Journal of Ayurveda Physicians & Surgeons (www.japs.co.in) (EISSN 2394-6350) Original Research A Study on Role of Kapikacchu (Mucuna pruriens) in Management of Parkinson's Disease Sanjay Dhruve 1* and Gurdip Singh 2 1 Postgraduate Scholar, Department of Kayachikitsa, IPGT&RA, Gujarat Ayurveda University, Jamnagar-361008, Gujarat, India 2 Director, PG & Ph D Studies, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, BM Road, Thanniruhalla, Hassan-573201, Karnataka *Corresponding author : Email address : dr.sanjaydhurve@gmail.com, Mobile number: 9850044207 Access this article on online: www.japs.co.in Published by International Academy of Ayurveda-Physicians (IAAP), 7HB, Gandhinagar, Jamangar-361 002 Date of submission: 01-01-2017; Date of Revision: 07-02-2017; Date of Acceptance: 17-04-2017 Abstract: Kapikcchu (Mucuna pruriens) has been reported to have L-dopa, which is nowadays prescribed for the treatment of Parkinson's disease, hence seeds of Kapikacchu were selected to evaluate its role in the management of Parkinson's disease (Kampavata). Powder of its seeds was administered in the dose of 6 gm thrice a day with water for 45 days. The results of this study showed that Kapikcchu (Mucuna pruriens) provided significant relief in signs and symptoms of the disease and clinical parameters. It significantly corrected the movement disorders of the patients. After the treatment 50% patients got marked improvement, 37.5% improvement and 12.5% patients remained stable. Keywords: Parkinson s disease, Kampavata, Kapikacchu, Mucuna pruriens Introduction: Parkinson's disease (Kampavata) is a progressive neurodegenerative disorder has insidious onset, usually in second half of life, characterized by slowly progressive akinesia, rigidity, postural abnormality and tremor. The symptoms of Parkinson's disease have now been established as due to dopamine deficiency consequent to death of the substantia nigra. This disease is a common disorder with a prevalence of about 1 in 1000, rising to 1 in 200 in the elderly. For the management of Parkinson's disease in modern medical science a lot of research works have been done but still no any radical therapy is available. Some drugs like L-dopa, Carbidopa which increase dopamine level are used in routine practice to provide some relief in sign and symptom. These medications usually provide good symptomatic control for few years but causes number of unpleasant and even intolerable side effects. Kapikcchu (Mucuna pruriens) is reported to have L-dopa, which is nowadays prescribed for the treatment of Parkinson's disease, hence the seeds of Kapikacchu were selected for this study. Aim: To ascertain the role of powder of seeds of Kapikcchu (Mucuna pruriens) in the management of Parkinson's disease. Patients and Methods: Patients were diagnosed on the basis of sign and symptom of Kampavata available in Ayurveda as well as of Parkinson's disease in modern medicine. Drug and Dose Kapikacchu churna in powder from was administered in the dose of 6 gm thrice a day with water for 45 days. Criteria of Assessment of the Effec: The individual symptoms were assigned the suitable score. The standard clinical tests were carried out before and after the treatment Observations Thirteen patients of Parkinson's disease (Kampa- Vata) were registered for this study. All the patients of this series were above 41 years with highest number i.e. 61.5% was belonging to 51 to 70 years age group; 76.9% were male and 84.6% were Hindu. The 61.5% of patients of this series belonged to middle class of the society, 84.6% were married, 69.2% were from urban population and 58.3% patients were suffering from the disease for 2 to 4 years Results Thirteen patients of Kampavata (Parkinson s disease) were registered in this series, out of which five patients were dropped out and Journal of Ayurveda Physicians and Surgeons July 2017 Volume 4 Issue 3
