Treatment of Immune Thrombocytopenic Purpura in Ayurveda

Abstract

Immune Thrombocytopenic purpura (ITP) is characterized by low platelets level. It is an auto-immune disease where the immune system destroys the platelets which are necessary for the normal clotting of blood. Platelets are the smallest compound of the blood which controls the process of bleeding and these cluster together to form a clot and prevent the site of injury from bleeding. These are the components which are present in blood and the spleen, which get pushed to the walls of vessels which allow plasma to flow through the centre and help the platelets to reach the site of injury quickly and prevent bleeding. They are small, colourless fragments of cells and sometimes resemble the legs of a spider. Some protein is found on the walls of platelets that adhere to the walls. The largest cells in the bone marrow are megakaryocytes which make platelets; a single drop of blood contains ten thousand platelets. In this article, we are going to discuss the Ayurvedic treatment of ITP with its causes and symptoms in detail.

Introduction

Immune Thrombocytopenic purpura (ITP) is autoimmune and is characterised by low levels of platelets and purpura and there are various hemorrhagic episodes which are caused by anti-platelet autoantibodies. ITP is a common blood disorder which is seen in both children and Adults. Thrombocytopenia means a Decrease in the number of platelets in the blood and Purpura stands for discolouration of the skin (bruise). This disease is caused by an immune reaction against platelets. It is also known as Autoimmune Thrombocytopenic purpura. Sometimes it can be well-associated with SLE, Lymphomas, Chronic lymphocytic leukemia and various viral infections.

Causes of Idiopathic Thrombocytopenic Purpura

In Itp, The Immune System Attacks Its Own Body Platelets, Due To Antibodies Against Platelets. The White Blood Cells Which Are T- Cells Directly Attack Their Own Platelets. It Can Be Due To Some Error Which Is As Follow-

1. Various Medications
2. Infections (Viral Includes Hepatitis C, Aids)
3. Pregnancy
4. Immune Disorders Such As (Rheumatoid Arthritis And Lupus)
5. Lymphomas And Leukemia Produce Abnormal Antibodies Against Platelets Proteins

Symptoms

1. Purple Discolouration Of The Skin, As Blood Leaks And Bruises Are Formed Under The Skin. Bruises Can Appear On Elbows And Knees.
2. Nose Bleed
3. Heavy Menstrual Bleeding
4. Blood In Vomit, Urine And Stools
5. Gum Bleeding
6. Minor Lacerations And Abrasions
7. Lower Gastrointestinal Bleeding
8. Subarachnoid And Intracerebral Haemorrhage

Types of Itp

1. Acute Thrombocytopenic Purpura- This Usually Affects Young Children And Is Commonly Seen Due To Illnesses Like Chickenpox. The Symptoms Which Are Seen In Acute Itp Usually Disappear In 6 Months Or Within A Few Weeks.
2. Chronic Thrombocytopenic Purpura- This Disorder Can Happen In Any Age Group And The Symptoms Last For Several Months Or Years. This Is Usually Seen During Bleeding Episodes For Months And Years.

Pathogenesis of Itp

1. In 60% Of The Cases, The Antibodies Against Platelets Are Detected.
2. These Antibodies Are Against The Membrane Glycoprotein Iib-Iiia Immunoglobulin Type
3. This Coating Undergoes Phagocytosis By Splenic Macrophages As Kupfer Cells Of The Liver
4. Igg Autoantibodies Damage The Megakaryocytes Which Further Decrease The Number Of Platelets.
5. This Impaired Production Of Glycoprotein Hormone, The Thrombopoietin, Is The Stimulant Of Platelets.
6. This Stimulus Is Due To The Abnormal Activity Of The T-Cell Activity.

Diagnosis

1. Complete Blood Count
2. Additional Blood And Urine Tests
3. Bone Marrow Aspiration
4. Biopsy

Treatment

1. Steroids
2. Intravenous Gamma Globulin (Ivgg)
3. Rh Immune Globulin
4. Platelet Transfusion
5. Rituximab
6. Romiplostim (N-Plate) And Eltrombopag
7. Splenectomy

Ayurvedic Aspect

Ayurveda Is One Of The Oldest And Most Holistic Systems Of Medicine In The World. It Is A 5000-Year-Old Tradition Aiming To Restore The Body, Mind And Spirit. In Ayurveda, Itp Is Described As “Rakta-Pitta” Which Leads To A Decrease In The Number Of Blood Platelets—Known As Tiryaka Raktapitta Which Occurs When The Rakta (Blood) Is Vitiated With Pitta Doshas And Flows Out Through Any Opening In The Body. The Tridoshas Get Vitiated And Result In An Imbalance Of Metabolism And Agni In The Rakta Dhatu Which Attack The Immune System And The Body Starts Tracking Its Own Platelets.

