www.aamj.in ANVESHANA Research Article AYURVEDA MEDICAL JOURNAL ISSN: 2395-4159 PREPARATION OF VANGA BHASMA AND VANGESHWARA RASA AND THEIR COMPARATIVE EFFECT IN MADHUMEHA (DM TYPE 2) Aditya A. Samant 1, Anjaneya Murthy 2 1 Reader of Rasashastra & Bhaishajya Kalpana Gomantak Ayurved Mahavidyalaya & Research Centre Shiroda, Goa, India 2 Prof. of Rasashastra & Bhaishajya Kalpana, TGAMC, Bellary, Karnataka, India Corresponding Author: adityasamant09@rediffmail.com ABSTRACT Vanga Dhatu (Tin Metal) in Bhasma form finds mention in various compendia as a drug of choice in patients suffering from madhumeha. Parada is said to be sarva vyadhi hara, so as a curiosity Vanga Bhasma alone and compound preparation of Vanga i.e. Vangeshwara rasa (along with Parada & Gandhaka) were compared for their hypoglycaemic effect in Madhumeha. When result was compared it was distinctly noticeable that Vangeshwar Rasa was advance in not only controlling blood sugar levels but also helped in alleviating various other symptoms. Key words: Madhumeha, Vanga, Parada INTRODUCTION Today as an alternative medicine worldwide have turned towards Ayurveda due to its Antiquity and Eternity. Today Ayurveda is gaining popularity not only in India but also in International market. The Herbal and Herbomineral drugs mentioned in classics are potent in therapeutic aspect as well as have minimal adverse effects. Amongst minerals, Dhatu Varga, which finds the mention even in Atharvaveda as Trapu has its own magnitude. In the present study Vanga Bhasma and Vangeshwar Rasa are two trial drugs. The Great masters of Ayurveda explained Prameha in detail with its causes, signs & symptoms, treatment and even preventive aspect. The characteristic features of Madhumeha are almost similar to the Diabetes mellitus described in the modern science. Diabetes mellitus is a metabolic disorder biochemically characterized by hyperglycaemia and glycosurea. According to WHO India stands top amongst the countries estimated for number of diabetic patients. In present study type 2 DM is selected for treatment aspect. Simho yatha hastiganam nihanti tathaiva vango akhilam meha vargam / AP 3/151 While describing the efficacy of Vanga it is said that Vanga has the potency to elevate the symptom complex meha with giving simile of lion. So, Madhumeha, which is a type of Vatika Prameha, was taken for study. The use of Vanga Bhasma on one hand and effectiveness of saagni, sagandha moorchana of Parada with Vanga in Vangeshwar Rasa on the other, holds good to evoke interest in very ardent follower of Rasashastra regarding their comparative
hypoglycaemic effect. The pharmaceutical aspect of the two trial drugs were carried out following inflexible SOP & their hypoglycemic effect was carried out on 30 patients of Madhumeha. MATERIALS AND METHODOLOGY The required raw drugs were collected from local market following stringent quality control. The Vanga Bhasma was prepared by doing Samanya shodhana, Vishesha shodhana, Jarana & then 7 ardha gaja puta processes to get yellowish, odourless, sumrut bhasma. For Vangeshwara rasa Shodhita Vanga, Shodhita Gandhaka & Parada extracted from Hingula were taken. Vangeshwara rasa was golden yellow, odourless & in soft powder form. Selection of patients: Patients were selected randomly & were diagnosed on the presentation of history, sign, symptoms details clinical examination and investigation (Biochemical) reports. No other drug was administered during the period of study. Inclusion criteria: Patients with classical signs and symptoms and Madhumeha (NIDDM) were taken up randomly with chronicity of 0 10 years. Only mild and moderate maturity onset NIDDM patients were selected. Patients who fall in age group of 35-60 years were selected. Exclusion Criteria: Insulin dependent diabetes mellitus Madhumeha (NIDDM) with severe