www.aamj.in ANVESHANA Research Article AYURVEDA MEDICAL JOURNAL ISSN: 2395-4159 CLINICAL STUDY TO EVALUATE THE EFFICACY OF RASAYANA AND NASYA IN THE MANAGEMENT OF KHALITYA (HAIR FALLING) Pawar Deepak K 1, Kundal Pankaj 2 1 PhD Scholar of Shalakya Tantra, IPGT&RA, Jamnagar, Gujarat, India 2 Lecturer of Shalakya Tantra, National Institute of Ayurveda, Jaipur, Rajasthan, India Corresponding Author: drdeep29@gmail.com ABSTRACT In present era early hair fall has been attributed to be the result of various factors like improper dinacharya and ritucharya, hormonal imbalance, faulty hair care, pollution, stress etc., which may occur to a healthy person also. As said in Ayurveda, Khalitya (hairs fall) is a sign of ageing process and Rasayana therapy is paramount for ageing disorder, so Rasayana treatment is included for the management of Khalitya. Further with Rasayana, Nasya is one of the therapies prescribed in Ayurveda for Khalitya. So by considering the importance of Rasayana and mode of action of Nasya, present study was carried out to evaluate the efficacy of Rasayana and Nasya in the management of Khalitya (hairs fall). Total 22 patients were registered for the current clinical trial. Results were impressive. Rasayana and Nasya alleviate in terminating the samprapti of khalitya and resulting in the alleviation of vitiated Doshas by which cessation of hair fall was achieved. Key words: Hair, hairs fall, khalitya, nasya, rasayana. INTRODUCTION In ayurvedic approach, increased falling of hair is termed as Khalitya. Acharya Charaka describes that Tejas combining with aniladi doshas reaches the shira kapala and causes hair fall by dahana of roma koopa (hair follicles). This is named as Khalitya. Chakrapani while commenting on this state the word Tejas here denotes Deha Ushma as well as Pitta Dosha. 1 Acharya Sushruta describes that Vrudda Pitta along with Vata reaches Romakoopa and causes hair fall, where Shleshma along with Shonita causes avaroda (obstruction) to the channel of Romakoopa which leads to the stoppage of regeneration of the hair and this condition is known as Indralupta, Khalitya or Ruhya. 2 Acharya Vagbhatta while defining Khalitya opines that the Khalitya is a disorder where hair fall occurs gradually whereas in indralupta the hair fall occurs comparatively faster than in Khalitya. 3 Causes of Khalitya: Acharya Charak 4 and Vagbhata 5 described the nidana of disease Khalitya under the heading of Shirogat Rog nidana. Charaka opines Khalitya as a lavana atisevana janya vikara i.e. excessive intake of salt in diet causes hairs fall. 6 Rupa/Symptoms: There are no definite lakshanas mentioned as regards to the disease Khalitya in the classical treatises. Madhava opines that the swabhava of Khalitya is aniyata i.e. referring to the unpredictability of the onset, duration and progression of the disease. 7 Still while dealing with disease
Khalitya one can notice the lakshana of Khalitya as increased number of hair fall which will be moderate in the purva rupa. Thus the cardinal symptom of Khalitya is gradual loss of hair. Samprapti/Pathogenesis: The samprapti of Khalitya explained by most of the authors are very much identical. Charaka stated regarding the samprapthi of the disease Khalitya that it occurs when tejas or vrudda pitta along with vrudda vatadi dosha s move to the kesha bhumi (hair root) and burns out the hair follicle. This condition is termed as Khalitya. 8 Whereas acharya sushruta opines regarding samprapti of Khalitya that the roma kupa gata/keshamulagata vitiated pitta along with vitiated vata leads to dislodgement or withering of the hair from the hair roots. Further in the samprapti, vitiated sleshma along with rakta will cover the hair root area and creates avaroda to the hair root, which results in no further hair growth from that place. 9 The author of ashtanga hrudaya describes the samprapti of Khalitya in similar words as acharya sushruta. In edition he opines that Khalitya occurs in a gradual pattern of hair loss whereas indralupta occurs in faster fassion. 