Evalution of the concept of ras-dosh sambandh siddhant by using kaphshamak ras (Katu, Tikta, Kashay) dravyas in kaphvruddhi lakshanani
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 420
- 试验地点
- 1
- 主要终点
- Reliving sign and symptoms of kaphvruddhi in the subjects intervened
研究概览
简要总结
Brief Summery:
Ayurveda aims at prevention and cure of diseases. Acharya Sushruta defined “Aarogya†as equilibrium or balanced state of dosha, agni, dhatu and mala, pleasant state of atma, indriya and mana is healthy state. [1]
The basic concept of Ayurveda is doshman. This Siddhanta provides fundamental knowledge for understanding of the theories of Ayurveda regarding Ahara pachana*,* Dhatu Utpatti*,Vyadhi Utpatti,* Ayu parigyana etc. With the help of that particular doshman, the body gets its samprapti by serial development of diseases. This can be understood in the terms of dosh how its vitiated and what are the possible management of it. It is quite clear that we simple approach the symptoms so that even don’t need to be having whole disease management, therefore a Vaidya should always take care of doshman which is least examined in course of treatment
Any disturbance in the equilibrium of dosh is known as disease and on the other hand the state of their equilibrium is health. [3] According to charak Samhitas “kaphavruddhi†is the basic cause for kaphjanya pathogenesis of disease. [4]
2.Literary review**:-**
a) Concept review:-
The concept of ras-dosha sambhandh is unique [4] and if one wan to manage the disease we must know pre-symptoms, sign and symptoms, upshay, sankhya, pradhanya, vidhi, vikalp, bal, kal vishesh, type of samprampti then we one know dosh as first priority, later aushdh, desh kal,bal, sharer, sar ahar, satmya, satwa. A vaidya must know all by just how it’s vitiated at extent it vitiated, treatment of any disease and symptoms is purely depedent on doshman.then its very easy to manage every thing.
Acharya Charak has mentioned that before management one should follow type of dosha which is involved in samprapti. By just knowing the exactly at what extent its vitited or mitiated. In rasviman addhay[6], Acharya charaka mentioned that, ekek dosha its to be formed by ek ek ras in the process of digestion. While katu, kashay and tikta ras aggrevates vatdosha, madhur amla lavan mitiates vaatdosha. Katu amla lawana ras aggrevates pittadosha while madhur tikt kashay mitiates pitta dosha, madhur amla and lawan ras aggrevates the kapha dosha while katu tikta kashay mitiates kapha dosha. [5] This main principle of management of disease by simple way approaches its pre- symptoms and symptoms.
STUDY RATIONALE
Doshman of any disease is simple way to approach a disease. Doshman gives a idea at what extent dose samprapti of dosha happens. There is co-realation between ras and dosh. Dravya are classifies o the basis of their ras-dosh prabhav. It’s extent of choosing for management of disease.
1) In ayurveda we should follow the ras-dosh relation without knowing samprapti.
2) Dravya take part into action with pradhan ras, dravya acts by ras parbhav and hence use of Kaphashamak ras is treat the kaphavruddhi in any disease.
3) Kaphashamak ras and its sanyog is best treatment for kaphavruddhi lakshans.
4) Kaphashamak ras and its sanyog acts by its panchbhautik sanghtan and act on kaphavruddhi. Production of excess “kaph†a main cause of sicknessdue to kaphavruddhi, root cause of all diseases is kaphavruddhi its simple to treat by selecting type of ras dravya.
Ahar Hetu
Vitiation of dosha by ras
kaphavruddhi dosh utpatti
kaphavruddhi janya lakshan utpatti
kaphavruddhi janya vicar utpatti
Thus deciding the dosh man which vitiated which affects body balance is of prime importance, to assess healthy and unhealthy state. Subjective parameters for assessment of kaphavruddhi mentioned in classical text.
