ANVESHANA CLINICAL EVALUATION OF DHATRYADI KWATH IN THE MANAGEMENT OF MOOTRAKRUCHHRA WITH SPECIAL REFERENCE TO URINARY TRACT INFECTION

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1 ANVESHANA Research Article AYURVEDA MEDICAL JOURNAL ISSN: CLINICAL EVALUATION OF DHATRYADI KWATH IN THE MANAGEMENT OF MOOTRAKRUCHHRA WITH SPECIAL REFERENCE TO URINARY TRACT INFECTION Dhalape Rupali 1, Bhujbal Annasaheb 2, Wasnik Sumedh 3, Vaibhav B. Sulakhe 4 1 Asst. Prof., 2 Asso. Prof., 3 Prof. and HOD of Shalya Tantra, 4 Asst. Prof. of Agadatantra, PMT s Ayurved College, Shevgaon, Ahmednagar, Maharashtra, India Corresponding Author: rupdhalpe6@gmail.com ABSTRACT In the speedy era of competition we don't have enough time to take care of our own health that renders the disease to us. Our ignorance to natural urges like micturition, defecation in busy schedule serve as oil to fire. Due to etiological factors like Ajirnashan (indigestion), Adhyashan (frequent eating), Atirukshannapan (eating dry food), Atimadyapan (drinking alcohol) various diseases occur including Mutrakrucchra (Dysuria). The symptoms of Mutrakrucchra are very distressing which disturbs routine life and when ignored will lead to severe complications like pyelonephritis. Modern science has established treatment of this disease by using antibiotics, anti-inflammatory drugs. It has got side effects and toxic effects. Ayurvedic counterpart for this disease is safe and effective, easily available & gives alternative for this disease. Dhatryadi Kwath is one of the medicated Kwath listed in Bhaishajya Ratnawali in the treatment of Mutrakruchhra. Key words: Mutrakrichchra, Urinary tract infection, Dhatryadi Kwath INTRODUCTION According to Ayurveda a healthy person should have balanced state of basic elements of body like dosha, Dhatu, Mala, Agni; sound body requires sound mind. 1 Recently the rapidly changing life styles of the population become the most important cause for the various disorders. The ideal way of living is eventually narrated by Ayurveda in details but we are more anxious to follow western culture and gets prone for most of systemic illness. Due to western effect of civilization and improved economic status of some population people staying away from their house and therefore depending upon hotel food, the nature of food substances and food habits are changed. Proper intake as per the digestive capacity is not made. Eating fast, spicy and heavy food has become the fashion among the youngsters. Our ignorance to natural urges like micturition, defecation in busy schedules is also responsible. Mootra-krichhra is shoola (ruja, pian) dahayukta pradhana samanya vyadhi affecting urinary system & leaving the person disable & disproved from the routine activity. In this way Mootra-krichhra & Dysuria can be correlated as they are having similar clinical presentation. 2,3 Antibiotics have their own limitations of development of resistance in

