An Integrative Framework of Ayurveda and Siddha Medicine for the Management of Environmental Toxicity and AQI-Driven Respiratory Disease: A Critical Analysis Based Narrative Review

Abstract

Poor air quality, measured through the Air Quality Index (AQI) has become one of the more under-
discussed drivers of chronic respiratory disease in South Asia. Millions of people especially urban
population live in a constant PM2.5 concentration exceeding safety thresholds, the clinical consequences
are real: rising COPD rates, worsening asthma control, and an inflammatory burden that lasts the period of
exposure because lipophilic pollutants accumulate in lung tissues. Conventional treatments handle the
symptoms well but does not handle the accumulated toxicant load at all.
The present content is made upon review of published and available clinical evidences for ayurveda and
siddha formulations in respiratory disease, and to propose a structured integrative protocol including an
AQI-stratified framework and four phased clinical sequence grounded in those evidences. An SANRA
aligned narrative review of highly indexed publications was carried out in assistance from classical primary
references.
Classical Ayurvedic formulations were reviewed namely, Vyaghariharitaki Avaleha, Vasadi Kashaya,
Kantakariavaleha, Eladi Gutika carried controlled or semi controlled clinical trial data showing statistically
significant improvements in FEV1, FEV1/FVC, PEFR and validated symptom scores. Siddha formulations,
particularly Kaba Sura Kudineer and Atatotai Kutinir, show respiratory and anti-viral efficacy in clinical
settings.
AQI—stratified and Four-phase protocol is proposed based on these findings thus bringing multi-target
pharmacology, Panchakarma based detoxification, Rasayana immunoprotection that the conventional
medicines lack large scale RCTs, Pharamacokinetic characterisation and Toxicant biomarker studies are
the essential next steps.