E-ISSN:2456-3110

Research Article

Darunaka

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 6 July
Publisherwww.maharshicharaka.in

A clinical study to evaluate the efficacy of Keechakadi Taila in Darunaka

Chandini N.1*, Angadi R.2, Kumar BN A.3, R Geethesh R.4, Kumar Shetty S.5
DOI: http://dx.doi.org/10.21760/jaims.7.6.9

1* N. K. Chandini, Post Graduate Scholar, Dept. of PG & PhD Studies in Rasashastra & Bhaishajya Kalpana, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

2 Ravindra Angadi, Professor & HOD, Dept. of PG & PhD Studies in Rasashastra & Bhaishajya Kalpana, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

3 Ashok Kumar BN, Associate Professor, Dept. of PG & PhD Studies in Rasashastra & Bhaishajya Kalpana, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

4 R R Geethesh, Associate Professor, Dept. of PG & PhD Studies in Rasashastra & Bhaishajya Kalpana, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

5 Sandesh Kumar Shetty, Associate Professor, Dept. of PG Studies in Swasthavritta, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

Darunaka (dandruff) is a disorder mentioned under the spectrum of Shirokapalagata Roga/Kshudra Roga by various Acharyas. It is a Kapha-Vata predominant disorder of Shiro-Kapala (scalp), characterized by Kandu (itching), Kesha-Chyuti (hair fall), Keshabhumi-Rukshata (dryness of scalp) and Keshabhumi-Sphutana (scaling). Shiroabyanga (oil massage to scalp) with Keechakadi Taila is mentioned as a treatment modality for Darunaka by Vangasena. It contains Keechaka (Bambusa arundinaceace), Sarshapa Taila (mustard oil), Gomutra (cow’s urine) as ingredients. In general all Tailas (oils) alleviates Vata-Dosha and does not aggravate Kapha-Dosha. It is Twak Prasadaka (nourishing), thus helping in treating the disease by Samprapthi Vighatana (breaking the pathogenesis). Though there are plenty of treatment options available for dandruff, there is no promising treatment in any of the allied sciences assuring its complete cure, avoiding recurrence. Thus with the aim to know the efficacy of Keechakadi Taila in treating Darunaka and also to know how effectively it can prevent/ reduce interval between recurrences of Darunaka the present study was carried out. The study showed statistically significant result in the management of Darunaka.

Keywords: Darunaka, Keechakadi Taila, Kandu, Kesha-Chyuti, Keshabhumi-Rukshata, Keshabhumi-Sphutana

Corresponding Author How to Cite this Article To Browse
N. K. Chandini, Post Graduate Scholar, Dept. of PG & PhD Studies in Rasashastra & Bhaishajya Kalpana, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.
Email: 		N. K. Chandini, Ravindra Angadi, Ashok Kumar BN, R R Geethesh, Sandesh Kumar Shetty, A clinical study to evaluate the efficacy of Keechakadi Taila in Darunaka. J Ayu Int Med Sci. 2022;7(6):59-64.
Available From
https://jaims.in/jaims/article/view/1946

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-06-01 2022-06-02 2022-06-09 2022-06-16 2022-06-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes

© 2022by N. K. Chandini, Ravindra Angadi, Ashok Kumar BN, R R Geethesh, Sandesh Kumar Shettyand 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].

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Introduction

Dandruff is a common persistent relapsing scalp disorder with prevalence rate of 50%.[1] Though it is not a dreadful condition, it is one of the most persistent and recurrent condition of scalp. Itchy, scaly scalp may cause social embarrassment in the sufferers, making them anxious and worried leading to even psychological issues later.

In Ayurvedic literature we can find that most of the Nidanas of Darunaka[2,3,4] are said to cause Vata Vridhi. When Gunataha Vridhi of Vata is seen in Kapala Pradesha, it results in Rukshata of Kapala Pradesha and Keshabhumi Sphutana. Other predominant Dosha vitiated is Kapha Dosha. This vitiated Kapha in Kapala Pradesha which is dominant of Kapha Dosha, results in manifestation of symptoms like Kandu. Vitiated Vata causes Kesha Chyuthi, associated Kapha blocks Roma Kupa and prevents further hair growth. Thus Kapha-vata Doshas together, results in manifestation of Darunaka. Lalata-Siravyadha, Nasya, Shirobasti, Shirolepa and Shiro-Abyanga are the line of treatment mentioned for Darunaka in our classics.[5] Shiroabyanga with Keechakadi Taila is mentioned as a treatment modality for Darunaka by Vangasena.[6]

All the Dravyas of Keechakadi Taila have Teekshna-Ushna Guna and Lekhana, Kapha-Vatagna property. Keechaka i.e., Bamboo is also being extensively used in hair care products in pharma and cosmetic industries nowadays. There is no evidence/studies carried out on utility of Vamsha in any hair, scalp related disorders in Ayurveda. Taking all the above points into consideration clinical study of Keechakadi Taila in Darunaka is planned to validate the efficacy of Keechakadi Taila.

