Management of Idiopathic Thrombocytopenia With Ayurvedic Modalities - Case Study

Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Management of Idiopathic Thrombocytopenia with

Ayurvedic Modalities- Case Study
1st Author 2nd Author
1)Dr. Nandadeep Vijay Chodankar Dr. RajeshKumar Mishra
Assistant Professor in Kayachikitsa At RJVS BSAM, Associate Professor in RJVS BSAM, Sawantwadi
Sawantwadi
3rd Author 4th Author

Muskan Rahim Shaikh Harshadip Kondiram Survase
Intern Doctor at R.J.V.S. Hospital Sawantwadi. Intern Doctor at R.J.V.S. Hospital Sawantwadi.
Abstract:- Ayurveda has developed a lot from the clinical The theories regarding Rakta Dhatu formation appears to
observation over several centuries and medicine was tried have changes from time to time as is evident from studies of
directly on human. The ultimate aim of any researcher of Ayurvedic classics. In Charaka Samhita, it is clearly
medical science is appropriate management of particular mentioned that Rakta is formed by the Ushma of Pitta which
disease and promoting healthy living. The clinical renders the Rasa into a coloured state.
therapeutically trials are of paramount importance in the
context of ayurveda. Stithi-Utapatti-Laya is the basic and शोणितस्यस्थानं यकृतप्लिहानौ । सु.सु. 21/160
fundamental laws of universe. In series of these changes,
newer diseases stand in front of all of us. Almighty, though Sushruta wrote the Rakta is formed in Yakrita and
about challenging changes as painful as Idiopathic Pleeha with the help of Ranjakagni.4 Another reference of
Thrombocytopenia towards the whole word.Population site of Rakta formation is available in Sushruta Sharir 4/135
based studies have shown that ITP has incidence of
upto6K per 100000 children and 3.3 per 100000 adults per स्थुलाप्लस्थषुणिशेषेनमज्जात्वभ्यत्नराणित:।
year.1 It is heamatogenic disease without a clinically अथेतरे षुसिेषुसरक्तमंमेदउच्यते ।।
apparent cause. In ITP there may be severe bleeding due
to thrombocytopenia, considering side effect of steroid
This shows that there is some relation of Rakta with the
and complications in platelet transfusion, we adviced Majja part of the bones also.
Shaman line of management with Ajaraktbasti which
proves to be best to conquer platelet count of patients and
Acharya Sushruta has described that inside the spaces
improved health and quality of life.
of long bones the Majja is present, but in short bone
Saraktayameda is present. In adult life fat is stored inside the
Keywords:- Idiopathic Thrombocytopenia, Tiryagatraktpitta,
space of long bones named as Majja and from modern view
Ajaraktabasti, Shaman Aushadhi.
it is called yellow bone marrow. Inside the short bone
Saraktameda is present proving that when the network of
I. INTRODUCTION
blood capillaries is abundant, it is named as red bone marrow.
According to the modern physiology, bone marrow is
Autoimmune thrombocytopenia, also known as
considered the main site for formation of platelet, considering
idiopathic thrombocytopenia purpura (ITP) or werlhof's
platelets as components of blood and comparing blood to
disease, is an autoimmune mediated disorder distinguished by
Rakta dhatu because of its formation from all above
a temporary or continuous decline of platelet count to less
references. Acharya mentioned that Rakta is origin of body,
than 100,000 /uL. When it occurs for less than 12 months but
maintains its vitality and life and should be preserved with
more than 3 months and is termed as persistent ITP. Chronic
greatest care. Its special property that it gives Prana to body
ITP is explained as existence of ITP for more than 12 months
seems to be holding whole importance. Acharya Charaka as
but more than 3 months and is termed as persistent ITP. 2
mentioned that Rakta is site of Prana among the 10
Population based studies have shown that ITP has incidence
Pranaaytans.
of up to 6.4 per 100000 children and 3.3 per 100000 adults
per year3It is heamatogenic disorder, characterised by isolated
So ITP can be correlated with “Tiryagatraktapitta” due
thrombocytopenia without a clinically apparent cause.
its cardinal feature of petechia perpura. Vaghbhatta
Platelets or thrombocytes are small, colourless cell fragment
mentioned 6
in our blood that form clots and stop or prevent bleeding.
Platelets are made in our bone marrow, the sponge like tissue
inside our bones. Bone marrow contains stem cells that उर्ध्वनासाणिकिावस्येमेड्रयोणनगुदेरध:।
develop into red blood cell, white blood cell and platelets.3 कुपीतरोमकुपैिचसमस्तेस्तइप्रितवते ।। िा.णन.3/7
IJISRT23JAN942 www.ijisrt.com 1313