PROBABLE MODE OF ACTION
Kaphashamakkar ras (Katu Tikta Kashay Ras-dosh Parbhav)
Kaphashaman
Mitiation of kapha vudhh lakshan
REVIEW OF LITERATURE:-
**ततà¥à¤°****दोषमेकैकंतà¥à¤°à¤¯à¤¸à¥à¤¤à¥à¤°à¤¯à¥‹à¤°à¤¸à¤¾à¤œà¤¨à¤¯à¤¨à¥à¤¤à¤¿,तà¥à¤°à¤¯à¤¸à¥à¤¤à¥à¤°à¤¯à¤¶à¥à¤šà¥‹à¤ªà¤¶à¤®à¤¯à¤¨à¥à¤¤à¤¿|**तदà¥à¤¯à¤¥à¤¾à¤•टà¥à¤¤à¤¿à¤•à¥à¤¤à¤•षाया
**वातंजनयनà¥à¤¤à¤¿,**मधà¥à¤°à¤¾à¤®à¥à¤²à¤²à¤µà¤£à¤¾à¤¸à¥à¤¤à¥à¤µà¥‡à¤¨à¤‚शमयनà¥à¤¤à¤¿;कटà¥à¤µà¤®à¥à¤²à¤²à¤µà¤£à¤¾à¤ƒà¤ªà¤¿à¤¤à¥à¤¤à¤‚जनयनà¥à¤¤à¤¿.II
**मधà¥à¤°à¤¤à¤¿à¤•à¥à¤¤à¤•षायासà¥à¤¤à¥à¤µà¥‡à¤¨à¤šà¥à¤›à¥à¤®à¤¯à¤¨à¥à¤¤à¤¿****;मधà¥à¤°à¤¾à¤®à¥à¤²à¤²à¤µà¤£à¤¾à¤ƒà¤¶à¥à¤²à¥‡à¤·à¥à¤®à¤¾à¤£à¤‚जनयनà¥à¤¤à¤¿,**कटà¥à¤¤à¤¿à¤•à¥à¤¤à¤•षायासà¥à¤¤à¥à¤µà¥‡à¤¨à¤‚
शमयनà¥à¤¤à¤¿****||६|| Ch.Sa.Vi1/6
Indications of use of Kaph shamak ras dravya in the management of Kaphvrudhi lakshanas.
तसà¥à¤®à¤¾à¤¦à¥à¤°à¤¸à¤ªà¥à¤°à¤à¤¾à¤µà¤¤à¤¶à¥à¤šà¤¦à¥à¤°à¤µà¥à¤¯à¤ªà¥à¤°à¤à¤¾à¤µà¤¤à¤¶à¥à¤šà¤¦à¥‹à¤·à¤ªà¥à¤°à¤à¤¾à¤µà¤¤à¤¶à¥à¤šà¤µà¤¿à¤•ारपà¥à¤°à¤à¤¾à¤µà¤¤à¤¶à¥à¤šà¤¤à¤¤à¥à¤¤à¥à¤µà¤®à¥à¤ªà¤¦à¥‡à¤•à¥à¤·à¥à¤¯à¤¾à¤®à¤ƒ**||१२||**
Ch.Sa.Vi1/12 **ततà¥à¤°à¥ˆà¤·à¤°à¤¸à¤ªà¥à¤°à¤à¤¾à¤µà¤‰à¤¦à¥à¤¦à¤¿à¤·à¥à¤Ÿà¥‹****à¤à¤µà¤¤à¤¿****’****इतिपठनà¥à¤¤à¤¿|****असà¥à¤®à¤¿à¤¨à¥****पकà¥à¤·à¥‡****दà¥à¤°à¤µà¥à¤¯à¤¦à¥‹à¤·à¤µà¤¿à¤•ारपà¥à¤°à¤à¤¾à¤µà¥‹à¤½à¤ªà¤¿****योऽतà¥à¤°**उदà¥à¤¦à¤¿à¤·à¥à¤Ÿà¤ƒ
**सोऽपिरसदà¥à¤µà¤¾à¤°à¤¾,****तेन****रससà¥à¤¯à¥ˆà¤µà¤ªà¥à¤°à¤ªà¤žà¥à¤šà¤¾à¤à¤¿à¤¹à¤¿à¤¤à¤¤à¥à¤µà¤¾à¤¤à¥à¤¤à¤¸à¥à¤¯à¥ˆà¤µà¤¾à¤à¤¿à¤§à¤¾à¤¨à¤®à¥à¤ªà¤¸à¤‚हरति****न**दà¥à¤°à¤µà¥à¤¯à¤¾à¤¦à¥€à¤¨à¤¾à¤®à¤¿à¤¤à¤¿à¤œà¥à¤žà¥‡à¤¯à¤®à¥||१३||
Chakrapani.
