Effectiveness of Ayurvedic Basti Chikitsa in the Management of Prameha Poorvaroopavastha with special reference to Prediabetes

Abstract

Prameha is a Santarpanottha vyadhi i.e., disease caused due to abnormal increase in body tissues. Various factors which vitiate Kapha dosha like Avyayama (sedentary lifestyle), Consuming Guru (heavy), Snigdha (unctuous), Madhura (sweet) food, Atinidra (excessive sleep) are responsible for causing Prameha. In Prameha, the Dravata (fluidity), Abaddhata (flaccidity) of Kapha Dosha and Dhatus abnormally increases and the patient passes large amount of turbid urine. Ayurvedic classics have described symptoms of Prameha poorvaroopavastha or prodromal stage of Prameha. Prameha is a broad Ayurvedic concept that includes a condition comparable to Diabetes Mellitus.  Diabetes mellitus is a metabolic non communicable disease with rising prevalence. It is associated with significant complications affecting vital organs. Prediabetes is the prodromal stage of diabetes. Most people with Prediabetes develop diabetes in future. Hence it is important to diagnose patients at prediabetic stage and treat them. The Poorvaroopavastha of Prameha can be compared to Prediabetic condition for the purpose of effective diagnosis and treatment. In this study, initially the symptoms of Prameha poorvaroopavastha such as Atisweda (excessive sweating), were used to categorize patients as prediabetic. Prediabetic blood sugar levels were further confirmed by means of laboratory investigation. 5 patients fulfilling these criteria were allotted for the study. A Kala Basti krama (15-day medicated enema treatment) with Rasnadi niruha and Anuvasana Basti was given to the patients.  During this period no internal medication was given. Marked improvement was observed in subjective criteria (reduction in grades of Prameha poorvaroopa symptoms) and objective criteria (reduction in fasting and post prandial blood sugar levels). A maximum of 21.4% reduction in fasting blood sugar level and 22.7% reduction in post prandial blood sugar levels has been observed following the treatment. The drugs used in Basti get absorbed via colonic mucosa and enter circulation through large intestine vasculature. Tikta, Katu (bitter, pungent) drugs used in this Basti caused reduction in Kapha, absorption of Kleda and helped treat the pathogenesis of Prameha.