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ALLERGIC RHINITIS
DEFINITION
• RHINITIS – Inflammation of mucous membrane of
nose
• ALLERGIC RHINITIS – Inflamation due to the
reaction in nasal mucosa from repeated allergen
exposures that causes hypersensitivity
• Characterised by watery nasal discharge , nasal
obstruction, sneezing and itching in nose
• Prevalance – 15-20%
• Higher in pediatric age group
•Symptoms appear only
in particular seasons
SEASONAL
•Symptoms present
throughout the year
PERENNIAL
AETIOLOGY
Pollen
Dust
Mould
spores
Debris
from insect
Genetic
Inhaled allergen produces specific
IgE antibody in predisposed
individuals
This antibody gets fixed to the
blood basophils or tissue mast cells
On subsequent exposure antigen
combine with IgE antibody
Causes degranulation of mast cells
with release of several chemical
mediators
• Tissue oedema
• Result- Nasal
blockage
Increased
vascular
permeability
& dilatation
• Result-
Bronchospasm
Change in
smooth
muscle tone
• Increased secretion
• Result - Rhinorrhoea
Hyperactivity
of glands
•Histamine
•Heparin
•Prostagland
ins
•Leucotriene
•ECF-A
•NCF-A
•PAF
• 5-30 min after exposure
• Sneezing, Rhinorrhoea, Nasal
blockage, Bronchospasm
• Due to release of vasoactive
amines
Acute
phase
• 2-8 hrs
• Due to the infiltration of
inflamatory cells at the site
causing swelling , congestion,
thick secretion
Late
phase
CLINICAL FEATURES
• Sneezing
• Blocking
• Running
• Itching
Nasal signs
• Transverse nasal crease
• Allergic salute
• Oedematous nasal mucosa
• Swollen turbinate
• Watery, mucoid discharge
Occular signs
• Oedema of lids
• Congestion and cobble stone appearance of
conjunctiva
• Allergic shinners
Otologic signs
• Ottitis media due to eustachian tube blockage
• Retracted tympanic membrane
Pharyngeal and laryngeal signs
• Pharyngitis due to hyperplasia of submucosal
lymphoid tissue
• In children prolonged mouth breathing as
seen in adenoid hyperplasia
• Hoarseness of voice
• Oedema of vocal cords
COMPLICATIONS
INVESTIGATIONS
• Eosinophil count
• Nasal smear- large no. of eosinophils
• Skin test- to identify specific allergen
• Total IgE –Rarely helpful as 50 % have IgE in
normal level
• Specific IgE – Radioallergosorbent test (RAST)
Measures IgE antibody concentration
• Nasal provocation test – Ask the pt to sniff small
amount of allergen and observe for allergic
symptoms
Skin prick test
• Rapid, efficient, cost effective
• Contain multiple antigen(pollen, dust, animal
dander, mold…)
NIDANA
• अवश्याया अनिल रजो …….
AH.U.19/1
• ………………धूमो रज: शीतमनतप्रताप:
S.U.24/3
LAKSHANA
नशरोगुरुत्वं क्षवथो : प्रवततिं तथा अङ्गमर्त :
पररहष्टरोमता |
उपद्रवाश्चाप्यपरे पृथग्विधा िृणां
प्रनतश्यायपुर: सरा: स्मृता: |
Su.U.24/5
SAMPRAPTI
• चयं गता मूधतनि मारुतार्या: पृथक
् समस्ताश्च
तथैव शोनणतम् |
• प्रकोप्यमाणा नवनवधै: प्रकोपणै िृणां प्रनतश्यायकरा
भवग्वि नह |
Su.U.24/4
• Nidana – K, V prakopa nidana
• Dosha – K, V , alpa P
• Dushya – Rasa, Rakta
• Srotas – Rasa, Rakta, Pranavaha
• Srotodushti – Sanga, Vimargagamana, Atipravrti
• Agni- Jataragni dhatvagni mandya
• Dosha marga – shaka
• Roga marga – bahya
• Udbhava sthana – Amashaya, Pakwashaya
• Adhishtana – Nasa, Shira
• Pratyatma lakshana- Kaphotklesha, Ghrana
viplava, Shira shoola, Nasa avarodha, Swara
bheda
VATAJA PITTAJA KAPHAJA
Nasal blockage High T , Thirst Dyspnoea
Dryness of throat,
palate,lips
Yellow hot nasal
secretion
White cold secretion
Hoarseness of voice Emaciation Swollen eyes
Thin secretion from
nose
Ulceration on tip of
nose
Heaviness in head
and face
Pricking pain in
temples
Giddiness Itching in nose,
throat,palate,lips
More sneezing Hot fumes from nose
AH.U.19 & Su.U.24
SAMANYA CHIKITSA
• िवं प्रनतश्यायमपास्य सवतमुपाचरेत् सनपतष एव पािै: |
स्वेर्ैनवतनचत्रैवतमिैश्च युक्तै: कालोपपन्नैरवपीडिैश्च |
Su.U.24/18
V CHIKITSA
• वानतक
े तु प्रनतश्याये नपबेत् सनपतयतथारमममम् |
पञ्चनभलतवणै: नसद्धं प्रथमेि गणेि च |
िस्यानर्षु नवनधं क
ृ त्स्रमवेक्षेतानर्ततेररतं|
• Snehapana- pancha lavana gritha
- Vidarigandhadi gana gritha
• Nasya- Anutaila, Sunti taila, Rjanyadi taila,
