ANIDRA AND ITS MANAGEMENT A REVIEW Scholar Keval Goti Co-Guide B.R.Patel Guide Kalpana Patel INSTITUTE FOR POSTGRADUATE TEACHING AND RESEARCH IN AYURVEDA GUJARAT AYURVED UNIVERSITY JAMNAGAR 361 008
PURPOSE Ahara (diet), Nidra (sleep) and Brahmacharya (celibacy), are mentioned as three Upastambhas (sub-supporting pillars) which play an important role in maintaining the health. The inclusion of Nidra in three Upastambha signifies its importance It is stated that ; happiness & sorrow, growth & wasting, strength & weakness, virility & impotence and knowledge & ignorance as well as the existence of life and its cessation depend on the sleep.
A disease condition, where lack or less sleep (Nidra) seen is known as Anidra which termed as Insomnia in Medical science. The modern medical science is still not having a definite treatment for insomnia. Although hypnotics, sedative, anxiolytic, psychotropic are evolved they have got their own limitations because of their hazardous adverse effects. Therefore, such agents cannot be safe for a long period. Hence, it becomes imperative to search out the drugs which are safe and effective from natural systems of medicine like Ayurveda which can help patients of insomnia.
MATERIAL AND METHOD In IPGT &RA, Jamnagar total 11 dissertation work has been carried out on Anidra management till date, from which studies carried out in the period 2001 to 2015 were analyzed and presented in scientific manner.
1. Comparative study on the effect of Sneha Dhara and Jala Dhara in Anidra (joshi chinmay- 2013) 1. Jatamansi Taila Dhara (Group A) Drug: Jatamansi Taila. Dose: 1 lit. Duration: 45 minutes for 2 weeks 2. Jala Shirodhara (Group B) Drug: Jala.( Luke warm water) Dose: 1 lit. Duration: 45 minutes for 2 weeks. Jaladhara was performed about 45 minutes daily in the morning for 2weeks
Result of clinical study Group-A Jatamansi Taildhara Group-B Jaladhara Total No. of patient 31 13 out of (15) 14 out of (16) Complete Remission : 100% relief 0% 0% Marked Improvement : >75% relief 7.69% 0% Moderate Improvement : >50 % to 75 % relief 76.92% 85.71% Mild Improvement : 25 % to 50 % relief 15.38% 14.29% Unchanged : <25 % or No relief 0% 0%
2. Anil kumar singh (2007) A clinical study of Manasika Bhavas in Anidra W.S.R to stress induced chronic insomnia and its management with Mamsyadi Ghrita & Dashmoola kwatha shirodhara (kayachikitsa,m.d.thesis) 1. Group-A.Mamsyadi Ghrita (MG) Drug : Jatamamsi, Shankhapushpi, Ashwagandha, Tagar formulated as Ghrita. Dose : 20 g twice a day orally Anupana : Lukewarm water Duration : 6 weeks Follow up : one month 2. Group-B. Dashamula Kwatha Shirodhara (SG) Drug : Dashamula Kwatha, Dose : 500 gm/day (2 liter kwatha form) Duration : 21 Days Follow up : one month.
Result of clinical study Group-A Mamsyadi Ghrita Group Total No. of patient 30 15 8 Complete Remission : 100% relief 0% 0% Group-B Dashamula Kwatha Dhara Group Marked Improvement : 76-99% relief 15% 25% Moderate Improvement : 51 % to 75 % relief 46.67% 50% Mild Improvement : 25 % to 50 % relief 33.33% 25% Unchanged : <25 % or No relief 0% 0%
3. Vansh bina (2008) A clinical study on Manasika Bhavas in Anidra W.S.R to stress induced insomnia and its management with Tagaradi kwatha and Mahishi Dugdha Shirodhara (kayachikitsa,m.d.thesis) 1.Group-A. Tagaradi Kwatha (TK) Drug: Jatamamsi, Shankhapushpi, Ashwagandha, Tagar, Brahmi, Draksha, Katuki, Parpatak, Dashamula, Musta, Raktachandana, Amaltas formulated as Kwatha. Dose: 40gm/day (Into two divided doses each of 20 gms) Duration: 6 weeks 2. Group-B. Mahishi Dugdha Shirodhara (SG) Drug: Mahishi Dugdha. Dose: 1 liter Milk Duration: 21 Days Dugdhadhara was performed about 30 minutes daily in the morning between 8:00 to 10:30 AM for 21 days with lukewarm Milk.
