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 Table of Contents  
CASE REPORT
Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 111-114

Practical application of Langhana therapy in the management of dyslipidaemia: A case reports


1 Department of Samhita and Siddhant, All India Institute of Ayurveda, New Delhi, India
2 Department of Sharira Kriya, All India Institute of Ayurveda, New Delhi, India
3 Department of Samhita and Siddhant, JSS Ayurveda Medical College, Mysuru, Karnataka, India

Date of Submission07-Oct-2020
Date of Acceptance17-Jul-2021
Date of Web Publication14-Dec-2021

Correspondence Address:
Dr. Anita Choudhary
All India Institute of Ayurveda, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jacr.jacr_78_20

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  Abstract 


Dyslipidemia, in current times, is gradually increasing the incidences of heart disease and associated risks. Globally, one-third of ischemic heart diseases are caused due to the high levels of cholesterol. Dyslipidemia is a major cause of disease burden in both the developed and developing world as a risk factor for ischemic heart disease and stroke. In Ayurveda, dyslipidemia can be correlated with Medo dushti (~vitiated fatty tissue). The deranged lipid or fat molecules can be compared to Ama in the body. Ama is a type of Rasa pradoshaja vikara. Acharya Charaka has explained Langhana (~fasting) therapy in Rasaja vyadhi (~disease due to vitiated Rasa) that is known to initiate important cellular repair processes and causes changes in hormone levels to make accessible the available body fat. Langhana therapy is also beneficial for the maintenance of lipid profiles. Fasting by focusing Ayurveda protocol aids in the improvement of the lipid profiles in healthy, obese, and dyslipidemia patients. In the present case report, a 50-year-old male patient was treated with Langhana karma. After 10 days of strictly following the Ayurveda protocol of Langhana therapy, the serum cholesterol and serum triglycerides levels were decreased, inferring that the Langhana therapy is effective in the management of dyslipidemia.

Keywords: Dyslipidemia, fasting, Langhana, Upavasa


How to cite this article:
Choudhary A, Vyas M, Bhojani MK, Pathak P. Practical application of Langhana therapy in the management of dyslipidaemia: A case reports. J Ayurveda Case Rep 2021;4:111-4

How to cite this URL:
Choudhary A, Vyas M, Bhojani MK, Pathak P. Practical application of Langhana therapy in the management of dyslipidaemia: A case reports. J Ayurveda Case Rep [serial online] 2021 [cited 2022 Jan 27];4:111-4. Available from: http://www.ayucare.org/text.asp?2021/4/3/111/332438




  Introduction Top


Dyslipidemia is characterized by a disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency. The condition refers to alteration in plasma cholesterol, mainly High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), and plasma triglycerides. In India, approximately 25%–30% of urban and 15%–20% of rural individuals are suffering from dyslipidemia.[1] Although it is more common among males, it affects both the genders. 30–40 years' age group has a tendency to high prevalence, but above 60 years, it become markedly high. In Ayurveda, dyslipidemia can be correlated with Medo dushti. The lipid or fat molecules of dyslipidemia can be compared to Ama (~undigested food product) in the body. Dyslipidemia is one type of Dhatvagnimandya janya medodushti and mainly due to increased Kapha dosha and Medo dhatu.[2] Achieving Dhatusamya is the main aim of treatment in Ayurveda.[3] To achieve this, Upavasa rupa langhana is followed in this case of dyslipidemia.[4] Upavasa karma here is not taking any kind of food and intake of 250 ml of milk that will not affect the purpose of fasting according to Ek tandulashana nyaya.[5]


  Patient Information Top


A 50-year-old male patient visited the outpatient department with complaints of Ashraddha (~loss of interest toward taking food), Aruchi (~tastelessness/anorexia), Gaurava (~heaviness in the body), Tandra (~drowsiness), and Hrullasa (~nausea) for two months. The patient had no history of diabetes, hypertension, and no positive family history. There was no history of alcohol, tobacco, or drug addiction. However, the patient was in stress because of his office workload.


