Panchakarma: Ayurvedic detoxification and allied therapies-Is there any evidence?

Abstract

Panchakarma is a collective term used to refer to the five main Ayurvedic procedures of detoxification: vamana (emesis), virechana (purgation), nasya (nasal instillation of herbal oils/powders), basti or vasti (herbal enema), and raktamokshana (bloodletting). These procedures are commonly used in conjunction with allied therapies in order to cleanse the channels, eliminate toxins from the body, and restore balance. Panchakarma is one of the most important Ayurvedic treatment modalities. When done correctly, it increases the receptivity and effectiveness of subsequent therapies. Each procedure is performed in three phases: preparatory procedures, the main procedure, and post-cleansing procedures such as diet and lifestyle modification. Examples of adjuvant allied therapies include shirodhara (ayurvedic oil dripping treatment), shirobasti (retention of warm herbal oil on the scalp), katibasti (retention of warm herbal oil on the back), and janubasti (retention of warm herbal oil on the knee). Treatment protocols are customized to meet the individual needs of each patient. In addition, Panchakarma may be used for preventative and rejuvenative purposes. Its use is therefore supported for everyone-including healthy individuals. Our literature review suggests that most of the procedures included under panchakarma have been investigated to some extent. The majority of the studies reviewed showed positive outcomes for panchakarma and allied therapies when compared to a control. Unfortunately, only a limited number of high-quality clinical trials have been conducted to date. Common limitations include low sample size, inadequate descriptions of randomization and blinding protocols, inadequate descriptions of adverse events, and nonstandard outcome measures. In spite of this, preliminary studies support the use of panchakarma and allied therapies and warrant additional large-scale research with rigorously designed trials.