A comparative clinical study of Tryoshnadi Guggulu and Lasuna in management of dyslipidemia

Dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low high-density lipoprotein level that contributes to the development of atherosclerosis. Causes may be primary (genetic) or secondary. Diagnosis is by measuring plasma levels of total cholesterol, TGs, and individual lipoproteins. Treatment is dietary changes, exercise, and lipid-lowering drugs.

There is no natural cutoff between normal and abnormal lipid levels because lipid measurements are continuous. A linear relation probably exists between lipid levels and cardiovascular risk, so many people with “normal†cholesterol levels benefit from achieving still lower levels. Consequently, there are no numeric definitions of dyslipidemia; the term is applied to lipid levels for which treatment has proven beneficial. Proof of benefit is strongest for lowering elevated low-density lipoprotein (LDL) levels. In the overall population, evidence is less strong for a benefit from lowering elevated TG and increasing low high-density lipoprotein (HDL) levels, in part because elevated TG and low HDL levels are more predictive of cardiovascular risk in women than in men.

HDL levels do not always predict cardiovascular risk. For example, high HDL levels caused by some genetic disorders may not protect against cardiovascular disorders, and low HDL levels caused by some genetic disorders may not increase the risk of cardiovascular disorders. Although HDL levels predict cardiovascular risk in the overall population, the increased risk may be caused by other factors, such as accompanying lipid and metabolic abnormalities, rather than the HDL level itself.

By seeing all conditions, we cannot find one to one co-relation with a single disease from Ayurveda classics, though condition is suggestive of pathologies like Rasagata Ama, Raktagata Ama, Sthaulya, Medoroga, Medodosha etc. By considering all the situations it can be assumed that of pathology is related to Kapha Karaka Nidana i.e.- Santarpana Ahara Vihara,which includes sedentary life style, high calories food intake, lack of exercise which finally leads to morbidity of Kapha Dosha and Medo Dhatu. Due to Medodhatwagni Dusti excessive accumulation of abnormal Kapha  and Medo  occurs in various Strotas in body. Aparipakva Kapha – Meda present in Rasa-Raktavaha Strotasa results in obstruction to the movement of Vata & Rakta through affected channel finally ends up in disease manifestation according to the site of affliction. The state of Apakva Kapha or Meda and its excessive presence Margavarana in Rasa-Raktavaha Strotasa is often compared with the state of dyslipidemia.

Hence, a formulation named Tryoshnadiguggulu containing Ushna,Tikshna, Katu and Shrotoshodhaka action was selected for patients of dyslipidemia, it may help to break the Samprapti or Clear the Ama, Kapha,and Meda and hence may help to manage the dyslipidemia.

Keeping in mind above facts, it may be said thatThe final purpose of management is to stop the formation of Apakva Kapha and Meda and to clear the avarana and then re-establishing the normal movement of vata.

Recent work on Lasuna has showed lipid/cholesterol lowering effect  and hence was also selected to establish its role in the management of dyslipidemia.