Nidana (Causes Of Raktapitta)

1. Excessive Exposure To The Sun
2. Excessive Exercise
3. Excessive Consumption Of Food
4. Corrosive Food
5. Excessive Consumption Of Sour Food

Types Of Raktapitta

Based On The Flow of Vitiated Blood It Is Classified Into 3 Types

1. Urdhwa Raktapitta– If The Flow Of Vitiated Doshas Is In An Upward Direction Associated With Kapha Doshas, The Bleeding Flows Through The Nostrils, Eyes And Nose.
2. Adhoga Raktapitta- The Flow Of Doshas Through The Downward Direction Or In The Lower Portion Of The Body. This Is Due To The Vitiation Of Vata Doshas, The Bleeding Comes From The Urinary Orifices And Vagina.
3. Ubhaya Margaga Raktapitta- Raktapitta Which Occurs In Combination Due To The Influence Of Vata And Kapha Doshas. Rakta Flows Out Through Both Upper And Lower Directions.

Based Upon The Predominance Of Doshas=

1. Vataja
2. Pittaja
3. Kaphja
4. Tridoshas
5. Dwandwaja

Pathogenesis

1. Pitta Doshas Get Aggravated Which Leaves Their Site And Reaches The Blood (Rakta Dhatu)
2. Being The Waste Product Of Rakta The Pitta Doshas Get Mixed With Rakta Dhatu
3. This Pitta Dosha Gets Vitiated With Rakta Dhatu, Due To Heat This Liquid Reaches The Mamsa (Muscles) And Meda (Fat) Which Oozes Out And Gets Mixed With Rakta.
4. This Enhances The Quantity Of Rakta Dhatu And Creates Much Pressure On The Walls Of The Vessels Which Starts Coming Out From The Various Channels
5. It Can Come Out Through The Mouth, Nose, Vaginal Area And Anal Area
6. This Is Known As Raktapitta.

Chikitsa

According To Charak, Raktapitta Is Mahagada Vyadhi Which Has Mahavega (Severe Severity In Bleeding Which Can Be Life-Threatening) And Is Sheeghra Kari (Which Destroys The Body Quickly And A Spark Of Fire Destroys The Heap Of Grass). So A Wise Physician Must Have Good Knowledge And Treat The Raktapitta As Quickly As Possible Without Any Delay.

Method Of Treatment Of Raktapitta

1. Nidana Parivarjana
2. Stambhana- The Main Aim Is To Stop Bleeding, The Blood Is Not Pure Blood It Is Contaminated Blood
3. Langhana- This Is Done To Digest The Ama
4. Tarpana- After Langhana, Tarpana Is Advised Which Includes A Nutritious Drink And Diet. It Can Be Given In The Form Of Drinks, Yavagu And In Ahara (Diet, Nutritious Vegetables)
5. Peya- This Is Done In The Form Of Gruels After The Process Of Langhana.
6. Shodhana Chikitsa- It Includes Vamana (Emesis) And Virechana (Purgation)
7. Pratimarga Harana- In The Treatment Of Raktapitta, The Doshas Are Expelled Through The Opposite Route, As Virechana Is Advised In Urdhwaga Raktapitta And Vamana In Adhoga Raktapitta.

Herbs Are Useful In The Treatment Of Itp (Immune Thrombocytopenia Purpura)

There Are Many Herbs Which Are Helpful In The Treatment Of Immune Thrombocytopenia Purpura (Itp) Without Any Side Effects. Further, We Are Gouging To Discuss The Herbs Which Will Help In The Positive Impact Of Itp. Here Are Some Herbs Let’s Discuss As Follows-

1. Guduchi

Guduchi (Tinospora Cordifolia) Is A Well Known Herbaceous Shrub Which Is A Large, Deciduous Climbing Shrub. In Ayurveda, It Has A High Medicinal Value And Is Commonly Known As An Immune-Modulating Herb. It Is Well Distributed Throughout The Tropical Regions Of India And Is Native To India, Sri Lanka And Myanmar. Helpful In Stimulating Digestion Which Is Helpful In Alleviating Vata And Kapha Doshas. 

Benefits of Guduchi

1. Boosts The Immune System Which Removes The Extra Toxins From The Body And Maintains Healthy Ailments In The Body
2. Useful In All Types Of Fever And In Various Bacterial Viral Infections.
3. Cures Digestive Ailments And Excessive Thirst
4. Is A Strong Emetic
5. Is The Best Brain Tonic Which Relieves Stress And Is Beneficial For The Nervous System

2. Ashwagandha

Ashwagandha (Withania Somnifera) Is A Short Woody Shrub Which Grows Up To 75 Cm In Height. It Is One Of The Most Potent Herbs Which Is Helpful In Strengthening The Immune System. Commonly Occurs In Every Part Of India And Is Cultivated On Large Scales Which Are Found In The Regions Of Nepal, China And Yemen. It Is Composed Of Two Sanskrit Words (Ashwa- Horse And Gandha- Smell).

