Clinical Study of Virechana Karma and SarpgandhaghanaVati in the management of Uchcha-Rakta-Chapa (EHT)

Pravin Kumar Rai¹*, Ajay Saxena², Shikha Sharma³, Priyanka Pandey⁴, Ajay Meena⁵,

Anupam Srivatava⁵, Kiran Srivastava⁶

¹Lecturer, Dept. of Panchakarma, J.D. Ayurved Medical College and Hospital, Bhankari, Aligarh (U.P.)

²Consultant, Ministry of AYUSH, New Delhi

³Lecturer, Dept. of Prasooti Tantra and Stree Rog, J.D. Ay. Medical College and Hospital, Bhankari, Aligarh (U.P.)

⁴Medical Officer, CGHS Wellness Centre, Devnagar, New Delhi

⁵Ministry of AYUSH, New Delhi

⁶MD (Dravyaguna), New Delhi

*Corresponding Author E-mail: drpravinrai16@gmail.com

ABSTRACT:

The 21th century is described as the age of anxiety and stress. The modern man is constantly facing symbolic stress. This stress and strain of day to day life affects one’s bodily organs through several psycho-physical mechanisms. The progress of medical science has helped us to conquer disease like plague, smallpox etc., but stress related diseases are rapidly increasing. Among the several psychosomatic diseases, the cardiovascular disorder like UchchaRakta Chapa (Hypertension) is quite significant.

A series of 25 patients suffering from UchchaRakta Chapa vis-à-vis Essential Hypertension were randomly selected from O.P.D. and I.P.D. of Panchkarma P.G. Department, Rishikul Govt. Ayurvedic P.G. College and Hospital, Hardwar, Uttarakhand, for the purpose of clinical trials of present study. Observation and results were drawn on the basis of alteration in the systolic and diastolic blood pressure, before and after treatment and gradation of general symptoms i.e. Shiroruka, Bhrama, Hridadravata, Shrama, Kampa etc. After full observation of therapies, it was found that no. of patient unchanged was 0, whereas, observed mild improvement was found in 2 patients (8 %), marked improvement in 13 patients (52 %) and excellent improvement was observed in 9 patients (36 %).

KEYWORDS: Uchcha Rakta Chapa, Hypertension, Virechana Karma, Sarpgandhaghana Vati.

INTRODUCTION:

Hypertension is a leading public health challenge globally due to its high prevalence and related morbidity and mortality^1-3. An estimated 978 million adults, or 28% of the world's adult population, had uncontrolled hypertension in 2008³. More alarming, conservative estimates indicate that the global burden of hypertension will increase to more than 1.56 billion by 2025¹. As the most important modifiable risk factor for cardiovascular disease and all-cause mortality, high blood pressure was responsible for approximately 7.6 million deaths globally, or 13.5% of all deaths, in 2001^1-3.

Hypertension is classified as either primary or essential hypertension and secondary hypertension, about 90–95% of cases are categorized as "essential/ idiopathic/ primary hypertension" which means high blood pressure with no obvious underlying medical cause. The remaining 5–10% of cases (secondary hypertension) is caused by other conditions such ascoarctation of aorta, renal artery stenosis, vesiculo-ureteral reflux nephropathy, Cushing syndrome and hemorrhage etc⁴.

In pathogenesis of hypertension (Uccharaktachapa), Vata (Vyana and Prana), Pitta (Sadhaka), Kapha (Avalambaka) (bodily humors) and Manovaha Srotas (psychechannels) involving Hridaya, Rasa-Rakta Samvahana and Oja are main responsible factors. They are vitiated due to disturbed Manasika Bhavas (psychological factors)like Chinta (Anxiety), Tanav (Stress), Krodha (Anger) etc. producing hypertensive state. That’s why Acharya Charaka has advised to control Manasika Bhavas (psychological factors)⁵. Preventive measures play an important role to keep away such disorder. The line of treatment in the disease consists of Nidanaparivarjana, Shodhana in the form of Virechana, Shirovirechana , Raktamokshana , Shirodhara,Shamana medications (different oral medication) and RasayanaChikitsa.

MATERIAL AND METHODS:

Selection of patients

Total 25 Patients were randomly selected from OPD and IPD of the Kayachikista and Panchkarma Departments of Rishikul Govt. Ayurvedic P.G. College and Hospital, Hardwar (U.K.) having complaints of Uchcha-Rakta-Chapa for the present study. The patients having signs and symptoms of Uchcha-Rakta-Chapa as mentioned in classics were primarily selected in accordance with following inclusion and exclusion criteria.

Inclusion Criteria

Patient of EHT in age group of 18-70 years were selected.

Exclusion criteria

· Patient who are weak and not able to tolerate Samshodhana therapy will not be included.

· Patient suffering from secondary hypertension.

· Patient having pregnancy will not be included.

Details of therapy

Following procedures were adopted for this purpose-

· Deepana- Pachana-with Ajmodadichurna.

· Abhayantara Snehana with Triphala Ghrita

· Virechana Karma by Virechana yoga (consists of four indigenous drugs like Trivrit, Haritaki, Amaltash and Eranda Tail)

· Sansarjana Krama-it will be followed after Virechana Karma according to the Shodhana of the patient (Pravar, Avar and Madhyam).

