International Journal of Innovative Pharmaceutical Sciences and Research www.ijipsr.com ROLE OF VALUKASWEDA AND RASONADI KASHAYA IN THE MANAGEMENT OF AMAVATA W.S.R. TO RHEUMATOID ARTHRITIS 1 Dr. Seetha Devi.P, 2 Dr Sandhya Rani, 3 V. Shreeshananda Sharma 1 Assistant Professor, Dept of Panchakarma, JSS Ayurveda Medical College, Mysuru-570028, Karnataka, INDIA 2 Reader,Dept. Of Shalakya Tantra, JSS Ayurveda Medical College, Mysuru-570028, Karnataka, INDIA 3 Reader,Dept. of PG Studies in Rasashastra and Bhaishajya Kalpana, JSS Ayurveda Medical College, Mysuru-570028, Karnataka, INDIA Abstract Amavata is a crippling disease, which moreover is a crippling disease, which hampers the day today activities of the person and specifically affecting the musculoskeletal system. The disease characteristically manifests itself with the cardinal symptoms like sandhishoola, sandhishotha and sthabdhata. The disease is said to obtain a critical picture with many dreadful complications in due course of its progression. Study design is comparative clinical study with pre-test and post test design.30 patients suffering from amavata are selected and divided into 2 groups with 15 patients in each group. GroupA is administered with valuka sweda and GroupB is abministered Rasonadi kashaya with valukasweda.statastical analysis showed better results in releaving signs and symptoms in both the groups. On comparing groupb showed better results than groupa. Keywords: Sandhishoola, sandhishotha, sandhisthabdhatha and amavata. Corresponding Author: Dr. Seetha Devi.P Dept of Panchakarma, JSS Ayurveda Medical College, Mysuru-570028, Karnataka, INDIA Email: drsitadevi@gmail.com Phone: +91-8431444499 Available online: www.ijipsr.com May Issue 560
INTRODUCTION Amavata is a crippling disease, which moreover is a crippling disease, which hampers the day today activities of the person The disease characteristically manifests itself with the cardinal symptoms like sandhishoola, sandhishotha and sthabdhata.angamarda, aruchi, thrishna, alasya,gourava, klama and jwara. In the later stages pain may begin to migrate from place to place with vrischika damshavath vedana [1]. The disease is said to obtain a critical picture with many dreadful complications in due course of its progression [2]. The Disease is caused due to viruddahara and vihara which results in ama formation, later vitiates vatadosha together results in the causation of amavata [3]. From the modern point of view, the disease looks similar to Rheumatoid arthritis in clinical appearance.the prevalence rate of the disease is about 3%.With a male to female ratio1:3 [4,5]. Amavata is a disease of madhyama rogamarga, hence the treatement is said to be krichrasadhya. Amapachana and swedana is considered as the prime line of treatement for amavata. Considering this here an attempt is made to evaluate the efficacy of valukasweda and valukasweda with rasonadi kashaya Rasonadi kashaya acts as amapachaka, shothahara and vedanasthapaka [6,7]. Aims and Objectives To evaluate the efficacy of valukasweda in the management of amavata. To evaluate the efficacy of valukasweda with rasonadi kashaya inthe management of amavata. MATERIALS AND METHODS Patients who are fulfilling the signs and symptoms and diagnostic criteria of amavata were selected from OPD and IPD of JSS Ayurveda hospital, mysore, irrespective of sex, religion and socioeconomic status. Diagnostic Criteria Patients having lakshanas of amavata like sandhishoola, sandhishotha,sandhisthabdatha along with angamarda alasya, aruchi, trishna, gourava, klama and jwara. American Rheumatism Association (ARA) criteria also taken into consideration as follows. i. Morning stiffness lasting for > 1 hour ii. Arthritis of 3 or more joint areas iii. Arthritis of hand joints iv. Symmetrical Arthritis Available online: www.ijipsr.com May Issue 561
v. Presence of Rheumatoid factor vi. Diagnosis of Rheumatoid arthritis is made with 4 or more criteria. Inclusion criteria Patient aged between 20-60years. Patients having signs and symptoms of amavata and Rheumatoid arthritis. Patients fit for swedanakarma. Exclusion criteria Patients having other systemic disorders. Patients not fit for swedana. Assessment criteria 1. Sandhishoola No pain-0 Mild pain comes occasionally-2 Moderate pain,slight difficulty in joint movement, Appears frequently-3 Severe pain, requires medication and may remain throughout the day-4 Severe pain, disturbing sleep and requires strong analgesics-5 2. Sandhishotha No swelling-0 Slight swelling-1 Moderate swelling-2 Severe swelling-3 3. Sandhisthabdhatha No stiffness or stiffness lasting for 5 min.-0 Stiffness lasting for 5 min to 2hrs-1 Stiffness lasting for 2 to 8 hours-2 Stiffness lasting for more than 8 hours-3 MATERIALS In the present study following drugs were utilised: VALUKA SWEDA (External heat treatment using sand packs) the heated sand taken in cloth made in to potali & applied over the joints. Available online: www.ijipsr.com May Issue 562
