Advances in Biology & BioMedicine. Research Article. Received January 24, 2015; Accepted February 02, 2015; Published February 13, 2015;

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1 Open Access Scientific Publisher Research Article CLINICAL EVALUATION OF GOKSHURA SPECIES IN MUTRAKRICHCHRA (DYSURIA) ABSTRACT Gajendra Kumar Sharma 1 1 Department of Dravya Guna, M.L.R. Ayurveda College Charkhi Dadri, Bhiwani, Haryana, Correspondence should be addressed to Gajendra Kumar Sharma Received January 24, 2015; Accepted February 02, 2015; Published February 13, 2015; Copyright: 2015 Gajendra Kumar Sharma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cite This Article: Sharma, G.(2015). Clinical Evaluation of Gokshura Species in Mutrakrichchra (Dysuria). Advances in Biology & BioMedicine, 1(1). Infection of the urinary tract is the second commonest site after respiratory tract infection. It is more frequent in women than men. Almost 50% women suffer UTI. In our classical texts, urinary tract infection is described as Mutrakruchcha. The great Acharya Charak has mentioned it in Chikitsa sthana, Trimarmiya adhyay, its 8 types and Basti as a Marma. For the treatment of all types of Mutrakruchcha, Gokshur is mentioned. In samhita period we find reference only for this Laghu Gokshura. But for the first time we find in Rajanighantu reference for Brihat Gokshura also called Gokshur dvaya. Botanically Laghu Gokkshura is called Tribulus terrestris of Zygophyllaceae family and Brihat gokshura is called Pedalium murex belonging to family Pedaliaceae. These are classified under mishrak varga as 'Dashmoola'. Gokshur is diuretic, aphrodisiac, tonic and rejuvenating herb with the ability to build lean muscle and strength. Brihat gokshur is mentioned to improve urogenital health. Gokshur possess Madhur rasa, Madhur vipaka and sheet Virya which causes diuresis by increasing Kleda in the body. Due to the visual similarities of the two fruits and their traditional interchanging in Goshukra formulas remarkable difference in there therapeutic properties is not so far studied. So in this study 20 patients complaining of mutrakriccha were assessed by giving laghu Gokshur decoction and brihat gokshur decoction in the dosage of 15 ml twice daily orally. Assessment was done on the basis of sign and symptoms like Mutra daha (burning micturition), Sashula mutrapravruti (painful micturition), Bastishul (suprapubic pain), Mutrapravruti (frequency of micturition), appearance of the urine, Sarakta mutrapravruti (haematuria), Sapuya mutrapravruti (pyuria). KEYWORDS: Mutrakruchcha, Gokshur, Dysuria, Tribulus terrestris INTRODUCTION Ayurveda, the indigenous system of medicine of India, dating back to the vedic ages has been an integral part of Indian culture. In his long struggle to acheive mastery over powerful forces of nature, man has always turned to plants for help. The fame of Ayurveda stands mostly on the magnificent edifice of vegetable materia medica and it can be said that herbs and herbal products occupied a prime place in all ages and in all civilizations on the earth, totally unconcerned with the development of synthetic and chemotherapeutic agents. The plants kingdom has proved to be a fruitful ground for the discovery of effective remedies. Ancient acharyas had developed the knowledge of use of medicinal plants but unfortunately due to the lack of continuity and organization there had been many drawbacks in the application of this knowledge in the present day. Some of the shortcomings are as follows. AIM OF THE STANDARDIZATION The main aim of standardization is to confirm the quality, safety and efficacy of the drug while quality and safety can be known by pharmacognostic and toxicological studies 1

