!!"# $%&'()*+,-./ %0405.6)*01)7*%()7,.8(91)7, CDEEFCGHFIEJKFLFMMMNOPQQRNSDT

Transcription

1 !!"# CDEEFCGHFIEJKFLFMMMNOPQQRNSDT $%&'()*+,-./ %0405.6)*01)7*%()7,.8(91)7,

2 CASE REPORT Impact Factor (2014) by International Scientific Indexing (ISI) UAE A CASE DISCUSSION ON CRF (MUTRAGHAT) TREATED WITH KSHAR BASTI AND MANSARAS BASTI Sneha Aswale 1*, V.E.Gogate, 2 S.I.Pathan 3, Abhijit Ahire 4 1. PG Scholar, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Maharashtra, Contact No snehaaswale2588@gmail.com 2. Associate Professor, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Contact No vgogate21@gmail.com 3. Assistant Professor, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Contact No pathanshamshirkhan@gmail.com 4. Assistant Professor, Department of Panchakarma, Govt. Ayurved College, Nanded, Contact No Article Received on - 20 th Jan 2015 Article Revised on - 14 th Feb 2015 Article Accepted on - 24 th Feb 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

3 CASE REPORT A CASE DISCUSSION ON CRF (MUTRAGHAT) TREATED WITH KSHAR BASTI AND MANSARAS BASTI *Corresponding Author Sneha Aswale PG Scholar, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Maharashtra, Contact No snehaaswale2588@gmail.com QR Code IJAAM ABSTRACT: Kidneys are the organs that have numerous biological roles. They maintain the homeostatic balance of body fluids by removing waste out of body. Chronic Kidney disease (CKD) or Chronic Renal Failure (CRF) refers to an irreversible deterioration in renal function, which develops over a period of years. The conventional approach of management includes dialysis and renal transplantation, which are involving the high costs and complexity so very few patients are able to obtain adequate treatment for kidney disorders because of financial limitation. Therefore, exploration of a safe and alternative therapy is needed, which proves to be helpful in reducing the symptoms and improve the quality of life. The use of herbal drugs for the prevention and treatment of various diseases is constantly developing throughout the world. In Ayurveda CRF can be correlated with Mutraghat due to similarity in symptoms. In present study a case was taken of chronic kidney disease treated with Basti Therapy. He was given Kshar Basti for 7 days followed by Mansaras Basti 21 days. This treatment approach has significantly reduces the symptoms and improve the quality of life. Key Words: Chronic Kidney Disease, Mutraghat, Basti Therapy INTRODUCTION The world is facing a global epidemic of chronic Kidney disease (CKD).As the morbidity and mortality from infectious disease decline, lifeexpectancy increases and chronic degenerative diseases have become more prevalent.ckd is unique amongst the chronic non-infectious illness. [1] Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR). [2] Chronic Kidney disease is an illness that has existed > 3months with either kidney damage or low GFR. [3] In early CRF the patient is often asymptomatic. Renal failure may present as a raised blood urea and creatinine found during routine examination, often accompanied by hypertension, proteinuria or anaemia. [4] Clinical feature includes Anorexia, Nausea, Tiredness, Oligouria,Oedema etc. The dispiriting term end-stage renal disease represents a stage of CKD where the accumulation of toxins, fluid, and electrolytes normally excreted by the kidneys results in the uremic syndrome. This syndrome leads to death unless the toxins are removed by renal replacement therapy, using dialysis or kidney transplantation. The monthly cost of hemodialysis (HD) in most private hospitals is very expensive. The treatment cost is a burden for common man. Therefore, exploration of a safe and alternative therapy is highly needed. Ayurveda does not individually suggest the causes and treatment for CKD. Though CKD patients involve multisystem & associated with variety of symptoms but main complaint i.e oligouriasupression of urine formation can be correlate with Mutraghat vyadhi as Acharya Chakrapani clarifies that Mootraghata is characterized by Shoshan and Hani of mutra [5], which indicate a state of suppression of urine. In mutraghat vyadhi because of vitiated vata urine formation get hamper so quantity of urine get minimized. Acharya charak has given that mutrakruccha can be caused due to santarpan [6] also and in Bheshajya Ratnavali acharya described that chikitsa of mutraghat can be done as that of mutrakruccha and described Bastii chikitsa for it [7] & CRF patients also complaining symptoms like agnimandya, aruchi which are due to Aama samchiti. Considering above factors, Basti therapy has been selected as a treatment modality for CRF patient. A single case study of CRF is reported here. In which vitiated Doshas were specified with the use of Kshar Basti followed by Mansaras Basti. CASE REPORT A 52 Year old male patient visited kayachikitsa OPD of Government Ayurved Colleage, Nanded, Maharashtra with complaints of Nausea, Anorexia, Page61

