E-ISSN:2456-3110

Research Article

Udarda

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 5 June
Publisherwww.maharshicharaka.in

Clinical review on comparative study of two different formulations Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati on the basis of clinical efficacy in patients of Udarda

Sharma P.1*, Gandharve S.2, Sood R.3
DOI: http://dx.doi.org/10.21760/jaims.7.5.5

1* Puneet Sharma, Assistant Professor, Department of Samhita and Siddhant, Shiva Ayurvedic Medical College and Hospital, Himachal Pradesh, India.

2 Satish Gandharve, Reader, Department of Samhita and Siddhant, Rajiv Gandhi Government Post Graduate Ayurvedic College and Hospital, Himachal Pradesh, India.

3 Rajesh Sood, Professor, Department of Samhita and Siddhant, Rajiv Gandhi Government Post Graduate Ayurvedic College and Hospital, Himachal Pradesh, India.

Present study deals with study and comparison of two ayurveda formulations in the patients of Udarda. Amritadi Kwath and Kandughna Mahakashaya Ghan Vati were used in separate groups of patients and their effect was compared. Kandughna Mahakashaya Ghan Vati was found to be more effective in the patients of Udarda.

Keywords: Udarda, Kandughna Mahakashaya Ghan Vati, Amritadi Kwatha

Corresponding Author How to Cite this Article To Browse
Puneet Sharma, Assistant Professor, Department of Samhita and Siddhant, Shiva Ayurvedic Medical College and Hospital, , Himachal Pradesh, India.
Email: 		Puneet Sharma, Satish Gandharve, Rajesh Sood, Clinical review on comparative study of two different formulations Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati on the basis of clinical efficacy in patients of Udarda. J Ayu Int Med Sci. 2022;7(5):29-33.
Available From
https://jaims.in/jaims/article/view/1879

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-04-30 2022-05-02 2022-05-09 2022-05-16 2022-05-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

© 2022by Puneet Sharma, Satish Gandharve, Rajesh Soodand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2022;7(5)29
Sharma P et al: Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati

Introduction

Udarda has been described by all Acharyas. The detailed description in separate chapters is available in Madhavanidana, Bhavprakash, Chakradutta, Sarangdhar Samhita, Yogratanakar and Bhaisjyaratnavali. Udarda has been described with Sheetpitta and Kotha. Udarda has Kapha dominancy.[1] It is caused by contact with Sheeta and Paniya Sansparsh especially in Shishsir Ritu.[2]

Udarda is characterized by Utsang, Raag and Kandu.[3] Present study was done to evaluate the effect of Kandughna Mahakashaya[4] Ghan-Vati and Amritadi Kwath[5] on patients of Udarda. Two separate groups of patients were selected on the basis of subjective and objective symptoms. In each group, different formulation was used for the duration of 45 days with three follow ups at the interval of 15 days.

Materials and Methods

Plan of study

An open-label comparative clinical trial was planned in the patients of Udarda. Patients were selected from the OPD of the hospital and brought under trial after informed consent.

Inclusion criteria

a. Patients willing for trial.

b. Patients in the age group of 15- 70 years of either sex.

c. Patients with the classical signs and symptoms of Udarda like Raga, Kandu, Udbhisch Mandala[6]

Exclusion criteria

a. Patients not willing for trial or not ready to give informed consent.

b. Patients whose age is less than 15 and above 70.

c. Pregnancy, lactating women and puerperium.

d. Failure of patients to follow up successive visits.

e. Patients diagnosed with severe systemic illness like (HIV, Tuberculosis, Malignancy, Systemic Lupus Erythematous, Hypertension and Anaphylaxis to Medicines)

Lab investigation: All the lab investigations were performed before and after trial.

Blood examination: Hb, TLC, DLC Neutrophils, Lymphocyte, Monocytes, Eosinophils, Basophils and E.S.R.