Benefits of Ashwagandha

1. Helpful In Improving Strength And Immunity
2. Provides Good Improvement And Mass
3. Rich In Antioxidants Which Boost The Immune System, Combats Various Allergies
4. Supports Healthy Cardiovascular Properties
5. Enhances The Growth Of Healthy Cells.

3. Bhumi Amla

Bhumi Amla (Phyllanthus Niruri) Is A Tropical Plant Which Is 50-70 Cm In Height. The Bark Of This Plant Is Green In Colour And Is Smooth. The Fruits Of Bhumi Amla Are Tiny And Smooth And Are Commonly Found In A Temperate Climate Over Coastal India. Commonly Known As Stone-Breaker, Gale Of Wind.

Benefits of Bhumi-Amla

1. Effective In An Anaemic Patient
2. Improves The Taste Bad Is Beneficial In Anorexia
3. Effective In Asthma And Other Respiratory Disorders
4. Helpful In Colds And Cough
5. Maintains The Liver Function Test

4. Draksha

Draksha (Vitis Vinifera) Is A Common Type Of Fruit Which Commonly Grows In Branches And The Leaves Of Grapes Are Green And Long Arranged On Woody Stems. Flowers And Fruits Grow In A Cluster And The Dried Form Is Known As Munakka, There Are Two Varieties Of Grapes- Black And Green. These Are Non-Climacteric Fruits Which Can Be Eaten Raw And Can Be Used In Various Preparations.

Benefits of Draksha

1. Balances Vata And Pitta Doshas
2. Helpful In Soothing The Throat And Improves The Voice
3. Has A Cooling And Soothing Property Which Controls The Pitta Doshas
4. Build The Whole Immune System
5. Rich In Vitamin E So Useful In Enhancing The Skin Vitality

5. Amla (Emblica Officinalis)

Is A Very Delicious Fruit Which Has Edible Fruit Rich In Vitamin C Which Makes Skin Healthy And Strengthens The Immune System. Is Found In The Semi-Arid Region Of Northern India In Various Parts Such As Uttar Pradesh, Madhya Pradesh And Rajasthan. Balances All Tridoshas Of The Body And Is Helpful With Fever.

Benefits of Amla

1. Is A Best Anti-Ageing Herb
2. Effective In Various Bleeding Disorders
3. Protect From Various Viral And Bacterial Infections
4. Has Rasayan Property Which Sustains Healthy Living
5. Has Analgesic And Gastroprotective Properties

6. Ushira

Ushira (Vetiveria Zizanioides) Known As Nectar Is Useful In Various Health Issues Related To Summer And In Hot Regions. This Is A Perennial Grass Which Grows Up To 2 Metres With Wide Clumps. These Clumps Arise From Rhizomes. Commonly Known As Khus-Khus Grass, Helpful In Pacifying The Pitta Doshas. It Is Cultivated In Pakistan, Sri Lanka And In Indonesia.

Benefits of Ushira

1. Is A Good Blood Purifier
2. Manages The Production Of Acid Production And Strengthens The Stomach
3. Improves The Glow Of Skin And Texture
4. Is A Wonderful Nerve Relaxant Which Calms The Brain

Conclusion

It Is An Auto-Immune Disease Where The Immune System Destroys The Platelets Which Are Necessary For The Normal Clotting Of Blood. Platelets Are The Smallest Compound Of The Blood Which Controls The Process Of Bleeding And These Cluster Together To Form A Clot And Prevent The Site Of Injury From Bleeding. In Ayurveda, Itp Is Described As “Rakta-Pitta” Which Leads To A Decrease In The Number Of Blood Platelets—Known As Tiryaka Raktapitta Which Occurs When The Rakta (Blood) Is Vitiated With Pitta Doshas And Flows Out Through Any Opening In The Body. Then We Discussed Various Herbs Which Are Helpful In The Treatment Of Itp Without Any Side Effects. 

Author Bio

Dr. Vikram Chauhan (MD – Ayurveda) is the CEO and Founder of Planet Ayurveda Pvt. Ltd. He is Author of the Book “Ayurveda – God’s Manual For Healing”. He is an Ayurveda Expert Serving People worldwide through all the Possible Mediums, Operating from Main Branch in Mohali, India. With his Vast Experience in Herbs and their Applied Uses, he is successfully treating Numerous Patients suffering from Various Ailments with the help of Purest Herbal Supplements, Diet, and Lifestyle, according to the Principles of Ayurveda.