AUTHOR=Sivadas Anjana , Indira Vikraman Aiswarya , Santharajan Vishnuraj , Panthalloor Balakrishnan Kadambari , Unnikrishnan Vishnu , Kesavan Namboothiri Parameswaran 

TITLE=Estimation of the inflammatory biomarker IL-6 in blood samples from varicose veins after repeated sirāvyadha (venesection/bloodletting)

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1638127

DOI=10.3389/fmed.2025.1638127

ISSN=2296-858X

ABSTRACT=IntroductionSirāgranthi results from vitiated vāta in sirās, leading to granthi due to Vātaprakopaka nidānas. Ācārya Vagbhata recommends sirāvyadha for treating sirāgranthi. The role of inflammation in vascular diseases is explored, with a focus on Interleukin-6 as a key biomarker. The absence of studies on sirāvyadha’s impact on inflammatory biomarkers, particularly Interleukin-6, underscores the study’s relevance, aiming to observe changes in inflammatory response in varicose veins post-sirāvyadha within a 15-day period.ObjectiveTo observe changes in IL-6 values before and after sirāvyadha within a 15-day period in individuals with varicose veins. Materials and Methods: After excluding deep vein thrombosis (DVT) through lower limb color doppler, five subjects who satisfied the inclusion criteria were selected. Assessments included BT, CT, Hb screening, and parameters like AVVQ, pain, edema, tortuosity, skin pigmentation, and itching. Sirāvyadha was performed over the tortuous vein with an 18G needle, and sample was collected from drained blood for IL-6 testing. After a 15-day follow-up, Sirāvyadha was repeated, and assessment of all parameters were done.ResultsStatistically significant differences (p<0.05) were observed after treatment in Interleukin-6, AVVQ, pain, edema, tortuosity, and skin pigmentation. However, itching showed no statistically significant difference after treatment (p > 0.05).ConclusionIn all 5 cases, a reduction in the rate of IL-6 was observed. Remarkably, three patients with initially high values showed a statistically significant reduction (p < 0.05) after sirāvyadha treatment, indicating a reduction in inflammation. Clinical and statistical significance (p < 0.05) were also observed in subjective parameters such as pain, edema, tortuosity, and skin pigmentation. Although itching decreased in patients, it did not reach statistical significance, possibly due to some patients not experiencing itching before the procedure. The study demonstrates that sirāvyadha effectively reduces the inflammatory response and subjective symptoms of varicose veins. Furthermore, the improvement in the quality of life after sirāvyadha was highly significant (p < 0.05). Overall, the study supports sirāvyadha’s efficacy in reducing inflammatory biomarker IL-6 and subjective symptoms in varicose veins.