An Anatomical study of Talahridaya Marma and Role of Talahridaya Marma Chikitsa and Sarpaghandha Ghan Vati in the Management of Prehypertension :A Randomised Controlled Clinical Trial

Need of the Study

Hypertension is a prevalent disorder that affects a significant proportion of the global population. Despite the existence of various antihypertensive treatments, the prevalence of hypertension is on the rise not only among the elderly population but also among young adults. Currently the modern medicinal treatment involves various drugs for the treatment of hypertension and a longer intake of such medicines comes with its own side effects on the human body. Considering these reasons, Marma chikitsa could be a better alternative to the current practise of treating hypertension. Clinicians who practise Marma chikitsa have observed a normalising effect on blood pressure, through this non-invasive method of treatment, hypertension and other diseases associated with it could be treated in a holistic manner [5]. Although the lack of clinical data on the effectiveness of this chikitsa has resulted in its limited application across various diseases, thus leaving its potential largely unexplored [3].

In Marma chikitsa a very light stimulation of Marma points on the body is done. Marma points when gently pressed on the skin can stimulate a chain of flow of Prana. Marma chikitsa can make the treatment easy without any medicinal use. Therefore, an attempt is made through this study to treat and manage prehypertension.

Aim*:*

·       Compare the efficacy of Talahridaya Marma chikitsa with Sarpagandh Ghan Vati in the management of prehypertension.

Objectives:

1.     An anatomical study of Talhridaya Marma.

2.     To evaluate the effectiveness of Talahridaya Marma chikitsa in the management of prehypertension.

Statement of Hypothesis

Null Hypothesis (Ho):

•        There is no difference in the effect of Talahridaya Marma Chikitsaand Sarpaghandha ghan vatiin the management of prehypertension.

 Alternative Hypothesis (Ha):

•        Talahridaya Marma Chikitsais more beneficial thanSarpaghandha ghan vatiin the management of prehypertension.

Outcome**:**

Change in JNC criteria

Materials and Methods

Step 01: Conceptual Study

·       Detail study of Talahridaya Marma as per Ayurveda classic and through cadaveric study

·       Detail study of hypertension as per modern literature

Step 02: Interventional study

An interventional open randomize trial involving 30+30 volunteer with the age group of 21-50 years of either gender will be taken for the study. For clinical study, patient attending OPD of Rachana Sharir in National Institute of Ayurveda (NIA) Arogyashala, SSBH and Satellite Hospital, Jaipur will be selected randomly with the symptoms of prehypertension.

Patients Selection Criteria

Inclusion Criteria:

·       Patients lying within the age group of 21-50 years.

·       Patient is currently not taking any drugs for hypertension.

·       Patient will come under the prehypertension range = 120-139 mm of Hg systolic BP to 80- 89 mm of Hg Diastolic BP.

Exclusion Criteria:

·       Patient who are suffering from acute systemic disease

·       Pregnant lady, lactating mothers and females who have recent history of abortion.

·       Patient coming under the range of grade 1 and grade 2 hypertension.

Withdrawal Criteria (Any of the following):

·       Patient himself /herself wants to withdraw from the trail.

·       Serious adverse reaction where continuation of the study pauses a serious risk to the participant.

·       Participant’s condition deteriorates during the course in the opinion of the clinician i.e., further continuation of the study is likely to be detrimental to health of participant.

·       Development of clinical condition leads to violation of inclusion /exclusion criteria.

Methodology

1.     Study Design: Open labeled randomized controlled clinical trial

·       Study Type: Randomized controlled clinical trail

·       Purpose: Treatment of pre-hypertension

·       Masking: Open label

·       Number of Groups: 02 groups

2.     Sampling Method: Random Sampling

·       Randomization:  Computer generated random number table

·       Sample Size: 60 (each group assigned 30 patients)

3.     Research Design: Interventional study

·       Study Duration: 30 Days

·       Follow up: 15 days

4.     Reference: Ayurveda.Sar Sanghra and Siddha Yoga Sanghra

5.     Ingredients of Drug: Sarpaghandha Ghan Vati

Drug name

Botanical name

Part

|01.

Sarpagandha

Rauvolfia serpentine

Root

|02.

Khurasani yavani

Trachyspermum ammi

Seed

|03.

Jatamansi

Nardostachys jatamansi

Rhizome

|04.

Bhanga

Cannabis sativa

Leaf

|05.

Pippalimoola

Piper longum

Root

Groups

The selected patient will be randomly divided into two group viz group A and group B on the basis of computer-generated random number chart. There will be equal number i.e., 30 patients in each group.

Group A: 30 Patients

• Patients will be given Marma chikitsafor a period of 30 days.
• Chikitsa period: maximum 30 days
• Follow up: 15 days
• Chikitsa protocol: Three times stimulations in one sitting (Two sitting in a day)
• Technique - by Pulp of 3 finger side to side movement.
• Marma to be stimulate: Talahridaya Marma

 Group B: 30 Patients

• Patients will be given Sarpaghandha Ghan Vati.
• Dose- 125 mg BD
• Time- After food

Assessment Criteria

·       JNC Criteria

 

BP Classification

SBP (mmHg)

DBP (mmHg

|Normal

≈120

≈80

|Prehypertension

120-139

80-89

|Stage 01 Hypertension

140-159

90-99

|Stage 02 Hypertension

160

100

Table 1: Classification of Hypertension

·       Lipid Profile

Statistical Analysis

1.     Paired t-test

2.     Unpaired t-test (between comparison)