2 clinical studies are considered as the markers to establish the efficacy of the drug. One such clinical study was done to evaluate the comparative efficacy of both Laghu Gokshura and Brihat Gokshur. In samhita period we find reference only for Laghu Goshur, also called simply as Gokshura. But for the first time we find in Rajanighantu reference for Brihat Gokshura also called Gokshur dvaya. Botanically Laghu Gokkshura is called Tribulus terrestris of Zygophyllaceae family and Brihat gokshura is called Pedalium murex belonging to family Pedaliaceae. Morphologically Tribulus terrestris is a procumbent herb and Pedalium murex is a much branched herb. Though both the do not look alike the fruits of Pedalium murex look almost similar to Tribulus terrestris i.e/ laghugokshura. If we take a look about its paharmacological aspect also, it is almost similar to laghu gokshura. Hence it can be assumed that by having similarity in pharmacological properties, in fruits and as it is bigger than Laghu goshur in size, Pedalium murex was named as Brihat Gokshur. In Ayurvedic classics Gokshur has been started as diuretic lithotropic and urinary tract antiseptic drug. But the problem arises when we have to choose among different type of Gokshur for the above purpose. Hence clinical study was done to establish the comparative efficacy of both Gokshur. AIMS & OBEJECTIVES OF STUDY i. To study the pharmacogonstic characteristics of birhat goshur and laghu gokshur which Is established drug as per textual reference for the treatment of mutrakrichchra. ii. Pharmacological evaluation of brihat gokshur & laghu gokshur, and its efficacy in treating mutrakrichchra. So as to establish it s utility as a best drug. iii. To provide a drug which is efficacious having low cost, short duration action and safe for the treatment of mutrakrichchra. iv. To provide a drug which produces no side effect. v. To Determinate the original gokshur as mentioned in Ayurvedic literatures on Ayurvedic parameters. MATERIALS & METHODS The study was done on 20 patients which were divided in two groups and the patients were selected randomly. i. Group A: In this registered patients were treated with Gokshur kwath no.1 in the dosage of 15 ml twice daily for 10 days. ii. Group B: In this 10 registered patients were given Gokshura Kweth no-2 in the dosage of 15 ml for 10 days twice daily. Advances in Biology & BioMedicine CRITIERIA OF ASSESSMENT A. Clinical improvement i. Pain in vankshan, vasti and mutrendriya. ii. Burning sensation in Mutramarga. iii. Yellow urine or harmaturia. iv. Heaviness in muska, mehan and vasti. v. Whiteness, slimness in urine. vi. Appearance of different colours in urine long with burning and pain. vii. Appearance of darkness in front of eyes while micturition. viii. Presence of adhman, school and mutrasang. ix. Other pathologies like- Ashmari, Sarkara, etc. B. Improvement in Lab.parameter i. Routine urine examination. ii. Daily urine output 2 Gokshura Kwath No.1: Consist of Kwath of Pendalium murex. Gokshura Kwath No.2: Consist of Kwath of Tribulus terrestris. A detailed history of the patients was taken and examination was done properly. The parameters selected for the study are as follows:

3 Criteria of assessment by clinical improvement GROUP A S.No. SYMPTOM Exam Total Imp % Of Pat. 1 Pain in BT Vakshan,vasti and Mutrendriya. AT Burning sensation in Mutramarg. BT AT Yellow urine or Haematuria. BT AT Heaviness,in Muska,Mehana and Vasti. BT AT Whiteness, Sliminess in Urine. BT AT Appearanceof different in colours in urine with burning pain. 7 App.of darkness in Eyes while micturiation. 8 Presence of Adhman,shool,and Mutrasang. 9 Othor pathologies like Ashmari Sharkara etc.. BT AT BT AT BT AT BT AT Total BT AT IMP %

4 GROUP B S.No. SYMPTOM Exam Total Imp % Of Pat. 1 Pain in BT Vakshan,vasti and Mutrendriya. AT Burning sensation in Mutramarg. BT AT Yellow urine or Haematuria. BT AT Heaviness,in Muska,Mehana and Vasti. BT AT Whiteness, Sliminess in Urine. BT AT Appearanceof different in colours in urine with burning pain. 7 App.of darkness in Eyes while micturiation. 8 Presence of Adhman,shool,and Mutrasang. 9 Othor pathologies like Ashmari Sharkara etc.. BT AT BT AT BT AT BT AT Total BT AT IMP %

5 Criteria of assessment improvement in laboratory parameter Group No.of Pt. No.of OPD/IPD Quantity of Urine B.T Imp. A.T. % Group A Group B RESULTS The data obtained after the study was analysed statistically and the results were presented scientifically. i. In group A the percentage of relief in Pain in vavankshana, vasti and mutrendriya is 62.5% and in group B also it is 62.5% only. ii. The percentage of relief in in group A is 78% whereas in group B is 80% iii. The percentage of decrease in yellowishness of urine and haematuria in group A is 86% B the percentage is 86% iv. In group A the % of relief in heaviness of mushka, mehana and vasti iis 50% and in group B the percentage is 67% v. In group A the decrease in slimness and hotness of urine is 50% whereas in group B it is 57% vi. The percentage of decrease in appearance of different colours in urine along with burning and pain in group A is 40% which is similar to the percentage in group B vii. The percentage of relief in tama while micturition in group A is 67 % and in group B it is group 50% 5