After Virechana Karma patient were kept over Sarpagandhaghana Vati. The duration of the treatment was 2 month. Patients were advised to take salt restricted diet.

Follow up study:

After completion of treatment all the patients were advised to report in the O.P.D. at the regular interval of one week for at least three weeks for the follow up study. Their blood pressure after 15 minutes rest was recorded. The condition of other sign and symptoms was also noted.

Criteria for Assessment:

1. On the basis of cardinal sign:

It was done by noting the alteration in the systolic and diastolic blood pressure, before and after treatment.

2. On the basis of gradation of general symptomatology:

Present before treatment -2

Improvement after treatment -1

Absent after treatment -0

No change after treatment -2

3. Effect of therapy on various biochemical parameters:

On the basis of total effect of therapy:

The total effect of therapy was assessed, by determining the percentage of score reduction.

Assessment Score

Excellent response >75%

Marked response 50-75%

Mild improvement 25-50%

No response <25%

OBSERVATION AND RESULTS:

The clinical data shows that demographic distribution of maximum number of patients of EHT belongs to the age group 40 to 55 years. It means that the chances of EHT are more in middle age group. Religion and sex wise distribution of the group have no significance because of very small no. of patients.44% patients have been given the history of hereditary relationship but studies show that there is definite relationship between disease and genetic influence.

The results assessed on the basis alteration of blood pressure before and after treatment were statistically significant (Table 1). Results assessed on the basis of symptoms i.e Shiroruka, Bhrama, Hriddravata, Kampa, Swasa Krichhata, Alpanidra and Tamodarshan were significant statistically (Table 2). On various biochemical parameters results were non-significant statistically. It was found that no. of patient unchanged was 01, whereas, observed mild improvement was found in 2 patients (8 %), marked improvement in 13 patients (52 %) and excellent improvement was observed in 9 patients (36 %) (Table 3).

Table: 1

B.P.	Mean		x	% Relief	S.D.	S.E.	t	P
	B.T.	A.T.
S.B.P.	168.4	132	36.4	21.61	10.11	2.02	17.99	<0.001
D.P.B.	106.16	86.4	19.76	18.61	3.57	0.71	27.64	<0.001

Table: 2

Symptoms	Mean		X	% Relief	S.D.	S.E.	t	p
	B.T.	A.T.
Shiroruka	1.52	0.32	1.20	78.94	1	0.20	6	<0.001
Bhrama	1.12	0.16	0.96	85.71	1.01	0.20	4.70	<0.001
Hriddravata	0.48	0.16	0.32	66.66	0.74	0.14	2.13	<0.05
Kampa	0.32	0.16	0.16	50	0.47	0.09	1.69	>0.10
Swasakrichhata	0.80	0.32	0.48	60	0.87	0.17	2.75	<0.02
Alpanidra	1.6	0.20	1.4	87.5	0.91	0.18	7.66	<0.001
TamoDarshan	0.56	0.08	0.48	85.71	0.87	0.17	2.75	<0.02

Table: 3

Assessment	No. of patients	%
Excellent improvement	09	36%
Marked improvement	13	52%
Mild improvement	02	08%
No response	01	04%

DISCUSSION:

Uchcha Rakta Chapa is a Vata-Pitta predominant Tridoshaja Vyadhi and the Rasa and Rakta are the chief culprits. Essential Hypertension is a psychosomatic hemodynamic disease with a multifactorial pathology originating from several dietary, environmental and genetic factors. In present study management of EHT was done with Virechana and Shaman with Sarpgandhaghana Vati. Relief observed in alteration of blood pressure SBP and DBP were 21.6 and 18.6% respectively. Relief in symptoms Shiroruka, Bhrama, Hriddravata, Kampa, Swaskrichchhata, Alpanidra, Tamodarshana were 78.9, 85.7, 66.67, 50, 60, 87.5 and 85.7 percent respectively. There was no significant result observed in biochemical assessment. For the treatment of Uccharaktachapa, according to nature of disease the Shodhana therapy (Virechana) is one of the treatment modality for this Tridoshaja ailment, as Virechana has also been equally effective in Rakta vitiation. The herbs used in Sarpgandhaghana Vati have Tridoshahara and Rasayana property and also acts on Mano Dosha (Psyche) Heart, Brain and kidneys (Trimahamarmas) as well as in disorder of G.I. tracts⁶.

CONCLUSION:

The prevalence of EHT is increasing day by day. There is need to find out treatment modality which will help in prevention and cure of the disease. Ayurveda believe in Shodhana, Shamana and Rasayan therapy for this ailment. Among Shodhana, Virechana is considered the main therapy because of Tridoshaja and Rakta Pitta involvement in the disease.

REFERENCES:

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^2. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006; 367:1747–1757.

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^5. Pt. Kashinath Shastry and Dr. Gorakhnath Chaturvedi. Vidyotini Hindi commentary on Charakasamhita. Reprint ed. Varanasi. Chaukhambha Bharati Academy; 1996 Part -1 Sutra Sthana 7/27 p.160

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Received on 23.01.2015 Accepted on 25.02.2015

© Asian Pharma Press All Right Reserved

Asian J. Res. Pharm. Sci. 5(2): April-June 2015; Page 73-75

DOI: 10.5958/2231-5659.2015.00012.0