10 Madhava opines that, the romakupagata bhrajaka pitta along with vata leads to hair fall and later the kapha along with rakta leads to obstruction of hair roots, thereby there will be no further production of hair. He regards the disease to be due to all the four doshas and the swabhava (the nature/progression) of the disease is aniyata (unpredictable). 11 According to this theory, the indulgence of Vata, Pitta and Kapha i.e. all three doshas has been held responsible for the production of Khalitya. According to Ashtanga Samgrahakara, there are four types of Khalitya i.e. Vataja, Pittaja, Kaphaja and Sannipataja. Acharya Harita adds one more type Raktaja Khalitya. Amongst four types of Khalitya, Sannipataja type is considered as Asadhya and it is advised that such patient should be discarded. This view is hold on by both Ashtanga Samgraha and Hridaya. Sequence of samprapti vighatana in Khalitya: The samprapti vighatana of any disease can be adopted in the following steps Nidana parivarjana Shodhana Shamana Nidana parivarjana in Khalitya includes avoidance of all the karanas mentioned under nidanas for shiro roga in particular. Acharya Charaka says that after adequate Samshodhana, patient of Khalitya should be subjected to Nasya, Abhyanga with oil and Shirolepa. So in Ayurveda; nasya, shiroabhyanga, shirolepa and rasayana therapy described for the management of khalitya. Madhukadi tail nasya (Chakradatta 54/105) was selected for the present study as it is said best for the Urdhvajatrugat Rog. As said early Khalitya is a sign of ageing process, hence, shwadanshtradi rasayana described in Ashtanga hridya (Rasayanavidhi Adhyaya- 39/159 Uttarasthanam) was administered. METHODOLOGY Clinical Study: Total 22 patients were registered for the current clinical trial. Among these 20 patients completed the study and 2 patients were discontinued due to long distance from home. The selection of patients was done from O.P.D. / I.P.D. wing of P.G. Dept. of Shalakya Tantra, N.I.A., Arogya Shala, Jaipur. Inclusion criteria: Both male and female patient of age group between 15-40 yrs were registered. Exclusion criteria: i. Patients whose age is less than 15 and above 40 years. ii. Patient with symptoms of asadhya khalitya. iii. Patient suffering from any severe systematic disease. AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 61
iv. Any prolonged debilitation associated hair fall. v. Necessary step were taken to exclude other condition as per facilities available in the institute. Drug dosage and duration: Shwadanshtradi Rasayan: 4-6 g 2 times in a day for 2 Months after 3-5 days course of Deepana- Pachana Medicine. Madhukadi Tail Nasya: 8-8 drops in each nostril for 2 Months. Clinical assessment: A. Subjective Parameters: Cessation of hair fall was counted as main feature to assess the effect of therapy. OBSERVATIONS AND RESULTS Graph 1: Distribution of patients based on Ahara Guna Nidan B. Objective Parameters All the investigations were conducted before treatment to rule out any systemic diseases. 1. Routine hematological investigations will be carried out to assess the present status of patients as well as exclude any pathological conditions. 2. Routine and microscopic examination of Urine. Criteria for assessment Reduction of hair fall within the normal range was counted as a main feature to assess the effect. Snigdha,guru Ruksha,ushna Laghu,snigdha Laghu,ruksha Guru Laghu 2 40% 0% 20% 30% 40% 50% Graph 2: Distribution of patients based on Ahara rasa Amla,lavana,katu Madhura,amla,katu Amla,katu Madhura,katu Madhura,amla Katu Amla Madhura 20% No. of Patients B.T. Mean A.T. Table 1: Overall result of the treatment Difference % Relief SD SE w p 20 1.750 1.200 0.5500 31.43 0.5104 0.1141 66.000 0.001 The result obtained through Wilcoxon matched-pairs signed-ranks test, indicates that 31.43% relief which was highly significant effect on reduction of Hair fall. DISCUSSION Inappropriate nutrition or exasperating factors leads to alleviation of function of hair root. As premature hairs fall 0% 20% 2 is a sign of early aging process and Rasayana is best for reversing aging process means anti-ageing therapy. So to check the antiaging properties or as antioxidant, rasayana therapy was added for reversing excessive AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 62
