Satellite Symposia / European Journal of Integrative Medicine 2 (2010) 165172
In recent times, several initiatives have been taken to improve
the research standards in Ayurveda and to generate documented
evidence for safety and efficacy of Ayurvedic interventions that
meet international standards and expectations. These include
new clinical studies including clinical trials, development of
new research methodologies, launching of new research jour-
nals, training programs for researchers, development of research
databases and the like.
This paper will discuss about three such initiatives in the area
of observational clinical research, randomized clinical trials on
whole Ayurveda interventions as well as development of a com-
prehensive research database and indexing service exclusively
for Ayurveda research journals.
The outcomes of observational studies that gives insights on
health seeking behavior of patients approaching practitioners of
traditional medicine and the overall safety issues and efficacy
trends will be outlined.
Development of rigorous clinical trial protocols that respect
the holism of Ayurveda as well as the rigor of science will
be discussed citing the outcomes and implications of studies
conducted through international collaborations.
Development of a comprehensive database of published
research papers and indexing system for Ayurveda journals will
be elaborated, which makes available to researchers information
related to the research work done on Ayurveda in India.
The paper will also look at the strengths and gaps in the
research initiatives from India that aim to generate evidence
to authenticate Ayurveda by blending traditional wisdom with
modern science in the areas of training in research, actual
conduct of research studies and publication of the research out-
comes.
doi:10.1016/j.eujim.2010.09.227
Complementary medicine in Parkinsons disease
H. Przuntek
Bochum, Germany
Complementary medicine means usage of two completely
different medicine systems as allopathic medicine and Ayurveda
or Traditional Chinese Medicine. We use Ayurveda which
belongs to the longest documented medicine systems. Parkin-
sons disease was described by Charaka more than 2000 years
before Parkinson published his booklet about Shaking Palsy
in 1817. Parkinsons disease for more than a century was
assumed to be a neurosis. Tretiakoff detected 1918 a neurode-
generative process of the nigrostriatal system. Since Sano and
Hornyciewicz have described a disturbance of the dopaminergic
nigrostriatal pathway it was supposed that the pathogenesis of
Parkinsons disease could be restricted to the nigrostriatal sys-
tem. Supported by the work of Korczyn, Przuntek and Woitalla
and the revolutionary results of Braak it became more and more
evident that Parkinsons disease is a whole body disorder, start-
ing in the gastrointestinal tract many years before motor signs
become visible. The pathogenesis seems to be achieved by a
genetic predisposition and intoxication. The toxins must exist
171
more than 3000 years. We postulate that these toxins are of
endogenous nature. That is in accordance with the Ayurveda
doctrin, which comes to the conclusion that Parkinsons disease
starts in the colon. This corresponds to a tridosha dysbalance
and vatta overflow, which has to be normalized by diet, basti,
massages and herbal nutraceuticals. Smelling is reduced very
early in the course of the disease. Up to now exists no allopathic
method to heal this disturbance. We have used Nashya for 6
days, after 10 days smelling was normalized. It is very difficult
to compare the efficacy of allopathic and ayurvedic treatment,
because most of the ayurvedic procedures are not evidence based
and the side effects of the herbal drugs are not sufficiently reg-
istered. We have started to establish a research working group
including researchers, who are interested in reverse pharmacol-
ogy, narrative empirical methods, reproductive medicine, cell
protection, stem cell activation, anti ageing, LOHAS, Ayurveda
genetics, Ayurveda engineering and biochemistry, toxicology
and detoxification, statistics and interpretation of Ayurveda text-
books under modern aspects. With this work we hope to clarify
many of the mysteries of Ayurveda medicine and to increase the
acceptance of this medicine system.
doi:10.1016/j.eujim.2010.09.228
Complex ayurvedic treatment for osteoarthritis of the knee
(CARAKA-trial)Design of a randomized controlled trial
comparing ayurveda and conventional standard care
C. Keler a, , C.M. Witt b , A. Michalsen a,b , A. Morandi c
a Immanuel Hospital Berlin, Department for Internal and Com-
plementary Medicine, Berlin, Germany
b Charit University Medical Center, Institute for Social
Medicine, Epidemiology and Health Economics, Berlin, Ger-
many
c Ayurvedic Point, Milan, Italy
Background: Ayurveda is a traditional Indian medicine: as a
whole medical system it consists of diagnostic procedures and
a complex treatment. The treatment is based on an ayurvedic
diagnosis and includes the following methods: manual thera-
pies, lifestyle and nutritional advice, dietary supplements, yoga
and purification techniques. In India Ayurveda is often used for
the treatment of osteoarthritis (OA) of the knee, however, no
systematic data is available on its effectiveness compared to
Western standard care.
Objective: The aim of this study is to evaluate the effective-
ness of a complex ayurvedic diagnosis and treatment compared
to conventional standard care in patients with OA of the
knee.
Methods and design: A total of 150 patients will be included
in a prospective, multicenter, randomized, controlled study.
Patients between 40 and 70 years of age, diagnosed with OA
of the knee following the criteria of the American College of
Rheumatology and an average pain intensity of 40 or more on a
100 mm visual analogue scale (VAS) at baseline will be random-
ized into two groups. In the Ayurveda group treatment will be
individualized according to the Ayurveda diagnosis and include
172 Satellite Symposia / European Journal of Integrative Medicine 2 (2010) 165172
manual treatments, massages, dietary advice, specific consider-
ation of selected food items, nutritional supplements, ayurvedic
lifestyle and yoga posture advice and daily self-applied knee
massage. Patients in the conventional standard care group will
receive conventional standard care for OA of the knee which
includes self-care advice, pain medication and intensified phys-
iotherapy and follows the current international guidelines for
OA of the knee. Patients of both groups receive each 15 treat-
ment sessions during 12 weeks and the whole study period is
12 months. Study visits are scheduled at baseline, 6 weeks, 12
weeks; and further follow-up questionnaires will be sent to the
patient after 6 months and 12 months. The primary endpoint
is the change in the Western Ontario and McMaster University
Osteoarthritis Index (WOMAC) after 12 weeks. Secondary end-
points are: WOMAC subscales, Pain Disability Index, VAS for
pain, a scale for assessing emotional aspects of pain, quality of
life (SF-36) and safety measures.
Acknowledgement: This study is funded by AYUSH, Govern-
ment of India.
doi:10.1016/j.eujim.2010.09.229