CLINICAL EVALUATION OF AYURVEDIC FORMULATIONS PUGAKHANDA AND AYUSH PVK GEL IN THE MANAGEMENT OF SWETAPRADARA (PATHOLOGICAL LEUCORRHOEA)

The term leucorrhoea means, strictly speaking, an excessive normal vaginal discharge, however it has become a generic term covering any purulent vaginal discharge.  Leucorrhoea is still a global problem in spite of many elaborate studies for past decades. It is a common problem which affects many women during their reproductive years. The discharge may range from excess of normal to one which is a part of wide spectrum of ailments. The most common cause of leucorrhoea is physiological, followed by vaginal infections due to bacteria, virus, fungi and parasites. Other causes include foreign bodies, cervicitis and atrophic vaginitis.

Normal vaginal flora consists of both aerobic and anaerobic bacteria, with Lactobacillus species being the predominant microorganisms and accounting for greater than 95% of all bacteria present. Lactobacilli are believed to provide defense against infection, in part by maintaining an acidic pH in the vagina and ensuring hydrogen peroxide is present in the genital environment.

Rationale of the study:

The word “Swetapradara†has not appeared in Brihatrayee i.e. Charaka Samhita, Sushruta Samhita, and Astanga Hridaya.) For white vaginal discharge Swetastrava or Yonistrava words have been used. Commentator Chakrapani, Sharangadhara Samhita, Bhava Prakash, Yoga Ratnakara have used the word Swetapradara for white vaginal discharge. Swetapradara or white discharge is a symptom of all gynecological disorders (Yonivyapads) developing due to vitiation of Kapha and Vatakapha (Atyananda, Karnini, Acharana, Aticharana, Sleshmala, Upapluta and Prasramsini Yoniivyapada). Commentator Chakrapani has explained the word Pandura-Asrigdara (Pale vaginal discharge) as Swetapradara (leucorrhoea) in his commentary. Acharya Sushruta has described it as a physiological discharge of women secreted during sexual act.

Recently, it has been demonstrated that many human pathogenic bacteria have developed resistance against several synthetic drugs.  Available reports on  lesser  efficacy  and  more  side  effects  of  synthetic  drugs  necessitate  alternative medicine. There are number of drugs mentioned in Ayurveda. Classical Ayurvedic compound Pugakhanda described in Bhaishajyaratnavali is used for thesuccessful treatment of Leucorrhoea since ancient times. Panchavalkala kwatha has been conventionally used for reducing infection and inflammation for centuries.

On the basis of textual and clinical experience compound drug Pugkhanda is selected for the clinical trial in patients of Swetapradara. Ayush PVK gel is another medicine which basically consist of stem barks of five plants mainly Udumbara (Ficus racemosa), Plaksha (Ficus microcarpa) Ashwattha (Ficus religiosa), Nyagrodha (Ficus bengalensis) and Parisha (Thepsia populnea). The aqueous extracts of the above said plants were developed in gel form for local application in vagina. In a previous study conducted by CCRAS in 2012, the vaginal application of PVK gel had similar clinical efficacy as allopathic treatment symptomatically. Therefore, this study plans to find out the efficacy of Pugakhanda & Ayush –PVK gel in the management of Swetapradara (Pathological Leucorrhoea).