Clinical Evaluation Of Asana Kashay In Sthaulya W.S.R. To Obesity Bhushan V. Sonawane 1 Rajan B. Kulkarni 2 1. PG Scholar Kayachikitsa Dept. 2. Professor and HOD, Kayachikitsa Dept Mob. No. 9823350440 A.S.S. Ayurved Mahavidyalaya, Panchavati, Nashik Corresponding Author: Mob. No. 7841046481; E-mail: bhushansonawane171@gmail.com Abstracts: Living with 21 st century has its advantage but along with fast lifestyle comes disadvantages. One disadvantage is having faulty lifestyle & unhealthy diet thereby causing Obesity (Sthaulya). A person who due to extensive growth of fat (Meda) & flesh is unable to work & disfigured with pendulous buttocks, belly & breasts is called Sthula & condition is termed as Sthaulya. The term Obesity is defined as excess storage of energy in the body in the form of fat. Obesity can leads to heart problems, diabetes & other serious health problems, which can cost millions to treat & which can reduce life expectancy. Obesity is treated in modern science with appetite suppressant & lipase inhibitor which has its own side effects. To avoid all these, an attempt was made to find a good alternative in Ayurveda. Many Ayurvedic preparations are also available for Sthaulya but we used Asana Kashay. Asana Kashay has Lekhan property and Laghu Ruksha Guna which reduces the Meda. So the aim of the study is to know the effect of Asana Kashay in Sthaulya. For this, clinical criteria are assessed with gradation and results are drowning with 1
statistical analysis & found encouraging results. Key Words: Sthaulya, Obesity, Meda Dhatu, Asana Kashay. Introduction: The person who is having balanced state of Dosha, Dhatu, Agni, Mala, Indriya and Manasa is said to be healthy person. According to Ayurveda, imbalance of these factors leads to various diseases. To prevent formation of disease & for healthy long life, Acharyas had suggested some rules in the name of Swasthvrutta Palana. Ayurveda have also specified very minutely about the kind of diet to be followed by every person according to the Prakruti (constitution), Vikruti (disease) & seasonal variation. Today s sedentary life style & improved socioeconomic conditions, availability of processed high caloric food & drinks, fast food leads to calories input & output misbalance thereby causing Obesity. Sthaulya (Obesity) is a disease in which Meda Dhatu is increased excessively. A person who due to extensive growth of fat & flesh is unable to work & disfigured with pendulous buttocks, belly & breasts is called Atisthula & condition is termed as Atisthaulya i. The term Obesity is defined as excess storage of energy in the body in the form of fat. The Obesity is described in Ayurvedic text in good manner, as repercussions of Obesity the overweight people are increasingly susceptible for many diseases & ailments. Obesity thus reduces the life expectancy, which is well explained in Ayurveda. Obesity (Sthaulya) if it is not controlled in time, it becomes predisposing factor to coronary heart disease, diabetes mellitus, hypertension, gall bladder diseases, osteoarthritis, asthma & certain form of cancers Etc. which possess a serious threat to the mankind. Regarding its treatment since it is multifunctional metabolic disorder, a precise treatment is not available in modern science. The drug used to treat obesity has many side effects so the management of such disease has become a great challenge for modern medical science. While going through different 'Ayurvedic literature, we come across Asana Kashay used in Sthaulya ii. As the drug is easily available and can be given on OPD 2
