E-ISSN:2456-3110

Research Article

Amlapitta Vinashaka Yoga

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 5 May
Publisherwww.maharshicharaka.in

A comparative clinical study to assess the effect of Amlapitta Vinashaka Yoga and Pantoprazole with Sheetali Pranayama in the management of Amlapitta

Channamma1*, C Nagalapur P2, S Karamudi C3
DOI:10.21760/jaims.9.5.3

1* Channamma, Final Year Post Graduate Scholar, Dept of Swasthavritta and Yoga, SJG Ayurvedic Medical College Hospital Pg Studies Research Centre Gavimath Campus, Koppal, Karnataka, India.

2 Prabhu C Nagalapur, Professor, Dept of Swasthavritta and Yoga, SJG Ayurvedic Medical College Hospital PG Studies Research Centre Gavimath Campus, Koppal, Karnataka, India.

3 Chandrashekaraddi S Karamudi, Associate Professor, Dept of Swasthavritta and Yoga, SJG Ayurvedic Medical College Hospital PG Studies Research Centre Gavimath Campus, Koppal, Karnataka, India.

Background: In this modern era there has been an unprecedented increase of incidences related to GI system due to marked change in life style. Diet pattern, behavioral pattern & mental stress & strain, these multiple factors lead to a clinical condition known as the Amlapitta. Symptoms of Amlapitta as explained in Ayurveda are nearer clinical entity with symptoms of hyperacidity Gastro-intestinal disorder mentioned in modern science. Aim and Objectives: This study aims to evaluate the efficacy of Amlapitta Vinashaka Yoga and Pantoprazole with Sheetali Pranayama. Materials and Methods: An open Randomized Comparative clinical study was conducted in 45 Patients. Patients were randomly selected in to 3 groups. Group A - 15 patients were treated with Amlapittavinashaka Yoga and Sheetali Pranayama, Group B - 15 patients were treated with Pantoprazole and Sheetali Pranayama and Group C - 15 patients were treated with Sheetali Pranayama & placebo. Results: The overall study suggestive of in group A, 7% patients showed moderate relief, 53% patients showed marked response to treatment where as 40% patients showed complete Response to the treatment. In group B 7% patients showed moderate response to treatment, 80% patients showed marked response to the treatment, where as 13% patients showed complete relief to the treatment. In group C 20% patients showed mild relief, 47% patients showed moderate response to treatment where as 33% patients showed marked response to the treatment. Conclusion: The study revealed that the study drug Amlapitta Vinashaka Yoga and regular practice of Sheetali Pranayama schedule 10 cycles at afternoon before meal is effective in treating Amlapitta (Hyperacidity).

Keywords: Amlapitta, Amlapitta Vinashaka Yoga, Ayurveda, Hyperacidity, Pantoprazole, Sheetali Pranayama

Corresponding Author How to Cite this Article To Browse
Channamma, Final Year Post Graduate Scholar, Dept of Swasthavritta and Yoga, SJG Ayurvedic Medical College Hospital Pg Studies Research Centre Gavimath Campus, Koppal, Karnataka, India.
Email: 		Channamma, C Nagalapur P, S Karamudi C, A comparative clinical study to assess the effect of Amlapitta Vinashaka Yoga and Pantoprazole with Sheetali Pranayama in the management of Amlapitta. J Ayu Int Med Sci. 2024;9(5):16-20.
Available From
https://jaims.in/jaims/article/view/3383

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-03-13 2024-03-23 2024-04-04 2024-04-15 2024-04-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 21.22

© 2024by Channamma, C Nagalapur P, S Karamudi Cand 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 recent years there has been an unprecedented increase of incidences related to gastro intestinal system due to change of lifestyle. And it can be described as a disease of modernization due to unhealthy eating habits, mental stress and strain. Hyperacidity is probably a commonest digestive disorder.

In a demographic survey, its prevalence range observed is about 11% to 38.8% of world population.[1]

By prolonged use of drugs such as aspirin, ibuprofen, muscle relaxants etc. which can irritate the esophagus and cause heart burn.[2] Along with this if there is an increased and frequent consumption of tea, coffee, tobacco, smoking and alcohol which would result in incompatibility of food and ends in gastric related complaints such as nausea, vomiting and heart burn etc.

Treatment is directed at the cause but often includes acid suppression. If left untreated it leads to several life-threatening complications such as ulceration, perforation, gastrointestinal bleeding and adenocarcinoma.

Modern treatment includes PPIs, H2 blockers, antacids etc. But these have their own limitations. However, the antacids are among the one of the most widely used medicine all over the world. The US Food and Drug Administration (FDA) warned that there is increased risk of fractures with the use of Proton Pump Inhibitors (PPIs) including Esomeprazole, Omeprazole, Pantoprazole.[3]

As per Modern interpretation symptoms of Hyperacidity can be correlated to Amlapitta. Description of disease Amlapitta and its Chikitsa has been found in detail in classical Ayurvedic texts like Kashyapa Samhita,[4] Yogaratnakar[5] and Bhaisajya Ratnawali.[6] In Brihatrayees, Amlapitta was not considered or grouped under any specific disease, but the symptoms are mentioned.

