Allergic rhinitis management with AYUSH treatment methods

After asthma, allergic rhinitis is the most common form of allergic condition faced or reported globally. It is a very common form of allergy and is mainly caused by pollens, dust, fly-ash, and other particulate matters. According to a study by The Global Asthma Network, (2018); approx. 70% of the global human population inhale or consume pollens, dust, fly-ash, and other particulate matters in one way or the other. In addition, over 30% of the world population suffers from allergic rhinitis. Above all, managing allergic rhinitis is possible by allopathic and traditional (AYUSH) medications. In addition, Sahu et al., (2014) implicated that, unlike allopathic medication for allergic rhinitis, traditional methods do not have side effects and therefore can be more efficient in their management.

Managing allergic rhinitis with Ayurveda

Allergic Rhinitis or as mentioned in Ayurveda, ‘Vataja Pratishyaya’ causes ‘Pratishaya’ or symptoms like sneezing, nasal inflammation, and breathlessness; caused by inhalation of toxins (ama) and due to the low immunity (Chawardol & Jain, 2014; Sahu et al., 2014). Furthermore, allergic rhinitis according to the philosophy of Ayurveda, toxins or ‘ama’ comprises of uncooked, unripe, undigested and immature material. In Ayurveda, allergic rhinitis is based on ‘Nidana-Parivarjana’ or avoidance of the causal factors (Sahu et al., 2014). Since the causal factors of allergic rhinitis comprise of smoke, dust, pollens and minute particle, ayurvedic methods advise against inhalation. Also, Chawardol & Jain, (2014) indicates that allergic rhinitis is caused by food materials having antagonistic properties and are also the etiological factors of allergic rhinitis. Management of allergic rhinitis, therefore, has different methods of treatment based on the etiological factors.

The following table presents different treatment methods to manage allergic rhinitis with Ayurveda. The table also consists of different compositions and their commercial products.

Ayurveda medication type Ayurveda nameCommon or Scientific name Commercial drugReference
Shamana Anand Bhairav Ras, Tribhuban Kirti Ras Rasa, Mayour Shriga Bhasm, Abbrak Bhasm, Sito Paladi Chura, Gudchadya yoga, Marichyadi yoga, Laanjadi Vati, and Khadiradi vati. Neem, turmeric, Petasites hybridus, Omega 3 fatty acids, Flaxseed oil, and Walnuts.Dr.Vaidya’s Swasaghna Pills 24’s, Himalaya Wellness Pure Herbs Vasaka Respiratory Wellness Tablet (Chawardol & Jain, 2014)
Haridra Khanda Guduchi, ginger, Shirish, Kutki, Anantmool, Long Pepper, Turmeric, Pippali, Twak, Sukshma Ela, Amala, Hirda, Musta, Lauha Bhasma, and Nagkeshara. Tinospora cordifolia, Zingeber officinale, Albizia lebbek, Picorrhiza sp., Tylophora indica, Piper longum, Curcuma longa, Cinnamomom sp., Elattaria cardamomum, Emblica officinalis, Mesua ferea, Cyperus sp., Terminalia sp.Himalaya Septilin Tablet, Planet Ayurveda Vatsakadi Churna, Himalaya Wellness Pure Herbs Vasaka Respiratory Wellness Tablet (Karmarkar, 2017)
Chitrak Haritaki Avaleha Chitraka, Guduchi, Bilva, Agnimatha, Shalaparni, Gokshura, Maricha, Yavakshara, and Honey. Plimbago sp., Tinospora sp., Aegle marmelos, Cledodendron sp., Desmodium sp., Solanum indicum, Zingiber sp., Cinnamon sp., Salt, Honey, Piper sp. Planet Ayurveda Vasaka Capsule, Planet Ayurveda Vatsakadi Churna (Karmarkar, 2017)
Agastya Haritaki Rasayana and Bresol tablets Dashamoola, Pippali, Bharangi, Kapikacchu, Haritaki, Tulsi / Basil, Turmeric, and Vasaka Piper sp., Clerodendrum sp., Mucuna pruriens, Terminalia sp., Curcuma longa, Ocimum tenuiflorum, Adhatoda vasika. Himalaya Bresol Tablet, Planet Ayurveda Vasaka Capsule   (Karmarkar, 2017)

Managing allergic rhinitis with the Unani treatment methods

Unani system of treatment names allergic rhinitis as ‘zukaam’ or ‘Nazla Haar’ (Fazeenah, & Quamri, 2015). According to Unani system, the pathophysiology of allergic rhinitis is caused due to immediate hypersensitivity reaction occurring in the nasal mucosa on exposure to a variety of allergens. Furthermore, it is treatable by clearance of nasal passage of phlegmatic secretions by the effect of ‘halela’ (Terminalia sp.), ‘balela senna’ (Terminalia bellerica) and ‘turbud’ (Ipomoea sp.), which comprises of phytochemicals chebulinic, chebulagic acids, aloe-emodin, cathartin and sennosides (Hussain et al., 2003). Drugs using a combination of these plants phytochemical are commonly Etrifal Ustukhudus, Etrifal Khasneezi, and Khamira Abreshm.