Action of dravya are mainly due to ras as its main content.
तसà¥à¤®à¤¾à¤¨à¥à¤¨à¥‡à¤•रसं दà¥à¤°à¤µà¥à¤¯ à¤à¥à¤¤à¤¸à¤¨à¥à¤˜à¤¾à¤¤à¤¸à¤‚à¤à¤µà¤¾à¤¤à¥
नॆकदोषसà¥à¤¤à¤¤à¥‹ रोगासà¥à¤¤à¥à¤°à¤¤à¥à¤° वà¥à¤¯à¤•à¥à¤¤ रसॠसà¥à¤®à¥à¤°à¥‚तॠII
As.Hri. Drav-Drav vigyaniyam 9
Taste in a substance also arises out of Pancha mahabhuta (5 element) combination. Hence, because of the combination of the elements, there is no substance having only one taste. Similarly, there is no disease arising out of a single Dosha. Any disease will have involvement of more than one Dosha.
शà¥à¤²à¥‡à¤·à¥à¤®à¤¾à¤—à¥à¤¨à¤¿ सदनॠपà¥à¤°à¤¸à¥‡à¤•ालसà¥à¤¯ गौरवमॠशà¥à¤µà¥‡à¤¤à¥à¤¯à¤¶à¥ˆà¤¤à¥à¤¯à¤¶à¥à¤²à¤¨à¥à¤¥à¤—तà¥à¤µà¤®à¥ शà¥à¤µà¤¾à¤¸ कासअतिनिदà¥à¤°à¤¿à¤¤à¤¾ II
A.Hri. Sutra.11/13
Kapha, when increased produces, Agnisadana – weak digestive activity,, Praseka – excess salivation, Alasya – lassitude, laziness, Gaurava – feeling of heaviness, Shvaithya – white discoloration, Shaithya – coldness,, Shlathangatva – looseness of the body parts, Shwasa – dyspnoea, Kasa – cough, Atinidrata – excess of sleep. 7 – 7½.
RESEARCH QUESTION:-
“Kaphshamak ekal ras and ras sanyog is effective in the management of *Kaphvruddhi lakshans.*â€
ALTERNATE HYPOTHESIS: -
There is relationship between “Kaphshamak ekal ras and its ras dravya sanyog prabhav with Kaphavruddhi lakshans’’
NULL HYPOTHESIS: -
There is no relationship between “Kaphshamak ekal ras and ras sanyog prabhav with Kaphavruddhi lakshans**â€.
AIM AND OBJECTIVES:
Aim of study:
To compare the effect of ekalras kaphashamak rasdravya with kaphvruddhi lakshanas
OBJECTIVES OF STUDY:
-
To evalute the effect of Kaphshamak ras on kaphavruddi lakshans.
-
To evaluate the effect of Kaphshamak rasdosha prabhav in the management of kaphavruddhi lakshana.
3) To compare the effect of combinations of kaphashamak ras on kaphvruddhi lakshan
-
To evalute ras-dosh prabhav siddhantby using Kaphshamak ras of kaphavruddhi lakshana.
-
To study the interrelationship between Kaphshamak rasdravya and its ras sanyog prabhav with Ras dosh prabhav.
PREVIOUS WORK DONE:-
1) Neera Saini, Pradeep Kumar Pal and P.S. Byadgi Critical Analysis of Etiological Factors of Ajirna, IJCAM 05 00141, Volume 5 Issue 1 – 2017.
2) Dr. Sudhir. L. Lad, Study Of Kiratadhya Churna In Grahani Vyadhi, International Journal of Advancements in Research & Technology, Volume 2, Issue 11, November-2013.