2 the microorganisms due to reinfections and relapses even after the long term therapy. 4 There is need to find out an alternative cost effective, affordable and easily available management. So relieve this condition Ayurveda has narrated many preparations, one of these is Dhatryadi Kwath. Hence clinical study on Dhatryadi Kwath in the management of Mootrakruchhra with special reference to Urinary tract infection was carried out. As per Bhaishajya Ratnavali, Mootrakruchhraadhikara, Dhatryadi Kwatha is specially indicated for Mootrakruchhra. 5 Different work have been carried out in different view, still an added effort was made by understanding the problem with available sources of literature and try to manage the condition, thinking that this may help in giving better management for patient and helping them in relieving their suffering. AIMS AND OBJECTIVES Study of efficacy of dhatryadi kwath with Sita (Sugar) in Mootrakruchhra. To conduct comparative study of dhatryadikwath with Tab Norflox in the management of Mootrakruchhra. MATERIALS AND METHODOLOGY Study type- Open randomize study Sample size- Thirty 60 patients Place of study- O.P.D. and I.P.D. of Shalya tantra Department. Inclusion criteria: 1) Patients in age group years of either sex irrespective of religion, occupation & Socioeconomic states. 2) Patients having textual lakshanas of Mootrakrichhra. 3) Patients having sign & symptoms of Dysuria. 4) Patients willing to participate in the study will be selected explaining them the details about study. Exclusion criteria: 1) Patients of diabetes mellitus 2) Known cases of congenital urinary tract anomalies 3) Immuno compromised patients like HIV, tuberculosis, leprosy 4) Known cases suffering from bladder outflow obstruction in conditions like stricture, BPH and renal stone Urinary tract Carcinoma etc. 5) Known cases suffering from organic disorders and renal failure pyelonephritis. 6) Age group below 12yrs. & old age above 60yrs. Group A: Trial Group (30 patients) Dhatryadi Kwath 6 Firstly all raw materials (Bharad form) were taken and properly cleaned. 1) Dhatri (Emblica officinalis) 2) Draksha (Vitis vinifera) 3) Vidari (Pueraria tuberosa) 4) Yashtimadhu (Glycerrhiza glabra) 5) Gokshur (Tribulus terrestris) 6) Sharkara Method: A prospective, randomized, single blind, controlled clinical trial was conducted on 60 patients. Procedure: Permission for conduction of clinical trial and no objection certificate from institutional ethical committee was taken. 1) Preparation of Dhatryadi Kwath 7 : All above constituents were taken with the help of Tula Yantra in equal quantity (4g each) and properly mixing done. The kwath (decoction) was prepared as given in Sharangdhar Samhita as follows: Bharad churna of all above contents (20g) mixed with 16 times water (320 ml). Then using mandagni (low heat), mixture was boiled till its 1/8 th part should be remained (40 ml). Stirring was done in between the AAMJ / Vol. 1 / Issue 6 / Nov Dec

3 procedure. Then kvatha was filtered and allow to cool it (koshna) then Madhu was added in it and then given to patients for drinking. The Kwath is prepared in Rasashatra Bhaishajya Kalpana dept. This treatment was given to patients for 10 days after every 3 days follow up. 2) Dose: Age group yrs 80ml in 2 divided doses i.e. 40 ml BD. 3) Seven kala: Apana kali i.e. Bhojanpurva (Before meal) 8 4) Anupan: Sita 5) Route of administration: Oral route. 6) Total duration of study: 10 days. 7) Follow up: - After every 3 days for 10 days. Group B : (Controlled Group): Other 30 patients were given Tab Norflox. Content-Norfloxacin: It is synthetic chemotherapeutic antibacterial agent used to treat urinary tract infections 9,10. 2) Dose: Age group yrs 400mg in 2 divided doses 3) Sevena kala: Apana kali i.e. Bhojanpurva (Before meal) 4) Route of administration: Oral route. 5) Total duration of study: 10 days. 6) Follow up: After every 3 days for 10 days. RESULTS This clinical trial has been proved to be effective all clinical symptoms seen in the Shitapurvak Jwarprachiti: Paired t test patients with significant results. Agnivardhak effect also found in good number of patients and in some patients got relief from complaints like Aruchi etc. Dhatradi kwath is effective in mootrakruchra. Dhatradi kwath with sita is easily available and safe. The drug was given by oral route; there is no need of hospitalization. The drug can be given on O.P.D. basis. No side effects or adverse reaction noted by this drug and seems to be very safe in every age group. Ayurvedic treatment is designed to bring out total sampraptibhanga. While the modern aspect of treatment only concentrate on pathogenic organisms. The Ayurvediya treatment also aims at strengthening the dosha, dhatus and malas and for nonrecurrence of the disease condition. This all can be achieved by employing suitable drug system. With the given observation, now it is time to draw some conclusions. In the comparison of Mootra varna significant difference was observed on D10 ( 2 = 10, df=1) in comparison of group A with Group B. In the comparison of Mootra gandha significant difference was observed on D10 ( 2 = 4.80, df=1) in comparison of group A with Group B. Unpaired t test Gr. A Gr. B Mean diff 0.06 SD T SE t table 2 t P > 0.05 t table P > 0.05 > 0.05 Mean Group A: In this group the comparison of Day 1 st and Day 10 by using Paired t test had shown the result as t = 6.16 which was statistically significant value as compare to t value 2.05 at df 29 and P>0.05. DISCUSSION Group B: The result in control group of comparison between Day 1 st and Day 10 by using Paired t test was 5.23 which is significant as compare to table t value 2.05 at df 29. P > AAMJ / Vol. 1 / Issue 6 / Nov Dec