Pippalyadi taila
Snigdha dhoomapana
• Shatahvadi – shatahva , twak, bala moola,
shynoka, eranda, bilwa, aragwada,
madhuchishta, vasa, gritha
• Gritha, Sakthu
• Sneha nasya – oil prepared with tila, aja
ksheera, yashti choorna, saindhava kalka &
dashamoola kashaya
K CHIKITSA
• Snehapana – gritha
• Vamana – after tila masha yavagu
• Samsarjana – kaphahara ahara
• Nasya- taila with bala, atibala, brhati,
kantakari, vidanga ,gokshura, sweta aparajitha
moola, gambhari, punarnava
• Dhumapana – Trivrit, kinihi, devadaru, danthi,
ingudi, Vidangadi
• Nasya
• Bharangyadi taila- Bharangi, madana phala,
tarkari, tulasi, gomutra ,sarshapa taila, vacha,
laksha, vidanga, kushta, pippali, karanja
• Pradhamana nasya- manashila, trikatu, vacha,
vidanga, hingu, guggulu ( CS.Ch.26)
• Trikatu, saindhava, kutaja, jeeraka, vidanga
grinded in avi mutra AH.U.20/13
AVOID ALLERGENS
• Avoid pet animals inside home
• Wash the pet weekly
• Regulation of ventilations and humidity of home
• Avoid walking in open grassy spaces during hot
dry days
• Keep windows closed
• Use face mask when going out
• Change of work place if it is a cause
• Live in pollution free environment
PATHYA YR.85/88
• Katu amla lavana
• Snigdha, ushna, lavana
• Purana yava & shali
• Kulatha , mudga yusha
• Gramya, jangala mamsa rasa
• Vartaka, kulaka, shigru, karkota, shigru
• Dadhi
• Taptambu, Varuni jala
• Trikatu
APATHYA
Snana
Krodha
Vegadharana
Bhumi shayya
Atidrava ahara
THANK U
Role of Panchakarma in Allergic Rhinitis.pptx

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Role of Panchakarma in Allergic Rhinitis.pptx

  • 2. DEFINITION • RHINITIS – Inflammation of mucous membrane of nose • ALLERGIC RHINITIS – Inflamation due to the reaction in nasal mucosa from repeated allergen exposures that causes hypersensitivity • Characterised by watery nasal discharge , nasal obstruction, sneezing and itching in nose • Prevalance – 15-20% • Higher in pediatric age group
  • 3.
  • 4. •Symptoms appear only in particular seasons SEASONAL •Symptoms present throughout the year PERENNIAL
  • 6. Inhaled allergen produces specific IgE antibody in predisposed individuals This antibody gets fixed to the blood basophils or tissue mast cells On subsequent exposure antigen combine with IgE antibody Causes degranulation of mast cells with release of several chemical mediators
  • 7. • Tissue oedema • Result- Nasal blockage Increased vascular permeability & dilatation • Result- Bronchospasm Change in smooth muscle tone • Increased secretion • Result - Rhinorrhoea Hyperactivity of glands •Histamine •Heparin •Prostagland ins •Leucotriene •ECF-A •NCF-A •PAF
  • 8. • 5-30 min after exposure • Sneezing, Rhinorrhoea, Nasal blockage, Bronchospasm • Due to release of vasoactive amines Acute phase • 2-8 hrs • Due to the infiltration of inflamatory cells at the site causing swelling , congestion, thick secretion Late phase
  • 9. CLINICAL FEATURES • Sneezing • Blocking • Running • Itching
  • 10. Nasal signs • Transverse nasal crease • Allergic salute • Oedematous nasal mucosa • Swollen turbinate • Watery, mucoid discharge
  • 11. Occular signs • Oedema of lids • Congestion and cobble stone appearance of conjunctiva • Allergic shinners
  • 12. Otologic signs • Ottitis media due to eustachian tube blockage • Retracted tympanic membrane
  • 13. Pharyngeal and laryngeal signs • Pharyngitis due to hyperplasia of submucosal lymphoid tissue • In children prolonged mouth breathing as seen in adenoid hyperplasia • Hoarseness of voice • Oedema of vocal cords
  • 15. INVESTIGATIONS • Eosinophil count • Nasal smear- large no. of eosinophils • Skin test- to identify specific allergen • Total IgE –Rarely helpful as 50 % have IgE in normal level • Specific IgE – Radioallergosorbent test (RAST) Measures IgE antibody concentration • Nasal provocation test – Ask the pt to sniff small amount of allergen and observe for allergic symptoms
  • 16. Skin prick test • Rapid, efficient, cost effective • Contain multiple antigen(pollen, dust, animal dander, mold…)
  • 17.