According to the Unani system, the etiology of allergic rhinitis is ‘hararat mizaj’, ‘hararate mizaj khaas’, exposure to sunlight, fire, ‘garam hamam’ or working in hot environment, applying pungent perfumes and strong smell or ‘mushk’, ‘zafran’, ‘onion’, strenuous psychic or physical activity and exposure to allergens like pollen, cotton fur, feather, and dust (Fazeenah, & Quamri, 2015).

Unani medication typeAyurveda nameCommon or Scientific name Commercial drugReference
General medication Inkibab, takmeed, fasd, and qutoor Steam inhalation, fomentation, venesection and nasal drops N/AFazeenah, & Quamri, (2015)
Etrifal Ustukhudus, Etrifal Khasneezi, and Itrifal Ustukhudoos Halaila Zard, Halaila Siyah, Balela, Amla, Ustukhdoos, Senna, Turbud Sufaid, Bisfayaj, Mastagi, Aftemoon, Kishmish, Munaqa, and Shahad khalis Terminalia sp., Emblica officinalis, Lavendula stoechas, Cassia augustifolia, Ipomoea turpethum, Polypodium vulgare, Pistachia lentiscum, Cuscuta chinensis, Vitis vinifera, and Honey Rex Itrifal Kishneezi, Hamdard Itrifal Kishneezi, Rex Itrifal Shahtara Hussain et al., (2003)
Muqawwiyate dimagh va me’dda Khameera Nazli, Sharbat banafsha, Hab nazli, Sharbat firyadaras, and sharbat aijaz Mytilus margaritiferus, Vateria Indica, Serpentine, White Sandalwood, and sugar Hamdard Khamira Marwareed, Hamdard Khamira Abresham Hakim Arshad Wala, Fazeenah, & Quamri, (2015)

Managing allergic rhinitis with the Siddha treatment methods

According to the Siddha system of treatment, allergic rhinitis is caused by activation of mast cells and basophils that leads to IgE releasing histamine, leukotrienes, and cytokines (Kanakavalli et al., 2014). The cytokine-induced reaction causes tissue injury thereby causing allergic rhinitis or inflammation of the nose. Consequently as per Siddha treatment methods, allergic rhinitis is known to cause primarily from Bronchial asthma and is known as ‘Eraippu Noi’ (Manicka Vasagam & Thomas, 2008).

However, there is a lack of detailed information on allergic rhinitis management. Furthermore, Karimi et al. (2017), identifies the medicinal Cydonia oblonga or Quince for use in case of allergic conditions caused by pollens and dust and is widely used for the treatment of allergic rhinitis. On the other hand, Ministry of AYUSH, (2013), Government of India, has classified allergic rhinitis under ‘Karuppu’ or bronchial asthma and all drugs manufactured for allergic conditions can also be used for rhinitis. The following table has listed the most common names of Siddha medications and their common names for treatment of allergic rhinitis.

Siddha medicine name Common or Scientific nameCommercial products References
Kundremani, Kuppaimeni, Vengayam, Aadu theendapaalai, Manjal, Korai kizhangu, Kollu, Thumbai, Kantakathiri, and Thalisapathiri Abrus precatorius, Acalypha indica, Allium cepa, Taxus baccata, Solanum xanthocarpum, Dolichos biflorus, Curcuma longa, Cyperus rotundus, Leucas aspera, and Aristolochia bracteolata N/A Kanakavalli et al., (2014)
Kasthuri karuppu, Thalakakkaruppu, and Pattukkaruppu Sesamum indicum, Tamarindus indicus, Cassia tora, Andrographis paniculata, Elettaria cardamomum, Saraca asoka, and Zingiber officinale N/A Ministry of AYUSH, (2013)

Managing allergic rhinitis with the homoeopathy treatment methods

The theory of homoeopathy for allergic rhinitis is not different from allopathic and ayurvedic or any other AYUSH methods (Banerjee et al., 2017). It simply says that it is an immunological response of the nasal mucosa to airborne allergens such as pollens, dust, or animal dander, and treatment must be based on corresponding to the manifestations of the allergic conditions like;

  • cough,
  • runny nose,
  • mucus formation, and
  • nasal irritation.