3) Wangle magala dilip, Importance of agni (digestive fire) in the mangment of grahani disease, with special reference to lawanbhaskara churna in grahani roga (Small intestine Disease) inter.J.Res. ayurveda pharm.4 (4), July-Aug.2013.
4) Dr. Subhash Chandra, Dr. Rashmi Gurao, Dr. O.P Dadhich Conceptual Study Of Hypothyroidism And Agnimandya International Journal of Ayurvedic and Herbal Medicine 5:4 (2015) 1923–1931.
5) Fundamental and Applied aspect of Lifestyle in Ayurveda classics and its role in Amajirna, Deshmukh Saylee H . April – 2014, IPGTRA, Jamnagar.
6) Madankar Mandarkumar et al: A Survey Study of the Prevalence of Various Diseases in Yamdanshtra Kala (Period between Nov-Dec), IAMJ: Volume 3; Issue 3; March- 2015.
7) An applied study of interrelationship of Jatharagni and dhatvagni in context to Dhatuvŗddhi, Dr Kishor g. Satani, Jamnagar, march – 2012.
8) Byadgi P S et al, IJRAP, An insight into the understanding of agni and its clinical importance, 2011, 2(6) 1637-1641.
Material and Methods:
Materials:
1) Participants: - Subjects with Kaphvruddhi lakshans will be randomly selected from the OPD and IPD of Hospital
2) Drug Review:-
Kaphshamak Ras dravya
| Dravya |
Chitrak [7]
Patala*[8]***
Bhibhitak[9]
|Latin Name / Chemical name
Plumbago
zeylanika
Linn*.*
Steriospermum suaveolens
Linn*.*
Terminalia
belerica Linn*.*
|Ras
Katu
Titka, kshay
Kashay
|Doshkarma
Kaphshamakkar
Kaphshamakkar
Kaphshamak
kar
|Part used
Root
Root
Fruit except seed
Kaphshamak Ras dravya combinations in group -
| No. |
1
2
3
4
5
6
7
|Dravya
sanyog
Ek Ras
dravya
Ek Ras
dravya
Ek Ras
dravya
Dvay Ras
dravya
Dvay Ras
dravya
Dvay Ras
dravya
Tray
Ras dravya
|Group
Group A
Group
B
Group
C
Group D
Group
E
Group
F
Group
F
|Drugs
Chitrak
Patol
Bhibhitak
Chitrak + Patol
Chitrak + Bhibhitak
Patala+ Bhibhitak
Chitrak +
Patala+ Bhibhitak
|Contents
3 gm
3 gm
3 gm
1.5 gm each
1.5 gm each
1.5 gm each
0.66 gm Each
|Dose
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
3 gm
Vati (500mg each)
|Anupan
Water
Water
Water
Water
Water
Water
Water
|Kal
Anannakal
(Before meal)
Anannakal
(Before meal)
Anannakal
(Before meal)
Anannakal
(Before meal)
Anannakal
(Before meal)
Anannakal
(Before meal)
Anannakal
(Before meal)
Methodology
Study design -. Comparative Clinical Seven arm study.
Type of study - Prospective Interventional study
Study Area – OPD/IPD of College hospital.
Study Duration – 1.5 years
Sample size: 420, (60 patients in each group)
Type of Sampling – Purposive sampling
Method of Selection of Patients
Grouping:- Dosh pariksha of all the selected subjects will be done on the basis of subjective parameters (Case Report Proforma). Then Cardinal signs and symptoms of kaphvrudhi will be identified. Accordingly all the participants will be divided equally in seven groups.
1) Group A – Subjects receiving Chitrak churnaVati
2) Group B – Subjects receiving Patala churnaVati
3) Group C – Subjects receiving Bhibhitak churnaVati
4) Group D – Subjects receiving two drug combination Chitrak + PatalaVati
5) Group E – Subjects receiving two drug combination Chitrak + BhibhitakVati
6) Group F – Subjects receiving two drug combination Patala+ BhibhitakVati
7) Group D – Subjects receiving Three drug combination Chitrak + Patala+ BhibhitakVati
FOLLOW UP PERIOD
Follow up period during Treatment is after 1st, 3th, 5th,7th day of completion of intervention. Subjects kept on routine diet, to avoid Kaphvrudhhikar ahar with pathyapathya palan.
