A Controlled Double Arm Open Labelled Clinical Trial to Evaluate the Efficacy of Vrusha Ghruta and Kulatthadi Kashaya in the Management of Tamaka Shwasa vis a vis Bronchial Asthma

Tamaka Shwasa is one among the five varieties of Shwasa roga manifested due to vitiation of kapha-vata dosha and rasa dhatu in pranavaha srotas, originating from pittastana. Shwasa krichrata, kasa, ghurghuraka and prana peedana are the pradhana lakshana Asthma is defined as a chronic inflammatory disorder of the airways which is associated with airway hyper responsiveness. It leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night and in early morning . According to WHO, Globally, Asthma has affected an estimated 262 million people in 2019. The overall burden of asthma in India is estimated to be more than 15 million . Asthma, owing to its chronic nature, has a significant impact on quality of life in patients due to the decreased capacity of physical exertion, constant dependence on medications, decreased quality of sleep, low performance at work and constant fear of trigger factors. The current management of Bronchial Asthma in modern medicine is only providing short term symptomatic relief but does not provide any long-term relief to the patient. On the other hand, prolonged use of these drugs are not safe, as it has many adverse effect with systemic manifestation and as the chronicity increases drug dose dependency increases. Ayurveda is the best way to effectively & safely manage the condition without inducing any drug dependency. Various shodhana procedures and internal medications are advised. They detoxify the body, provides nutrition to tissues, increases the elasticity of lung tissue and develops natural immunity. Thus, decreasing episodic recurrence of the disease and providing long term relief to the patient . Kapha is the sthanika dosha involved in Tamaka shwasa and it will cause obstruction to vata leading to a Pratiloma gati  of vata.kaphavruta vata samprapti is observed in tamaka shwasa and it is important to remove the obstruction and clearing the vata marga. The management protocol for kaphavruta vata includes usage of kaphahara dravya and achieving vatanulomana, lavana taila abhyanga and nadi sweda told as primary treatment in shwasa. Hence Sthanika abhyanga with samudra lavana yukta Vishagarbha taila followed by nadi sweda and Nithya mrudu virechana with Gandharva hastadi eranda taila are selected in the study. Vasa is present in Vrusha ghruta which is kasa shwasahara,hence Vrusha ghruta has been selected for the study. kulatta is also having the property of kasa shwasahara. Hence the present study is designed to compare the efficacy and internally vrusha ghrutha and kulattadi Kashaya in patients of Tamaka Shwasa keeping Nithyavirechana, Lavanataila abhyanga followed by Nadisweda as control in both the groups.