P. D. F. - Ayurlog

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P. D. F. - Ayurlog

ISBN 978-93-5173-179-3
http://www.ayurlog.com
ISSN 2320-7329
Vol. 3
Special issue*- 16th Feb. 2015
Ayurlog: National Journal of Research in Ayurved Science
A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
“A prospective clinical study to evaluate the efficacy of pradarripu rasa in
comparison with shalmali ghruta in the management of raktpradar.”
1. Nitika Sahebrao Badhiye, 2.Jayashree S. Deshmukh
1. Author.-P.G. Scholar,Department of PrasutiTantra&StreeRoga, CSMSS College of
Ayurveda & Hospital, Aurangabad. 431001.
2.Guide : Head of Department, Department of PrasutiTantra&StreeRoga, CSMSS College of
Ayurveda & Hospital, Aurangabad. 431001
ABSTRACT:
Raktapradar is one of the main
gynecological disorders. A condition
associated with severe bleeding may be
accompanied with menstruation or may
not be. Ayurvedic texts have described a
variety of treatment options in the
management of “Raktapradar”. Despite of
wide treatment options for its management
which have multiplied over the recent
years, yet considering the factors such as
age, parity & wishes of the patient with
regard to contraception, future pregnancy
etc, which is non-hormonal, non surgical,
effective & without any adverse effects is
the needed. Pradarripu Rasa and
ShalmaliGhrutaare
mentioned
in
Yogratnakar in the management of
Raktapradar.
Both drugs are easily
available, easy to consume and it is cost
effective also.Therefore the present study
INTRODUCTION
Raktapradar1 is one of the main
gynecological disorders. A condition
was carried out for comparing clinical
evaluation of the efficacy of both drugs.
Total 60 patients were selectedby using
purposive sampling method which was
divided
in
2
groups.The
treatmentconducted for duration of 3
menstrual cycles.The responses to the
treatment were recorded by parametersand
therapeutic effects were evaluated by
symptomatic relief. In the present study,
according collected data, it is observed that
both the drugs i.e. Pradarripu Rasa and
Shalmalighrutahas provided significant
relief in all the symptoms of
Raktapradar.As total comparison of both
Group drugs mentioned that Group A
drug (Pradarripu Rasa) is quite effective
than Group B drug ( ShalmaliGhruta).
Key words – Raktapradar, Pradarripu
Rasa, ShalmaliGhruta,
associated with severe bleeding
may be accompanied with menstruation or
may not be.Raktapradar is a debilitating
disorder; the woman requires rapid, safe
and effective treatment.In the female the
reproductive system has a great
importance and any disease in this system
1
*Special Issue for “National Seminar- Practical approach in Prasutitantra And Streerog 2015”
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
will seriously affect her health and
happiness and also it proves to be a
great discomfort. Raktapradar is one
among extensive range of occurrence.
Ayurvedic texts2 have described a variety
of treatment options in the management of
“Raktapradar”.This is seen in 15% of all
patients
attending
the
Strirog&Prasutitantra O.P.D. from puberty to
menopause. In the absence of any organic
pathology, medical therapy3 is the first
choice
of
treatment
for
controllingRaktapradar. However the
conventional treatment with hormones has
its limitations. It is associated with their
side effects and is contraindicated in
women with diabetes, hypertension and
cardiac diseases often occurring around
premenopausal age. Hence there is a need
for a herbal drug that can be used for all
patients to tide over this temporary
phenomenon.
Good numbers of researches have
brought
few
recipes
sufficiently
efficacious; however the attempt to find
new
recipes
or
remedies
never
4
ends.Pradarripu
Rasa
andShalmali
5
Ghruta are mentioned in Yogratnakar in
the management of Raktapradar. Both
drugs are easily available, easy to consume
and it is cost effective also. So this study
has been selected.
AIM & OBJECTIVES
Aim- To study the efficacy of Pradarripu
Rasa in comparison with ShalmaliGhruta
in Raktapradar.
Objectives1. To compare the symptomatic relief
by them on Raktapradar.
2. To carry out a comprehensive
literary study of Raktapradar.
MATERIALS AND METHODS
Randomly selected 60 patients of
Raktapradar attending OPD and IPD
department
ofstreeroga&prasutitantrawere included
in study and divided into 2 groups.
Group A and Group B
All the patients fulfilling inclusion and
exclusion criteria were selected for the
study with fully informed consent.
Methodology
Group A
Group B
No of
Patients
30
30
Drug
Pradarripu
rasa
ShalmaliGhrita
1000 mg
Matra(per ( 500 mg
day)
BD)
20 ml
(10 ml BD)
Anupan
KoshnaJala Godugdha
Duration
15 days
15 days
Sevankal
Twice a
day
Twice a day
2
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
Followup
After next
menstrual
cycle.
After next
menstrual
cycle.
No of
follow ups
2
2