maturity onset. Madhumeha with upadravas like pitikas. Madhumeha with any other existing disorders like hypotension etc., NIDDM with complication like Neuropathy, Retinopathy, Nephropathy etc., Krush pramehi. Parameters for assessment: (1)Individual symptoms (2)Laboratory investigations (FBS, PPBS, FUS, PPUS) Materials & Methods: Randomly Selected 30 patients were grouped into two groups of 15 patients (Group A-Vangeshwar Rasa & Group B- Vanga Bhasma) each who could continue the treatment as per the schedule, they were given the trial drugs Vanga Bhasma & Vangeshwar Rasa 125mg each orally for 21 days with proper diet control and regular exercise. OBSERVATIONS AND RESULTS Along with clinical assessment, investigation reports were given prime importance in assessing therapeutic effect of the trial drugs in the comparative hypoglycaemic management of Madhumeha. Gradation of 0-3 was given for various symptoms for objective data. Table 1: Distribution of Patients of Madhumeha by Age Age Group Group A (15Pts.) Group B (15 Pts.) Total (30 Pts.) 31-35 yrs. 0-0 - 0-36 40 yrs. 2 13.32 1 6.66 3 10 41 45 yrs. 1 6.66 2 13.33 3 10 46 50 yrs. 3 20 5 33.33 8 26.66 51 55 yrs. 3 20 2 13.33 5 16.16 56 60 yrs. 6 40 5 33.33 11 36.36 Table 2:Distribution of patients of Madhumeha according to sex Sex GroupA(15pts) Group B(15pts) Total(30 pts) Male 10 66.66 12 80 22 73.33 Female 5 33.33 3 2 8 26.66 AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 25
Table 3: Distribution of patients of Madhumeha according to Occupation Occupation Group A Group B Total 30 Pts. House hold 6 40 3 20 9 30 Manual 3 20 4 26.26 7 23.33 Office 3 20 2 13.13 5 16.66 Business 1 6.66% 3 20 4 13.33 Others 2 13.13 3 20 5 16.66 Table 4: Distribution of Patients of Madhumeha according to Prakruti Prakruti Group A 15pts Group B 15pts Total 30 Pts. Kapha 1 6.66 0-1 3.33 Kaphapitta 5 26.26 7 46.66 12 36.66 Kaphavata 5 33.33 6 40 11 36.66 Vatapitta 4 26.26 2 13.13 6 20 Table 5: Distribution of patient according to Body Mass Index (BMI) Prakruti Group A 15pts Group B 15 pts Total 30 Pts. Normal BMI i.e. upto 22.5 4 26.66 3 20 7 23.33 High BMI i.e. above 22.5 11 73.33 12 80 23 76.66 Table 6: Distribution of patients according to family history Family history Group A 15 pts Group B 15pts Total 30 Pts. No history 8 53.33 6 40.00 14 46.66 Maternal 3 20.00 5 33.33 8 26.66 Paternal 1 6.66 2 13.33 3 10.06 Brother 3 20.00 2 13.33 5 16.66 Table 7: Lakshanas and Biochemical values of the patients were taken before and after treatment. SN Lakshanas Vangeshwara rasa Vanga Bhasma X SD SE t p X SD SE t p 1 Mutradhikya 1 0.534 0.138 7.246 p<0.001 0.533 0.761 0.196 2.712 p<0.05 2 Kshudadhikya 0.266 0.457 0.068 3.876 p <0.01 0.2 0.414 0.106 1.87 p<0.05 3 Trishnadhikya 0.733 0.457 0.118 6.2 p<0.001 0.866 0.516 0.133 6.5 p<0.001 4 Padadaha 0.6 0.507 0.130 4.58 p<0.001 0.933 0.883 0.228 4.08 p<0.01 5 Daurbalya 0.2 0.414 0.106 1.87 p<0.05 0.066 0.258 0.066 1 p<0.05 6 Kandu 0.6 0.507 0.130 4.58 p<0.001 0.866 0.743 0.191 4.51 p<0.01 7 Swedadhikya 0.4 0.632 0.163 2.44 p<0.05 0.133 0.351 0.090 1.46 p<0.05 8 Bhrama 0.33 0.487 0.126 2.619 p<0.05 0.133 0.743 0.191 0.694 p<0.05 9 FBS 40.92 36.09 9.32 4.39 p<0.001 26.01 18.51 0.126 2.619 p<0.05 10 PPBS 76.74 55.6 14.35 5.34 p<0.001 40.33 30.56 10.41 3.874 p<0.01 11 FUS 0.2 0.519 0.134 1.49 p<0.05 0 0.163 0.042 0 p<0.05 12 PPUS 0.533 0.721 0.186 2.71 p<0.05 0.216 0.693 0.179 1.210 p<0.05 DISCUSSION Majority number of patients was from old age i.e. 56 60 yrs. May be due to senile changes in islets cells / development of insulin resistance in peripheral tissues / decreased in physical activities. Amongst male & female ratio more number of male patients i.e. 73.33% was observed. This may be due to over stress & over indulgence is diabetogenic factor. The occupation wise distribution directs this disease is more in House hold people, retired or house wives, who are leading sedentary life s which is one of the main diabetogenic factor. The distribution shows patients with Kaphapitta and Kaphavata prakruti is high and rest is equally distributed. The due fact that this disease is tridoshaja the domination of Kapha is vital in Samprapti. It was observed that among 30 patients, 23 of them belong to high BMI. This indicates towards indul- AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 26