basis. Hence, I have decided to work on the leading health issue of the society. So considering the importance of this disease, results of Ayurvedic treatment and the graceful guidance of my teachers, I have selected this topic for my study Clinical evaluation of Asana kashay in the management of Sthaulya w.s.r. to Obesity. Aim: To evaluate the effect of "Asana kashay" in the management of Sthaulya w.s.r. to Obesity. Objectives: To reduce the symptoms of Sthaulya such as; Kshudrashwasa, Nidradhikya, Trushnadhikyata, Daurbalya & Kshudhadhikya. To conduct comparative study of Asana kashay with Triphala kashay in the management of Sthaulya. Materials and methods: Study type: Clinical study. Study design: It was open, randomized, preliminary clinical study. Source of Data: Patients were selected from OPD and IPD of A.S.S.Arogyashala Hospital, Nashik, having classical clinical features of Sthaulya as well fulfilling inclusion and exclusion criteria. Sample size: Total 60 patients were selected for the present study. Inclusion criteria: 1. Age: 18 to 60 years. 2. Weight more than 20% excess of the desirable weight according to height, sex, age or age adjusted BMI above 85 th percentile (Indian standard). 3. WHR (Waist Hip Circumference Ratio) >0.95 in males &>0.8 in females. 4. Patient of Sthaulya presenting features as per Ayurvedic text. Exclusive criteria: 1. Associated with Coronary heart disease, Hypertension, etc. 2. Associated with hormonal disorders such as Hypothyroidism, PCOD etc. 3. Pregnant & lactating woman 4. BMI > 45 Grouping Of Patients: 3
In this study, selected 60 patients were equally divided into 2 groups. Group A (Experimental Group) treated with Asana Kashay Group B (Control Group) treated with Triphala Kashay iii. Kala Pragbhakta i.e. before meal (twice/day) Pragbhakta i.e. before meal (twice/day) Matra 40ml 40ml Duration 30days 30days Anupana Madhu (Honey) Madhu (Honey) Follow-up D10, D20, D30 D10, D20, D30 Clinical Assessment Will Be Done As Follow: A) Subjective parameters: 1. Kshudra Shwasa: Dysponea on steping up + more than 20 steps More than 10-20 step ++ Stepping up less of 10 steps +++ 2. Nidradhikya: 8 to 10 hrs + 10 to 11 hrs ++ 11 to 12 hrs +++ 3. Trushnadhikyata: Water intake upto + 2000-2500 ml/day Water intake upto ++ 2500-3000 ml/day Water intake upto +++ 3000-4000 ml/day 4. Durbalya: Occational sensation of fatigue + Intermitent sensation of fatigue ++ 4
Always feeling the fatigue +++ 2) Body Mass Index Ratio (BMI) 3) Measurement of Waist-Hip Ratio (WHR) 5. Kshudhadhikya: Hunger sensation 4-5 + hrs after having food Hunger sensation with ++ 3-4 hrs after having food Hunger sensation with +++ 3 hrs after having food B) Objective parameters: Investigation: Serum Cholesterol (T) Observation and Result: All statistical analysis is done by 2 - test and t-test, where p value <0.05 were considered to be statistically significant. All the observations in reduction of symptoms and statistical analysis are given in table iv. 1) Measurement of Height: Weight with reference to height and weight proportion table on Indian value. Symptoms D 10 2 value D 20 D 30 Result Kshudra Shwasa Nidradhikya Trushnadhikyata Durbalya 1.46 0.11 0.98 4.6 1.36 0.6 Not significant 1.13 0.39 Not significant 1.2 0.72 Not significant 0.4 0.26 Not 5
significant Kshudhadhikya 3.3 7.14 6.9 Significant Objective Paired t value Unpaired t value parameters Group A Group B Weight 6.64 9.58 0.8996 BMI 9.032 10.22 0.222 WHR 8.46 7.05 0.1167 Serum Cholesterol 7.3 9.11 0.1197 Discussion: In Sthaulya Samprapti, abnormally increased vikrut medodhatu causes blockage in Strotasa (stroto avarodha) and also there is disproportional growth of Sharira Bhara to Sharira Bala as a result of this Sthaulya patient experiences Kshudrasvasa. The study drug has Katu Vipak which opens the blockage in Strotasa, also it reduces Meda and ultimately reduces the symptoms of Kshudrashvasa. As in Sthaulya patient, vikrut Kapha also