SELECTION CRITERIA

 Inclusion Criteria
Patients willingly participated in the trial
and given consent form.
Patients having textual symptoms of
Raktapradar were taken as subjects for
study.
 Age group of patients between 18
to 50 years.
 Patients having symptoms of
Raktapradar that is excessive &
irregular PV bleeding.
 Hb % above 7 gm%
 Exclusion Criteria
Patients unwillingly participated &
associated with other complications such
as
 Malignancy
 fibroids
 Associated with IUCD
 Systemic disorders
 Infections like Chlamydia and
tubercular cervicitis etc
 Threatened or spontaneous or
incomplete abortion
Clinical Study

A single blind randomize clinical
trial was carried out.
Selected patients were randomly
divided into two groups.
o Group A & Group B
A special case paper was prepared
to note the history & clinical
findings of the patients before
during & after the treatment.
The treatment started on day of
counseling, for 15 days and 2 such
menstrual cycles were monitored
for observations which were noted
in the tabular form.
During the course of treatment both
groups were advised similar dietary
& behavioral instructions.
ASSESSMENT CRITERIA OF THE
WORK -Gradation of symptoms
Sr
.
n
o.
Sign &
symptoms
score
1
score
2
score
3
1
Duration of
flow
( Raja
pravrutti
Kala)
5 days 7
+
days+
9
days
+
2
Amount of
blood loss
(No of pads/
day)
(Raja
Pramana)
3-4
4-5
5+
3
colour(Raja
Varna)
Bright
red
Brisk
red
Dark
red
3
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
4
Clots in
bleeding
(Raja
Swaroop)
+
++
+++
5
.HB %
(Pandutva)
Hb>
10
Hb> 8
Hb>
7
6
Weakness
(
Daurbalya)
+
++
+++
7. Lower
abdomen
pain
(
Adhodarsho
ol)
+
++
+++
Investigations
• BT
• CT
• HB%
• USG (Pelvis)
Investigations done as needed.
Follow up
Patients follow up for 2 consecutive
menstrual cycles.
OBSERVATION AND RESULTS
Total 42 patients were taken in group A
and 36 patients were taken in group B.Out
of which 30 patientsfor each group were
selected randomly for the project work. All
the selected patients were thoroughly
examined and diagnosed and selected,
based on exclusive and inclusive criteria.
The assignment revealed the following
statistics.
Discussion on Observations–
 Age: In the present study,
maximum no. of patients i.e. 33%
were from the age group of 21-25
years.
 Education: In the present study the
maximum 90 % patients could
literate.
 Occupation: In the present study
maximum 46.67 % patients were
Housewives.
 Economical Status: Majority of the
patients i.e. 43.33 % belonged to
middle class.
 Religion: In the present Study
Hindus were 60 %.
 Marital Status The present study
shows that 73.67 % patients were
married.
 Diet Pattern: Maximum numbers of
patients i.e. 56.67% of this series
were mixed vegetarian.
 Addiction: The present study
revealed that majority of the
patients i.e. 51.67 % were not
having any type of addiction.
 Prakruti: Maximum no. of patients
i.e. 46.67 % were having pittavataprakriti
 Locality: In the present study,
61.67% were urban inhabitants,
while 38.33 % were rural in
habitants.
 Aakruti: In the present study, 43.33
%
patients
were
having
madhyamaaakruti.
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ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
 Nidra: The present study showed
that majority i.e. 48.67 % patients
were having Prakrutnidra.
 Agni:The present study showed
that majority i.e. 65 % of the
patients were having Mandagni.
 Koshtha: The present study showed
that maximum i.e. 45% patients
were having mruduKoshtha.
COMPARATIVE ANALYSIS:
Statistical Analysis6:The null hypothesis, H0:
The effect of treatment on all
symptoms in Pradarripu Rasa (Group A)
is
not