remaining eight patients completed the full course of the treatment. These patients were administered Kapikacchu powder orally in the dose of 6 gm three times a day with water for 45 days. Effect of the drug on the main signs and symptoms has been shown in Table-1, effect on clinical parameters has been shown in Table-2, effect on parameters of movement disorders has been shown in Table-3. The next Table-4 depicts the effects of the therapy on general symptoms, Table-5 shows the effect of the therapy on Vital data, Table-6 shows the effect of the drug hematological investigation and table-7 shows the effect of the therapy on biochemical parameters. The overall effect of the therapy has been presented in Table-8. Table-1 Effect of Kapikacchu on Main Signs and Symptoms of Parkinson s disease (Kampavata) Tremor 1.63 0.75 53.99 0.35 0.125 7.00 <0.001 Rigidity 2.00 1.53 25.00 0.58 0.29 1.73 >0.05 Gait disorder 1.85 1.00 42.5 0.38 0.14 6.0 <0.001 Speech disorder 1.29 0.57 55.8 0.49 0.18 3.87 <0.01 Memory 0.63 1.38 54.34 0.46 0.16 4.58 <0.001 Depression 2.00 1.13 43.5 0.35 0.13 7.0 <0.001 Table-2 Effect of Kapikacchu (Mucuna pruriens) on the Clinical Tests of Parkinson s Disease Clinical Tests Mean Score % of relief SD (±) SE (±) t P Pill rolling 2.00 0.87 56.3 0.35 0.12 9.0 <0.001 Micrographia 2.00 1.14 43.0 0.38 0.14 6.0 <0.001 Rombergism 2.0 1.25 37.5 0.46 0.16 4.58 <0.01 Finger to nose 2.0 1.5 25.0 0.53 0.19 2.64 <0.05 Glabellar tap 2.0 1.4 30.0 0.55 0.24 2.44 >0.05 Impairment of upward gaze 2.0 1.4 30.0 0.83 0.37 2.13 >0.05 Table-3 Effect of Kapikacchu on Parameters of Movement Disorders of Parkinson's Disease Movement disorders Mean Score % of relief SD (±) SE (±) t P Buttoning Time in sec. 13.37 9.62 28.05 2.87 0.99 3.77 <0.01 Rapid alternative movement 1.38 2.00 44.92 0.51 0.18 3.41 <0.02 Marie sign 8.87 11.86 33.71 2.00 0.70 4.24 <0.01 Walking time in sec. 61.0 50.25 21.39 6.90 2.44 4.40 <0.01 Pin Picking time in sec. 89.0 74.50 19.46 5.33 1.88 6.99 <0.001 Chest expansion Cm. 0.90 1.00 11.00 0.14 0.50 2.00 <0.05 Hand grip power 24.50 32.50 32.50 5.20 1.84 4.34 <0.01 Foot pressure 26.50 35.12 24.49 4.51 1.59 5.55 <0.001 Table-4 Effect of Kapikacchu on General Symptom of Patients of Parkinson's Disease Vibandha 2.00 1.4 30.00 0.55 0.25 2.45 >0.05 Gurugatrat 2.00 0.5 75.0 0.55 0.22 2.44 >0.05 Angamarda 2.00 1.38 31.0 0.52 0.18 3.42 <0.05 Katishula 2.00 1.4 30.0 0.55 0.24 2.44 >0.05 Mutradaha 1.5 0.75 50.0 0.82 0.41 2.45 >0.05 Erectile Dysfunction 2.0 1.0 50.0 0.41 0.17 5.00 <0.01 Journal of Ayurveda Physicians and Surgeons July 2017 Volume 4 Issue 3 43
Table-5 Effect of Kapikacchu on Vital Data of Patients of Parkinson's Disease Vital data Mean Score % of relief SD (±) SE (±) t P Pulse 75.6 75.5 0.15 0.18 0.42 0.89 >0.05 Systolic BP 128.9 127.5 1.06 2.92 1.03 1.32 >0.05 Diastolic BP 87.25 86.75 0.57 2.87 1.01 2.94 >0.05 Weight 58.75 59.25 0.85 0.52 0.18 2.04 >0.05 Table-6 Effect of Kapikacchu on Haematological Investigation of Patients of Parkinson's disease Hemoglobin 13.96 14.16 1.43 0.60 0.21 0.88 >0.05 Total WBC count (cmm) 8475.0 8493.8 0.22 430.9 152.3 0.45 >0.05 PCV 42.0 40.17 4.36 0.98 0.40 2.08 >0.05 ESR 27.62 25.13 9.02 4.98 1.76 1.41 >0.05 Table-7 Effect of Kapikacchu Administered orally on Biochemical