Pilot Study to Test Efficacy of Sira Vedha in Non-Alcoholic Fatty Liver Disease

Introduction: Sushruta said that the Sira Vedha (phlebotomy) at Dakshin Kurpara Sandhi (Right Elbow Joint) as a therapy for Yakrit Vikara (Liver Diseases). Modern science also on the same page that phlebotomy treatment for some liver diseases but did not mention the exact site for phlebotomy. Similarly, there is variation in the withdrawal of blood and time duration, every research study indicating different quantity to be withdrawn and the interval between two sessions. In the context of Ayurveda, both the things mentioned earlier are mentioned well in advance. Still, because of a lack of clinical evidence, one cannot confidently practice it in routine exercise. Thus, there is a need to validate Sushruta's principle with clinical evidence for liver diseases.

Methodology: Twenty eligible patients who had Non-Alcoholic Fatty Liver Disease (NAFLD) Grade I/II were enrolled in the pilot study and randomly allotted for control (group A) and trial group (group B). Obtained written informed consent, each patient's blood serum was taken for aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK-P), and lipid profile. Then, group A patients were advised only diet alterations. Group B patients underwent diet alteration and Sira Vedha (phlebotomy) with 65 cc blood three times by the interval of 15 days. Before every phlebotomy, checked hemoglobin for safety purposes to discontinued the patient. The blood sample was taken before recruitment in the study and after the last follow-up, i.e., the 60th.

Day—observation & Results: Compared the serum values of the first and final follow-up. Twenty patients (12 males and eight females) were enrolled, and the mean average age was 34.8 ± 7.84 years. This pilot study suggested that there was the improvement in liver enzymes and lipid profile significantly (P < 0.050) in group B compared to group A. Still, the changes that occurred with the treatment are not good enough to exclude the possibility that the difference was due to chance or because of small sample size. So, we can conclude that phlebotomy can improve liver enzymes and lipid profiles in patients with NAFLD.