AN OPEN LABEL RANDOMIZED CONTROLLED CLINICAL STUDY TO EVALUATE COMBINED EFFECT OF MATRABASTI,PADABHYANGA AND SRINRIPATIVALLABHA RASA IN DIABETIC PERIPHERAL NEUROPATHY

Diabetes Mellitus is a metabolic disorder of multiple etiologies. It is characterized by chronic hyperglycemia together with disturbance of carbohydrate, fat and protein metabolism resulting from defect of insulin secretion, insulin action or both.These are associated with the development of specific microvascular complication such as retinopathy, nephropathy and neuropathy.

Diabetic Peripheral Neuropathy[DPN] is one of the most common microvascular complication of Diabetes Mellitus and a major cause of morbidity. About 50% of Diabetic population are affected by Diabetic Peripheral neuropathy[DPN]. Patients with Type 2 Diabetes Mellitus are more often affected than those with Type1. In India, prevalence of Diabetic Peripheral Neuropathy ranges from 15 to 60%.

The TORONTO consensus meeting, defined Diabetic Peripheral Neuropathy[DPN] as asymmetrical and length-dependent sensorimotor polyneuropathy attributed to metabolic and micro-vascular alteration, as a result of long-standing hyperglycemia and metabolic derangements.

Common clinical features of Diabetic Peripheral Neuropathy[DPN] are diminished perception of vibration sensation distally, glove and stocking impairment, loss of tendon reflexes in lower limbs, paranesthesia in the feet(and, rarely, in the hands), pain in the lower limbs(dull, aching and/or lancinating, worse at night, and mainly on the anterior aspect of the legs), burning sensation in soles of the feet, cutaneous hyperesthesia and an abnormal gait and often associated with a sense of numbness in the feet. Management of Diabetic Peripheral Neuropathy includes strict glycemic control(life style modification and intensive insulin therapy) anticonvulsants, antidepressants and opiates. But the treatment is unsatisfactory in most of the respect. Hence its a need of hour to throw a light on effective and feasible treatment for Diabetic Peripheral Neuropathy[DPN].

Based on the clinical features of Diabetic Peripheral Neuropathy[DPN], it can be inferred that there is vitiation of Vata Pitta pradhana tridosha.

Basti is the prime treatment modality for Vata vyadhi. Acharya Sushrutha quotes that Basti is not only indicated for Vata Dosha, but also beneficial for Pitta, Kapha and Raktha Doshas. In present study, Dhanvantara Gritha mentioned in Astanga-Hrudaya Prameha chikista, indicated in Prameha pidaka, Madhumeha, Shotha and Vatashonita it is selected for Matra Basti.

Focusing on the clinical feactures of Diabetic Peripheral Neuropathy[DPN], Chandanadi taila is selected for Padabhyanga, it is indicated in Angadaha and vatarakta.

Srinrupativallabha Rasa mentioned in Grahani Rogadhiraka of Bhaishajya Ratnavali having indication in Prameha,Daha,Vatarakta,Shotha also having karma of Ayushya, Balya & Veerya vardhaka is selected as the Shamanoushadi .