A comparative clinical study to evaluate the efficacy of pratishyayahara nasya and tulasi swarasadi taila nasya in kaphaja pratishyaya with special reference to chronic rhinosinusitis

In Ayurvedic classics, Pratishyaya has been discussed extensively under Nasa rogas. Various types of pratishyaya has been explained by Ayurveda Acharyas. Kaphaja pratishyaya is characterized by Shukla sheeta srava from nasa, Shoonakshi, Guruta in shira and mukha and kandu in Shira, gala, talu & oshta. The common nidanas include Peete nanyena varina(Intake of different source/infected water frequently), Guru, sheeta ati sevana, Raja dhoomatisevana(Exposure to wind and dust) Rutu viparyaya(seasonal variations) etc. Most of these clinical features are correlated with signs and symptoms of Chronic Rhinosinusitis. Rhinosinusitis is an inflammation of nasal air sinuses. If the symptoms persist for more than 12 weeks, it is called as Chronic Rhinosinusitis. Rhinosinusitis affects the mucosa of nose and para nasal sinus affecting approximately 15% population in India and 12-15% general population in the world. It is seen that increased air pollution and exposure to cold and flu have caused an increase in this condition. Over 85% of people with cold develop inflamed sinus. These inflammations are typically brief & mild. Only between 0.5% and 5% people with cold develop true sinusitis. Maxillary sinusitis is most commonly seen. The complications of Chronic Rhinosinusitis include Pre-septal cellulitis, Orbital cellulitis, Cavernous sinus thrombosis etc and conservative treatment is indicated for Rhinosinusitis like Antibiotics, nasal decongestant drops, steaminhalation, analgesics. In this scenario, where there is no effective management for Rhinosinusitis in conventional system of medicine, Ayurvedic line of management may be beneficial. Acharya Sushrutha has mentioned that for any patient who is suffering from Pratishyaya, the first line of management is nothing but the Nasyakarma. It is easy to administer, cost effective, easily acceptable by patients and can be done at OPD level. Considering the above factors this study was taken up. Pratishyayahara nasya5 is used in the form of pradhamana nasya and Tulasi swarasadi taila6 is taken for nasya as drugs used in this formulation has Kaphahara property.