investigation of Parkinson s disease) Blood Sugar (fasting) 88.2 82.6 6.4 9.63 3.4 1.65 >0.05 Serum creatinine 1.3 1.1 15.3 0.38 0.14 1.98 >0.05 Blood urea 16.9 17.0 0.59 0.42 0.3 0.33 >0.05 Table-8 Total effect of Kapikacchu on the Patients of Parkinson s Disease (Kampavata) Result No. of patients Percentage Cured 0.0 0.0 Markedly improved 4.0 50.0 Improved 3 37.5 Stable 1 12.5 Deteriorated 0 0.0 Discussion The therapy provided significant relief of 53.99% in tremor, 25.0%.relief in rigidity, 55.8% in speech disorder and 43.5% relief in depression, and it caused significant increase of 54.3% in memory (Table-1). The therapy provided significant improvement on pill rolling test i.e. 56.25% (P<0.001), followed by 43.00%. improvement in micrographia 30.0% improvement in glabellar tap and impairment of gaze and 25.00% improvement in finger to nose coordination (Table-2). Effect of Kapikacchu on Movement Disorders: The effect of oral therapy was highest i.e. (44.92%) on rapid alternating movement, followed by (33.71%) on Marie sign, buttoning time (28.05%), picking pins (19.46%) and chest expansion (11.00%), walking capacity (21.39%), hand grip power (32.5 %) and foot pressure (24.49%) as shown in Table-3. Effect on General symptom: Maximum (75.00%) relief was found in Gurugatrata, followed by (50.00%) relief was noted in each of sexual dysfunction and Mutradaha, Angamarda (31.00%) and Vibandha (30.0%) as shown in Table-4. Effect on Vital Data: In this group slight decrease in pulse, systolic and diastolic blood pressure was noted and also slight increase in Journal of Ayurveda Physicians and Surgeons July 2017 Volume 4 Issue 3 44
body weight was found. However, all these result were statistically insignificant (Table-5). Effect on Hematological Investigations: Haemotological investigation slightly increase in hemoglobin count but no change in total leucocyte count and reduce the in PCV and ESR values were Seen which were statistically insignificant. (Table-6) Effect on Biochemical investigation: No significant change was observed in blood sugar serum creatinine and Blood urea is shown in (Table-7) Total Effects: In this study 50.00 patients showed marked improvement. Improvement was seen in (37.5%) patients and (12.5%) patients were remained stable. Neither cure nor deterioration was found (Table-8). Follow up: 6 patients were followed from 2 month to 6 months. No patient showed deterioration of sign and symptom. Conclusion Powder of Kapikacchu seeds administered orally for 45 days provided significant relief in signs and symptoms of Parkinson s disease such as tremors, rigidity, speech disorder and depression and it caused significant increase in memory. The therapy provided significant improvement in clinical tests such as pill rolling test, micrographia, glabellar tap, impairment of gaze and in finger to nose coordination. The therapy significantly corrected movement disorders such as rapid alternating movements, Marie sign, buttoning time, and picking pins. It also significantly increased power of chest expansion, walking capacity and hand grip power and foot pressure. It also provided significant relief in heaviness of the body, sexual dysfunction and burning micturation. The therapy provided marked improvement to 50% patients and improvement to 37.5% patients and remaining 12.5% patients remained stable. Bibliography A.M.Bronstein, J.D.Hood, M.A.Gtesty, Christina panagi: Visual control of balance in Cerebellar and parkinsonian syndrome Annual of Neurology - 1982. Agid V. and Javoy Agid F: Peptides and Parkinson's