E-ISSN:2456-3110

Research Article

Panchakarma Sutra

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 10 October
Publisherwww.maharshicharaka.in

To evaluate the relevance of Panchakarma Sutra “Jwarmukte Virechanam” by estimating the status of Doshas in post covid patients

Kirti1*, Dabas A2
DOI:10.21760/jaims.8.10.7

1* Kirti, Post Graduate Scholar, Post Graduate Department Of Panchakarma, Ch Brahm Prakash Ayurved Charak Sansthan Khera Dabar, New Delhi, India.

2 Ankit Dabas, Professor and Head, Post Graduate Department of Panchakarma, Ch Brahm Prakash Ayurved Charak Sansthan Khera Dabar, New Delhi, India.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an infectious disease and is commonly called Covid-19. It affects the human respiratory system causing difficulty in breathing. It is a contagious disease and has been spreading across the world like wildfire. The virus was first identified in 2019 in Wuhan, China. In March, WHO declared Covid-19 as a pandemic that has been affecting the world. Most of the infected patients have recovered from the disease. However, many cases are suffering from various symptoms after recovery from the disease which are different from covid-19 symptoms and can be called as post covid symptoms. Jwar is one of the major symptoms of covid 19 disease. A major treatment principle of Jwar is given by Acharya Bhava Prakash which is “Jwarmukte Virechanam” which means after the recovery of Jwar, Virechana should be given. Aim: To evaluate the incidence of Dosha Prakopa Lakshan and its relevance in post covid management. Objective: To evaluate the incidence of Dosha Prakopa Lakshana in patients recovered from Covid-19 and to perform Virechana Karma in 15 patients recovered from Covid-19 and assess the status of Dosha before and after administering Virechana. Methods: It is Interventional, Prospective, Single arm study. Total of 100 complete patients met the criteria of the clinical study, selected for observational study to find the Dosha Prakopa Lakshan and out of these 100 patients, 15 are selected randomly to perform Virechana Karma and to assess Virechana Karma effect in post covid condition. Result: Dosha Prakopa Lakshan were statistically analyzed and mean of Pitta Prakopa Lakshan in Post covid symptoms is significantly high. Virechana Karma shows significant improvement in Vata, Pitta and Kapha Prokopa Lakshan but results are more significant in Pitta Prakopa Lakshan. Conclusion: Patients recovered from covid - 19 exhibits symptoms of Pitta Pakopa Lakshan. Virechana Karma was found effective in reducing Dosha Prakopa Lakshan irrespective of Dushti in post covid patients.

Keywords: Jwar, Covid-19, Post Covid Symptoms, Virechana Karma

Corresponding Author How to Cite this Article To Browse
Kirti, Post Graduate Scholar, Post Graduate Department Of Panchakarma, Ch Brahm Prakash Ayurved Charak Sansthan Khera Dabar, New Delhi, , India.
Email: 		Kirti, Dabas A, To evaluate the relevance of Panchakarma Sutra “Jwarmukte Virechanam” by estimating the status of Doshas in post covid patients. J Ayu Int Med Sci. 2023;8(10):48-52.
Available From
https://jaims.in/jaims/article/view/2695

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-08-16 2023-08-28 2023-09-11 2023-09-19 2023-09-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 17.25

© 2023by Kirti, Dabas Aand 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

In January 2020, during the most current pneumonitis outbreak, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was found in Wuhan, China.[1] Patients with SARS-CoV-2 infection may exhibit moderate to severe symptoms, while a considerable proportion of carriers are asymptomatic. The majority of people (83%), cough (82%), and shortness of breath (31%), respectively, report having a temperature.[2] Chest X-rays of pneumonia patients typically exhibit numerous mottling and ground-glass opacity.[3] In between 2 and 10% of COVID-19 patients, gastrointestinal symptoms such vomiting, diarrhea, and abdominal pain are reported, and in 10% of patients, diarrhea and nausea appear before fever and respiratory symptoms.[4] Similar to other respiratory viruses, SARS-CoV-2 spreads primarily through the respiratory route with great efficiency and infectivity. The most popular method of transmission is by droplets; however, aerosols may also be a significant one.[5]

Numerous projects have been launched in India to take use of Ayurveda's enormous potential in this epidemic. A collection of recommendations for improving immunity and taking self-care actions based on Ayurvedic principles has been made public by the Ministry of AYUSH.[6,7]

The majority of the affected patients have made a full recovery. Another RTPCR or RAT test, the lack of symptoms for many days, or both might attest to this recovery. However, many individuals experience a variety of symptoms following the disease's recovery that are distinct from covid-19 symptoms.