catabolic process occur at the hair roots. Shwadanshtradi rasayana combination prepared from the drugs Gokshur, Guduchi, Amalaki, as all drugs are rasayana properties was chosen for oral administration. Deepana- Pachana Medicine was given to patients in the present study before starting Rasayana therapy for Agni-deepana. By Pachana property, Shwadanshtradi rasayana digests food materials properly and absorbs Ahara rasa (precise elements from digestive food) by its absorbent property ultimately rasadi dhatu poshana takes place subsequently leading nutrition of hair roots. Madhukadi taila contents Yashtimadhu & Amalaki drugs which possess Pitta-Rakta Shamaka and rasayana properties. Madhukadi taila administered through nasya by its doshagna property, pacify the doshas which cause the khalitya. Madhukadi taila nasya also clears the obstruction of the hair roots by its sookshma srotogaami property leading to the roma koopa vishodhana. When the obstructed srotas gets cleared, the ahara rasa nourishes the roots of the hair which take place in the cessation of hairs fall. All the drugs of both yogas possesses Keshya, Rasayana and Balya properties, results in proper function of hair roots i.e. mechanical strengthen of hairs in addition with proper growth of the hair. CONCLUSION It can be concluded that those who take amla and katu rasa are more susceptible for the disease. It can also be concluded that consumption of snigdha and guru ahara also play a role in causation of disease khalitya. From the data obtained it can be concluded that Pittaja prakruti makes the individuals more susceptible to khalitya. The series of the trials showed that there is highly significant reduction in the hair fall among the patients when data before treatment is compared with the data after treatment (p<0.001). It can be inferred from this data that shwadanshtradi rasayana and madhukadi taila nasya has a pronounced effect on reduction of Hair fall. Thus, shwadanshtradi rasayana and madhukadi taila nasya aid in reversing the samprapti of khalitya and resulting in the alleviation of vitiated Doshas by which cessation of the hairs fall is achieved. REFERENCES 1. Charaka Chikitstasthana 26/132, P 606, Charaka Samhita of Agnivesha elaborated by Charaka and Dridhabala with Ayurved- Deepika commentary by Chakrapanidutta, Edi. By Vd. Acharya, Varanasi:Chaukambha surbharati prakashan; Varanasi, Re-edition 2009. 2. Sushruta Samhita Nidana Sthana 13/33,34., P 322, Sushruta Samhita of Sushruta with the Nibandha sangraha Commentaryof Sri Dalhanacharya and the Nyayachandrika Panjika of Sri Gayadasacharya on Nidanasthana. Edited by Vaidya Jadavji Trikamji Acharya and Narayan Ram Acharya Kavyatirtha, New ed. Varanasi:Chaukambha surbharati prakashan; 2008. 3. Astanga Hridaya Uttaratantra 23/26.,P 859-860, Ashtanga Hridaya of Vagbhata with the commentaries: Sarvangasundara of Arunadattau and AyurvedRasayana of Hemadri, annotated by Dr. Anna Moreshwar Kunthe and Krishna Ramachandra Shatri Navre; edited by Pt. Hari Sadashiva Shatri Paradakara, Reedition 2010 4. Charaka Sutrasthana 17/8-11, P 99, Ibid Ref 1. 5. Astanga Hridaya Uttaratantra 23/1-3, P 858, Ibid Ref 3. 6. Charaka Sutrasthana 26/(3)43, P 144, Ibid Ref 1. 7. Madhava Nidana 55/28,29, P 241, Madhava Nidana with Madhukosha AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 63
Commentary of Sri Vijayarakshita and Sri Kanthadatta with Vidyotini Hindi Commentary and Notes by Sri Sudarshana Shatri Part II Edition : Reprint 2009 P 337. 8. Charaka Chikitstasthana 26/132, P 606, Ibid Ref 1. 9. Sushruta Samhita Nidana Sthana 13/33, 34., P 322, Ibid Ref 2. 10. Astanga Hridaya Uttaratantra 23/26., P 859-860, Ibid Ref 3. 11. Madhava Nidana 55/28, 29, P 241, Ibid Ref 7. How to cite this article: Deepak Pawar, Pankaj Kundal: Clinical Study to evaluate the efficacy of Rasayana and Nasya in the Management of Khalitya, AAMJ 2015; 1 (2): 60-4 AAMJ / Vol. 1 / Issue 2 / Mar Apr 2015 64