Aim and Objectives

1. To know the efficacy of Keechakadi Taila in treating Darunaka.

2. To know how effectively it can prevent/ reduce interval between recurrences of Darunaka.

Materials and Methods

Source of data: 30 patients diagnosed with Darunaka, fulfilling inclusion criteria were selected from OPD and IPD of SDMCA, Udupi.


Study design: It was a non-randomized, single group, open label efficacy study with treatment as primary purpose. Study included 30 diagnosed patients of Darunaka, fulfilling diagnostic and inclusion criteria, assessed based on specially formulated gradation index.

Intervention: Recruited subjects were administered with Keechakadi Taila as mentioned below             

Table 1: Intervention of clinical study

Dose Quantity sufficient for application on the scalp
Dosage form Taila
Route of Administration Parenteral (local application)
Mode of drug administration Once daily in the morning before bath for 30 minutes
Duration of study: 30 days of study with 15 days of intervention and follow up on 15th day and 30th day.

Diagnostic criteria

The diagnosis was made based on following Lakshanas of Darunaka.[7,8]

  • Itching (Kandu)
  • Hair fall (Keshachyuti)
  • Dryness of scalp (Keshabhumi Rukshata)
  • Scaling (Keshabhumi Sphutana)

Inclusion criteria

  • Subjects fulfilling diagnostic criteria who were willing to give their written informed consent and follow up the protocol of study were selected irrespective of gender, occupation, food habits and chronicity.
  • Darunaka manifesting only on scalp.
  • Both fresh and treated case of Darunaka who were not under any medications currently.
  • Age group between 18 to 60 years.

Exclusion criteria

  • Patients suffering from diseases of scalp other than
  • Patients suffering from major systemic disease.
  • Patients on oral antibiotics and antimycotics.
  • Patient with hypersensitivity, immunodeficiency and known drug allergies.
  • Pregnant women, lactating mother, children.

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jaims_1946_01.JPGFigure 1: Dandruff scales

Assessment criteria: Assessment was made on 0th, 15th and 30th day using gradation index, based on

1. Kandu - Itching

2. Kesha-Chyuthi - Hair fall

3. Keshabhumi-Sphutana - scaling

4. Keshabhumi-Rukshata - dryness of scalp

Gradation index of clinical study

Kandu

  • 0 - Absent
  • 1 - Occasionally present
  • 2 - Constantly present without hampering routine activities
  • 3 - Constantly present hampering routine activities

Kesha Chyuthi

  • 0 - Normal
  • 1 - Mild loss
  • 2 - Moderate loss
  • 3 - Maximum loss

Kesha Bhumi Sphutana

  • 0 - Absent
  • 1 - Visible inside the hair
  • 2 - Visible over the hair
  • 3 - Spreaded over the shoulder

Kesha Bhumi Rukshatha

  • 0 - Absent
  • 1 - Occasionally present
  • 2 - Without discomfort on the scalp
  • 3 - With discomfort on the scalp

Statistical analysis: Statistical analysis was carried out using Wilcoxon signed rank test.

Observations

Age: It was found that incidence of Darunaka was more in age group between 24-29 years. The reason might be, at this age group most of the individuals are beauty conscious, this might attract them to use various range of cosmetic products. Chemical in the cosmetics can cause local irritation and may cause dandruff. Hormonal changes, stress etc. are also common in this age group, contributing to increased incidence of dandruff.

Gender: It was observed that incidence of Darunaka was more in females. Long hair might cause difficulty in maintaining the hygiene, leading to dandruff. Highest use of cosmetics by females too contributes to this.

Socio-economic status: It was observed that incidence of Darunaka was more in upper middle-class individuals. Sedentary life style, unhealthy food habits might have been the contributing factor here.

