Abstract
Introduction: Siravedha (venesection) a type of bloodletting, is indicated for varicose vein in Ayurveda. Effects of siravedha manifests at multiple levels from the blood hemodynamics to the Quality of Life of varicose vein patients. Present study was planned to understand the effect of siravedha in varicose vein in terms of all the available subjective and objective parameters which will give a better understanding on the effect of siravedha.
Objective:
To develop a mathematical model for predicting the outcome of siravedha in varicose vein, using the data regarding clinical staging and blood profile.
Materials and methods:
A total of thirty subjects were recruited. Subjective and objective parameters were assessed at before and 15 days post siravedha intervention. Subjective parameters were Clinical Etiologic Anatomic Pathophysiologic [CEAP] classification, Venous Clinical Severity Score [VCSS], Aberdeen Varicose Vein Questionnaire, scoring of raktadushti (vitiation of blood) symptoms and prakriti (body constitution) assessment whereas objective parameters include blood profile, Arterial Blood Gas test etc.
Results: Objective parameters in blood that showed a significant change after siravedha were RBC count in cubital vein, hematocrit in cubital and varicose vein, and also Red cell Distribution Width standard deviation (RDW – SD), MCV, base buffer, partial pressure of oxygen, chloride ion and glucose level in varicose vein. Also there was significant improvement in the subjective parameters - CEAP VCSS, AVVQ and raktadushti.
Correlation between CEAP score and each parameter in cubital and varicose vein was done separately to find the high positively and negatively correlated parameters and 11 parameters were identified. Parameters obtained are Neutrophil, Eosinophil, pH, SO2, HCO3, Chloride, RDW – SD, Mean Corpuscular Hemoglobin Concentration (MCHC), Glucose and Lactate. Using physicochemical parameters as independent variables, CEAP the dependent variable, the CEAP was best predicted by linear regression model (R2 = 0.17) whereas VCSS by both linear (R2 = 0.21 ) and polynomial (R2 = 0.16) regression models.
Conclusions: Developing multi scale mathematical model provides more insight and clear understanding of effects of siravedha on qualitative and quantitative parameters.

Key words: Ayurveda, CEAP, VCSS, Quality of Life, Hypoxia, Systems biology