ISSN No:-2456-2165
According to the modern science treatment for ITP with  History Of Past Medicine
severe platelets drop is platelets transfusion. Maharshi  Tab omnacortil 10mg OD for 1month ( Prednisolone)
Charaka as mentioned Raktabasti treatment in severe blood  Inj mepresso 1gm IV OD for 10 days ( methyl
loss 7 prednisolone)
Tab Fol 5mg BD for 3 months (Folic acid)
णपबेतज्जीिाभीसंधानं जीिंताधाशुगछत्ती ।  Tab vozet 5mg HS (Levocetrizine)
तदै िदभव मृदीतंरक्तबस्तीप्रदापयेत ।। च.णच.6/83
 Personal History
Oral use of Ajaraktabasti is not practical, patient find it  General condition –good
uncomfortable, Basti is very effective treatment in Ayurveda.  Agni – vishamaagni
Practically it is acceptable because of anorectal route of  Mala/ bowel habbit- prakrut
Ajarakta doesn’t mixed with human body directly so it is free  Mutra/ bladder habbit – prakrut
of risk and complications so we decided to give Ajaraktabasti  Temperature- Afebrile
to the patient of Idiopathic thrombocytopenia.  Blood pressure- 110/70 mm of hg
 Pulse rate - 80/min
II. MATERIAL & METHODS
 Systemic Examination
A known case of ITP was taken from OPD, detail  RS –AEBE clear
history of the patient was taken. Complete examination &  CVS - S1 S2 normal
Investigation was done. Ayurvedic treatment was given along
 CNS – NAD
with panchkarma therapy.
 P/A – No splenomegaly, no hepatomegaly
Take fresh AjaRakta and add Madhu to it, add 1/2 tsp of
 Local Examination
Guduchi & Amalki to collect Ajarakta, by using special blood
transfusion set & rubber catheter of size of No.10, administer  Patch
Raktabasti to the patient.
III. CASE HISTORY
A 22 year old male patient, Presented to the OPD of

kaychikitsa department in RJVS Hospital Sawantwadi
complaining of subcutaneous haemorrhage, recurrent
ecchymosis, weakness. with the H/O Fever & decreased
platelet count. His Bone marrow report showed Normo
cellular trilineage hematopoiesis with monocytes,
megakaryocytes - adequate &hediagnosed with ITP. Before
attending the opd of RJVS, he consulted to haematologist and
was taking steriod for 1 year, which was showing only
symptomatic effect Patient was not wiling to take steroid and
visited this hospital for further Ayurvedic treatment. Fig 1:- Patch
 History of Past Illness :-  Purpura

 Fever with chills and decreased platelet count since 1 yr. Red or Brown spot on skin appeared on right forearm
ago just below cubital fossa
 Febrile convulsions – 4-5th years of age  Size-4cm
 No blanching
 Family History :-  Colour- red, purple on lighter skin.
No any family history was present regarding ITP  Non palpable.
 Marital History : – No consanguineous marriage  Investigation
●CBC :-
 History of Blood Transfusion
Received 4 points of platelets at parulekar hospital, DATE HB TLC PLATELETES
kolhapur on 1/08/2020 07/10/2019 11.0gm% 2300 28000 /mcl
cells/mm3
 Chief Complaints :-
08/10/2019 11.0 gm% 2500 14000 /mcl
 Subcutanous haemorrhage (purpura) recurrent cells/mm3
ecchymosis 13/10/2019 14.0 gm% 2800 6000 /mcl
 Weakness cells/mm3
Table 1:- CBC