significant
than
in
ShalmaliGhruta(Group B).
The alternative hypothesis Ha:
The effect of treatment on all
symptoms in Pradarripu Rasa (Group A)
is
significant
than
in
All the values in following tables
are calculated by using Mann – Whiteny
test for subjective criteria and Unpaired t
test for the objective criteria.
Symptoms
N
Raja pravrutikala
55
Mean of Group A
1.75
Mean of Group B
1.407
S.D(+) of Group A
0.7
S.D(+) of Group B
0.636
S.E.(+) of Group A
0.132
S.E.(+) of Group B
0.122
U
273.5
U„
482.5
P
<0.05
As the p value is less than the significance
level alpha = 0.05, we should reject the
null hypothesis H0 and accept the
alternative hypothesis Ha, i.e. Pradarripu
Rasa (Group A) is significant than in
ShalmaliGhruta(Group
B)
for
Rajapravrutikala.
Symptoms
N
Raja pramana
59
Mean of Group A
1.414
Mean of Group B
1.267
S.D(+), of Group A
0.627
S.D(+), of Group B
0.583
S.E.(+), of Group A
0.116
S.E.(+), of Group B
0.106
U
376
U„
494
P
<0.05
As the p value is lower than the
significance level alpha = 0.05, we should
reject the null hypothesis H0 and accept the
Rasa (Group A) is significant than in
ShalmaliGhruta(Group B) for Raja
pramana
5
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
Symptoms
Raja varna
N
46
Mean of Group A
1.89
Mean of Group B
2.31
S.D(+), B.T.
0.698
S.D(+), A.T.
0.582
S.E.(+), B.T.
accept the null hypothesis H0 and reject the
Rasa (Group A) is not significant than
B)
for
Rajaswaroopa.
0.134
Symptoms
N
Adhodarshool
53
S.E.(+), A.T.
0.133
Mean of Group A
1.542
U
172.5
Mean of Group B
1.828
U„
340.5
S.D(+), B.T.
0.589
P
<0.05
S.D(+), A.T.
0.658
S.E.(+), B.T.
0.12
S.E.(+), A.T.
0.122
U
268
U„
428
P
>0.05
As the p value is lower than the
reject the null hypothesis H0 and accept the
Rasa (Group A) is significant than
ShalmaliGhruta(Group B) for Raja varna.
As the p value is greater than the
B)
for
Adhodarshool.
Symptoms
Rajaswaroop
N
51
Mean of Group A
1.63
Mean of Group B
1.375
S.D(+), B.T.
0.629
S.D(+), A.T.
0.494
Symptoms
N
Daurbalya
55
S.E.(+), B.T.
0.121
Mean of Group A
1.308
S.E.(+), A.T.
0.1
Mean of Group B
1.379
U
256.5
U„
S.D(+), B.T.
0.47
391.5
S.D(+), A.T.
0.493
>0.05
S.E.(+), B.T.
0.092
S.E.(+), A.T.
0.091
U
350
P
6
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
U„
404
P
>0.05
alternative hypothesis Ha, i.ePradarripu
ShalmaliGhruta(Group B) for Daurbalya.
Symptoms
Haemoglobin
N
60
Mean Difference Score,
Group A
0.273
Mean Difference Score,
Group B
0.347
Combined S.D. (+)
0.31
S.E. (+)
0.08
Unpaired t
0.916
P
<0.05
Result
No Significant
Difference
As the t value calculated is lower
than the t tabulated value at p=0.05, where
df = 58, so there is no significant
difference between the two groups.
% RELIEF in OBSERVATIONS
Sr.
No.
Parameter
Group A
Group
B
1
Raja Kaal
77 %
58 %
2
Raja Praman
78 %
72 %
3
Raja Varna
80 %
70 %
4
Raja Swaroop
69 %
52 %
5
Adhodarshool
58 %
83 %
6
Daurbalya
60 %
71 %
RESULT:
In the present study, according
collected data, it is observed that both the
drugs i.e. Pradarripu Rasa and
ShalmaliGhrutahas provided significant
relief in all the symptoms of Raktapradar.
The effect of treatment for the
symptoms – Rajakala, Rajapramana , and
Rajaswaroop of Raktapradar, Pradarripu
Rasa (Group A) is significant than
But The effect of treatment for the
symptoms – Adhoodarshool&Daurbalya of
Raktapradar, ShalmaliGhruta(Group B) is
significant than Pradarripu Rasa (Group
A).
There is no significant difference
between the two groups for Haemoglobin.
7
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
CONCLUSION
Mode of action of drugs :In Raktapradar, excessive bleeding
per vagina during menstrual cycle,
prolonged
menstrual