Biochemistry

  • Fasting blood sugar,
  • RFT - Blood urea, Serum creatinine, Uric acid.
  • Lipid profile - Cholesterol, HDL, LDL, VLDL, Triglycerides

Urine examination

  • Routine
  • Microscopic

Criteria of assessment

Subjective criteria

Assessment of Raag[7] (Erythema), Kandu[8] (Pruritis), Mandalotpatti[9] (Wheal formation) and frequency of attacks was done before and after treatment on the basis of gradings. (Table 1)

Criteria for final assessment of results

  • Complete remission - 100 % relief in signs and symptoms.
  • Excellent Improvement - Patients showing more than 75% of relief in signs and symptoms were taken as excellent improvements.
  • Moderate Improvement - Patients showing 50% to 75% of relief in signs and symptoms were taken as moderately improved.
  • Mild improvement - Patients showing 25% to 50% of relief in signs and symptoms were taken as mildly improved.
  • Unimproved - Patients showing 25% of relief in signs and symptoms were taken as unimproved.

Consent of patient: All the selected patients were informed about the nature of study and written consent was obtained on the case report form before inclusion in the trial.

Results

Effects of trial drugs

Total 20 patients were registered in present study. Patients were divided in two groups. 10 patients were given Kandugha Mahakashaya Ghan Vati. Amritadi Kwath was given to next 10 patients. The results obtained are discussed below.


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Sharma P et al: Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati

Effect of Kandughna Mahakashaya Ghan Vati in patients of Udarda

The trial drug provided statistically highly significant relief (p<0.001) of 53.33% in Raag, 64.996% relief (p<0.001) in Kandu, 41.665% relief (p=0.001) in Mandlotpatti and 54.998% relief (p<0.001) in frequency of attacks.

p value was highly significant with all the symptoms.

Effect of Amritadi Kwath in patients of Udarda

The trial drug provided significant relief (p=0.01) of 28.332% in Raag, 33.332% relief (p=0.011) in Kandu, 28.332% relief (p=0.025) in Mandlotpatti and 43.332% relief (p=0.029) in frequency of attacks.

p value was significant in raag and non-significant in Kandu, Mandlotpatti and frequency of attacks.

Comparison of trial group 1 and trial group 2

In intergroup study between group 1 and group 2, Raag and Kandu shows statistically significant difference, rest of symptoms shows no significant reduction. (Table.2)

On the basis of percent relief, it can be said Kandughna Mahakashaya Ghan Vati was more effective than Amritadi Kwatha in the patients of Udarda.

Discussion

The purpose of discussion is to interpret and describe the significance of findings in the light of what was already known. Discussion based on Shastras about any conceptual or clinical study is always fruitful.

Clinical study incorporates the role and comparison of Kandughna Mahakashaya Ghan Vati and Amritadi Kwatha in the patients of Udarda.

Udarda has been described by all Acharyas. The detailed description in separate chapter is available in Madhavaidana, Bhavprakash, Chakradutta, Sarangdhar Samhita, Yogratanakar and Bhaisjyaratnavali. Udarda has been described with Sheetpitta and Kotha. Udarda has Kapha dominancy. It is caused by contact with Sheeta and Paniya Sansparsh[10] especially in Shishsir Ritu.[11]Udarda is characterized by Utsang, Raag and Kandu.[12]

Probable mode of action of Kandughna Mahakashaya Ghan Vati

Rasa : Out of 10 ingredients 8 have Tikta Rasa which is Kapha and Pitta Shamak.

Guna : Laghu and Ruksha Guna are predominant in the contents.

Vipaka : Seven contents have Katu Vipaka and three have Madhura Vipaka.

Overall effect of Kandughna Mahakashaya is Kapha and Pitta Shamak, hence, it is useful in normalizing doshas involved in Udarda.

Probable mode of action of Amritaadi Kwatha

Rasa : Contents of Amritaadi Kwatha have Katu, Tikta and Kashaya Rasa which are Kaphanashak.

Guna : Laghu and Ruksha Gunas are predominant in Amritaadi Kwatha.