Fever is one of the major symptoms of covid 19 disease which can be correlated with Jwar in Ayurveda. Acharya Charak describes Jwar as “Santaapo Deha Mansa”.[8] Jwar is consider as supreme among all diseases by the shloka “Sarvarogagrajo Bali.[9] A major treatment principle of Jwar is given by Acharya Bhava Prakash which is “Jwarmukte Virechanam”[10] which means after the recovery of Jwar, Virechana should be given. Virechana is one of the Panchakarma therapies wherein purgation is induced by drugs and is specifically aimed at the elimination of excessive Pitta Dosha from the body. Vitiated Dosha is the basic factor in the manifestation and progress of any disease. Panchakarma therapy, specifically the Sanshodhana

like Vamana and Virechana, is a treatment of its kind that tries to get rid of vitiated Doshas from the body so that sickness can be avoided or, if pathology has already set in, treated in the best way possible.

 According to the siddhanta “Jwarmukte Virechanam” it seems that there may be vitiation of pitta dosha after Jwara which get cured by doing Virechana karma. In this survey, if it is found that post covid patients exhibits symptoms of Pitta Dushti, then it will aid in developing treatment protocols for post-covid disorders. In this research, Pitta and another dosh such as Vata and Kapha Prakopa Lakshan will be assessed in patients and among them Virechana Karma will be performed to assess Dosha Prakopa Lakshana before and after Virechana Karma. Dosha Prakopa Lakshana will be assessed on the basis of the Lakshan given by Acharya Vagabhatta in Ashtanga Hridya Sutra Sthana Doshbhediya Adyaya.[11]

In this study, Jwarmuktawastha will be considered after 14 days of covid positive report and also presence of good appetite experienced by patients as Acharya Sushruta given this as a symptom of Jwaramukta:[12] Considering above facts an attempt has been made to evaluate Dosha Prakopa Lakshan in post covid patients and effect of Virechan Karma in same.

Materials and Methods

Research is essential for diagnosis of disease, development of new treatment and gives the latest information. It often leads to effective treatment that helps people to improve the quality of life. Keeping this in mind the present study was taken into consideration. A study was planned to evaluate Dosha Prakopa Lakshan in post covid patients and effect of Virechan Karma in post covid symptoms. 100 Post covid patients were selected from OPD of Chaudhary Brahm Prakash Ayurved Charak Sansthan.

IEC Certificate No. CBP-IEC/2020/PK-01/MD/16

CTRI No. CTRI/2022/03/041093

Plan of Study

Pre-Clinical screening: Complete medical history of patients was done.

Clinical screening: A detailed case history


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proforma was specially prepared for this purpose. All the following mentioned points were recorded in this proforma before the initiation of the trial. A total of 100 post covid patients fulfilling the inclusion criteria were taken for the study

Eligibility Criteria

Inclusion criteria

  • Patients diagnosed (in past) with COVID-19
  • Patient who had fever as major symptom of covid-19
  • Patients above 18 years of age
  • Patients of either sex.

Exclusion criteria

  • Patients referred from CBPACS hospital to higher center.
  • Patients less than 18 years of age.

Total of 100 complete patients met the criteria of the clinical study, selected for observational study to find the Dosha Prakopa Lakshan and out of these 100 patients, 15 are selected randomly to perform Virechana Karma and to assess Virechana Karma effect in post covid condition.

Group A - Observational study to evaluate Dosha Prakopa Lakshan

Group B - Intervention of Virechana Karma on 15 patients

Procedure - As per standard operative procedure of Virechana Karma

Duration of study - 12 months

Study design - Interventional, Prospective, Single arm study

Assessment Criteria

Based on questionnaire prepared on the basis of Dosha Prakopa Lakshan mentioned by Acharya Vagbhatta in Ashtanga Hridya Sutra Sthana Doshabhediya Adhyaya.

Observation and Results

From the above data it is observed that Pitta Prakopa Lakshan have maximum mean value (20.5) followed by Vata (15.4) and then Kapha Prakopa Lakshan (13.8)

Graph 1: Showing Dosha Prakopa Lakshan

Jaims_2695_01.jpg

Graph 2: Shows assessment of Dosha Prakopa Lakshan in Group A on the basis of mean values
Jaims_2695_02.jpg

Graph 3: Showing combined effect of Virechana Karma in group B
Jaims_2695_03.jpg

P-Value for Vata Prakopa Lakshan is less than 0.05, for Pitta Prakopa Lakshan is less than 0.05, for Kapha Prakopa Lakshan is less than 0.05. From the above data, it is observed that Virechana Karma is more effective in Pitta Prakopa Lakshan in post covid patients.