bleeding,
intermenstrual bleeding is observed along
with abdominal pain ,daurbalyaetc which
disturbs the normal life of female.
In samprapti of Raktapradar we
have seen that nidanasevan like
Abhishyandi, vidahi, guru, amla, lavana,
katurasatmakahara curd ,shukta, mastu,
sura leads to pitta prakopa& ultimately
raktadhushti also it aggrevates the vata
which vitiates into garbhashayagatsira
results in Raktapradar.
Pradarripu Rasa is tikta-madhur-Kashay
rasatmak7 drug having katuvipak and
ushnavirya. Being laghu, ruksha causes
Kaphashaman. Being tikta-madhur-kashay
causes Pittashaman. It acts as pachak,
Jathharagnivardhak,aamdoshnashak,
saarak , balya, raktastambhak, vranaropak
and purishsangrahak. Thus suppreses
vitiated
pitta
&kapha.
Relieves
agnimandata
and
makes
aaharrasaprakrut.
Relieves
rasagnivaishamya
,
makes
prakrutaartava&rakta.
With
ushnaviryaand
laghu- rukshaguna ,
relieves the increased dravaguna of rakta.
Thus prakrutaartava&rakta reaches to
garbhashaygatrajovahasira.
With
prakrutapanvayu controls the deerana(
ExcessiveExcreation )of Raja. Thus cures
the Raktapradar.
In this way
,Pradarripu Rasa mainly acts on Pitta
&Kapha . So markable results are
observed
on
RajapravruttiKaal,
RajapravruttiPramana ,Rajastrav Varna
and Raja swaroop.
ShalmaliGhrut
a is madhur-tikta rasatmak8 drug having
madhurvipak and sheetavirya. Being
snigdha, guru, mrudu, pichhil causes
mainly
Vatashaman.
Being
madhurvipaki&sheetavirya
causes
Pittashaman. It acts as raktastambhak,
daahprashamak, anulomak, grahi, deepan,
balya, medhya, agnivardhak, aayubalavardhak,
dhatu-ojavardhak
and
rasayan. Mainly suppresesvitiated Pitta
&Vata. Relieves agnimandata and makes
rasagniprakrut.
Thus
causes
prakrutaartava&rakta. It also relieves
apanvayudushti.
Thus
relieving
pittavruttatva of apanvayu, causes
prakrutdeerana (excreation) of rajaand
thus cures Raktapradar.
In this way, drug acts mainly on Pitta
&Vata, so markable results are observed
on adhodarshool&dourbalya.
As total comparison of both Group
drugs mentioned that Group A drug is
quite effective than Group B drug. So
more research in this work is necessary
to bind firm conclusion about efficacy of
drugs.
ACKNOWLEDGEMENT.
I am grateful to Shri. S. G. Deshmukh ,
Principle of CSMSS
AyurvedMahavidhyalaya for providing all
8
ISBN 978-93-5173-179-3
ISSN 2320-7329
Vol. 3
the facilities for research. I am also grateful
to Jayshree S. Deshmukh for her guidance.
I am also thankful to AjayThote for his
help with statistics.
REFERANCES
1. Ed. Vd. P.G.Aathvale,
DrushtarthaSushrutChintan,
Godavari Publishers,
1stEdition,Page 545.
2. Ed.PremvatiTiwari,Ayurvedicprasu
titantraavamstreeroga , Part
2,Chaukhamba Sanskrit sansthan
,1stEdition,Page 204
3. Ed. Dr. D.C .Datta.,Textbook of
Gynaecology, New central book
agency, 5th edition, Page 183
4. Ed Vd. LuxmipatiShashtri,
Yogratnakar,ChoukhambaPrakasha
n, 5th Edition, Page 401
5. Ed Vd. LuxmipatiShashtri,
Yogratnakar,ChoukhambaPrakasha
n, 5th Edition, Page 400
6. Ed. Dr. B. K. Mahajan
,Biostatisics, Jaypee Publication,
6th edition.
7. Ed. P.S. Sharma, Database on
Medicinal Plants used in Ayurveda,
Central Council for Research in
Ayurveda &sidhaVol – 2.
8. Ed. P.S. Sharma, Database on
Medicinal Plants used in Ayurveda,
Central Council for Research in
Ayurveda &sidhaVol – 2.
Cite this article:
“A PROSPECTIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF PRADARRIPU RASA
IN COMPARISON WITH SHALMALI GHRUTA IN THE MANAGEMENT OF RAKTPRADAR.”
NIKITA SAHEBRAO BADHIYA
Ayurlog: National Journal of Research in Ayurved Science-2014; 2(4): 1-9
9

P. D. F. - Ayurlog

Transcription

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