ASSESSMENT PERIOD
Signs and symptoms of kaphvruddhi lakshana are assessed on the 1st, 3th, 5th,7th day
Case Definition: -Subjects Satisfying inclusion criterion having cardinal signs and symptoms of kaphvrudhhi of either gender between age group 16-50 yrs.
Inclusion criteria:
1. Subjects of either gender between age group 16-50 yrs will be selected.
2. Cardinal signs and symptoms of *Kaphvruddhi (*Agnisadana, Praseka Alasya, Gaurava, Shvaithya, Shaithya, Shlathangatva, Shwasa, Kasa, Atinidrata)
3. Obedient and regular in attending or reporting the OPD & IPD patients.
Exclusion criteria:
1. Subjects having sign and symptoms other than Kaphvriddhijanya vikar.
2. Patients known case of tuberculosis, carcinoma of stomach and intestine etc.
3. Subjects with addiction of alcohol, tobacco, smoking, kharra, mava etc.
4. Pregnant woman and lactating mothers.
5. Subjects performing night duty shifts.
Withdrawal criteria:
1. Patients willing to quit in between the trial will be allowed to quit and replaced.
2. If any adverse effect and drug reaction develops patients excluded.
Drug Standardization:
All Raw materials used in trial in crude form will be collected from genuine source. They Will be Authenticated and standardized.
Preparation of Drug:
Preparation of Churna vati will be prepared is done in attached pharmacy.
Study Plan: -
Seven Arm Clinical trial
Screening of patients
Patient Satisfied Inclusion criteria Patient Satisfied Exclusion criteria
(Yes) (Yes)
Counseling Patient will be excluded
Initial Assessment
Cases will be recorded in CRF
Written Informed consent taken
Randomization in seven groups (Purposive random sampling)
Drug Intervention
Rescue Medicine given if required.
Assessment done every 1th, 3th, 5th,7th day.
Data Collection
Statistical Analysis
Discussion
Conclusion
DRUG AND METHOD OF ADMINSTRATION
Intervention Table:
| Groups |
Group
A
Group
B
Group C
Group D
Group E
Group F
Group
G
|Sample size
Will be decided
after pilot study
Will be
decided
after pilot study
Will be decided
after pilot study
Will be
decided
after pilot study
Will be decided
after pilot study
Will be
decided
after pilot study
Will be
decided
after pilot study
|Intervention
Chitrak churna Vati
Patala churna**Vati
Bhibhitaka churna**Vati
Chitrak churna + Patala churna**Vati
Chitrak churna + Bhibhitaka churna**Vati
Patala churna + Bhibhitaka churna**Vati
Chitrak churna + Patalachurna + Bhibhitaka 0.66gm each**Vati
|Dose
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
1.5 gm bid, with Anupan - Water Before meal.
|Route of Drug
Oral
Oral
Oral
Oral
Oral
Oral
Oral
|Drug Form
Churna vati
Churna vati
Churna vati
Churna vati
Churna vati
Churna vati
Churna vati
|Duration
7 days.
7 days.
7 days.
7 days.
7 days.
7 days.
7 days.
|Follow up period during 2 year (during Treatment)
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
After 1st, 3th, 5th, 7th days of completion of intervention
Assessment criteria
Parameters for Subjective Criteria
Symptoms of Kaph dosh vrudhhi
1. Agni sadan
2. Prasek
3. Alasya
4. Gaurav
5. Shvaithya – white discoloration,
6. Shaithya – coldness,
7. Shlathangatva – looseness of the body parts,
8. Shwasa – dyspnoea
9. Kasa – cough, cold
- Atinidrata – excess of sleep. 7 – 7½.
