Comparative clinical trial to Evaluate the efficacy of Phalatrikadi Ghanvati with and without Virechana Karma in Metabolic Syndrome

Metabolic syndrome encompasses a combination of interconnected physiological, biochemical, clinical and metabolic factors that significantly elevate the risk of cardiovascular diseases, type 2 diabetes mellitus and all cause mortality. It is an emerging clinical challenge in the society today. A fat rich diet, sedentary lifestyle, stress, sleep disturbances, excessive alcohol use, being overweight, genetic factors can contribute to the metabolic syndrome. In Ayurveda, the initial stage of Metabolic syndrome can be correlated with Medavaha Sroto Dushti (vitiation of micro channels of lipid metabolism and transportation), which manifests as a group of symptoms of Atisthula(obesity) and premonitory signs and symptoms of Prameha. Clinical features of Metabolic syndrome like Atitrushna, Daurgandhya, Swedadhikya resemble with Apathya Nimittaja Prameha mentioned in ayurveda. In contemporary science, the approach of management is multifaceted involving lifestyle intervention and use of drugs like-hypolipidemic, anti-diabetic and anti-hypertensive. However, these approaches of modern therapy have several long-term & short term side effects. So, there is a need for urgent development of effective and safe approaches for preventing and managing the syndrome. Majority of achayaras has told samshodhan chikitsa as prime treatment for shtula pramehi. So, here I taken virechana as a therapeutic measure because it will improve the function of digestive system through the way of intensive purgation. It clears the microcirculatory channels which results in better metabolites and blood circulation which result in the improved efficacy of liver. As it reduces the extra unnecessary burden on liver which result in correcting the physiology of liver and hence the reduces the production of excess lipids. The major pathway of excretion of excess cholesterol from the body is usually by conversion to bile acids excreted in faeces as bile salts and virechana increases this secretion and causes purgation. And also phalatrikadi ghanvati has been told a prime shamana aushadh in sarva prakara prameha and it has Medohara, Pramehahara, Rasayana, Deepana, Pachana properties. So, the goal of current study is to assess the effect of phalatrikadi ghanvati used with and without virechana karma in managing metabolic syndrome. According to reports, patients of metabolic syndrome had considerably low serum adiponectine level than healthy controls. So, in this study we will also see the effect of phalatrikadi ghanvati with and without virechana karma on serum adiponectine in patients of metabolic syndrome.