  • 18. NIDANA • अवश्याया अनिल रजो ……. AH.U.19/1 • ………………धूमो रज: शीतमनतप्रताप: S.U.24/3
  • 19. LAKSHANA नशरोगुरुत्वं क्षवथो : प्रवततिं तथा अङ्गमर्त : पररहष्टरोमता | उपद्रवाश्चाप्यपरे पृथग्विधा िृणां प्रनतश्यायपुर: सरा: स्मृता: | Su.U.24/5
  • 20. SAMPRAPTI • चयं गता मूधतनि मारुतार्या: पृथक ् समस्ताश्च तथैव शोनणतम् | • प्रकोप्यमाणा नवनवधै: प्रकोपणै िृणां प्रनतश्यायकरा भवग्वि नह | Su.U.24/4
  • 21. • Nidana – K, V prakopa nidana • Dosha – K, V , alpa P • Dushya – Rasa, Rakta • Srotas – Rasa, Rakta, Pranavaha • Srotodushti – Sanga, Vimargagamana, Atipravrti • Agni- Jataragni dhatvagni mandya • Dosha marga – shaka • Roga marga – bahya • Udbhava sthana – Amashaya, Pakwashaya • Adhishtana – Nasa, Shira • Pratyatma lakshana- Kaphotklesha, Ghrana viplava, Shira shoola, Nasa avarodha, Swara bheda
  • 22. VATAJA PITTAJA KAPHAJA Nasal blockage High T , Thirst Dyspnoea Dryness of throat, palate,lips Yellow hot nasal secretion White cold secretion Hoarseness of voice Emaciation Swollen eyes Thin secretion from nose Ulceration on tip of nose Heaviness in head and face Pricking pain in temples Giddiness Itching in nose, throat,palate,lips More sneezing Hot fumes from nose AH.U.19 & Su.U.24
  • 23. SAMANYA CHIKITSA • िवं प्रनतश्यायमपास्य सवतमुपाचरेत् सनपतष एव पािै: | स्वेर्ैनवतनचत्रैवतमिैश्च युक्तै: कालोपपन्नैरवपीडिैश्च | Su.U.24/18
  • 24. V CHIKITSA • वानतक े तु प्रनतश्याये नपबेत् सनपतयतथारमममम् | पञ्चनभलतवणै: नसद्धं प्रथमेि गणेि च | िस्यानर्षु नवनधं क ृ त्स्रमवेक्षेतानर्ततेररतं| • Snehapana- pancha lavana gritha - Vidarigandhadi gana gritha • Nasya- Anutaila, Sunti taila, Rjanyadi taila, Pippalyadi taila
  • 25. Snigdha dhoomapana • Shatahvadi – shatahva , twak, bala moola, shynoka, eranda, bilwa, aragwada, madhuchishta, vasa, gritha • Gritha, Sakthu • Sneha nasya – oil prepared with tila, aja ksheera, yashti choorna, saindhava kalka & dashamoola kashaya
  • 26. K CHIKITSA • Snehapana – gritha • Vamana – after tila masha yavagu • Samsarjana – kaphahara ahara • Nasya- taila with bala, atibala, brhati, kantakari, vidanga ,gokshura, sweta aparajitha moola, gambhari, punarnava • Dhumapana – Trivrit, kinihi, devadaru, danthi, ingudi, Vidangadi
  • 27. • Nasya • Bharangyadi taila- Bharangi, madana phala, tarkari, tulasi, gomutra ,sarshapa taila, vacha, laksha, vidanga, kushta, pippali, karanja • Pradhamana nasya- manashila, trikatu, vacha, vidanga, hingu, guggulu ( CS.Ch.26) • Trikatu, saindhava, kutaja, jeeraka, vidanga grinded in avi mutra AH.U.20/13
  • 28. AVOID ALLERGENS • Avoid pet animals inside home • Wash the pet weekly • Regulation of ventilations and humidity of home • Avoid walking in open grassy spaces during hot dry days • Keep windows closed • Use face mask when going out • Change of work place if it is a cause • Live in pollution free environment
  • 29. PATHYA YR.85/88 • Katu amla lavana • Snigdha, ushna, lavana • Purana yava & shali • Kulatha , mudga yusha • Gramya, jangala mamsa rasa • Vartaka, kulaka, shigru, karkota, shigru • Dadhi • Taptambu, Varuni jala • Trikatu APATHYA Snana Krodha Vegadharana Bhumi shayya Atidrava ahara