ISSN No:-2456-2165
●Bone Marrow Study :-
Site- Posterior superior iliac spine myelogram.  Collection Of AJA Rakta:-
Result- Normo cellular marrow with trilineage hematopoesis Aja Rakta was collected from slaughter house of
with monocytosis Sawantwadi. No specific blood collection method is
-megakaryotes adequate described in Ayurveda. So we collected blood after physical
-Lymphocytes mature and have normal morphology. check up blood was mixed at time of collection with Madhu.
Blood was free from HIV antigen.
●Coagulation test show :- Normal results
●Serum ferritin:- 206.0 ng/ml.  Rakta Basti Procedure :-
In the collected blood Guduchi ½ tsp and Amalki ½ tsp
IV. DIAGNOSIS were added. Aja Rakta was filled up in well sterilised glass
bottle. A special blood transfusion set made from suction tube
By taking complete medical history and performed a was attached with the bottle. End of the set was attached with
physical examination all investigations were excluded with a catheter of no.10 size. Patient with prior Shuddhi with
careful review of past medication done. Showing no possible Avipattikar churn 1 tsp HS given 1 day before administration
cause of bleeding (purpura) and a low platelet count. A of Raktabasti.
diagnosis of idiopathic thrombocytopenic Purpura was
reached based on clinical, bone marrow examination and ●Posture :- Patient advice to lay down in left lateral posture.
other investigation findings of patient. Total 100 ml blood was administered. After Basti Patient was
advised to lay down in same posture for 10 minutes. Basti
 Treatment:- Was administered weekly once for four weeks. Along with
In various blood loss conditions like Raktapitta, this Shaman line of management given.
Raktatisar, pandu and jivadan 0.rakta is only treatment.
Maharshi charka also explained that Rakta is giving bal,  Shaman Chikitsa :-
varna, Ayush, Sukh etc (Ch.su.24/4). The therapeutic use of
different type of animal blood like Mrug, Gov, Mahish and Formulation Dose Time Duratio Anupan
Aja are described in Charaka Samhita Siddhi Sthana chapter n
6/82,83 7 Vasaguduchyad 3 tsf BD 2 months Koshnaja
i kashay l
Here, we used Aja Rakta (Goat blood). Goat is healthiest Dadimadi ghrut 2 tsf BD 4 months -
animal on earth. No other infections or viruses are detected in Sarivadyasav 2 tsf BD 4 months koshnajal
the goat blood. So it is very safe for using human body. Goat Raktpachak vati 2 tab TDS 2 months Jal
blood is also available freely and in required quantity from Mauktik pishti 1 tab TDS 2 months -
slaughter house. Table 2:- Shaman Chikitsa
 Selection Of Drug And Dosages  Pathya – Apathya :-
It is very important that drug dose and method of Patient where advice to take Laghu -Ushna Ahar and
administration must acceptable and convenient. Those avoided to take Paryushit Ahar. Avoiding Ras which causes
should be harmless and should not produce any complication. Raktadushti.
For this we decided to use goat blood in 100 ml dose by
anorectal route. Basti harmless and painless procedure.
V. OBSERVATION AND RESULT
Raktabasti Date Basti Basti Basti Platelet Before Platelet After

Deyak Nirgaman Dharan Administration of Administration of Basti
Kaal Kaal Kaal Basti
1st 28/11/2020 10:45am 11:10am 45 min 23000 cells/mm3 29000 cells/mm3
(03/12/2020)
2nd 08/12/2022 09:50am 10:20am 30 min 16000 cells/mm3 52000 cells/mm3
(11/12/2022)
3rd 14/12/2020 09:55am 10:30am 35 min 24000 cells/mm3 32000cells/mm3
(18/12/2022)
Within 3 AjaRakta Basti Platelet count increased as VI. DISCUSSION

compared to Platelet count before administration of
Raktabasti but it was observed that platelet count drops after सिवदासिवभािनासामान्यत्विृद्धीकारिम् |च. सु. 9/44 8
some days which eventually got within normal range after 4th
Aja Raktabasti & with oral administration of medicine. Ayurveda Acharyas said that dhatu loss should be
replaced by same dhatus.Raktakshay means blood loss should
be replaced by blood. Basti is a safe painless procedure with