Group-A Tagaradi Kwatha Total No. of patient 31 17 10 Complete Remission : 100% relief Result of clinical study 0% 0% Group-B. Mahishi Dugdha Shirodhara Marked Improvement : >75% relief Moderate Improvement : >50 % to 75 % relief Mild Improvement : 25 % to 50 % relief Unchanged : <25 % or No relief Result 0% 20% 23.53% 60% 76.47% 20% 0% 0% More effactive
4. M.P.S.K.R. Muthugala (2013) - Evaluation of Parasikayavanyadi capsule in the management of Anidra W.S.R. to insomnia (kayachikitsa, M.D. Thesis) Parsikayavanyadi capsule Parasikayavani-1/4 th part Jatamansi -1 part Shankhapushpi-7 Bhavanas of Svarasa Kushmanda -7 Bhavanas of Svarasa Grouping Group P.V (Parsikyavanadi Vati) Group P.M (along with allopathy medicine) Group P.C (Placebo) Dose 5 Capsules 5 Capsules 5 Capsules Time At bed time At bed time At bed time Anupana Luke warm water Luke warm water Luke warm water Duration One month One month One month
Result of clinical study Parasikayavanyadi capsule group P.V Parasikayavanyadi capsule group P.M: Placebo capsule group P.C: Total No. of patient 20 20 12 Complete Remission : 100% relief 0% 0% 0% Marked Improvement : >75% relief 0% 0% 8.33% Moderate Improvement : >50 % to 75 % relief 40% 55% 0% Mild Improvement : 25 % to 50 % relief 50% 40% 0% Unchanged : <25 % or No relief 10% 5% 75%
5. Nirmal Dhamini (2004) Role of Manasika Bhavas in Anidra and its management with certain indigenous drugs and Shirodhara. 1. Group A (Apamargadi Vati Group) : Dose : 1 gm t.d.s. Duration : 8 weeks Anupana : With milk (buffalo) 2. Group B (Taila Dhara Group) : Drug : Kshira Bala Taila Duration : Shirodhara done for 30 min. daily in the morning for 2 weeks. 3.Group C (Combined Group) In this group combined therapy has been given as mentioned in the groups above.
Group A (Apamargadi Vati Group) : Group B (Taila Dhara Group) : Group C (Combined Group) Total No. of patient 20 20 12 Complete Remission : 100% relief 0% 0% 0% Marked Improvement : >75% relief 0% 62.50% 62.50% Moderate Improvement : >50 % to 75 % relief 85.70% 25% 37.50% Mild Improvement : 25 % to 50 % relief 14.30% 12.50% 0% Unchanged : <25 % or No relief 0% 0% 0%
6. A clinico comparative study of Madhukadi taila Shiropichu and Pippalimoola Churna in the management of Anidra w.s.r. To insomnia Group A: Drug : Madhukadi Taila Form : Taila - Pichu Dose : 50 ml approximately Mode of administration : Local application(60minutes) Time : At morning Duration : 2 weeks Group B: Drug : Pipplimoola Form : Churna Dose : 1 gm twice a day Mode of administration : Oral Time of administration : After food Anupana : Guda (Jaggery) 2 gm twice a day Duration : 4 weeks
Group A Madhukadi Taila Shiropichu Group B Pipplimoola Churna Total No. of patient 30 30 Complete Remission : 100% relief Marked Improvement : 75% to 99%relief Moderate Improvement : 50 % to 75 % relief 0% 0% 20% 23.33% 53.33% 40% Mild Improvement : 25 % to 50 % relief Unchanged : 25 % or No relief 20% 33.3% 6.67% 3.33% result Highly significant insignificant
7. Kalpesh panara (2013-2014) A pharmaco clinical evaluation of Beejapoorapatra (leave of citrus medica linn.) W.S.R to insomnia.- (Dravyaguna, ph.d thisis) Group A: Drug :Powder of Beejapura Dose: 3g Anupana :Honey (5g) Route of administration :Oral Time of administration :Half an hour before bed time Duration of treatment : 4 weeks Follow-up :2 weeks Group B: Drug: leaves Powder of Jatamansi Dose: 3g Anupana :Honey (5g) Route of administration: Oral Time of administration: Half an hour before bed time Duration of treatment: 4 weeks Follow-up :2 weeks
Group A Powder of Beejapura Total No. of patient 33 33 Complete Remission : 100% relief 7% 13% Group B Leaves Powder of Jatamansi Marked Improvement : 76% to 99%relief Moderate Improvement : 51 % to 75 % relief Mild Improvement : 26 % to 50 % relief Unchanged : up to 25 % relief result 3% 9% 7% 19% 40% 59% 43% 3.33% Highly significant
8. Krutika joshi (2013-2014) a pharmaco clinical evaluation of Pippalimoola (root of piper longum) W.S.R to insomnia.- (Dravyaguna, ph.d thesis) Group A: Drug: Powder of Pipplimula Dose : 2g Anupana:Jaggery(5g) Route of administration :Oral Time : Half hour before bed time once at night Duration : 4 weeks Follow up: 2 weeks Group B: Drug: Powder of Jatamansi rhizome Dose : 2g Anupana:Jaggery(5g) Route of administration :Oral Time : Half hour before bed time once at night Duration : 4 weeks Follow up: 2 weeks
Group A Powder of Pippalimula Group B leaves Powder of Jatamansi Total No. of patient 28 28 Complete Remission : 100% relief 0% 0% Marked Improvement : 76% to 99%relief Moderate Improvement : 501% to 75 % relief Mild Improvement : 26 % to 50 % relief Unchanged : up to25 % relief result 42.86% 3.57% 57.14% 89.29% 0% 7.14% 0% 0% Similar effect to standard drug
CONCLUSION Therapies and formulation of the study which has given significant result were enlisted below. Madhukadi Taila Dhara, Mahishi Dugdhdhara, Jatamansi powder, Parsikyavanyadi capsule, Mansyadi Ghrita, Apamargadi Vati, Jatamansi Tailadhara, Dashmoola kwatha dhara Madhukadi Taila Shiropichu From the review work it can be concluded that internal medication with Shirodhara is much effective in the management of Anidra.