Occupation: It was observed that incidence of Darunaka was more among students. Stress, lack of hygiene might be the contributing factor for the same.

Nidana: It was observed that incidence of Darunaka was more in the individuals who indulged in Ratrijagarana. Ratrijagarana causes Vata Prakopa and also hormonal imbalance, contributing to Darunaka.

Relieving factor: Most of the individuals found relief from Darunaka, by practicing regular head bath. Hygiene is the contributing factor here.

Diet: It was observed that incidence of Darunaka was more in individuals who had mixed diet. May be spicy oily food, causes Tridosha Prakopa, leading to Darunaka.

Desha: It was observed that incidence of Darunaka was more in individuals of Anupa Desha. As most of the individuals included in the study were from local region i.e., Anupa Desha, this cannot be justified and applied to large sample.

Prakruthi: It was observed that incidence of Darunaka was more in


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Vata-Pitta Prakruthi individual. Only after conducting study on large sample we can conclude about the association between incidence of Darunaka and Shareera Prakruthi.

Frequency of head bath and oil application to scalp: It was observed that incidence of Darunaka was more in individuals who applied oil weekly once to scalp and took head bath weekly once. Lack of hygiene is the contributing factor here.

Results

The results of various parameters analysed statistically with Wilcoxon signed rank test are tabulated below.

Table 2: Results of clinical study

Parameters Mean Z value P value Interpretation
BT AT FU BT-AT BT-FU BT-AT BT-FU BT-AT BT-FU
Kandu 1.1852 0.333 0.2333 -4.767 -4.456 0.00 0.00 HS HS
Keshachyuthi 1.9583 1.5333 1.500 -1.00 -1.414 0.317 0.157 NS NS
Keshabhumi Rukshata 1.1875 0.00 0.0333 -3.755 -3.626 0.00 0.00 HS HS
Keshabhumi Sphutana 1.700 0.100 0.5333 -4.894 -4.311 0.00 0.00 HS HS

Results of Wilcoxon signed rank test for Kandu: When Kandu was compared before treatment (mean 1.1852) to after treatment (mean 0.333) with Wilcoxon signed rank test, 27 subjects showed negative ranks, no subjects showed positive ranks and 1 subjects showed no change with z value -4.767 and p value 0.000, which is statistically highly significant.

When Kandu was compared before treatment (mean1.1852) to follow up (mean-0.2333) with Wilcoxon signed rank test, 22 subjects showed negative ranks, no subjects showed positive ranks and 5 subjects showed no change with z value -4.13 and p value 0.000, which is statistically highly significant.

Results of Wilcoxon signed rank test for Keshachyuthi: When Keshachyuthi was compared before treatment (mean 1.9583) to after treatment (mean-1.5333) with Wilcoxon signed rank test, 1 subject showed negative ranks, no subjects showed positive ranks and 23 subjects showed no change with z value -1.0 and p value 0.317, which is statistically not significant.

When Keshachyuthi was compared before treatment (mean1.9583) to follow up (mean- 1.500) with Wilcoxon signed rank test, 2 subjects showed negative ranks, no subjects showed positive ranks and 22 subjects showed no change with z value -1.414 and p value 0.157, which is statistically not significant.

Results of Wilcoxon signed rank test for Keshabhumi Rukshata: When Keshabhumi Rukshata was compared before treatment (mean - 1.1875) to after treatment (mean- 0.00) with Wilcoxon signed rank test, 16 subject showed negative ranks, no subjects showed positive ranks and no subjects showed no change with z value -3.755 and p value 0.00, which is statistically highly significant.

When Keshabhumi Rukshata was compared before treatment (mean - 1.1875) to follow up (mean- 0.0333) with Wilcoxon signed rank test, 15 subjects showed negative ranks, no subjects showed positive ranks and 1 subject showed no change with z value -3.626 and p value 0.00, which is statistically highly significant.

Results of Wilcoxon signed rank test for Keshabhumi Sphutana: When Keshabhumi Sphutana was compared before treatment (mean 1.700) to after treatment (mean- 0.100) with Wilcoxon signed rank test, 30 subject showed negative ranks, no subjects showed positive ranks and no subjects showed no change with z value -4.894 and p value 0.00, which is statistically highly significant.

When Keshabhumi Sphutana was compared before treatment (mean 1.700) to follow up (mean- 0.533) with Wilcoxon signed rank test, 23 subjects showed negative ranks, no subjects showed positive ranks and 7 subjects showed no change with z value -4.311 and p value 0.00, which is statistically highly significant.

