JR..A.5'. Vol. XIX, No. 3-4, (1998) pp.1l6-121

EFFECT OF TRAYODASANGA GUGGULU ANDVISHATINDUKA VATI ALONGWITHABHYANGA

AND SWEDANON THE MANAGEMENT OFGRlDHARASI (SCIATICA)

G.c. Nanda', M.M. Padhi2 and K.K. Chopra'

(Received 12.1.99)

Clinical trial of Trayo das angaGuggulu and Vishatinduka Vati alongwi thSnehana (Abhyanga) and Swedana (PatraPinda Sweda) were conducted in 52patientssufferingfrom Gridharasi (sciatica). It isfound that the disease is equally commonin both the sex thoughfemales are slightlymore prone to it. Age-wise it afflicts moreto patients hetween 41-60 years. Optimumresponse to the ahove mentioned treatmentis found to he in about 3 weeks. An efforthas heen made in this paper to analyseclinically, the efficacy of the compoundformulations along with Snehana andSwedana Karma both from clinical andclinically related cases.

Introduction

Gridharasi is a disease of the neuro-musculo-skeletal system having typical

signs and symptoms which simulate moreto sciatica than to anv other disorder. Itscharacteristic pain is of great specificimportance to diagnose the disease. TheGait of the patient is also typical for whichthe disease is named so in the classics.Certainly the disease is quite painful andeven may cause disability to the patient, ifleft untreated. It is very commonly seenamong those people who have history ofmild trauma or some sort of physiologicalderangement of the sciatic nerve.

The basic treatment of the diseaseaccording to Ayurveda lies ui Pancakarmasince it is categori sed under the Vatavyadhy.Number of formulations have been stressedin classics, for its treatment and most ofthem are the Guggulu preparations. TheseGuggulu preparations are found to bequite effective in this disease. Considering

I. Research Officer CAy.)2. Assistant Research Officer CAy.)3. Director, Central Research Institute CAy.), Unit-I, Bhubaneswar-TS! 009.

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EFFECT OF TRAYODASANGA GUGGULU AND VISlIATINDUKA VAT!

the anodyne and anti-inflammatory effectsofGuggulu a combination of TrayodasangaGuggulu and Vishatinduka Vati have beenput to clinical trial along with Abhyangaand Swedana.

Materials and Methods

One group consisting of 52 patientsselected from the institute's O.P.D. wereadmitted in I.P.D. for a period of21 dayseach with the single blind trial drug withTrayo dasanga Guggulu 2gms.Vishatinduka Vati - 250mg. (combineddose was administered three times a daywith water) and Abhyanga with NirgundiTaila followed by Patra Pinda Sweda. Thepatients were provided normal hospitaldiet consisting of rice, dal, vegetable, curryand milk during the trial period.

The method of study was based on thefactors, (a) selection of cases, (b) periodicalobservation of the finding and (c)assessment of results.

a) Selection of patients : The patientswith the parameters, (i) radiating painfrom gluteal region, (ii) tingling &numbness, (iii) tenderness of thesciatic trunk and (iv) positive straight-leg raising test (on degree ofmovement) were taken for trial

b) Periodical observations of thefindings: The observations were doneon the basis of proforma attached andthe remission/aggravation of clinicalsigns and symptoms with, (i) pain:The patient complains when asked-mild (+), the patient frequentlycomplaints of pain by himself-

moderate (++) and the patient cries ofshows painful look-severe (+++);(ii) Tenderness: The patient expresseswhen pressed by digital pressuremeter, pressure - grade-I, the patientwinces-grade-Il, the patient wincesand withdraws the affected part-grade-III and the patient does notallow the part to be touched grade-IV;(iii) Tingling sensation: It is measuredas for pain criteria and (iv) Positivestraight leg raising test : The patientbecomes unable to raise his leg upto15 degree grade-III. The patientbecomes unable to raise upto 60 degreegrade-II. The patient becomes unableto raise upto 90 degree grade-I wereassessed in the proforma.

(c) Assessment of results : Theassessment of results has been madeaccording to the features of the groupmentioned below

(i) Goodresponse

(ii) Fairresponse

(iii) Poorresponse

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Complete relief ofclinical signs &symptoms or therelief more than75%.

Moderate relief ofclinical signs &symptoms or therelief more than50%.

Mild to moderaterelief of clinicalsigns andsymptoms or therel ief more than25%.

G.C. NANDA, et al ..

Table I

Age & sex distribution of 52 patients

Age/Sex 11-20 21-30 31-40 41-50 51-GO 61-70 TotalYrs. Yrs, Yrs. Yrs. Yrs. Yrs.

Male 5 4 9 6 25

Female 4 2 7 9 5 27

Total 5 7 11 18 II 52

Results

Results of treatment in relation with sex

Table II

Age/Sex

Goodresponse

Male 11(2Ll5%)

FemC:lle 13(25%)

TotC:l1 24(46%)

Fairresponse

8(15.38%)

12(23.07%)

20(38%)

of treatment

Poor No Drop Totalresponse response out

2 () 4 25(3.84%) (7.69%) (48.07%)

0 0 2 27(3.84%) (51.92%)

2 0 6 52(3.84%) (11%) (100%)

(iv) Noresponse

(v) Drop out

No relief or verynegligible relief ofclinical signs andsymptoms or therelief is less than25%.