6 viii. Relief in pathologies like ashmari & sarkara in group A is 67 % and ingroup B it is 75 % ix. The overall relief in all the sympotes of the patients of group A is 62 % and in group B it is 67 % x. The percentage of increase in daily urine output is 63.43% in group A while the percentage of increase in group B is 71.40% CONCLUSION i. The laghu gokshur is clinically more efficacious then brihat gokshur UTI symptoms are mainly Pitta predominant, Gokshur with its Shita veerya cools and soothes the urinary tract membrane by pitta shaman. It reduces inflammation and pain. Gokshur with its Madhur rasa- vipaka and Snigdha guna increase Sharirastha kleda. Kleda increases urine formation. It also has Balya action on Basti (urinary bladder). ii. The diuretic action of Tribulus terrestris (Laghu) is more pronounced than pedalium murex (birhat) iii. The symptomatic relief of Tribulus terrestis (Laghu) is more efficacious than pedalium murex (birhat) in mutrakrichchra rog. iv. So laghu gokshur (Tribules terrestis) can be used effectively in the management of mutrakrichchra without any side effect. REFERENCES Advances in Biology & BioMedicine [36] Acharya Yadavji Trikamaji Dravyaguna Vigyana [37] Vadhya Banvari Lal Mishra Dravyaguna Hastamalaka [38] Vadhyaraj Hakim Daljit Singh Yunani Dravyagunadarsha [39] Dr. Mayaram Uniyal Prayogatmaka Abhinav Dravyaguna Vigyana [40] Keshavdeva Yog Ratnakara [41] Govindadas Sen Bhashjya Ratna Vali [42] Amar Singh Amar Kosh [43] A. Ramamurthy B.H.U. Tjesis On Diuretic effect [44] Govt. Publication - Wealth of India [45] Kritikar & Basu - Indian Medicinal Plants Vol.II [46] K.M. Nadakarni - Indian Materia Medica [47] M.M. Bhandari - Flora of Indian Desert [48] B.V.Shetty & V.S. Singh Flora of Rajasthan [49] K.C. Chunekar -Glossary of vegetable drugs in Brahatrayi [50] C.C. chatarjee - Human Physiology [51] P.G. Mehta - Practical Medicine [52] Harsh Mohan Text Book of Pathology [53] Golwala Physical Dignosis 6 [1] Jaidev vidhyalamkar - Atharvaveda [2] Acharya Bhel - Bhel Samhita [3] Pt. Satyanarayan Shastri,Chakrapani Tika - Charak Samhita [4] Ambikadatta shastri,dalhan Tika Srushut Samhita [5] Acharya Vagbhatta - Astanga Samgraha [6] Acharya Vagbhatta - Astanga Hridaya [7] Pt. Hemraj - Kashyap Samhita [8] Acharya Chakrapani - Chakradatta [9] Acharya Sharngadhara - Sharngadhara Samhita [10] Acharya Bhavamishra Bhava prakash Samhita [11] Acharya Madhava - Madhav Nidana [12] Pt. Guru Prasad Sharma Dhanvantari Nighantu [13] Acharaya Shodhal - Shodhal Nighantu [14] Vadhyacharya Keshav Sidhamantra Prakasha Nighantu [15] Acharya Vopdev - Hridaya Deepaka Nighantu [16] Raja Madanapal - Madanpal Nighantu [17] Acharya Bhavamishra - Bhavprakash Nighantu [18] Kayadeva - Kayadeva Nighantu [19] Narhari pandita- Raj Nighantu [20] Rajavallabha - Rajavallabha Nighantu [21] Lala Shaligram Vaishya - Shaligram Nighantu [22] Data Ram Chaobe - Abhinav Nighantu [23] Aryadas Kumar Singh - Mahoaushadha Nighantu [24] Acharaya Priyavrata Sharma Priya Nighantu [25] Vadhya Bapalal G. Shah Nighantu Adarsh [26] Acharya Shodhal - GadaNigraha [27] Priyavrata Sharma - Ayurved Ka Vaigyanik Itihasa [28] Dalhana - Nibhandha Samgrah [29] Gayadas - Nyaya Chandrika [30] Vadhya Ranjit Rai - Ayurvediya Kriya Sharir [31] Shiv Kumar Goda. - Sharir Kriya Vigyana [32] Chandra Raj Bhandari Vanoaushadhi Chandrodaya [33] Chaukhamba - Dhanvantari Vanoaushadhi Visheshamk [34] Dr. Ram Sushil Singh - Vanoaushadhi Nidrshika [35] Acharya Priyavrata Sharma Dravyaguna vigyana