4 weakness, Edema over both lower limb, oligouria (suppression of urine).he was diagnosed with CKD before 3 years and having history of hypertension for more than 6 years. Patient was treated with diuretic-tab Lasix-20 mg-1 OD, Tab Amlodepine 5 mg -1 OD, Calcium and Iron Supplements. Thorough clinical examination of patient was done. Patient was afebrile, pulse-76/min regular, pallor present, coated tongue (sam jivha) BP-160/100 Mm/Hg, RS, CVS, CNS showed no abnormality. Patient was investigated Hb%-7.2 gm%, Sr.creatinine-3.2 mg/dl, Bl.Urea-56 mg/dl, Urine albumin +, Urine output-400 ml. According to Ayurveda Patient was Diagnosed as Mutraghat as Oligouria is the main symptom. The laboratory diagnostic tests and sonological investigation had confirmed the presence of chronic kidney disease. Patient was having the symptoms of Aama like Agnimandya,Aruchi, along with above complaints,for this following treatment regimen was followed.. 1) Kshar Basti-(260 ml) at morning after meal for 7 days. 2) Mansa Rasa Basti-(260 ml) at morning after meal for 21 days. Patient experienced increased in Apetite,Angalaghavata, Decreased in Nausea, Oedema slightly decreses, sr.creatinine level also slightly decrease i.e.3 mg/dl after 7 Days of Kshar Basti. After 7 Days of Kshar Basti,Mansaras Basti was started for 21 days. After 28 days of Basti Therapy patient experienced very good relief in symptoms like Weakness, Nausea, Oedema, Anorexia. Sr.creatinine level also slightly decrease i.e 2.86mg/dl. Preparation of Basti Kshar Basti- Ingrediant of Kshara Basti [8] 1. Saindhava Lavana : 5 gm 2. Guda(Jaggary) : 50 gm 3. Chincha (Tamarindus) : 50 gm 4. Shatahva(Souph) : 5 gm 5. Gomutra : 160 ml Total : 260 ml Initially 50 gm of Jaggary (Guda) and 50 gm of chincha was mixed uniformly with equal quantity of lukewarm water then 5 gm of Saindhava was added to the above mixture then 5 gm of Kalka of Shatahva were taken and added to above mixture carefully. Lastly 160 ml of Gomutra was added slowly and mixing is continued so as to have uniform Basti Dravya. Finally after filtering, Basti Dravya is made lukewarm by keeping it into hot water. Ingredients of Mansaras Basti [9] 1. Madhu : 50 ml 2. Ghrut : 50 ml 3. Mansaras : 160 ml 4. Nagarmotha kalka : 5 gm Total - : 260 ml Initially 50 gm Madhu was mixed uniformally with equal quantity of Ghrut. Then Musta Kalka was taken and added to above mixture and mixed properly. Lastly 160 ml Mansras was added slowly and mixing is continued so as to have uniform Basti Dravya. Kshar & Mansaras basti were prepared with slight modification from the textual reference. Amount of all dravyas as mentioned in the text was taken in its half quantity keeping in the mind the body strength (rogbala) of the patient. PROBABLE MODE OF ACTION Kshar Basti comprises of Saindhava, Guda, Chinch, Gomutra and shatava. In this Basti, maximum quantity is of Gomutra which is having Tikshna, Ushna, Agnideepak, Kshar Guna. [10] These has the property of Lekhan and Rukshana which are antagonistic to Ama. Chinch to be taken in Kshar Basti should be in Pakva stage that is having Deepan, Ruksh gun & ushana virya because of these properties it is Vata Kaph shamaka. [11] In this basti Puran Guda is used, it is laghu, pathya annabhishyandi, agnivardhaka and vata-pittaghna. [12] Saindhava due to its sukshma and tikshna property helps the Basti dravya to reach up to the molecular level. [13] It is capable of liquefying the viscid matter and breaking it into minute particles. In this way, strotorodh and samata might be reduced due to kshar basti. Mansaras Basti was given for dhatu and bala vardhana purpose after strotoshodhan done by ksharbasti. For preparation of Mansaras we used Ajamansa. Acharya Vagbhata has said that,because of having samshitoshna character it doesn t vitiated any dosha. Guna of Aja mansa are as similar as sharir guna of human beings so they may help to nutriat, sapta dhatu. [14] Ghrut also ingredient of mansaras basti is Agni,Bala vardhak, [15] properties so in this way bruhan karma done by mansaras basti. Basti therapy has the quality to eliminate both vat and kapha-kleda also it is the best shodhan therapy for the elimination of Dosha lying in the lower parts of the body, so ultimately basti therapy provide significant relief in Anorexia, Nausea,weakness, oedema. CONCLUSION Page62