Vipaka : Katu Vipaka is present in all contents except Guduchi.

Hence, overall effect of Amritaadi Kwatha is Kaphnashak.

Effect of therapy

Kandughna Mahakshaya Ghan Vati (Bar diagram 1)

Patients taking Kandughna Mahakashaya Ghan Vati shows significant relief in all the symptoms. 64.99% relief in Kandu followed by 54.99% relief in frequency of attacks, 53.33% relief in Kandu and 41.66% relief in Mandalotpatti.

Amritadi Kwatha (Bar diagram 2)

Patients taking Amritadi Kwatha show significant relief in Raag and non-significant relief in other symptoms. There was 33.33% relief in Kandu, followed by 28.332% relief in Raag, 28.332% relief in Mandalotpatti and 43.332% relief in frequency of attacks.

Intergroup comparison of two groups (Table 2) (Bar diagram 3)

In intergroup study between group 1 and group 2 only Raag and Kandu shows statistically significant difference, rest of symptoms shows no significant reduction.

Effect of Kandughna Mahakashaya Ghan Vati was better than Amritadi Kwath in patients of Udarda.


Journal of Ayurveda and Integrated Medical Sciences 2022;7(5)31
Sharma P et al: Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati

Conclusion

Udarda is a Vyadhi caused by Kapha dominance. Due to its acute nature Udarda has been a disease a concern. Acharyas has mentioned various formulation for its treatment. Amritadi Kwatha and Kandughna Mahakashaya were found to be effective in Udarda. Kandughna Mahakahsaya was found to be more effective in Udarda.

jaims_1879_01.JPGBar diagram 1: Effect of Kandughna mahakashaya ghan vati in patients of Udarda.

jaims_1879_02.JPGBar diagram 2: Effect of Amritadi Kwatha in patients of Udarda.

jaims_1879_03.JPGBar diagram 3: Comparison of trial group 1 and trial group 2.

Table 1: Subjective Parameters

1. Raag (Erythema) Before Trial After Trial
  No 0 0
  Mild 1 1
  Moderate 2 2
  Severe 3 3
2. Kandu (Itching) Before Trial After Trial
  No 0 0
  Mild 1 1
  Moderate 2 2
  Severe 3 3
3. Mandalotpatti (Wheals formation) Before Trial After Trial
  No 0 0
  Mild 1 1
  Moderate 2 2
  Severe 3 3
4. Frequency of attacks Before Trial After Trial
  No 0 0
  Once a week 1 1
  Alternate day 2 2
  Daily 3 3

Table 2: Comparison of trial group 1 and trial group 2

Criteria N Mean Percentage relief SD SE t p
Raag n 1 = 10 1.5 53.33% 0.707 0.224 6.708 0.001
  n 2 = 10 0.7 28.332% 0.675 0.213 3.28 0.01
Intergroup - - 24.998% 0.691 0.309 2.588 0.0186
Kandu n 1 = 10 1.8 64.996% 0.632 0.2 9 <0.001
  n 2 = 10 0.8 33.332% 0.789 0.249 3.207 0.011
Intergroup - - 31.664% 0.714 0.320 3.128 0.0058

Reference

1. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

2. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

3. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

4. Kushwaha H. Sadvirechashatashritiya Adhyaya, Sutrasthan, Chapter 4, Verse 14. Chakrapani teeka on Charaka Samhita. Chaukhamba Orientalia. 2018, p.63.

5. Sharma P. Udarda, Kotha and Sheetpitta Chikitsa Adhyaya, Chapter 51, Verse 3. Cakradutta. Chaukhamba orientalia. 2013, p. 410


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Sharma P et al: Amritadi Kwatha and Kandughna Mahakashaya Ghan Vati

6. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

7. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

8. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

9. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

10. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 1. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.283.

11. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

12. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284.

13. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 5. Madhavnidanam. Chaukhamba Sanskrit Sansthan. 2012, p.284


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