Effectiveness of Lākṣādi cūrna Utsādana in comparison with Udgharsana with Triphala cūrna and Dhānyamla in the management of Diabetic Distal Symmetric Polyneuropathy – A Pragmatic Randomized Controlled Clinical Trial

Polyneuropathy is a common and debilitating complication of Diabetes Mellitus, affecting more than half of all Diabetic patients. Currently available drugs are often ineffective and complicated by adverse events, hence treatments not entirely satisfactory. Considerable number of patients are seeking nonpharmacologic/alternative medical systems for their management19. DSPN is one of the most important research area in Ayurveda. Several panchakarma procedures have been studied and results are encouraging.A review of researches of external procedures in complications of prameha like DSPN shows that most of the studies focussed are on efficacy of rooksha procedures udvartana, assuming role of kapha in the pathology of prameha. There are studies showing the effect of udgharsana with Triphala cūrna, Triphala cūrnaand dhānyamla, Triphala cūrnaand taila in prameha or sthoulya. But textual references consider predominance of vata in DSPN. In addition to that extreme apatarpana is contraindicated in prameha by all acharya and which can give raise to mutra graha, ruja, gulma, kshaya etc24. Hence many authors consider snigdha mediated procedures. In uts**ādana, even though the medium is snigdha the mechanism of procedure is same as that of udvartana, rubbing in the upward direction. Thus it can be considered as an administration of snigdha in a controlled manner which will be more useful in complications of prameha. Even though there is textual indication for uts**ādana in prameha no studies on uts**ādanain DSPN are available. Hence the present study has been planned to assess the efficacy of uts**ādana in DSPN.