Amlapitta is one of the common problems of Annavaha Srotas caused due to Mandagni and vitiation of Pachaka Pitta. Increase in Ama and Drava Guna of Pachaka Pitta gives rise to Amlapitta with symptoms as Amla-Tiktaudagar, Hrut-katha Daha, Aruchi, Avipaka, Klama[7] etc.

Hence, we shall consider the Nidana Parivarjana and Samprapti Vighatana to overcome the disease[8] and the drug selected to control is Amlapitta Vinashaka Yoga described in Bhaishajya Ratnavali, Amlapitta Adhikara, which contains Pathya, Bhringaraj and Jeerna Guda having Tikta and Kashaya Rasa which are Agnideepaka, Pittashamaka, Anulomana properties.[9]

Sheetali is one of the type of Pranayama which helps the people who suffer from acidity or any Pittajanya Rogas, by the regular practice.[10]

Hence a clinical study to assess the effect of Amlapitta Vinashaka Yoga along with Sheetali Pranayama in the management of Amlapitta is being undertaken.

Objectives of study

1. To study the effect of Sheetali Pranayama in Amlapitta.

2. To study the combined effect of Amlapitta Vinashaka Yoga and Sheetali Pranayama in Amlapitta.

3. To study the combined effect of Pantoprazole and Sheetali Pranayama in Amlapitta.

Materials and Methods

Selection of Patients

Inclusion Criteria

1. Patients of Amlapitta with classical symptoms like Tikta Amlodgara, Hrit Kantha Daha, Aruchi.

2. Age between 16-40 years.

3. Patients of Amlapitta without any critical complication.

Exclusion Criteria

1. Past or present history of Duodenal or Peptic ulcer.

2. Evidence of Malignancy.

3. Patient taking drug such as NSAIDs which is supposed to increase acid production and gastric ulcerations.

4. Present history of esophageal varices and hematemesis.


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5. Pregnancy or lactating Mother

6. Low Blood Pressure

Drugs used

Table 1: Composition of trial drug

SNDrug NameLatin NamePart UsedQuantity
1.PathyaTerminalia chebulaPhala Majja1 Part
2.BhringarajaEclipta albaLeaves1 Part
3.Jeerna GudaJaggery1 Part

Preparations of medicine

Amlapitta Vinashaka Yoga was prepared in the Dept. of Rasa Shastra & Bhaishajya Kalpana of S.J.G. Ayurvedic Medical College, Koppal as mentioned in classics. Pantoprazole drug was been taken, which is available in market.

Table 2: Study design: Open randomized comparative clinical trial

GroupsGroup AGroup BGroup C
Sample size  15 patients15 patients15 patients
DrugAmlapitta Vinashaka Yoga and Sheetali PranayamaPantoprazole and Sheetali PranayamaPlacebo and Sheetali Pranayama
Dose6gm BD20mg BD6gm BD
Time of administration of drugBefore FoodBefore FoodBefore Food
Sheetali Pranayama10 cycles at afternoon Before meal10 cycles at afternoon Before meal10 cycles at afternoon Before meal
Duration15 Days15 Days15 Days

Parameters of Study

Assessment Criteria

Improvement in Subjective Parameters of Amlapitta was been assessed before & after the treatment.

Table 3: Subjective Criteria

A.Subjective Parameters
1.Tiktaamlodgara (Acid Sour Eructation).
2.Hrit-Kanthadaha (Burning Sensation in Throat& chest Region).
4.Aruchi (Nausea).
5.Avipaka (Dyspepsia).

Assessment of variables

Patients were assessed by using Subjective parameters and severity of clinical conditions before, after treatment and follow up.

Observation and Results

Table 4: Showing comparative effect of therapy on subjective parameters in Group A, Group B & Group C.

Overall ResponseGroup AGroup BGroup C
MeanSDMeanSDMeanSD
Tikta Amlodgara1.530.5161.670.4881.730.458
Hrit Kanta Daha1.200.4141.400.5071.730.594
Aruchi1.530.5161.600.5071.800.561
Avipaaka0.870.3521.070.4581.400.507

Table 5: Showing the overall effect of study on both Group A, Group B & Group C

Overall ResponseGroup A%Group B%Group C%
Unchanged00%00%00%
Mild Response00%00%320%
Moderate Response17%17%747%
Marked Response853%1280%533%
Complete Response640%213%00%
Total15100%15100%15100%

Discussion

Majority of patients were from age group of 32-40 years. This suggests that persons are with struggle of life giving them more stress. This age is also the age of Pitta predominance.

