Efficacy of PANCHATIKTA GHRITA GUGGULU in the Management of PANDU W.S.R to Iron Deficiency Anemia in Geriatric Patients – A Randomised Control Trial

Iron deficiency anaemia is one among the commonest types of anaemia also affecting the geriatric population with prevalence of 23% globally and 45% in India. Anaemia is common in old age and increases the risk of physical disability, associated with impaired performance and muscle weakness and has been shown to affect older person’s physical function.Anaemia should not be accepted as an inevitable consequence of aging.[2] The potential negative impact of a low haemoglobin (Hb) level on performance status, physiology, and functional independence appear to be highest in elderly patients. WHO classifies geriatric people with age group of 65-75 as old age,75-85 as advanced old age ,>85 as very advanced old age and it is estimated that there will be 10% increased incidence of iron deficiency anaemia in old age group of 65 years and up to 50% increased risk in age group of >80 years[2].Aging and IDA are directly proportional to each other as there is decreased absorption and assimilation of iron, decreased dietary iron intake, decreased Erythropoeitin sufficiency which brings lot of changes at the cellular levels during erythropoiesis which results in decreased incorporation of iron in red blood cells.The conventional system of medicine uses Iron formulations which are having iron salts such as ferrous sulphate ,ferrous fumarate, iron dextan,ferrous calcium citrate, ferrous succinate etc .long term use of these drugs are reported with nausea, heartburn, constipation, gastric discomfort etc. In a meta analysis comparison of oral and intravenous Iron supplementation shows, that adverse events were reported in 32% of oral supplementation ,and proves the intolerance of oral iron supplementation. Acharya Sushruta opines that there is a decline of Sarva Dhatu (tissue), Indriya (sensory-motor system), Bala (strength), Virya (virility) after Sampurnavastha. Acharya Charaka also considered “hriahyamana Dhatu Guna” (successive decrease in the qualities of Dhatu). Thus, it is clear from the Charaka’s view that both qualitative and quantitative decrease in Dhatu occurs during old age. Bhela Samhita throws further light in this regard. In old age, the capacity for digestion and assimilation (nutrients into Dhatu) is hampered due to Kshaya of Dhatu. Therefore, the replacement of Dhatu is also reduced as a result of already existing vitiation. Panchatikta ghrita guggulu is one of the classical formulation which is commonly used to manage different shula pradhana vata vyadhis,also indicated in the management of Pandu by Bhaisajya Ratnavali.The predominant tikta rasa of Panchatikta ghrita guggulu can act as Raktashodhaka and also can supplement nourishment to asthi,majja dhatus aiding in proper erythropoiesis.[12] So to establish these benefits of Panchatikta ghrita guggulu in pandu this study has been planned.