4 Group A vs Group B: On comparing the improvement in Sheetpurvaka JwaraPrachiti in both group by unpaired t test, the value was t= at df 58 and P > These values showed that there was no statistically significant difference is observed between Dhatryadi Kwath and Tab. Norflox, thus Number of pus cells: Paired t test both are equally effective. The Dhatryadi Kwath contain Gokshur which has antiinflammatory property and most of the drug in it are Vata Pitta Shamak and Yashtimadhu has anti-bacterial activity thus reducing the infection. 9 Unpaired t test Gr.A Gr.B Mean diff 0.1 Mean T SD t table 2.00 SE P < 0.05 t t table P > 0.05 > 0.5 Group A: In this group the comparison of Day 1 st and Day 10 by using Paired t test had shown the result as t = 6.27 which was statistically significant value as compare to t value # at df 29 and P>0.05. Group B: The result in control group of comparison between Day 1 st and Day 10 by using Paired t test was 5.42 which is significant as compare to table t value. # atdf 29. P > Group A vs Group B: On comparing the improvement in sarakta mootra pravrutti in both group by unpaired t test, the value was t=3.07 at df 58 which is significant as compare to table t value. # at df 58 and P > These values showed that there was statistically significant difference is observed between Dhatryadi Kwath and Tab. Norflox. The Dhatryadi Kwath has shonitsthapan and raktapittashamak and dahashamak property. 10 CONCLUSION Mootrakruchra is commonly found in females (34 females & 26 males). It affects the years age group mostly. In regards to prakruti, pittapradhanvata & vatapradhan pitta prakruti peoples are mainly affected. After the treatment sadaha, sashula, muhurmuhu & sarakta mootra pravruti were definitely found to be relieved more in trial group as compared to those of the control group. Sadahamootrapravrutti was found to be relieved at a more extent in trial group as compared to control group. Shitpurvakjwarprachiti & number of pus cells is found to be decreased in both group simultaneously. Along with these symptoms, Dhatradi kwath was found to be effective for colicky pain in abdomen, Aruchi etc. Control group i.e. Tab Norflox was also found to be effective in painful & burning micturition but at a lesser extent compared to the trial group. During study the patients of trial group did not show any major complication, or adverse reaction, thus it may be said that drug was well tolerated. In Urine examination, RBC count, Pus cells, Crystals etc. also found to be decreased after the treatment in trial group. In postoperative patients, those with administration of the Dhatradi kwath burning micturition due to catheterization was certainly found to be decreased than those to whom the drug was not given. From the study, it can be concluded that administration of Dhatradi kwath is an effective treatment modality for mootrakruchra especially for sadaha and sashulamuhurmuhu and saraktamootrapravrutti. AAMJ / Vol. 1 / Issue 6 / Nov Dec

5 REFERENCES 1. Shri satyanarayan shastri, charaksamhita, chaukhamba prakashan, 1995 edition, chikitsasthan 26/33-35, Ambikadatta shastri, sushrutsamhita, chaukhamba pratishtan 9 th edition, 1995, uttartantra 59/3,8-12, 3. Dr G.K. Gadre, sarth vagbhat, anamol prakashan, 7 th edition, nidansthan 9/35, Chris v mann& russel Williams, a short practice of surgery, churchil & livingstone, 2 nd edition, chapter 75&76, page no Siddhinandan mishra, bhaishajya ratnavali, chaukhamba prakashan, 2009 edition, 34/23, A.P.Deshapande & Subhash ranade, dravyagun vidnyan part 2, anamol prakashan pune, 307, 349, Aacharya radhakrishna parashar, sharangdharsamhita, baidyanath ayurved bhavan, 4 th edition 1994, 2/1-3, V. A. Dole, bhaishajya kalpana, anamol prakashan, th edition, chapter 5, Dr S.das, a concise textbook of surgery, publisher dr S.Das, chapter 57, Chris o callagnam, renal system at a glance, 2 nd edition chapter 46, 102 How to cite this article: Rupali et. al: Clinical Evaluation of Dhatryadi Kwath in Mootrakruchhra w.s.r. to Urinary Tract Infection. AAMJ 2015; 1: Source of Support: Nil. Conflict of Interest: None declared AAMJ / Vol. 1 / Issue 6 / Nov Dec