Clinical Efficacy of Kamsaharitaki Avaleha in the management of Tamaka Shwasa (Bronchial Asthma)

Department of Rasa Shastra and Bhaishajya Kalpana including Drug Research

Institute for Post Graduate Teaching & Research in Ayurveda

Gujarat Ayurved University, Jamnagar.

Dilip Prajapati

MD Scholar

Why This Topic?

Due to this alarming increase the prevalence ofBronchial asthma, effective management of asthmaclaimed by almost all the traditional health caredelivery system. Ayurveda has a strong scientificbackground, which was translated intorecommendations for clinical management of thiscondition.

Aims & Objectives

To evaluate Clinical efficacy of Kamsaharitaki Avaleha in the Management of Tamaka Swasa (Bronchial Asthma).

Material and Method

30 Patients fulfilling the criteria of Tamaka Swasa (BronchialAsthma) from OPD & IPD of RS&BK Dept IPGT & RAhospital, Jamnagar were selected randomly irrespective ofAge, cast, sex, religion etc.

Physical examination was done on the basis of a special pro-forma including signs and symptoms of the disease.

Conti…

Clinical study was started after obtained Institutional Ethics Committeeclearance (PGT/7/-A/Ethics/2013-2014/1767, Dated 10/09/2013.)

The study was registered at Clinical Trial Registry of India, ICMR, NewDelhi, vide: CTRI/2013/11/004167.

Ingredients Botanical Name / English name

Parts used Quantity

DashamoolaKwatha

- Root 1 Kamsa = 3.072 Liter

HaritakiTerminalia chebula

RetzFruit 100 in No.

Guda Jaggery - 100 Pala = 4800g

Trikatu - - Each 48g

Trijata - - Each 48g

YavaksharaHordeum vulgare

Water soluble ash of plant

12g

MadhuHoney - 384g

7

Ingredients of Kamsaharitakiavaleha*

* Ch.chi. 11

Tamaka Shwasa - The Shwasa in which attacks of breathlessness exaggerate at

Tamakala i.e. night and patient feels darkness in front of eyes during attack.

According to Acharya Susruta, the vital vayu known as Prana-vayu foregoing itsnormal functions rises upword in unison with disturbed Kapha of the body andproduced that gasping and laboured breathing which is called Shwasa.

Tamaka Shwasa can be correlated with Bronchial Asthma in modern science.

विहाय प्रकृति िाय ुः प्राणोऽथ कफसयं िुः।श्िासयत्यदूर्धिवगो भतू्िा िं श्िासं परिचऺि॥े

स .उ.५१/४

What Is Tamaka Shwasa ?

1. Age 16 years -60 years.

2. Mild persistent cases of BronchialAsthma with daytime symptoms 3-6/week and nocturnal symptomswith 3-4/month

3. Moderate persistence cases withdaytime symptoms daily andnocturnal symptoms with one ormore than one week but not morethan 2 weeks.

1. Age >60 years and < 16 years.

2. Dysponea resulting from other

diseases like cardiac origin, anemia,

tuberculosis, malignancy and other

chronic debilitating diseases.

3. Patients having classical symptoms

of Maha, Urdhava, Chhinna and

Kshudra Shwasa.

4. HIV positive cases.

5. Pregnant/lactating mother.

6. Patients who need Salbutamol

inhaler daily

Exclusion CriteriaInclusion Criteria

Posology

Trial Drug : Kamsaharitaki Avaleha

Dose : 12 gm Twice a Day

Anupana : Usna Jala (Luke warm Water)

Duration : 28 days

Follow up : 14 days.

Criteria for Assessment

Subjective criteria: Improvement in signs and symptomsbefore and after treatment was assessed by scoring pattern.

Objective criteria: RR, BHT, PEFR, AEC etc. were observedbefore and after treatment.

Student “t – test” was applied to evaluate clinicalsignificance of the therapy.

7/28/2016 15

Routine

HematologicalTLC, DLC, Hb., ESR,

AEC

Biochemical F.B.S., S.G.O.T, S.G.P.T.

Alkaline Phosphates, etc.

urine examination

Specific

PEFR (Peak Expiratory Flow Rate)

BHT (Breath Holding Time)

Chest X-ray (if required)

Investigations

(Cha. Chi. 17)

Administration of Bheshaja, Pana and Anna which arehaving the properties like Vatakaphahara, Ushna Guna andAnulomaka Karma.

Chikitsa Sutra

[VALUE]

[VALUE]

[VALUE]

75.75% 76.08%

[VALUE]

Effect of Therapy on Cardinal Symptoms

(n=28)

66.08%

85.71%

80.74% 81.60%80.00%

Conti...

(n=28)

75%

80.21%

77.52%

68.96%

76.76%

[VALUE]

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Awaking in night due to Asthma

Awaking in morning due to Asthma

Limitation of activities

Shortness of breathing

Wheezing

Need of short acting bronchodilator

Effect of Therapy On Cardinal Symptoms as Per ACQ

(n=28)

(n=28)

-77.90%

23.22%

67.83%

-8.33%

RR BHT PEFR AEC

Effect of Therapy On Objective Parameters

Discussion

In the treatment of Shwasa, Acharyas gives more importance toShamana and Brimhana therapies.

Here Kamsaharitaki Avaleha may act as Brimhana and does theShamana .

The formulation acts by rectifying pratiloma gati of vayu by UshnaVirya, Madhura rasa, Anulomana property and Srotho-Shodhana by itsKatu, Tikta, Kashaya Rasas, Ushna Virya and Katu Vipaka, thus it helps inbreaking the Samprapti.

As Tamaka Shwasa originate from the site of Pitta and treatment forPitta Sthan Udbhav Vikar is Rechana, Haritaki does the same by itsAnulomak property.

Yavakshara has Laghu, Snigdha, Sukshama property and eliminatethe Kapha.*

Formulations are having qualities like Madhura rasa, which inturn increases the bala (strength) which is usually decreased inShwasa rogi, thus it helps in improving the condition of the patient.

In this compound formulation Dashamoola acts as theactivator, Haritaki acts as the potentiator, Trikatu acts asbioavailability enhancers, Trijata gives a soothing effect and thehigh percentage of sweetening agents being the base of theformulation, resists microbial decomposition which there byincreases the shelf life of the product.

*Bhavaprakash nighantu haritakyadi varg 252-253

Study Intervention

Modern medicine was allowed S.O.S. in patients who feltacute breathlessness in pretreatment & treatment periodby referring them to a modern doctor.

Conclusion

Kamsaharitaki Avaleha showed Significant effect onalmost all the Cardinal symptoms of Tamaka Shwasaand objective parameters like RR, BHT, PEFR, AEC etc.

Based on these observations it can be concluded thatKamsaharitaki Avaleha is effectively used in themanagement of Tamaka Shwasa as a promisingtherapy, complementary to morden medicine.

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