increased with that of vikrut Meda, so the patient experiences Nidradhikyata which further complicates Sthaulya Vyadhi. Asana Kashay along with Madhu encounters Kapha & Vata Dosha by virtue of its Katu vipaka and relives the symptom Atinidra. In Sthaulya Samprapti, as channels have been obstructed by vitiated Medadhatu, Vata Dosha moves about abundantly in umbilical region and thus stimulates Agni and absorbs food. Hence the person digests the food quickly and desires more food intake. These two, Agni & Vayu are particularly complicating Sthaulya, because of this, patient experiences Kshudhadhikyata & Trushnadhikyata. Asana Kashay along with Madhu has Katu vipak and Laghu, Ruksh guna and 6
Lekhan Karma which opens the blockages of Strotasa v. Ultimately relives symptom of Kshudhadhikyata & Trushnadhikyata. There is disproportional growth of Sharira Bhara to Sharira Bala in Sthaulya and other Sharira Dhatu does not get proper nourishment, as a consequence Sthaulya patient experiences Daurbalya. Asana Kashay along with Madhu acts as a Naimittik Rasayana in Medoroga, so it nourishes all Sharira Dhatu equally and alleviate symptom of Daurbalya. Thus, we may conclude that mostly combination of Kashay, Tikta rasa, Katu vipaka, Laghu Ruksh guna and Lekhan Karma of Asana Kashay, which can do the function of Strotorodha Nashana and against Kapha, Kleda & Meda. It is found that, the chemical constituents of Pterocarpous marsupium (marsupsin, pterosupin, liquiritigenin) are Triglycerides, Sr. Cholesterol, and LDL VLDL cholesterol without any significant effect on the level of HDL cholesterol. From the above explanation we can conclude that Asana Kashay probably possesses anti-lipidemic property and may be found useful in the management of Sthaulya. Conclusion: Asana Kashay has shown significant relief in the symptoms of Sthaulya Vyadhi i.e. Kshudrashwasa, Nidradhikya, Trushnadhikyata, Daurbalya except Kshudhadhikyata which is significantly reduced by Triphala kashay. The efficacy of the study drug Asana Kashay is nearly same as the control drug Triphala Kashay in the Sthaulya Vyadhi. Analysis of Sr.Cholesterol level shows significant improvement in almost all patients with Asana Kashay (Group A) as well as Triphala Kashay (Group B) in a given period. Same treatment given for significantly reduces level of Sr. 7
longer time may give more significant result in lowering Sr.Cholesterol level. Acknowledgement: I am grateful to Dr. S. L. Dasari Sir, Principal A.S.S. Ayurved College, Nashik, for permit me to do this research work. I also very grateful to Dr. R. B. Kulkarni Sir, HOD Kayachikitsa dept. A.S.S. Ayurved College, Nashik, for giving me opportunity to do this work and to guide me in each and every step of this study. References: 1. Agnivesha, Charak Samhita, with Vaidyamanorama Hindi commentary, Acharya Vidyadhar Shukla and Prof. Ravidatta Tripathi, Sutra Sthana, Chapter 21, Chaukhambha Sanskrit Pratishthan, Delhi, 2009. P. 301,(Ch.su.21/9). 2. D.V. Panditrao, Chapter no.30, Kashay Yoga, Sahastrayog (Sanskrit- Hindi Anuvad), New Delhi, Vangmay Anusandhan Ekak, Kendriya Ayurved Evam Siddha Anusandhan Parishad, 30 Nov,1990, P.6. 3. Vaidya Laxmipati Shastri, Medorog Nidanam, Yog ratnakar, Vidyotinee Hindi commentary, Chaukhambha Sanskrit Sansthan, 7 th Edition, Varanasi, 1999, P.68 (Shlok No 10). 4. BK Mahajan, Chapter no. 9 Significance of Difference in Means, Methods in Biostatistics, 7 th edition, New Delhi, Jaypee Brothers Medical Publishers (P) LTD, 2010. P. 127-138. 5. Acharya Priyavat Sharma, Dravyaguna Vidyan Volume 2, Varanasi, Chaukhamba Bharti Acadamy, 2006, P. 682-683. Cite this article: Clinical Evaluation Of Asana Kashay In Sthaulya W.S.R. To Obesity Bhushan V. Sonawane, Rajan B. Kulkarni -2015; 3(3): 1-8 8