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Year | Clinical events and intervention |
---|---|
1998 | Onset of lower backache |
2003 | Diagnosed for ankylosing spondylitis. (HLA-B27 – positive. ESR – 55 mm/h, X-ray pelvis, and spine revealed bilateral sacroiliitis, hematological, biochemical reports were normal) |
2004 | Patient underwent for naturopathy treatment for 2 months |
2004–2008 | Patient had no major illness, was not under any medical supervision |
2009 | The condition of patient worsening, X-ray revealed osteoarthritic changes with marginal sclerosis and mildly reduced hip joint space, destruction of SI joint margins with widened SI joint spaces. He was treated with Panchakarma for 2–3 months, symptoms relieved |
2010–2014 | The patient was not under any medical supervision. He self-medicated with diclofenac sodium – 75 mg when needed |
10/3/2015 | Patient was admitted in I.P.D. for agonizing pain and severely restricted spinal movements |
10/03/2015–12/03/2015 | Castor oil was given at night for mild purgation |
12/03/15 | Hematological investigations were done (Hb – 11.6 g%, TLC – 6700th/μl, ESR – 75 mm/h and CRP-was positive) |
13/03/2015–11/04/2015 | Shalishastic Pind Svedan and Mustadi Yapana Basti alternated with Anuvasana of Ashavagandha oil along with Ayurvedic oral drugs such as Rasrajras, Triyodashang Guggulu, Asvagandha curna, Eranda mool curna and Chausath Prahari Pippali curna. Ayurvedic oral medication is continued to till date |
08/04/2015 | Hematological parameters were reinvestigated (Hb – 11.3 g%, ESR – 45 mm/h) |
13/04/2015 | Patient was discharged from I.P.D. (BASDAI – 4.9, BASFI – 6.1, BASMI – 6.5) |
13/04/2015–12/05/2015 | Pratimarshya nasya was given in dose of 2 drops/nostril twice in a day along with Ayurvedic oral drugs |
16/05/2015 | Hematological investigations were repeated, and assessment for clinical improvement was done (Hb – 13.0% and ESR 20 mm/h, BASDAI – 3.5, BASFI – 4.8, BASMI – 5.4) |
September-2015 | Patient condition is stable with slight improvement in pain and spinal mobility (BASDAI –3.8, BASFI – 4.3, and BASMI – 5.1) |
Intervention | Details of intervention | Dose | Anupana | Treatment duration |
---|---|---|---|---|
Oral medication | ||||
Rasrajrasa | Rasasindura, Au, Ag, Abhraka, Vanga, Lauha, Hg, S | 100 mg twice a day | Honey | 2 months |
Ashvagandha churna | 3 g twice a day | Milk | 2 months | |
Eranda moola churna | 2 g twice a day | Milk | 2 months | |
Chausatha Prahari Pippali churna | 500 mg twice a day | Honey | 2 months | |
Triyodashanga Guggulu | 1 g twice a day | 2 months | ||
Panchakarma procedures | Method of preparation | Method of administration | Treatment duration | |
Shalishastika Pinda Svedana | A bolus of rice boiled in milk and Bala Kwatha | Massage with Ashwagandha oil was done on the whole body for 15 min followed by whole body massage for 45 min with the help of a cotton bag filled with bolus of processed rice | 1 month | |
Ashwagandha oil Anuvasana Basti | 75 ml of oil mixed with rock salt | Given after meal with Basti Yantra | Total 18 Basti in Karma Basti manner | |
Mustadi Yapana Basti | Saindhava salt 5 g, honey 25 g, Ashwagandha oil 50 ml, Panchatikta Ghrita 25 ml and milk processed with Mustadi Yapana Basti, Kwath drugs 300 ml and soup of goat femur bone marrow 50 ml | Given with Basti Yantra before meal | Total 12 Basti in Karma Basti manner | |
Pratimarsha Nasya with Anu Taila | 1 month after completion of Basti procedure |
Domain | Instrument | BT | AT | Percentage relief |
---|---|---|---|---|
Function | BASFI | 9.4 | 4.8 | 48.9 |
Pain | NRS | 10 | 3 | 70 |
Spinal mobility | BASMI | 8.7 | 5.4 | 37.94 |
Patient global | NRS | 9 | 3 | 66.67 |
Affected peripheral joints | Peripheral joint count | 14 | 0 | |
Enthesitis | MASES | 9 | 3 | |
Stiffness | NRS | 10 | 4 | 60 |
Acute phase reactants | ESR | 75 mm/h | 20 mm/h | 73.33 |
Fatigue | BASDAI | 8.7 | 3.5 | 59.77 |