A THREE ARM CLINICAL STUDY TO EVALUATE THE INDIVIDUAL AND COMBINED EFFECT OF NYGRODADI CHURNA AND ASANADI KASHAYA IN THE MANAGEMENT OF MADHUMEHA VIS-A-VIS TYPE 2 DIABETES MELLITUS

The word Prameha is derived from, Pra – means excess, Meha – ksharane - passing of urine. So Prameha  is  (passing  excessive  urine  which is turbid  in  color) prabhootha  avila  mootrata.  In Charaka Samhita  literature 20 types of Prameha are described which are in general characterized by  Prabhootmutrata . Mentioning about the causative factors of Madumeha ,Acharya Charak says it occurs due to- inactivity or lack of exercise, excessive sleep, excess use of milk, milk products like curd, use of gramya, audaka and anoop mansa, use of newly harvested cereals, use of jaggery and their derivatives, use of  kapha promoting things etc. Any of the twenty Prameha when left untreated is converted into Madhumeha (type 2 diabetes Mellitus) and patient passes large amount of sweet urine as madhu (glycosuria)and  craves for excess food due to highly illuminated jatharagni by medavrita vata dosha.. Due to above features T2 DM is correlated with Madhumeh6 According to charak samhita madhumeha is considered under astamahagad rogas.Madhumeha being one of the type of vataj prameha is  considered as asadhya roga because of mahatyayikatvat, virudhopakramatvat. As the disease is considered asadhya ,urjaskara chikista is done .

The word diabetes has been derived from two words, diabetes (Greek) which means ‘siphon through’ and mellitus (Latin) which means ‘sweetened with honey’. Type II Diabetes Mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to less production of insulin and increased resistance of insulin receptors (due to avaran of insulin receptors by meda dhatu) due to which glucose do not enter the cell effectively and remain in blood in high concentration.  Similarly modern science says that in DM, hyperglycemia occurs by eating too much sugary food, drinking alcohol, not complying with body insulin or exercise. Other risk factors are- Age more than 45 years, Family history of diabetes, Overweight, Smoking or alcohol, High blood cholesterol level, History of high blood pressure, Women with pregnancy related diabetes .

The incidence of diabetes is rising, globally, it is estimated that 366 million people had diabetes in 2011(approximately8.3 percent of the world population, or 3 new cases every 10 sec’s), and this figures expected to reach 522 million by 2030.This global pandemic principally involves type 2 diabetes. The burden of Type 2 Diabetes Mellitus (T2DM) in India is massive, and with 77 million people, the country ranks second for having the highest number of T2DM patients in the world, following China.

In the context of managing Madhumeha, Nygrodadhi Churna and Asandhi Kashaya have been identified as standard drugs. These two drugs were selected from nygrodadhi and asnadhi gana, respectively. Both of these formulations have been extensively researched and established as effective treatments for diabetes in various major articles. These drugs are readily available and cost effective. The novelty of this research lies in exploring the combined action of both Nygrodadhi Churna and Asnadhi kashaya.