RASONADHI KASHAYA- Ingridients-lashuna, Shunti, nirgundi. METHODOLOGY 30 patients fulfilling the criteria were selected, then they were randomly divided into two groups Group A & Group B. Group A -15 patients were administered Valuka sweda for 15 days Group B- 15 patients were administered Valuka sweda & rasonadhi kashaya for 15 days. OBSERVATIONS AND RESULTS Out of 30 patients maximum 83.33% patients were female, 70.33% in between the age group 35-50years, 53.33% were Hindus, 76.66% patients were married, 53.33% were vata kapha prakriti, 53% were kroora koshta and 78% patients were non vegetarians. Table 1 showing the statistical results of the parameters of Group A Parameters Mean Mean Mean Mean S.D S.E t P BT AT diff. % Shoola 3.8 1.4 2.4 59.64.59.15 12.60 <0.001 Shotha 2.8 0.73 2.07 73.80.79.20 10.020 <0.001 Sthabdatha 1.66.46 1.2 72.56.144 8.26 <0.001 BT before treatment, AT- after treatment, S.D-standard deviation, S.E-standard error The mean score of shoola was 3.8 before treatment which reduced up to 1.4 after treatment with 59.64% relief. In shotha the mean score was 2.8 before treatment which reduced up to 0.73 after treatment with 73.80 %relief where as the mean score of stabdhata was 1.66 before treatment which reduced up to 0.46 after treatment with 72% relief. Table 2 showing the statistical results of the parameters of Group B symptoms Mean Mean Mean Mean % S.D S.E t P BT AT diff. Shoola 3.6 0.8 2.8 74.07.72.18 14 <0.001 Shotha 2.86 0.46 2.4 83.72.50.13 18.5 <0.001 Sthabdhatha 1.8.2 1.6 88.8.50.13 12.22 <0.001 The mean score of shoola was3.6 before treatment which reduced up to 0.8 after treatment which reduced up to 0.8 after treatment with 74 % relief. In shotha the mean score were 2.86 before treatment which reduced up to 0.46 after treatment with 83.72% relief where as the mean score of sthabdhatha was 1.8 before treatment which reduced up to 0.2 after treatment. DISCUSSION The swedana therapy is considered as prime in the treatment of vata diseases, due to its ushna property overcomes the seetha property of vata in turn sheeta (cold), shoola (pain) and sthamba Available online: www.ijipsr.com May Issue 563
(stiffness) will be relieved. So valuka sweda helps in relieving the signs and symptoms of Amavata. The contents of rasonadi kashaya are shunti, lashuna and nirgundi.these dravyas are having katu, tiktarasa, ushnaveerya.by this property they are vatakaphahara,deepana and acts as shothahara, vedanathapaka, shoola prashamaka, pachana, anulomana,jwaragna,there by helps in samprapti vighatana of amavata.rasonadi kashaya helps to relieve associated complaints like gourava, agnimandya and klama. CONCLUSION Amavata a commonest joint disorder of middle age. The clinical signs and symptoms of amavata can be compared to Rheumatoid arthritis of modern science. It is noticed that relief in signs and symptoms of amavata was found in both group. When both the groups were Compared valuka sweda with rasonadi kashaya showed better result. REFERENCES 1. Madhavakara, madhavanidana with commentary of Vijayarakshita and Srikandadatta, Amavatanidanam, published by Chaukhambha Sanskrit Samsthana ; Varanasi; 2002 2. Harrisons, Harrison: principles ofinternak medicines, edited by Eugene Braunwald, Anthony S Franci, Stephen L Hauser, Dennis L Kasper, Dan L Longo, J Larry Jameson Mc Graw Hill- Medical publishing division, Vol.1, 12 th international edition 2002. 3. Chakrapanidatta, chakradatta, amavata chikitsa, published by Chaukhambha Sanskrit Samsthana; Varanasi;2000. 4. www.wikipedia.com 5. www.pubmed.com 6. Govindadas, Bhaishajya Ratnavali, Hindi Commentary by AmbikadattaShastri, Chaukhambha Sanskrit Sansthan, Varanasi, 20 th edition, 2010. 7. Susrutha, Sushrutha Samhita Dalhana Commentary, 4 th edition, Choukhambha Orientalis Publication; Varanasi; 1994 Available online: www.ijipsr.com May Issue 564