5 In Ayurveda Mutraghat has the symptom similar to CRF. So Mutraghat can be correlated with CRF.As Mootrarogas are Santarpanjanya roga and Mutraghat is one of the Mutraroga Kshar Basti is the effective treatment for this, to prevent excessive apatarpan Mansras Basti is used. Basti Therapy showed very good result in reducing the symptoms but has very low effect in reducing the sr.creatinine level. From the above study it can be said that Kshar Basti and Mansaras Basti might prove beneficial to the patients of CRF in reducing the associated symptoms and to improve the quality of life. REFERANCES 1. Siddharth N. Shah, API text book of medicine, vol. 1, 8 th ed. reprint, published by the association of physicians of India, Mumbai, 2009, p AS Fausi et al; Harrison s principles of internal medicine, 17th ed., Mc Graw Hill Medical publication, 2008, p Siddharth N. Shah, API text book of medicine, vol. 1, 8 th ed. reprint, published by the association of physicians of India, Mumbai, 2009, p C Haslett et al; Davidson s Principles and practice of medicine,18 th ed., Churchill Livingstone Harcourt Publishers Limited,1999, p Yadavaji Trikamji, Charak Samhita, Sanskrit commentary, Chaukhambha Prakashan Varanasi, 2013, p Yadavaji Trikamji, Charak Samhita, Chaukhambha Prakashan Varanasi, 2013,ch.su,chp 23,shlok-31, p Siddhinandan Misra, Bhaishyaj Ratnavali of Kaviraj Govind Sen edited with Siddhiprada Hindi Commentry Vol.2, First ed. Chaukhamba Surbharati Prakashan Varanasi, 2005, p Indradeva Tripathi, Chakradatta-with the Vaidayaprabha Hindi Commentary of Shri Chakrapanidatta, 2 nd ed., Chaukhambha Sanskrit Sansthan,Varanasi,1994, p Yadavaji Trikamji Acharya, Charak Samhita with Ayurved Dipika commentary of Chakrapanidatta, Chaukhambha Prakashan Varanasi, 2013, p Chunekar K. C., Bhavaprakasa Nighantu, Bhavamisra, Chaukhambha Bharati Academy,Varanasi, 2010, p Chunekar K. C., Bhavaprakasa Nighantum, Bhavamisra, Chaukhambha Bharati Academy,Varanasi, 2010, p Chunekar K. C., Bhavaprakasa Nighantu, Bhavamisra, Chaukhambha Bharati Academy,Varanasi, 2010, p Chunekar K. C., Bhavaprakasa Nighantu, Bhavamisra, Chaukhambha Bharati Academy,Varanasi, 2010, p Brahmananda Tripathi, Astanga Hrdayam, Vagbhata, Chaukhambha Sanskrit Pratishthan, Delhi, 2010, p Brahmananda Tripathi, Astanga Hrdayam, Vagbhata, Chaukhambha Sanskrit Pratishthan, Delhi, 2010, p.73 CITE THIS ARTICLE AS Sneha Aswale et. al., A Case Discussion on CRF (Mutraghat) Treated with Kshar Basti and Mansaras Basti, Int. J. Ayu. Alt. Med., 2015; Source of Support Nil Conflict of Interest None Declared Page63

6 #401/8-A, 4 th Floor, Shiv Shrishti Apt. Nardas Nagar, TP Rd., Bhandup (W), Mumbai E:mail-editorijaam@gmail.com, Web-