gence in excessive eating, lack of physical exercise, sedentary life style, less awareness of health consciousness amongst the community. Statistical inference of Lakshanas and Biochemical values of the patients: Lakshanas and Biochemical values of the patients were taken before and after treatment. The clinical study was carried out to find out comparative hypoglycaemic effect of both drugs i.e. Vanga Bhasma and Vangeshwar Rasa, using the parameters of pradhana & anubandha lakshnas & Bio chemical values in the selected cases of Madhumeha. It was observed that Vangeshwar Rasa shows highly significant effect in pradhana lakshanas (p< 0.001) in reducing Mutradhikya, Trishnadhikya and Padadaha but only moderate reduction of Kshudhadikya (p<0.01). Whereas the other drug Vanga Bhasma shows highly significant effect in reducing only Trishnadhikya (p<0.001) and it moderately reduces Padadaha. Among Pradhana Lakshanas, Vanga Bhasma show effectiveness in reducing Trishnadhikya (p<0.001). But in Anubandha Lakshanas both drugs shows reduction in Kandu but both drugs do not show much influence on Swedadhikata & Bhrama. Amongst Bio- chemical values Vanga Bhasma do not show much significant reduction in FBS, PPBS, FUS, PPUS values on the other hand Vangeshwara rasa shows reduction in FBS & PPBS much significant (p<0.001) but do not show much variation in FUS & PPUS. The Trishnadhikya or Polydypsia is the result of series of pathological changes occurring due to lack of insulin; to begin with it decreases anabolism further leading to hyperglycaemia which inevitably leads to glycosuria and to end in osmotic Diuresis. To compensate the loss of fluid symptom like polyadipsia develops. Both the drugs help in improvising metabolism by improvising the Agni even at Datwagni level by Deepan and Agnivardhaka qualities. This increases the anabolism in the body and proper channelizing Rasadi dhatus which may be helpful in samprapti bhanga of Mutradhikya. Due to proper anabolism, the proper utilization of glucose takes place and cut the further pathogenesis of diuresis leading to decrease in Trishnadhikya. The texts substantiate sufficiently regarding the Sarvavyadhi haratva properties of Parada. But in the present drug Vangeshwara rasa the only impact of Parada on Vanga and Gandhaka shows highly significant reduction in the major symptoms like Mutradhikya and Padadaha. This may be due to the target oriented nature i.e. acting directly on Islets cells in order to produce more insulin (which requires extensive research to prove) along with it diminishing insulin resistance which may be helpful in lowering high level of blood glucose further decreasing diuresis. The daha may be attributes towards the ashayapakarshatva of pitta by vitiated vata. The drug pacifies tridosha and hence may be helpful in swasthanagatatva of pitta leading to reduction in daha. Both the drugs show significant reduction in kandu. The etiopathology of kandu directs to metabolic dysfunction leading to damage of axons and myelin sheath. This leads to development of symmetrical motor neuropathy of distal parts of body. Both the drugs possess ushna veerya, tikta rasa, and agnideepana properties. These qualities help in agnidipti and further helping in Amanashana and going proper metabolic status. The proper functioning of dhatwagni further helps building even deeper dhatus like majjadi dhatus. The damage of axons and myelin sheath gets rectified to some extent and the kaphagna property helps to elevate the symptom kandu. Vangeshwara rasa shown highly significant results in reducing fasting blood AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 27
