02236 67082 0002 S
16 Katisuptata 167 0670 60 0721 02120 65200 0031 S
16 Akunchana
prasarane
pravrutti
Savedana
175 0937 46429 075 01875 433 0002 S
EFFECT OF RAKTAMOKSHANA ON
SUBJECTIVE PARAMETERS
24
Wilcoxon Signed Rank Test
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
EFFECT OF THERAPY ON OBJECTIVE PARAMETERS
6150
50
90
50 47505555
75
4722
FORWARD FLEXION
LATERAL FLEXION
EXTENSION VAS SLR LASEGUE ODI SCHOBERS TEST
FORWARD FLEXION LATERAL FLEXION EXTENSION
VAS SLR LASEGUE
ODI SCHOBERS TEST
25
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
15 Flexion 173 067 6153 0457 011 9252 lt0001 HS
2 Rt L Flexion 2 1 50 045 - - 05 NS
2 Lt L Flextion 1 05 50 - - - 05 NS
9 Extension 111 0111 90 05 0167 6 0008 S
16 VAS 2 1 50 0365 009 1095 lt0001 HS
16 SLR 25 13125 475 0655 0165 725 lt0001 HS
16 Lasseguersquos
Sign
056 025 5555 0602 015 2074 lt0001 HS
16 ODI 125 03125 75 057 0143 653 lt0001 HS
16 Schoberrsquos test 225 118 4722 0771 0193 5505 0001 HS
EFFECT OF RAKTAMOKSHANA ON OBJECTIVE
PARAMETERS
26
Wilcoxon Signed Rank Test
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
OVERALL EFFECT OF THERAPY
0
25
75
0
MILD(21-40) MODERATE (41-60) Marked (61-80) complete Remission (81-100)
RAKTAMOKSHANA
27
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
28
BY APPLYING MSY
Dhatu Kshaya
Janya Samprapti
Marga Avarana
Janya Samprapti
Removes Vata
vitiated blood
Establishes Proper Rasa
Rakta Samvahana amp
regulates the function of
Prakrut Vata ndash ie
Gati Vibhajana Etc
Removes Avarana of
Shleshma over Vyana
Vayu
Improves Rasa Rakta
Samvahana amp Poshana Krama
Reduces Shotha
Janya Samprapti
PROBABLE MODE
OF ACTION OF
RAKTAMOKSHANA
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
29
BLOOD LETTING THERAPY
Normal body tissues under constant positive pressure and opposite to
atmospheric pressure
Inflammatory changes can cause collection of interstitial fluid at the site of tissue damage
Which Increases pressure on the
tissue walls
By application of cups
Establishment of negative pressure amp
suction
Which lead toVasodilatation amp
improvement of local blood circulation
Process of blood letting
Releases amp eliminates toxins amp
inflammatory agents amp
Decreases the tissue pressure
Ultimately Normal blood
flow is established
Viability of normal tissue
and proper nourishment of
tissues is achieved
Finally Localised pain
Is relieved
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
30
CONCLUSION
Sandhigata Vata is a Vata Vikara which is Kashtasadhya in nature and it
can be correlated with lumbar spondylosis
Raktamokshana is an office procedure amp practically it gives good results
specially in Marga- Avarana Janya Samprapti with potential effects
No adverse effect was observed in this study
31THANK YOUALL
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