Effect of Madhuyashtyadi taila Snehapana followed by Virechana in Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disorder.It is an autoimmune disorder which occurs when your immune system mistakenly attacks your own body tissues.Rheumatoid arthritis affects the lining of the joints causing a painful swelling that can eventually result in bone erosion and joint deformity. Due to its similar presentations it can be correlate with vatarakta of our classics. The treatment principle of vatarakta includes proper snehana followed by mrdu virechana.Madhuyashtyadi taila mentioned in Ashtanga hrdaya vatarakta chikitsa is an important yoga mentioned in  *vatarakta chikitsa.*The objectives are to determine the effect of Madhuyashtyadi taila  snehapana in arohanakrama upto samyak snigdha lakshana followed by virechana in  reducing the disease activity score measured by DAS 28 and To determine the effect of shodananga snehapana with madhuyashtyadi taila administered in arohanakrama upto samyaksnigdha lakshana followed by virechana in reducing the haematological parameters like RA factor,CRP,ESR in rheumatoid arthritis.Study design is an experimental study with pre-post test without control group. Participants aged 20-60 years registered in the IPD of government ayurveda panchakarma hospital, poojappura, thiruvananthapuram diagnosed to have rheumatoid arthritis and satisfying inclusion criteria will be selected. The base line data will be collected through interview, laboratory investigations and observations. After collecting base line data, detailed history and examination will be done using clinical case proforma.  A total of 20 participants will be selected by consecutive sampling and they were subjected to deepana pachana for 5 days using amrthotharam kashayam 48ml bd before food and shaddharana choorna 6g bd with kashayam and panchakola choornam 12g at 11 am along with takra(anupana). After samyakrookshana lakshana attained snehapana will start with Madhuyashtyadi taila in arohanakrama.The snehapana should be stopped while attained samyak snigdha lakshana. After that abhyanga with pinda thailam and ooshma sweda will  be administer for 3 days. Then on the next day virechanam with nimbamrtadi erandatailam should be done. The participants will be assessed on 0thday, before snehapana(6thday) *,*after virechana(17thday),on 23rdday and after follow up with regards to changes in  subjective parameters . RA factor ,CRP,and ESR will be assessed before treatment (0thday) and after follow up(47th day).Depending upon the distribution of variables, it will be analysed using Wilcoxon’s signed rank test or paired t test or anova test.