A Randomised Comparative Clinical Study To Evaluate the Efficacy of Virechana in Sthula Pramehi (Obese NIDDM) with and without Udwarthana as Purvakarma wsr to assess the Rukshana effect

The burden of Diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of Overweight/Obesity and Unhealthy Lifestyles. The estimates in 2019 showed that 77 million individuals had Diabetes in India, which is expected to rise to over 134 million by 2045.

Prameha is a Tri doshaja Vyadhi, mainly with vitiation of Kapha, Meda and Shareera Kleda and Madhumeha (Vataja Prameha) renders the condition more dreadful with association of Vata. Acharyas Charaka and Sushrutha have mentioned Shodhana as the line of treatment for Sthula Pramehi where as Vagbhata has mentioned Vamana and Virechana are the prime treatment in Prameha as it does Kleda shamana. The treatment of Prameha is served by the dual approach of Shodhana and Brimhana in Sthula and Krisha patients respectively.

In this study, Udwarthana has been taken as a Purvakarma before Virechana. According to Acharya Vaghbhata patients who are – Mamsala, Medhura, Bhuri Shleshma, Vishamagni, has to undergo Rukshana as Purvakarma before Snehana. As Prameha is associated with Kapha and Medha dhatu, here also in Sthula Pramehi Udwarthana is selected for Purvakarma in one group.

Group A- receives Udwarthana (Triphala, Kolakulatthadi churna) and Bashpa Sweda as a Purvakarma for 7 days, Shodhananga Snehapana with Priyangwadi Ghrita followed by Virechana.

Group B- (No Udwarthana) receives Deepana Pachana with T. Chitrakadi vati 2bd before food for 3 days (or till nirama lakshanas are seen). Shodhananga Snehapana with Priyangwadi Ghrita till Samyak Snigdha Lakshanas. During Vishrama kala - Sarvanga Abhyanga with Moorchita Tila Taila and Mrudu Bashpasweda will be given for 3days.