A Controlled Clinical Study To Evaluate The Efficacy Of Thila Kshara Vida Lavana Yoga Over Apamarga Kshara In The Management Of Mutra Ashmari (Urolithiasis)

Mutrashmari is one of the most common disease of the mutravaha srotas. It is one among Ashta Mahagadas. This shows that the mutrashmari disease prevailed since the inception of medicine in India. Majority of the signs and symptoms of the disease mutrashmari resembles with that of Urolithiasis. It occurs more frequently in men than in women, because of different dietary habits or genetic background and it is rare in children*. Research statistics shows that in India, 12% of the people is estimated to have urinary stones, out of which 50% of the population are severely affected by renal damage, which even leads to a failure of kidneys. It is peak in population aged over 30 years". Urolithiasis is a stone-like body composed of urinary salts bound together by a colloid matrix of organic materials. It consists of a nucleus around which concentric layers of urinary salts are deposited*. And has clinical features - Pain, haematuria, frequency. The treatment principle in urolithiasis in contemporary science is flush therapy in case of stones up to 5mm, in larger stones the percutaneous procedure like ESWL (Extracorporeal shock wave lithotripsy) and PCNL (percutaneous nephrolithotomy), URS(Ureteroscopy) and operations like Pyelolithotomy, Nephrolithotomy, nephrectomy are done. These are limited to  urban areas and is expensive. There is 40-50% recurrence rate of urolithiasis even after treatment’°. For this reason, efforts are being made to evolve an effective formulation for the treatment as well as for the prevention of recurrence of calculi. Ashmari is kapha ashrita vyadhi, which is caused by not taking panchakarma samshodana therapies and by not following pathya where kapha dosha aggravates and aggravated kapha dosha with vata and mutra enters basti and cause ashmari. Then develops symptoms like pain, haematuria, split urine stream, dysuria, generalized weakness, anorexia. Even though a number of ashmarighna yogas have been mentioned in the classical texts of Ayurveda, only a few formulation have been made available in the day-to-day practices and others are not even known and revalidated clinically. Among them tila kshara vida lavana yoga is also one which is explained in Rasatarangini. Acharya Sushruta mainly explained about kshara in the conservative management of mutrashmari, and also advised tila in the chikitsa of mutraashmari.? Ingredients of Tila kshara vidalavana yoga has the properties of ashmari bhedana by its teekshna and sookshma property; vataanulomaka and kapha dosha hara and agnidipana by its sakshara and ushna property; shulanashana (udarashula) and mutrala.384 As Apamarga kshara has already proven to be effective in the management of mutraashmari, hence in the present work, an attempt will be made to evaluate the efficacy of tila kshara vida lavana yoga in the management of mutraashmari over apamarga kshara.