A Randomized Comparative Clinical Study to evaluate the efficacy of Yavaadi Upanaha and Atasi Upanaha with internal administration of Kaishora Guggulu in the management of Siraja Granthi with special reference to Varicose Veins.

Siraja Granthi is one of the Granthi Roga described in Ayurvedic Samhitas. The person’s who is weak, indulging in more of physical exercise, Vata get aggravated, invades the network of blood vessels causing Sampeedana, Sankochana and Vishoshanam and produce Granthi formation in Sira, this condition is called as Siraja Granthi. Siraja Granthi is non-pulsatile.

By similarity in clinical features Siraja Granthi can be correlated with varicose veins, as varicose veins are dilated, tortuous and elongated veins in the leg. In varicose vein there is reversal of blood flow through its faulty valves. This occurs frequently in the superficial venous system of the lower limbs, resulting in varicose veins of lower limbs, he prevalence of trunk varicosities in the age groups 18-24 years, 25-34 years, 35-44 years, 45-57 years and 55-64 years was 11.5%, 14.6%, 28.8%, 41.9% and 55.7% respectively. It is a painful condition, so it hampers day to day activities of the person. Most people consider them more of an unsightly cosmetic inconvenience. Women are affected more frequently than men. Varicose veins may eventually reach five times their usual size if left to develop for long enough. Venous eczema, venous pigmentation, lipodermatosclerosis, superficial thrombophlebitis and venous ulceration are commonly observed complications of varicose veins. The treatment for varicose veins in modern science includes use of elastic compression stockings, sclerotherapy and surgical treatment.

Acharya Vagbhata explained about Chikitsa of Siraja Granthi as internal administration of Sahacharadi Taila, application of Upanaha, Basti with Vata Shamaka Dravyas and Siravyadha. Upanaha is a type of Swedana, so it induces hyperthermia which improves local blood and lymphatic circulation and thereby improving local tissue metabolism, reduces inflammation by modifying secretion of various inflammatory mediators, relaxes local musculature by physical effect of heat and thereby reduces pain and increases the rate of trans-dermal drug delivery.In Upanaha, Bandha have added benefits, it indirectly provides firm support and relieves the muscle strain.

In Siraja Granthi, Vata along with Shonita are vitiated, which are responsible for Sampidana(Pain), Sankocana (Constriction), Vakri (Distortion), and Vishosya (Drying up). Upanaha is mainly indicated in Vata Vikaras. The Upanaha should be applied to the area which presents with Kunchyamanam (contracted), Ruja (painful), Gatrastabdhata (stiffness) and firmly bandaged with Patta or Kshouma or Karpasa. As Siraja Granthi is also Dhatugata Vikara, hence Upanaha isconsideredfor its management.

Yavaadi Upanaha is explained in the treatment of Vatarakta in Mahavatavyadhi Chikitsitam Adhyaya in Chikitsasthana of Sushruta Samhita. Its ingredients are Yava, Madhuka, Eranda, Tila and Varshabhuwhich has properties of Vatahara, Shoolahara, Shothahara, Varnya, Shonita Vikarahara, Balakar, Stairyakara. The ingredients of Atasi Upanaha are, Atasi churna, Godhuma churna, Haridra churna, Tila tail and Saindhava lavana,which have the properties of Shoolahara and Shophahara. According to Sarangadhara Samhita in the context of Gutika Kalpana, Kaishora Guggulu is used in Vatarakta.

Hence, the present study is undertaken to evaluate the efficacy of Yavaadi Upanaha and Atasi Upanaha with internal administration of Kaishora Guggulu in the management of Siraja Granthiwith special reference to Varicose Veins.