sugar and post prandial blood sugar levels compared to Vanga Bhasma. This may be because of impact of Parada which shows yogavahi and rasayana property which may show Eu-metabolic properly further reducing insulin antagonist activity and proper utilization of glucose by body cells. The decreased intake of carbohydrate in the form of starches or other complex sugar, proteins along with carbohydrates, unsaturated fact an overall low caloric diets along with proper exercise must have been also supporting factor in reduction of blood glucose level. Probable mode of action: Vanga Bhasma: The tikta rasa of Vanga Bhasma may be helpful in channelizing vitiated rasa dhatu along with the bhedana of avaranatmaka samprapti. The ushna veerya along with deepana properties may attributes in amapachana and Agni dushti which is also one of the prime etiological factors. Again these properties act at the level of dhatwagni facilitating the metabolism and once metabolism control is achieved the pathological changes like axinopathy or mylenopahty which occur mostly due to metabolic dysfunction gets rectified. The pharmaceutical action like medohara and lekhana may be helpful in reducing bahu and abadha meda also facilitating circulation and normal binding of insulin, rectifying the receptor it may be helpful in proper utilization of glucose by target cells. Vangeshwara rasa Vangeshwara rasa acts as tridosha shamaka drug and in etiopathogensis of madhumeha the basic involvement is tridosha with water dominance. Ushna veerya along with katu tikta rasa and katu paka helps in breaking the etiopathogenesis of disease by correcting Agni and Rasa dhatu facilitating nourishment of other dhatus anterogradely. The laghutva and sukshmatva helps the medicine to reach target cells enhancing their receptor membrane to facilitate binding and proper action of insulin. The yogavahi properly of impacted Parada along with medhohara, lekhana properties of Vanga strengthens abadha medodhatu and depicts bahu meda, smoothly balancing the body requirements of glucose and other nutrition s by removing blocks. The kashaya rasa checks the samprapthi of atipravruti of jaliya amsha through mutravaha srotus. The highlighting property rasayanatva of this yoga not only replenishes oja but helps the architecture of this yoga to act with insulin like property. CONCLUSION Vangeshwara rasa along with diet control and proper exercise shows highly significant reduction in blood glucose levels along with reduction in symptoms like mutradhikya, trishnadikya, padadaha & kandu, where as Vanga Bhasma did not show much encouraging results in both blood sugar levels and helped in reducing symptoms like trishnadhikya and kandu. The mere impact of Parada on Vanga shows high therapeutic efficacy in treating madhumeha in Vangeshwara rasa. The role of Parada in this talastha rasayana is probably catalyst in enhancing therapeutic efficacy against symptoms complex madhumeha. In comparative hypoglycaemic aspect of both drugs Vangaeshwara Rasa shows highly significant reduction in FBS (p<0.001), PPBS (p<0.001) & significant reduction in FUS & PPUS (P<0.05). But Vanga bhsama shows only significant reduction in FBS (p<0.05), PPBS (p<0.01). Vangeshwara rasa shows better results in showing hypoglycaemic effect then Vanga Bhasma in patients with madhumeha (DM type 2). REFERENCES 1. API text book of medicine; G. S. Sainani, v ed. 1994 AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 28
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