ArticleJournal of Ayurveda and integrative medicine
Conceptualization and design of an Ayurveda framework for the diagnosis of Duchenne Muscular Dystrophy: insights from a prospective cohort study.
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Abstract
backgroundDuchenne Muscular Dystrophy (DMD), an X-linked neuromuscular disorder is caused by dystrophin gene mutations. Ayurveda perceives DMD under adibalapravrittaroga (hereditary anomalies) and janmabalapravrttaroga (congenital anomalies) caused by bijabhagavayava dosha (defects in the subpart of seed) leading to innate vata imbalance progressively damaging the mamsadhatu (muscle tissue), medadhatu (fatty tissue), and asthimajjadhatu (bone-bone marrow), resulting in muscle atrophy and mobility loss.
objectiveThe framework aims to establish a diagnostic protocol, elucidate the pathogenesis of DMD based on empirical evidence, and differentiate the stages of the disease using Ayurvedic concepts such as dosha, dhatu, mala, agni, and ojas.
methodsThe framework is based on cross-sectional data prior to intervention in a three-year prospective observational cohort study involving 67 participants with molecularly confirmed DMD not receiving steroid therapy for the past six months and consented. Participants underwent multidisciplinary clinical assessments, including Ayurvedic evaluations of Prakrti (individual constitutional typology), Sara (predominance of fundamental structural components), Doshavrddhi-laksana (indicators of Dosha aggravation), and Rogavastha (disease staging).
resultsTridosha prakrti and Mamsa-asthisarah were identified as the most prevalent classes, respectively. The kapha class demonstrated the longest duration of ambulation loss at 3.1 years. Ambulant individuals comprised 47 % in the asthisara class and 27 % in the Mamsa-asthisarah class. Vata dosha exhibited the highest deviation among the doshavrddhi-laksana. Under rogavastha, significant differences between ambulation stages were observed in Sarvagatavata, Asthimajjagatavata, and Ojovisramsa.
conclusionDMD follows a vata-vyadhi trajectory, with dhatu-specific involvement shaping functional decline. Early mamsavrtavata and persistent medavrtavata emphasize the need for tissue-targeted interventions, while progressive sarvagatavata and asthimajjagatavata drive neuromuscular and skeletal compromise. Advanced ojas disturbances contribute to systemic and cardiopulmonary decompensation. These findings support Ayurvedic strategies focused on dhatu nourishment and ojas restoration and provide a framework for further evidence-based studies.
trial registrationCTRI Reg No: CTRI/2020/07/026906.
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