A comparative clinical study to assess the efficacy of Murchita tila taila anuvasana basti with avapa dravya and without avapa dravya in the management of Gridhrasi Vis A vis Sciatica

6.1 NEED FOR THE STUDY:

Panchakarma forms the basis of purificatory therapy in Ayurveda. In more precise sense, Panchakarma is nothing other than the strongest transcellular bio-purificatory mechanism ever evolved. Movement is the sign of radiant life but unfortunately in some clinical conditions this vital factor is affected and such person feels himself as miserable creature as he has to depend on others for his daily activities. Gridhrasi is one such disorder where in these locomotor functions are affected. It is one among Vataja Nanatmaja Vikara. Pain radiating from Sphik (Waist) and extends to leg in the order as Kati(Low back ), Prishta (Buttocks), Uru(Thigh), Janu (Knee), Jangha (Calf), and Pada (Foot)1. Vataja Gridhrasi is characterized by Sthambha(Stiffness), Ruk(Pain), Toda(Pricking pain), Muhurmuhuspandana(Pulsating pain) Sphurana(Throbbing pain) and Sthabdtha(Stiffness) of Janu ,Jangha, Uru, are Predominant . In Vatakaphaja Gridhrasi Gaurava(Heaviness), Arochaka(Anorexia), Tandra(Drowsiness) are predominant.2 Sciatica resembles the disease Gridhrasi of Ayurveda. It causes excruciating pain which radiates through the pathway of sciatic nerve. Here Piercing type of pain is present which restricts the movement of affected leg. The gait resembles with that of bird vulture.

About 80-90% of people get affected by low back pain. In general, an estimated 5-10% of patients with low back pain have sciatica, whereas the life time prevalence of low back pain ranges from 49% to 70%. The Annual prevalence of disc related sciatica in the general population is estimated at 2.2%. A few personal and occupational risk factors for sciatica have been reported, including age, height, mental stress, smoking, and exposure to vibration from vehicles. Evidence for an association between sciatica and sex or Physical fitness is conflicting.3

Basti is one among Panchakarma procedures and it is the best treatment for most of the Vatavyadhi as quoted by Maharshi Charaka that “Basti Vataharanam Shrestham”. 4 It claimed as the main radical aspect of Chikitsa seeking the absolute cure of disease by eliminating its root cause. Acharya Charaka consider Basti as “Ardhachikitsa.” 5 It is advocated as the best and quickest way to provide strength and immunity to even children and old people.

Siravyadha, Basti Karma and Agni Karma are considered as the treatment of choice in the management of Gridhrasi.6 Basti being one of the main treatment, plays a major role in mitigating vitiated Vata and thus relieves the Pain in Gridhrasi. Ruksha Guna plays a vital role in producing vitiation of Vata which can be tackled by Sneha Guna due to their opposite nature. Anuvasana is a type of Snaihika basti and it can be used as a single therapy for various Vataja Vikaras.

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Tila taila is best among Sthavara Sneha and it is Bruhmana, Balakara, and Vatashamaka7. Due to Snigdha,

Guru, Sookshma, Ushna Guna it acts on Vata and Kapha dosha. Three Phala is generally been considered as the fixed dosage of Anuvasana Basti according to Acharya Gayadasa. But it is observed that the Sneha Matra does not get retained as much as it is desired for 3 Yama. Hence Acharyas mentioned many Avapa or Prakshepaka Dravyas to be used in Basti Dravya. According to Chakrapani “Avapasthuanuvasaneapi Satahvadinam karthvya eva” in Anuvasana Basti , Satahva etc are used as Avapa8. Sarngadhara mentioned Saindhava lavana, Shatapushpa, Rasna, Vacha, Devadaru ,Kusta as Avapa Dravya used in Anuvasana Basti. No previous research work was done on Anuvasana Basti with Avapa Dravya and without Avapa Dravya. Hence, an attempt will be made to assess the efficacy of Anuvasana Basti with Avapa Dravya and without Avapa Dravya on retention time and on different subjective and objective parameters .