ADRAVYABHUTA CHIKITSA (NON-PHARMACOLOGICAL TREATMENT) IN NASH (NONALCOHOLIC STEATOHEPATITIS)- CONCEPTUAL REVIEW

Abstract

Non alcoholic steatohepatitis (NASH) is the cause behind liver related morbidity and mortality but is also responsible for the increased susceptibility of atherosclerosis, cardiovascular disease and type 2 diabetes mellitus. According to studies Non Alcoholic Fatty Liver Disease (NAFLD)/NASH is having a strong association with obesity, type 2 diabetes mellitus, dyslipidemia etc. A two hit hypothesis has been proposed to describe the pathogenesis of NAFLD the first hit causing steatosis that than progress to steatohepatitis if a second hit occurs. In the view of Ayurveda concept the Medoroga (metabolic disease), Prameha(diabetes) , Santarpanajanya (over nourished) roga nidanas play a major role in pathogenesis of the disease so the Chikitsa mentioned in these disease may help in the management of NAFLD/NASH. Treatment of NAFLD/NASH comprises of pharmacological and non pharmacological method. According to available references no pharmacological agents are currently licensed specifically for NASH therapy. Treatment directed at coexisting metabolic disorders such as dyslipidemia ,Type 2 diabetes mellitus,obesity and hypertension. Current non pharmacological treatment comprises life style modification to promote weight loss and improve insulin sensitivity through dietary changes and physical exercise. Acharya Charaka in Vimanasthana has classified the Chikitsa into Dravyabhuta and Adravyabhuta Chikitsa. Adravyabhta Chikitsa can be employed in the form of Vyayama, Langhana, etc. contemporary science also says the non pharmacological treatment is the first line of treatment in NAFLD/NASH. This review article is a meticulous compilation of available Adravyabhuta Chikitsa which is are specified in Medoroga, Prameha and Santarpanajanya rogas and trying to understand their scope in treatment of NAFLD/NASH.