disease.trends in neuroscience, 8: 30-35, 1985 Ann.E Tylor, A.E.Lang.J.A.Sant-cyr: Frontal lobe dysfunction in Parkinson s disease the cortical focus of Neostriatal out flow, Brain Journal of Neurology (Oct 1986) Anthony.S, Fauci M.D), E ugene Braunwald, Kurt J. Jean D, Joseph B, Martin, Dennis Kasper, Stephen L- Harrison's Principle of Internal medicine 14th edition 1998. Mcgraw-Hill, Health profession division printed in Singapore. Basvarajiyam: - By Basavraj, Ed and Pub. By Rajeshwar Datt, Shastry, Chalikhambha sanskrit series, varanasi 1987. B. K. Mahajan :- Methods in Biostatistics, Sixth Edition, Published by Jaypee Brothers Medical publishers Pvt. Ltd., B -3 Emca House, 23/ 23B Ansari road, DaryaganJ post Box 7193, New Delhi 110002, India. Bhavamisra :- Bhava prakasa with Vidyotini, Hindi Commentary by Brahmasankar Shastri Chaukhambha Sanskrit Series, Banaras (1956), Bouldue Helens L, Marcelo, Paulal robert, Robinson's Sergio E, Starkstein, Thomas: Depression and cognitive impairment in Parkinson's disease. Annual of Neurology, 1989 Caraka Samhita :- Agnivesh Revised by Caraka and Dridhabala, Vidyotini Hindi commentary by pt. Kashinath shastri and Dr. Gorakh Nath Chaturvedi - 13th edition 1986, Chaukhambha Sanskrit series Varanasi. Caraka Samhita :- Gulabkunverba Ayurveda Society, Jamnagar Caraka Samhita :- Charaka Samhita with English translation of Chakrapani commentary. By Bhagwan Dash, Chhaukhambha Sanskrit series, Varanasi. Caroline M. Tanner (MD, M.P.H. ), Samul. G. Goldman: Epidemiological of Parkinson s disease from the Parkinson s Institute, Sunnyvale, California U.S.A. Neurological clinic Annual of Neurology - May 1996. Caroline M. Tanner (MD, M.P.H. ), Samul. G. Goldman: Epidemiological of Parkinson s disease from the Parkinson s Institute, Sunnyvale, California U.S.A. Neurological clinic Annual of Neurology - May 1996. Cotzias AC, Papavasiliou PS, Gellene R:- modification of Parkinsonism - chronic treatment with L - dopa - New England Journal of medicine - 1969 ; 280 : 337-45. Dhurve Sanjay A and Gurdip singh: A clinical study on Kampa-Vata (Parkinson s disease) and its management with Kapikacchu (Mucuna pruriens). Journal of Ayurveda Physicians and Surgeons July 2017 Volume 4 Issue 3 45
MD (Ayu) Thesis IPGT&RA, GAU Jamnagar (2001) Goodman and Gilman s:- The pharmacological Basis of therapeutics- 7th edition Macmillan publishing company (New York, U.S.A). Govind Das:- Bhasjya Ratnavali with chandraprabha commentary, Edited by Vaidya Lal Chandraj 8th Edition, Motilal Banarasidas Delhi (1997) Jankovic, j. (ed) (1994): Movement disorders, in neurological clinics vol. 2.pp 415-634 w.b. Sunders, Philadelphia. Sharma P. V. (1988):- Dravyaguna Vigyana, Chaukhambha Surbharti Academy, Varanasi. Sharangadhara:- Sharangadhar Samhita Edited by Siddhinandan Mishra, 1st Edition, Chaukhambha oriental, Varanasi. Shivram Krishnam & Singh Gurdip: A study on Ayurved management of sakampa pakshagvata (Paralysis agitans) P. G. thesis, 1989, I.P.G.T. & R. A. Jam. Slegfried:- J. European Neurology 1987; 27(Suppl.C) 98-104. Sodhala :- Gada Nigraha, Chaukhambha Sanskrit series, Varanasi (1964) Susruta: Susruta Samhita with Ayurveda Tatva sandipika, Hindi commentary by shastri A, Chaukhambha Sanskrit Sansthan, Varanasi Cite this article as : Dhruve S and Singh G. A Study on Role of Kapikacchu (Mucuna pruriens) in Management of Parkinson's Disease. Journal of Ayurveda Physicians and Surgeons. 2017 (July) Volume 4(3) :42-46. Conflict of interest: Not declared Journal of Ayurveda Physicians and Surgeons July 2017 Volume 4 Issue 3 46