Discontinuation ofthe trail before theend of trial period.

Observations and Results

It was observed that the disease is mostcommon in the age group of 41 to 60 yrs.

with less frequency in the age group of 21to 40 yrs. Sexwise, both the sexes werealmost equally affected (Table-I & Fig. I).

It was found from the observationsthat most of the patients were sufferingfrom the disease for more than 1-112 yearsof chronicity where as patients were alsofound to be suffering less than 1 yr.Moreover the patients were getting relaxedafter Snehan and Swedan Karma is donerather than the patients without it. Asregards analysis of data's in relation to ageand sex, it was found that the results were

118

EFFECT OF TRAYODASANGA GUGGULU AND VISHATINDUKA VAT! ..521-

35

o Male - Female30

25

2018

15

10

5

011-20 21-30 31-40 41-50 SI-60 61-70

AaG 8 CltS

Fig. 1 : Age and. sex wise distribution among the patients Gridharasi.60

50

o(0 '10)

6(11'10)

TOTAL GOOD FAIR POOR NO DROp·RESPONSE RESPONSE RESPONS$ RESPONSE OUT

119

Fig. 2 : Response of treatment in relation to sex in the cases of Gridharasi

52(100'10)

40

(I)f-<

~ 30

~p...t.L,o020Z

24(46r,)

20(38'10)

10

G.C. NP...•"IDA, et al.,

more or less equal in both sexes i.e. goodresponse was there in 11males & 13 femalesfair response in 8 males & 12 females. Theover all result was good response on 24patients and fair response in 20 patients outof total 52 patients. Hence it can be saidthat the results were definitely optimal dueto the response in 84% of cases. Even thedrug was also found to be mildly effectivein 2 cases out of 52 reported (Table II &Fig.-2).

Discussion

The drug schedule was found to bedefinitely effective in the cases ofGri dharasi . The combination ofTrayodasanga Guggulu and VishatindukaVaN were effecive due to their analgesicactions and more probably due to inclusionof Pancakarma. The overalJ activity maybe analgesic and anodyne for which pain isgenerally considered the cause in Vatikdisease. Inclusion ofSnehan with NirgundiTaila was also another plus point for thetreatment of Vatik disease especially inGridharasi (P.K. Jain et al., 1976).

Moreover, the application of Patra PindaSweda was quite a support to the SnehanaKarma normally done in Vatik disease dueto palliative properties (Nair, P.R. et al.,1978). The disease was also found equallyrespondent in both the sexes though it wasslightly higher in females 25% & 23.07%to 21. 15% & 15.38% of good response &fair response of female & male casesrespectively, although almost same type ofresponse was found in all other remaininggroups. It was also found that the drug wasmore effective to the patients of higherchronicity of 1-112 yrs. The diseasebecomes more difficult to cure in chronicform as described in classics. Since, it wasfound that the result was more positive inolder age groups, it is presumed that theVayu is definitely aggravated in old age.

Acknowledgement

Author's are highly indebetcd toDirector, CCRAS for his kind co-operationand for providing financial support toconduct this clinical study. Thanks are alsodue to all those who helped in theaccomplishment of the study.

REFERENCES

Jain, PK. et al. 1976

Madhavkara 1976

Mason, S. & Swash, M. 1980

RoleofNirgundi tVitex negundo) in Gridharasi.JRlMY & H, XL No.2, P. 97-102.

Madhava Nidan (Commentary by SudarashanShastri), Chowkhamba Sanskrit Sansthan,Varanasi.

Hutchison's Clinical Methods, ELBS Ed.,Bailiere Tindall, London.

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EFFECT OF TRAYODASANGA GUGGULU AND VISHATINDUKA vsn ...

Nadkarni. K.M. 1976 Indian Meteria Medica. 3rd Edn., Vol. 1&11.

Nair, P.R.C. et af. 1978 The effect of Nirgundi Pancanga & Guggulu inSodhana-cum-Sa mana treatment of Gridharasi.JRlMY & H, XIII, No.3, Sept. P. 14-19.

Kishore, Prem et al . 1984 Role of Hingutriguna Taila in the Treatment ofGridharasi (Sciatica), .JRAS, Vol-V, No.1, P.36-93.

Ramachandra Nair, P. 1980 The Role of Sodhana Therapy in Gridharasi,JRAS, Vol-I, No.4, P. 519-549.

Sharma, P.V. 1975 Dravyaguna Vijnana, Ilnd Edn., Part II & Ill,Chowkhamba Sanskrit Sansthan, Varanasi.

Tripathi, S.N., Ojha, D. &Kishore, P.

1965 Role of Semi carpus ana cardium in theManagement of Sciatica, Antiseptic.

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