  Clinical Findings Top


On general examination, the patient was medium built. Blood pressure was 120/80 mmHg and pulse was 70/min. Tongue was coated. On systemic examination, no abnormality was found in circulatory, respiratory, and nervous systems. Icterus was absent.

Ashtavidha pareeksha (~eight-fold examination)

Nadi (~pulse) was Kaphaja, Mala (~bowel) was irregular, Sama and Dourgandhya yukta (~bad smell), Mutra (~urine) was normal (3–4 time/day), Jihva (~tongue) was Sama (~coated), Shabda (~voice) was Sadharana (~normal), Akriti (~body built) was Madhyama (~moderate) and Drik (~vision) was normal.

Dashavidha pareeksha (~ten-fold examination)

Prakriti (~body temperament) was Kapha-pittaja, Vikriti was Kaphaja pradhana, Sara (~excellence of tissues) was Madhyama, Samhanana (~compactness of organs) was Madhyama, Satmya (~suitability) was Avara (~poor), Satwa (~psyche) was Pravara (~superior), Pramana (~measurement of body organs) was Madhyama, and Aahara shakti (~food digesting power) was Madhyama. The patient was vegetarian, consuming diet predominantly in Madhura, Amla rasa; Vyayama shakti (~power of performing exercise) was Avara and Vaya (~age) was Madhyama.


  Diagnostic Assessment Top


Diagnostic assessment was done with the help of blood examination, i.e., total cholesterol, HDL, serum triglycerides, and Erythrocyte Sedimentation Rate (ESR) [Table 1].
Table 1: Effect on the investigation parameter


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  Timeline Top


After thorough examination of the patient, the treatment was started with Upavasa karma for 10 days (September 30, 2019, to October 9, 2019). Apart from this, the patient was advised to drink only hot water for the whole day and avoid taking food for 10 days. He was allowed to take 250 ml of cow milk as part of his daily routine habit. After 10 days, the patient was advised to start the regimen as per the Samsarjana krama. On the 1st day (morning and evening) in the diet green gram soup (according to the appetite), on the 2nd day (morning and evening) given rice water soup, then for the next three days (morning and evening) green gram water soup cooked with spices and on 4th day, it was advised to take Krushara (cooked rice + green gram with spices) in the morning and then started normal food diet (like three chapatis according to hunger and green vegetables according to season) when hungry[6] [Table 2].
Table 2: Samsarjana karma


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  Follow-up and Outcome Top


After one year, serum cholesterol of the patient was maintained at 148.28 mg/dl. Serum cholesterol and serum triglyceride were reduced with the 10 days of Langhana [Table 1] with appearance of Samayak langhana lakshana and disappearance of Ama lakhshana[7] [Table 3].
Table 3: Samyaka Langhana Lakshna (~proper fasting symptoms)


