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शुक्रवार, 19 फ़रवरी 2016

The conceptual study of connective tissue diseases as one of causative factors in Interstitial lung diseases (ILDs)

The conceptual study of connective tissue diseases as one of causative factors in Interstitial lung diseases (ILDs) : both modern and ayurveda perspective ;patients with ILDs come with the onset of progressive exertional dyspnea or a persistent nonproductive cough. Hemoptysis , wheezing and chest pain may be present. Often , the identification of interstitial opacities on chest X-ray focuses the diagnostic approach on one of the ILDs. Rheumatoid arthritis is one of connective and autoimmune diseases which cause ILDs.. inflammation in the air space and alveolar walls and interstitial fibrosis are present due to autoimmunity.. the presence of jts pain , stiffness and deformity like swan neck etc with +ve antinuclear antibodies and anti- immunoglobulin antibodies ( RA factors ) confirm the diagnosis , however these tests are +ve even in absence of defined connective tissue diseases. ILDs are characterized as a significant part of a multiorgan process , as may occur in the connective tissue diseases ( SLE, RA , Ankylosing Spondylitis, systemic sclerosis , sjogren's syndrome , polymyositis-dermatomyositis. Aamavaata mentioned in madhav nidan is classical example of autoimmune diseases , otherwise in relation to grahani chikitsa acharya charak mentions yakshma peenas mehaadeen kaphajaan kaphasangatam; aamavisha along with kapha when reaches into urahsthaana , can induce yakshmaa peenasa like diseases. I consider the role of aamavisha yukta kapha as part of autoimmunity , since vaata is major initiator of immune phenomenon , so vaata and kapha as predominant dosh can be considered in ILDs. The presence of inflammation and fibrosis is due to autoimmune reaction , ie aamaavisha yukta kapha reactions with vaata on surface of epithelium.. shirisha tulasi gorakhamundi darvi haridra amrita karkatashringi shunthi pippali aamalaki dashamoola pushkaramoola kantakaari bharangimoola kushtha ashwagandha like drugs are found somewhat effective in ILDs...Salient features in pathogenesis of ILDs ; the lung is naturally exposed to repetitive injury from a variety of exogenous and endogenous stimuli . Several local and systemic factors e.g. fibroblasts , circulating fibrocytes, chemokines , growth factors , and clotting factors contribute to tissue healing and functional recovery. Dysregulation of this intricate network through genetic predisposition and autoimmune conditions ,or superimposed diseases can lead to aberrant wound healing , with the result of pulmonary fibrosis. Alternatively , excessive injury to the lung may overwhelm even intact reparative mechanisms and lead to pulmonary fibrosis..For inhibition of dysregulation , or promotion of reparative mechanisms , rasaayana chikitsa may be helpful.. Tulasi saarivaa kushtha haridraa daruharidra ashwagandhaa gokshuru shati lashuna jivanti musta bhumyamalaki pippali dashamoola kutaki haritaki aamalaki tejapatra shirisha bilva pushkaramoola chitraka pravaala tamra lauha rajata bhasma abhraka etc can be tried in different form..

.Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com

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