Subjective Parameters
Kapha vruddhi lakshana assessment
| Sr. No. |
Criteria
Gradation
Follow-up
|Before
Treatment
Day1
Day15
Day30
|01
Agni-sad
(Loss of Appetite)
Absent - 0
|Mild - 01
(Mild Appetite)
|Moderate - 02
(Moderate Appetite)
|Severe - 03
(Loss of Appetite)
|02
Prasek
(Water Eructations)
Absent - 0
|Mild - 01
(Alpa Prasek)
|Moderate - 02
(Madhyam Prasek)
|Severe - 03
(sampurn Prasek)
|03
Alasya
(Lassitude at the
somatic as well as
psychological
level)
Absent - 0
|Mild - 01
(Mild Lassitude)
|Moderate - 02
(Moderate Lassitude)
|Severe - 03
(Higher Lassitude)
|04
Sharir Gaurava
(Feeling of Heaviness)
Absent - 0
|Mild - 01
(Alpa Gaurav)
|Moderate - 02
(Ekang Gaurav)
|Severe - 03
(Sarvang Gaurav)
|05
Shvaithya
(White discoloration)
Absent - 0
|Present – 01
|06
Shaithya
(coldness)
Absent - 0
|Present – 01
|Shlathangatva – (looseness of the body parts)
Absent - 0
|Present – 01
|07
Shwasa
(dyspnoea),
Absent - 0
|Present – 01
|08
Kasa – cough, cold
Absent - 0
|Present – 01
|09
Atinidrata – excess of sleep. 7 – 7½.
Absent - 0
|Present – 01
|Apla -02
|Ati – 03
Parameters for Objective Criteria. - Nil
Case Record Proforma: - Case Record Proforma will be prepared for assessment of kaph vruddhi lakshan , sign and symptoms of kaph vruddhi (attached in annexure)
Routine investigations:
Assessment of kaphavruddhi lakshan, (Through CRF)
Specific investigations: Nil
PICO MODEL
| Population |
Subjects of either gender between age group 16-50 yrs
|Intervention
Group A - Chitrak Churna (katu)
Group B - Patala(Tikta)
Group C - Bhibhitak (Kashay)
Group D - Chitrak Churna (katu)+ Patala(Tikta
Group E - Patala(Tikta)+ Bhibhitak (Kashay)
Group F - Chitrak Churna (katu+ Bhibhitak (Kashay)
Group G- Chitrak Churna (katu)+ Patala(Tikta)+ Bhibhitak (Kashay)
|Comparison
Subjects of Group A will be compared on assessment criteria’s with Group B, Group C, Group D, Group E, Group F, and Group G vice versa before and after intervention.
· Kaphvruddhi lakshan parikshan.
|Outcome
· Reliving in sign and symptoms in the subjects intervened.
· Correlation between Ras dosh on the basis of Subjective parameters of Kaphshamak Ras dravya.
· Transitory scale of assessing Ras-dosha prabhav by choosing type of ras.
· Founding new drug Intervention which effective on to doshlakshans by choosing on type of dravya.
研究设计
- 研究类型
- Interventional
- 分配方式
- Computer generated randomization
- 盲法
- Not Applicable
入排标准
- 年龄范围
- 16.00 Year(s) 至 80.00 Year(s)(—)
- 性别
- All
入选标准
- •Subjects of either gender between age group 16-50 yrs will be selected.
- •Cardinal signs and symptoms of Kaphvruddhi (Agnisadana, Praseka, Alasya, Gaurava, Shvaithya, Shaithya, Shlathangatva, Shwasa, Kasa, Atinidrata).
- •Obedient and regular in attending or reporting the OPD & IPD patients.
排除标准
- •Subjects having sign and symptoms other than Kaphvriddhijanya vikar.
- •Patients known case of tuberculosis, carcinoma of stomach and intestine etc.
- •Subjects with addiction of alcohol, tobacco, smoking, kharra, mava etc.
- •Pregnant woman and lactating mothers.
- •Subjects performing night duty shifts.
结局指标
主要结局
Reliving sign and symptoms of kaphvruddhi in the subjects intervened
时间窗: Within One Week
次要结局
- Effect of Katu, tikta, kashay dravya in either single or different combination form on Kaphvruddhi Symptoms.(At the baseline, 3rd Day, 5th Day,7th Day,9th Day)