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  Discussion Top


With the Ayurvedic perspective, dyslipidemia can be placed under Kapha and Medo dushti janya vyadhi, which comes under the category of Santarpanajanya vyadhi.[8] Furthermore, the treatment of any Samtarpanajanya vyadhi is explained in Ayurvedic treatise through Apatarpana. Langhana, a type of Apatarpana, as a successful treatment modality in the condition of Santarpanjanya vyadhi is included among Shadvidha upakrama.[9] Langhana therapy is reported to improve lipid profile.[10] Furthermore, Acharya Charaka has described 10 types of Langhana. Upavasa is included as one among in these.[11] Apatarpana which is described as treatment modality in various Santarpana janya vyadhi can be understood as Upavasa rupi langhana (~fasting). Hence, we can consider Langhana as the form of fasting and accordingly for the Ama pachana in the patient of dyslipidemia, can be used as in treating this disease.[12] In the present study, in order to see the effect of Upavasa in combating the symptoms of dyslipidemia, the patient was advised to remain on fasting for 10 days and was kept only on fresh cow milk (about 250 ml) and hot water to drink. Strictly fasting with Ayurveda protocol aids in the improvement of lipid profile in obese, and dyslipidemia patients by reducing total cholesterol, LDL, triglycerides and increasing HDL levels. Before starting the Upavasa, serum cholesterol, serum triglyceride, HDL, and complete blood count with ESR were evaluated, and after 10 days, all these investigations were again carried out. Satisfactory reduction was noticed in total cholesterol and serum triglycerides. Reduction in lipid profile infers that fasting has caused Ama paachana, i.e. digestion of fat or lipid molecule. Fasting for 10 days has also resulted in increased level of HDL from 36 to 45.1 mg/dl. The symptoms experienced by the patient were of Rasa pradoshaja vyadhi,[13] that have reduced gradually with Langhana [Table 4]. Following fasting and consuming hot water and about 250 ml of cow milk in a day has showed improvement in lipid profile. The profiles were in physiological limits even after one year. For one year, no medicines were taken, only Pathya-Apathya were followed avoiding oily, refrigerated food, Divaswapa (~sleep during the day) and took seasonal green vegetables, chapati when feel hungry.
Table 4: Patients clinical outcome


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  Conclusion Top


Dyslipidemia has been recognized as one among the refractory lifestyle-related conditions since ages. Medodushti (~dyslipidemia) is the condition having Kapha predominance. Langhana therapy plays an important role in the Medodushti. Upavasa rupi langhana has showed a significant improvement in the symptoms of dyslipidemia. It is a simple, effective, nonpharmacological intervention that maintains lipid profiles in physiological ranges. If these treatment strategies are followed under the supervision of qualified physicians, better results can be anticipated.

Declaration of patient consent

Authors certify that they have obtained patient consent form, where the patient/caregiver has given his/her consent for reporting the case along with the images and other clinical information in the journal. The patient/caregiver understands that his/her name and initials will not be published and due efforts will be made to conceal his/her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Available from: https://www.nhp.gov.in/dyslipidemia_mtl/. [Last accessed on 2021 Jul 08].  Back to cited text no. 1
    
2.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 21., Ver. 4. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 116.  Back to cited text no. 2
    
3.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana; Ch. 9., Ver. 4. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 62.  Back to cited text no. 3
    
4.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 25., Ver. 25. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 179.  Back to cited text no. 4
    
5.
Acharya YT, editor. Commentary Nibandhsamgraha of Shri Dalhana on Sushruta Samhita of Mahrshi Sushruta, Sutra Sthana. Ch. 15., Ver. 41. Varanasi: Chaukhamba Publications; 2017. p. 75.  Back to cited text no. 5
    
6.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Siddhi Sthana. Ch. 1., Ver. 11. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 678.  Back to cited text no. 6
    
7.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 22., Ver. 34. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 121.  Back to cited text no. 7
    
8.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 23., Ver. 6. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 122.  Back to cited text no. 8
    
9.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 22., Ver. 7. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 120.  Back to cited text no. 9
    
10.
Joshi S, Goyal M. Role of Gomutra Haritaki with and without langhana and pachana in the management of dyslipidemia: An open labelled randomized clinical trial. Int J Res Ayurveda Pharm 2016;7:165-75.  Back to cited text no. 10
    
11.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 22., Ver. 18. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 121.  Back to cited text no. 11
    
12.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 23., Ver. 8. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 122.  Back to cited text no. 12
    
13.
Acharya YT, editor. Commentary Ayurveda Dipika of Chakrapanidutta on Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 28., Ver. 9-10. Varanasi: Chaukhamba Krishnadass Academy; 2011. p. 179.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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Abstract
Introduction
Patient Information
Clinical Findings
Diagnostic Asses...
Timeline
Follow-up and Ou...
Discussion
Conclusion
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