Furthermore, Banerjee et al., (2017), in their systematic study found Betula sp. and Galphimia glauca as the most commonly used herbals and their phytochemicals for the treatment of rhinitis. On the other hand, Ministry of AYUSH, (2013) identified over 10 medicinal plants that help in the treatment of allergic rhinitis. Goossens et al., (2009) mentioned the use of the following compounds for the treatment of allergic rhinitis;

  • Sulphur,
  • Pulsatilla,
  • Medorrhinum,
  • Tuberculinum aviaire,
  • Natrum muriaticum,
  • Phosphorus,
  • Sepia,
  • Arundo,
  • Calcarea phos., and
  • Thuya.

Commercial homoeopathic products for allergic rhinitis include;

  • SBL Drops No. 8,
  • Bakson’s Aller Aid Tablet,
  • Bioforce Blooume 30 Rhinitisan Drop, and
  • Physiomer Hypertonic Nasal Spray.

The current state of allergic rhinitis management with AYUSH treatment methods

The mode of approach for the management of allergic rhinitis in different methods of AYUSH based treatment is almost the same. However, only the Unani method points out larger symptoms and aetiology to plan allergic rhinitis management. It is also implicative that, a few of the listed medicinal plants are used in common like Piper sp., Curcuma longa, Zingiber sp., Terminalia sp., and Cassia sp. However, the level of effectiveness of any of these methods of allergic rhinitis management is unavailable. Therefore, it is difficult to estimate the effectivity of these treatment methods. This indicates a lack of clinical studies of the AYUSH based drugs for allergic rhinitis management.

Furthermore, it is seen that a number of companies and AYUSH healthcare institutes have established to reach out to a larger population. Over 100 colleges, healthcare centres and industries have been established. This, however, is only possible if existing patients have seen positive results from AYUSH based allergic rhinitis management. It is suggested that clinical studies must be published with respect to AYUSH based treatments for allergic rhinitis and results made available to the public for a better understanding of the chemistry and pathophysiology.

References

  • Chawardol, S. G., & Jain, S. B. (2014). Ayurvedic Line of Treatment of Allergic Rhinitis. International Journal of Ayurvedic and Herbal Medicine, 4(4), 1527–1531.
  • Fazeenah, A. A., & Quamri, M. A. (2015). Unani perspective of allergic rhinitis (Nazla Haar): A literary review. Journal of Pharmacognosy and Phytochemistry3(6), 22-25.
  • Global Asthma Network. (2018). The Global Asthma Report 2018. Available online: http://globalasthmareport.org/Global%20Asthma%20Report%202018.pdf.
  • Goossens, M., Laekeman, G., Aertgeerts, B., & Buntinx, F. (2009). Evaluation of the quality of life after individualized homeopathic treatment for seasonal allergic rhinitis. A prospective, open, non-comparative study. Homeopathy98(01), 11-16.
  • Hussain, S. A., Khan, A. B., Siddiqui, M. Y., Latafat, T., & Kidwai, T. (2003). Evaluation Of A Combination Of A Unani Pharmacopeal Preparation (Itrifal Ustukhudoos) With Cloves (Qaranfal) In Allergic Rhinitis–A Preliminary Clinical Study. Ancient science of life22(4), 152.
  • Kanakavalli, K., Parthibhan, P., Geetha, V., Chithradevi, R., Latharani, M., & Thillaivanan, S. (2014). A Review On Anti Allergic Herbs In Siddha System Of Medicine. IJPRNK, 3(6), 312–320.
  • Karimi, A., Movahhed, M., HajiMehdipoor, H., & Allahyari, F. (2017). A Review On Cydonia Oblonga Miller As An Herbal. IAJPS, 4(12), 4370–4386. https://doi.org/10.5281/zenodo.1098379.
  • Karmarkar, A. B. (2017). Herbal (Ayurvedic) Way of Treatment and Management of Allergic Rhinitis. Journal of Emerging Technologies and Innovative Research, 4(10), 35–39.
  • Manicka Vasagam, K., & Thomas, M. (2008). The role of Nasiyam (nasal application) in the treatment of Eraippu noi (bronchial asthma). Available online: https://www.researchgate.net/publication/36447823_The_role_of_Nasiyam_nasal_application_in_the_treatment_of_Eraippu_noi_bronchial_asthma.
  • Ministry of AYUSH. (2013). Essential Drugs List of Ayurveda Siddha Unani and Homeopathy. Available online: http://ayush.gov.in/
  • Sahu, D., Dhiman, D., Vaghela, D. B., & Mata, S. (2015). Allergic Rhinitis in Ayurvedic Perspectives. World Journal of Pharmaceutical Research4(8), 2192-2198.
  • WHO. (2016). White Book on Allergy: Executive Summary. Available online: http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf.

Avishek Majumder

Research Analyst at Project Guru
Avishek is a Master in Biotechnology and has previously worked with Lifecell International Private Limited. Apart from data analysis and biological research, he loves photography and reading. He loves to play football and basketball in his spare time with an avid interest in adventure and nature. He was also a member of the Scouts in his school and has attended Military training.
Avishek Majumder

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