Authors' objectives:

The objective of this evidence report was to conduct a search of the published literature on the use of Ayurvedic medicine/therapies for the treatment of health conditions and, on the basis of that search, to choose either a condition or a modality for a comprehensive review. Based on the results of initial searches, diabetes was chosen as the topic for the comprehensive review. The specific questions addressed in this project were: (1) What Ayurvedic therapies have been reported in the literature, for which conditions/body systems, and using what kinds of research designs? (2) What is the efficacy of Ayurvedic medicine/therapies, as reported in that literature, for the treatment of diabetes?

Authors' results and conclusions: Our search of the Ayurvedic literature in the West found the largest number of studies for the following systems/disease states: diabetes mellitus, liver/hepatitis, hypercholesterolemia, central nervous system disorders (dementia/depression), infectious diseases, and cardiovascular diseases. Botanical therapy was by far the most commonly studied treatment. Herbs were studied either singly or as formulas containing multiple herbs and sometimes minerals. For diabetes, 52 of the 54 articles focused on either single herbs or herbal formulas, while the remaining 2 articles focused primarily on diet. Although some of the Indian studies included Ayurvedic terms, these studies focused on Western diagnostic criteria and outcomes. The most commonly studied single herbs were Gymnema sylvestre, Coccinia indica, fenugreek (Trigonella foenum-graecum), and Eugenia jambolana. A number of herbal formulas were tested, but Ayush-82 and D-400 were the two most often studied. The 54 articles contained the results of 62 studies. Thirty-five of the studies included in the comprehensive review came from the Western literature, and 27 came from the Indian literature. The designs of these studies were varied. There were 7 randomized controlled trials (RCTs) and 10 controlled clinical trials (CCTs). There were 38 case series, the most frequently used clinical design, and 7 cohort studies. There is evidence to suggest that the single herbs Coccinia indica, holy basil, fenugreek, and Gymnema sylvestre and the herbal formulas Ayush-82 and D-400 have a glucose-lowering effect and deserve further study. Evidence of effectiveness of several other herbs is less extensive (C. tamala, Eugenia jambolana, and Momordica charantia).

Authors' recommendations: There is great heterogeneity in the available literature on Ayurvedic treatment for diabetes. The overwhelming majority of studies test herbal therapy. Heterogeneity exists in the herbs and formulas tested (more than 44 different interventions identified) and in the method of their preparation. We observed significant methodological shortcomings, specifically: there were few RCTs and CCTs; studies in general were underpowered to determine even large effect sizes: many studies had an extremely small number of subjects; in a number of studies, appropriate statistical methods were not used in reporting the results. The majority of the studies tested non-insulin dependent diabetes mellitus (type 2) patients only. Therefore, no definitive conclusion can be drawn on the effect of these therapies on insulin dependent diabetes mellitus (type 1) patients. Despite these limitations, there is sufficient data for several herbs or herbal formulas to warrant further studies.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/epcsums/ayurvsum.htm

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)