Year : 2017 | Volume
: 38 | Issue : 1 | Page : 1--2
Clinical trials in Ayurveda: Issues, challenges and approaches
Department of Kayachikitsa, IPGT & RA, Gujarat Ayurved University, Jamnagar- 361008, Gujarat, India
Department of Kayachikitsa, IPGT & RA, Gujarat Ayurved University, Jamnagar- 361008, Gujarat
|How to cite this article:|
Goyal M. Clinical trials in Ayurveda: Issues, challenges and approaches.AYU 2017;38:1-2
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Goyal M. Clinical trials in Ayurveda: Issues, challenges and approaches. AYU [serial online] 2017 [cited 2021 Sep 28 ];38:1-2
Available from: https://www.ayujournal.org/text.asp?2017/38/1/1/230782
Ayurveda literatures are the systematic documentation of the clinical experiences gathered by the ancient sages of Ayurveda who had treated ample number of patients of different diseases at different stages. They recognized herbs and minerals and evolved their medicinal properties in terms of Rasa (taste), Guna (properties), Vipaka (postdigestion changes), Virya (active principles) and Karma (therapeutic actions). The main principle of the treatment in Ayurveda is discontinuity of pathogenesis by identifying the cause and related factors involved in the etiopathogenesis of the disease and accordingly plan treatment either by selecting appropriate formulations or procedures along with avoidance of the causative factor. Further, as the disease may manifest differently in different individuals, every individual may need specific set of the treatment for efficient management. This indicates that a single formulation may not be very effective in every stage of disease, that too in different individuals. For the quick and better relief as well as for the prevention of recurrences, Ayurveda has a concept of Rasayana, particularly Naimittika Rasayana by which the underlying tissue is strengthened for better tolerance against the disease. Thus, Ayurveda approach toward disease is multifaceted, and with this holistic approach, Ayurveda has been successfully tackling the health problems of people of our country for centuries.
However, in the present era with the emergence of allopathic medicine, things have changed as it has taken the front seat in the health care. The patients of the present time are becoming more health conscious and undergo many types of laboratory tests, and due to facility of the Internet, sometimes they acquire good knowledge of the terms such as cholesterol, sugar, uric acid, high blood pressure and heart attack and insist for the specific treatment for such disorders. As direct references of such terms are not available in Ayurveda literature, it is need to do research on Ayurveda drugs to find out answers of these problems. For this purpose, modern laboratory technology has to be adopted for the research. Further, in recent past, many new diseases such as AIDS, chikungunya, dengue fever and swine flu have emerged and their Ayurveda management has to be worked out. For such problems, it is necessary to adopt Ayurveda research methodology.
At present, our country is having a full-fledged Central Council for Research in Ayurveda System (CCRAS) with sufficient financial support and ample task force for research and is contributing its share in Ayurveda field. In addition, there are many institutes of the country where postgraduate courses in Ayurveda are being conducted leading to MD/MS (Ayu.) and Ph. D. degrees. Research is a mandatory part of these degrees; thus, these institutes are contributing as a resource for research in various specialties of Ayurveda. However, difficulty is that these courses are time bound and the research scholars have to complete their work within the stipulated period of 2 years or so; therefore, long-time clinical studies are not possible in these centers.
The postgraduate teachers are supposed to be in touch with the latest development in Ayurveda field at various levels. The teachers of clinical departments also contribute as physicians/surgeons at the outpatient department and inpatient department of the institute's hospital and thus are exposed to various clinical materials and challenging cases which are discussed in clinical meetings and departmental and institute seminars. They also attend seminar, symposia, workshop, etc., which provide platform for exchanging thoughts and new thoughts evolve during this brainstorming events. It is suggested that if the field of CCRAS and institutes are demarcated and coordinated, more rewarding results can be obtained. For instance, Ayurveda institutes may act as resources of generating plan and providing baseline data, and on the other hand, these plans may be executed in the form of multicenter clinical trials and thus producing sufficient evidence-based data for needful conditions. At present, Dravyaguna and Rasashastra specialties are concentrating on the drug identification aspects. These resources can be utilized by assigning to them the clinical pharmacology of the single drugs of their respective specialty. The division of research work may be done by allotting Samprapti Vighittana Chikitsa to the clinical departments wherein they can try formulation or multiple drug therapy and Dravyaguna and Rasashastra research may be limited to the drug action of the single drugs only such as analgesic, antipyretic, hypoglycemic actions, antitussive, expectorant and hypocholesterolemic.
As Ayurveda considers disease occurring due to multifactors and follows multitargeted management, a research design where a single formulation is attempted in different patterns of presentations with different phenotypes can never give satisfactory outputs and hence overall results of most of the researches planned without this approach ends up in the mild response or even negative findings. Planning individualistic approach treatment protocol in a single research trial is a need of the time, but such projects will be based on large sample analysis. In addition, till date, many clinical trials have been carried out at various research centers and institutes of Ayurveda, and if meta-analysis is done of these studies, a fruitful thinking regarding future research plan for various diseases can be worked out.
Thus, it can be concluded that suggesting a single drug or a group of drugs for a particular disease should not be the aim of Ayurveda research. Instead of finding out the efficacy of the drugs, focus should be on exploring the mechanism of efficacy. Developing treatment protocols for different presentations of same diseases in individuals with holistic approach should be the main concern of Ayurvedic research. This demands trained task force and ample funding, and at this hour, as the Government of India has been showing keen interest in nourishing streams of AYUSH and many new research institutes and councils are being set up at various regions of country, this task can be accomplished. However, we have miles to go before we sleep.