Discussion

The clinical study was carried out with the purpose of knowing how effectively Keechakadi Taila can treat Darunaka. How effective it is to prevent/ reduce interval between recurrences of Darunaka.

Shiro-Abyanga: Shiro-Abyanga is one among Murdha Taila.[9] It is a Bahya Snehana procedure. Acharya Vagbhata has indicated Abyanga


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in Rukshata, Kandu of Shira-Kapala and in Mala Sanchaya in Shirapradesha.[10] It is advised to practice Abyanga regularly once in a day or once in two days or once in three days. As Abyanga do not vitiate any Dosha, depending on the formulation and condition the frequency of Abyanga can be fixed according to ones Yukti. Dalhana has told the effect of Abyanga on various Dhatus according to the duration. He said Abyanga Dravya reaches Romakupa by 300 Matrakala and Twacha by 400 Matrakala, which can be taken as 1-2 minutes.

In the present study Abyanga was advised daily, once before bath in the morning. The patients were asked to apply lukewarm Keechakadi Taila for the scalp, massage each area for 2minutes later leave oil for 30 minute and then take head bath using the soap/ shampoo which they used regularly.

Darunaka is a Kapha-Vata predominant disorder of the scalp. Lack of hygiene is said as one of the cause for Darunaka. Keechakadi Taila contains drugs which are Ushna, Teekshna. Abyanga reduces Vata Dosha. Keechakadi Taila does Lekhana Karma and also is Kapha Vata Shamaka. Considering all this points duration of treatment was fixed 15days with daily Shiro-Abyanga. As this was the first clinical study carried out on the drug minimum duration was fixed to see the effect. As 300-400 Matrakala was duration required by drug to enter Romakupa and Tawk, massage to each area for 2 minutes was advised. Though it is said that absorption by Romakupa and Twacha takes place within 2 minutes, asking patients to apply oil, massage for 2 minutes and then wash, would not be clinically practiced. Also leaving oil on scalp for long hours/ overnight would engulf surrounding dust and could aggravate the symptoms like Kandu and scaling. So, 2 minutes massage, head bath after 30 minutes was advised.

Mode of absorption of Abyanga Dravya

Brajaka Pitta located in Twak, helps in absorption and metabolism of applied oil. Veerya of the drug after Paka is absorbed by Romakupa and later by different Dhatus. Thus, it nourishes the sclap, scalp hair and treats the ailment.

Taila is a dosage form where active components are present in lipid media. Drugs in lipid media can be absorbed easily by the cell membranes, skin layers through penetration between cells and also diffusion through the cells.

Lukewarm state of the oil, soft gentle massage improves the blood circulation to Kapala Pradesha. This intern helps in fast absorption of oil. Sneha Gunas also play an important role in absorption of Aushadhis.

Probable mode of action

Effect on Kandu: Keechakadi Taila showed highly significant result in the management of Kandu. All the drugs of the formulation had Kandugna property. The combined effect of all these drugs might have been added up, showing the highly significant reduction in Kandu.

Effect on Keshabhumi Rukshata: Keechakadi Taila showed highly significant result in the management of Keshabhumi Rukshata. Sneha having inbuilt Snigdha Guna.[10] regular massage of it to scalp might have resulted in combating Rukshata of scalp.

Effect of Keshabhumi Sphutana: Keechakadi Taila showed highly significant result in the management of Keshabhumi Sphutana. All the drugs in the formulation have Lekhana property. This might have helped in scrapping out the dead cells, thus reducing scaling.

Effect on Kesha Chyuti: Keechakadi Taila showed non-significant result in the management of Kesha Chyuti. Though Keshya effect of individual drug of the formulation has been proved through various researches, Keechakadi Taila showed non-significant result. Keshabhumi is affected in Darunaka, making hair root weak. Keechakadi Taila due to Lekhana property might have scraped weak hairs along with scales, resulting in non-reduction of hair fall. Duration of study too matters here. Long term use of the oil may kill Krimis in Keshabhumi and later may help in growth of healthy hair.

Conclusion

Keechakadi Taila showed statistically and clinically highly significant results in management of Darunaka in terms of Kandu, Keshabhumi-Rukshata and Keshabhumi-Sphutana. It showed non-significant result in management of Kesha-Chyuti.

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