ISSN No:-2456-2165
scientific value. Pitta dosha & Rakta dhatu have ashryaashri
relation so considering dusti of raktadhatu we have given
pitta shaman chikitsa.
 Vasaguduchyadi kashay - main content are vasa &

Guduchi having tiktarasa 9 and guduchi having madhur
Vipak which helps in Raktaprasadhon. guduchi acts on
pitta dhatu by doing shodhan of Ras raktgat vimargit pitta
because of its tiktaras gaduchi is best to cause astringent
effect useful in rakapitta (bleeding disorder)
 Raktapachak gan are mention as vishamjwaraghna & also
called dhatupachak gan, by using dhatupachak help in
pacifing Dosha improves quality of dhatuutpati
(formation) 10
 Sarivadysav -helps in Raktaprasadan reduces Raktas
tikshan, ushan gun pacifies vikrut pittadosha
 4.MuktiPisti helps in Raktaprasadan. Madhur rasatmak
Shitvirya & madhur vipak, helps to reduces Ushanata,
trivrata, amalta of pitta.
VII. CONCLUSION
Ayurveda has potential to treat cases in its own to way.

Raktobasti has been subjected. On patient suffering from ITP.
Ajaraktabasti is useful in idiopathic thrombocytopenia, as
basti is painless and non-invasive procedure as compared
toblood transfusion. In patient with thrombocytopenia while
doing BT, prick also causes severe bleeding so giving Basti
is best treatment.
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[1]. Terrell DR, Beebe LA, VeselySk, Neas BR, SegalJB,

George JN. The incidence of immune thrombocytopenic
purpura in children and adults: a critical review of
published reports. Am I Hematol. 2010;85:174-80.
[2]. API Text book of Medicine Volume I, Editors-
Y.P.Munjal 12/E, 2022 edition.
[3]. https://www.red cross blood.org
[4]. Acharya Sushruta, Sushruta Samhita; Ayurveda - Tattva
- Sandipika Hindi commentary Edited by Kaviraja
Ambikadutta Shastri; Chaukhambha Sanskrit Sansthan,
Varanasi Edition: Reprint, Sutra Sthana, Chapter-21,
2020;117.
[5]. Acharya Sushruta, Sushruta Samhita; Ayurveda Tattva-
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Ambikadutta shastri; chaukhambha Sankrit Sansthan,
Edition, Reprint, sharira shtana, Varanasi, chapter-4.
[6]. Acharya Vagbhata, Asthang Hridaya; Sarth Vagbhata;
Marathi commentary; Edited by Ganesh Garde; Edition,
Reprint, Nidanshtana, chapter - 3; 171
[7]. Vijay Kale, charka, sidhi Sthana– 6Shloka No 83, 2016,
Page No-9/2
[8]. Vijay kale, charka, Sutra Sthana - 1 Shloka No-45,
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[9]. Sahastrayogam, Dr.Ramnivas Sharma, Dr. Surendra
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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology

Management of Idiopathic Thrombocytopenia with

3rd Author 4th Author

IJISRT23JAN942 www.ijisrt.com 1313

III. CASE HISTORY

A 22 year old male patient, Presented to the OPD of

 History of Past Illness :-  Purpura

IJISRT23JAN942 www.ijisrt.com 1314

V. OBSERVATION AND RESULT

Raktabasti Date Basti Basti Basti Platelet Before Platelet After

Within 3 AjaRakta Basti Platelet count increased as VI. DISCUSSION

IJISRT23JAN942 www.ijisrt.com 1315

 Vasaguduchyadi kashay - main content are vasa &

Ayurveda has potential to treat cases in its own to way.

[1]. Terrell DR, Beebe LA, VeselySk, Neas BR, SegalJB,

IJISRT23JAN942 www.ijisrt.com 1316

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