Discussion

In Group A

Out of 100 patients - Patients mainly displayed Dosha Prakopa Lakshan as follows:


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Table 1: Showing Dosha Prakopa Lakshan

Dosha PrakopaNo. of PatientsPercentage
None33
Vata 88
Pitta 2424
Kapha77
Vata-Pitta2020
Pitta-Kapha88
Vata-Kapha33
Tridosha2727

From the above data, it is concluded that maximum patients i.e., 27% showed Tridosha Prakopa Lakshan. 20% showed Vata- Pitta Prakopa Lakshan, 24% showed Pitta Prakopa Lakshan, 8% showed Pitta-Kapha Prakopa Lakshan, 8% showed Vata Prakopa Lakshan, 7% showed Kapha Prakopa Lakshan and 3% showed Vata-Kapha Prakopa Lakshan.

Table 2: Dosha Prakopa Lakshan in Group A on the basis of mean values

Dosha PrakopaNMeanSD
Vata Prakopa Lakshan10015.2610.50
Pitta Prakopa Lakshan1001810.87
Kapha Prakopa Lakshan10012.559.71

From above data, it is observed that Pitta Prakopa Lakshan had maximum mean value i.e., 18, Vata Prakopa Lakshan had 15.26 mean value and Kapha Prakopa Lakshan had 12.55 mean value. Hence it can be concluded that post covid patients had more Lakshanas of Pitta Prakopa.

In Group B

Effect of Virechana Karma on Vata Prakopa Lakshan - p value is less than 0.05, a considerable difference between mean BT and mean AT has been found. Hence it is concluded that Vata Prakopa Lakshan is decreased significantly i.e., Virechan Karma decreased Vata Prakopa Lakshan significantly.

Effect of Virechana Karma on Pitta Prakopa Lakshan - p value is less than 0.01, a considerable difference between mean BT and mean AT has been found. Hence it is concluded that Pitta Prakopa Lakshan decreased highly significant i.e., Virechan Karma decreased Pitta Prakopa Lakshan highly significant.

Effect of Virechana Karma on Kapha Prakopa Lakshan - p value is less than 0.05, a considerable difference between mean BT and mean AT has been found.

Hence it is concluded that Kapha Prakopa Lakshan is decreased significantly i.e., Virechan Karma decreased Kapha Prakopa Lakshan significantly.

Table 3: Overall Effect of Virechana Therapy as per Statistical analysis

SNParametersBT MeanAT MeanComparison (Paired t test)
1.Vata Prakopa Lakshan15.126.30Significant
2.Pitta Prakopa Lakshan15.504.50Highly significant
3.Kapha Prakopa Lakshan11.474.59Significant

Interpretation

Mean of Pitta Prakopa Lakshan in Post covid symptoms is significantly high. We should reject the null hypothesis and accept H1 i.e., Patients recovered from covid - 19 exhibits symptoms of Pitta Prakopa Lakshan.

In group B of 15 patients, Virechana Karma shows significant improvement in Vata, Pitta and Kapha Prakopa Lakshan but results are more significant in Pitta Prakopa Lakshan. The result of this thesis showed that Ayurvedic Panchakarma therapy is effective in challenging post covid symptoms. Post covid symptoms exhibits Pitta Prakopa Lakshan predominantly and Virechana Karma is effective in these Dosha Prakopa Lakshan. Hence, Sutra - Jwarmukte Virechanam is relevant in post covid symptoms and Virechana Karma is also effective in Jwar Muktawastha which showed that any disease can be treated by considering the basic Siddhant of Ayurveda.

Conclusion

In group A of 100 patients, mean value of Pitta Prakopa Lakshan was 18, Vata Prakopa Lakshan 15.26 was and Kapha Prakopa Lakshan was 12.55. Post covid patients shows Dosha Prakopa Lakshan as follows: None - 3%, Vata - 8%. Pitta - 24%, Kapha - 7%, Vata-Pitta - 20%, Pitta-Kapha - 8%, Vata-Kapha - 3%, Tridoshaja - 27%.

Virechana Karma was found effective in reducing Dosha Prakopa Lakshan irrespective of Dushti in post covid patients. In 15 patients, effect of Virechana Karma is Mean of Pitta Prakopa Lakshan before Virechana is 15.50 and after Virechana is 4.50. Mean of Vata Prakopa Lakshan before Virechana is 5.12 and after Virechana


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is 6.30. Mean of Kapha Prakopa Lakshan before Virechana is 11.27 and after Virechana is 4.59.

References

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