1DR. Dhanokar C.A. MS(Shalya) ,2DR. Kulkarni A.S. MD(Shalya) ,3Dr.Mankar D.K. MD(Shalya)
1Asst.Prof.Shalya Dept.,RTAM. ,Akola , 2Prof.& Hod Shalya Dept.RTAM,Akola 3Prof.RTAM,Akola
TAO also known as buerger’s disease is non atherosclerotic, inflammatory disease of peripheral blood vessels affecting small & medium sized vessels of extrimities.TAO is one of the cause of chronic lower limb ischaemia or CLI (critical limb ischaemia)1 .It mainly occurs in males habited to smoke . Smoking is strongly associated with disease course & progression. However exact cause of TAO is still not known . Symptoms includes sever cramp like pain in affected limb during walking , (ischaemic pain also called as intermitant claudication) , rest pain , non healing deep painful ulcer at the most distal part of the body like tip of toes,gangrenous patches of skin or subcutaneous tissue or gangrene of distal parts like toes,ischemic changes like coldness of limb , colour changes from pale , redish to blue , loss of hairs ,dry brital nails.
Conservative treatment includes narcotic analgesics as simple NSAID dose not work,buerger’s position (elevation of head end of the bed),abstinence from smoking(nicotin in any form should be stopped complitly),vasodialators like prostacyclines or xanthinol nicotinate may given to improve circulation particularly for healing of ulcer.Theses all gives temporary relief . Apart from these chemical sympathectomy or surgical sympathectomy,omentoplasty are tried but not done know a days as the results are not satisfactory & procedure related complications are more & may prove fetal to the life of patient. Conservative amputation of gangrenous toe is done . Amputation below knee or above knee is not needed generally but in sever cases not responding to any treatment may be the last option to get rid of pain. Treatment is bessicaly aimed at reliving pain , healing of ulcer if present , & stoping progress of disease2
Inspite of all these treatment measures the patients of TAO have severe pain , they spend sleepless nights & some have suicidal tendancy due to severe pain.(cases are on record that the patients have commited suicide by jumping from 2nd floor of hospital) 3 . So there is still need for effective managent of disease by alternative means.
In present case study one of our patient suffuring from TAO was effectively managed by leech application, Kaishor Guggulu & chandrakala rasa along with modern treatment regim . This case illustrates the effectiveness of ayurvedic treatment in the management of peripheral vascular disorder..
1.&2.Thromboangiitis oblitrance(Buerger’s Disease)-current practices - NCBI Vijayakumar
Rahul Tiwari,Vinod Kumar Prabhuswami.
3.Manipal mannual of surgery by K Rajgopal Shenoy-2nd edition.
4.Leeches medicinalis.com , RICARIMPEX(Biology)
5.Sharangdhar Samhita – Madhyam khand,Dipika & Gudarth Dipika commentary page 203,
edited with footnotes by Parshuramshstri Vidyasagar – 3rd edition 1983
6.A clinical study of combination therapy i.e. Jalaukavcharan with Kaishor Guggulu in
management of Siraj granthi w.s.r. to Varicose veins.
7.Siddha Yog sangraha.