Amlapitta showed its direct impact on Annavaha Srotasa. Agnimandya was present in majority of patients. Present lifestyle that has disturbed the food habits gives rise to Agnimandya, Vidagdhajirna, and finally leads to Amlapitta. Socio-economic condition, mental stress, and strain play an important role in causing and aggravating the disease.

Among all Pranayamas, Sheetali Pranayama is choice for the clinical condition that are related with the gastrointestinal tract, Sheetali is one of the types of Pranayama which helps the people who suffer from acidity or any Pittajanya Rogas. It has cooling and soothing effect on the body. Sheeta Guna of Vata Dosha is increased, it may reduce extra heat and balance Pachakpitta. By this effect Daha will be diminished and increase the Jataragni.

Amlapitta Vinashaka Yoga which contains Pathya, Bhringaraj and Jeerna Guda having Tikta and Kashaya Rasa which are Agnideepaka, Pittashamaka, Anulomana properties.


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Standard drug (Pantoprazole) was found to be quite effective in providing immediate relief from symptoms such as Daha, Amlodgara, and Shula (pain). Pantoprazole acts by inhibiting the secretion of hydrochloric acid in the stomach by specific action on the proton pumps of the parietal cells. However, during follow-up after 1 month, there is reduction in percentage relief and relapse of symptoms occurs while treatment with ayurvedic palliative medicine more sustained relief was found.

The overall study suggestive of in group A, 7% patients showed moderate relief, 53% patients showed marked response to treatment where as 40% patients showed complete response to the treatment. In group B, 7% patients showed moderate response to treatment, 80% patients showed marked response to the treatment, where as 13% patients showed complete relief to the treatment. In group C, 20% patients showed mild relief, 47% patients showed moderate response to treatment where as 33% patients showed marked response to the treatment.

Conclusion

In recent years there has been an unprecedented increase of incidences related to gastro intestinal system due to change of lifestyle. And it can be described as a disease of modernization due to unhealthy eating habits, mental stress and strain. Hyperacidity is probably a commonest digestive disorder. By considering overall result, in the present study the effect of Sheetali Pranayama with giving medicine was more beneficial.

In Group A (Amlapitta Vinashaka Yoga with Sheetali Pranayama), 7% patients showed Moderate relief, 53% patients showed Marked response to treatment where as 40% patients showed complete Response to the treatment. The standard drug (Pantoprazole) was found to be quite effective in providing immediate relief from symptoms such as Daha, Amlodgara, and Shula (pain). However, during follow-up after 1 month, there is reduction in percentage relief and relapse of symptoms occurs while treatment with Ayurvedic palliative medicine more sustained relief was found.

References

1. Gaddam Srinivas, Sharma Prateek, Shedding light on the epidemiology of

GERD IN India-a big step forward, Indian J. Gastroenterol, May-June 2011;30(3):105—107.

2. National Digestive Diseases Information Clearinghouse (NDDIC): Heartburn, Gastro-esophageal Reflux (GER), and Gastro-esophageal Reflux Disease.” The Times of India, Ahmedabad, dated 29th May, Saturday 2010.

3. Drug safety communication: Possible increased risk of fractures of the hip, wrist and spine with the use of proton pump inhibitor, Available from: http://www. fda.gov, last assessed on 23rd march 2011.

4. Satyapal B, Kashyapa samhita, vidyoyini. Hindi commentary, chaukhamba Sanskrit sansthan, Varanasi, 9thedition, chapter 16th Amlapitta chikitsa adhikaar; 2004.p.335.

5. Yogaratnakar, Hindi commentary by vaidya shri laxmipati shastri Ayurveda acharya, chaukhamba Sanskrit sansthan, Varansi uttarardha, Amlapitta nidanam;2009.p.134

6. Bhaisajya ratnawali. chauukhamba Sanskrit sansthan, Varanasi, 56th chapter, Amlapitta Chikitsa Prakaranam; 1998.p.332.

7. Sri Madhavakara, Madhava Nidana with Madhukosa Sanskrit commentary by Shrikanthadutta with the Vidyotini Hindi commentary, edited by Prof. Yadunandana Upadhyaya Chaukhambha Prakashan, Varanas, Reprint 2009 Amlapittanidana 51st chapter, page 203.

8. Govinda Dasa virachita Bhaishajya Ratnavali; Vidyotini Hindi commentary by Ambika datta Shastri; 15th edition 2002; Chaukhamba Sanskrit Samsthana,Varanasi; Amlapitta adhikara, Page number 651.

9. Bhaishajya Ratnavali of Kaviraj Govind Das Sen. B.R.56/10 Amlapitta Edited with Siddhiprada Hindi Commentary by Prof. Siddhi Nandan Mishra. Varanasi: Chaukhambha Surbharati Prakashan; 2001 p. 902.

10. Paramhansa Swami Anant Bharti Hath Yoga Pradipika Edition 2013. Varanasi, Chaukhamba Publishers 2/55 Pg 56.


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