E-ISSN:2456-3110

Research Article

Madhumeha

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 9 SEPTEMBER
Publisherwww.maharshicharaka.in

A Clinical Study to evaluate the therapeutic effect of Akulyaabdadi Kashaya in Madhumeha (Type-II Diabetes Mellitus)

Malik P1*
DOI:10.21760/jaims.9.9.1

1* Pavitra Malik, Assistant Professor, Dept of Kayachikitsa, National College of Ayurveda Barwala, Hisar, Haryana, India.

Introduction: In 2024 approximately 540 million adults (20-70 years) are living with diabetes as per data of IDF (international diabetes Federation). WHO states that diabetes will be 7th leading cause of death by 2030. Ayurveda says Madhumeha is a variety of Vataja Parmeha where the patient passes the urine with sweetness and astringency. The main symptoms involved are Prabhoota Mootrata (excessive urination) and Avila-Mootrata (non-transparency of urine). The major cause of disease is sedentary lifestyle and indulgence in Kapha-Medakar Aahara along with Divaswapana (day sleeping), avoidance of any form of exercise, hence indicating Santarpanjanya origin of disease.

Methods: Akulyaabdadi Kashaya, the first Kashaya mentioned in Pramehahara Kashayas if Sahasrayoga is taken for single blind clinical study on 30 patients and the efficacy is established post 30-days of treatment.

Results: During the study, it was found that signs and symptoms like polyuria, turbidity in urine, polyphagia, excessive thirst, burning sensation and numbness in feet, weakness, excessive sweating and lassitude were significantly reduced and Akulyaabdadi Kashaya, the trial drug was found highly significant at 0.1% level with p- value <0.001 to improve the FBS, PPBS, urine glucose (FUS & PPUS) and establishes it as a good treatment of Diabetes as a long term drug.

Keywords: Madhumeha, Akulyaabdadi Kashaya, Type-II Diabetes Mellitus

Corresponding Author How to Cite this Article To Browse
Pavitra Malik, Assistant Professor, Dept of Kayachikitsa, National College of Ayurveda Barwala, Hisar, Haryana, India.
Email: 		Malik P, A Clinical Study to evaluate the therapeutic effect of Akulyaabdadi Kashaya in Madhumeha (Type-II Diabetes Mellitus). J Ayu Int Med Sci. 2024;9(9):1-11.
Available From
https://jaims.in/jaims/article/view/3824

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-08-08 2024-08-19 2024-08-30 2024-09-10 2024-09-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 11.11

© 2024by Malik Pand 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].

J Ayu Int Med Sci 2024;9(9)1
Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Introduction

Prameha is a disease which shows effects all over the body and specifically the urinary system. Madhumeha a variety of Vataja Prameha is one among the Astamahagadas,[1] in which the vitiation of Vatakapha Pradhana Tridoshas associate with Medas and other Dhatus along with Ojas reaches the Mootravaha Srotas and results in the illness.[2] Based on the pathology Madhumeha is of two types - Dhatu Kshayaja and Avaranaja. Avaranjanya Madhumeha is considered as Krichrasadhya.[3] Madhumeha vitiates all three Doshas and 10 - Dushyas Meda, Rakta, Shukra, Ambu, Vasa, Lasika.[4] Vitiation of Kapha results in Medadushti, and it moves in downward direction through the Mootravaha Strotas, and gets Sthanasamshraya in Basti leading to Prabhoota Mutrata, Avila Mutrata etc. symptoms. In Diabetes Mellitus, reduced insulin secretion, decreased glucose utilization, and increased glucose production causes hyperglycemia. This dysregulates metabolic system, and causes pathophysiological changes in multiple organ systems, and imposes tremendous burden on health of an individual.

Type-II Diabetes Mellitus (NIDDM) is burning Health issue across the world in the near past and India leads the world with largest number of Diabetic subjects and being termed as diabetic capital of the world.[5] Globalization may be good for economy but is disastrous for civilization. Societies following modernized lifestyle and avoiding traditional system in diet, medicines and lifestyle are experiencing highest rates of diabetes mellitus.[6] The IDF reported 6.7 million deaths due to diabetes in 2021.[7] Despite all the modern advancements in hypoglycemic drugs, management of diabetes is still big challenge for medical world. The long-term use of hypoglycemic drugs is accompanied by several adverse effects. Hence there is increasing need to go back to the roots i.e., Ayurveda and in this direction the Ministry of AYUSH has also launched “The Mission Madhumeha” on 28th October,2016 on first National Ayurveda Day.

Ayurvedic texts, mention about effective treatment of Madhumeha which not only helps in reducing the blood sugar level but also improves overall health of the patient. Akulyaabdadi Kashaya is mentioned in Prameha chikitsa, Kashaya Prakaran of Sahasrayoga.[8]

In this current study an effort being made to provide a good oral hypoglycemic drug effective in improving the quality of life of diabetes patient. The trial drug Akulyaabdadi Kashaya was formulated as per the description in Prameha Chikitsa, Kashaya Prakaran of Sahasrayoga.[9]

Madhumeha (Type-II Diabetes Mellitus). The aim is a good control and management of Madhumeha. And I found out that the individual components of the drug have already been scientifically evaluated in pharmacological sector, establishing their hypoglycemic effect.

The study has been conducted on taking the number of cases for a trial period of 30 days. Has been used as a trial drug. All the clinical features, blood and urine values have been recorded pre and post the trial systematically and assessed with the help of suitable statistical parameter and is presently in form of charts and tables.

Aim

To assess the therapeutic effect of Akulyaabdadi Kashaya in Madhumeha (Type-II Diabetes Mellitus).

Objective

1. To Study in detail about Madhumeha (Type-II Diabetes Mellitus).
2. Preparation of Akulyaabdadi Kashaya in accordance with textual reference.
3. To study the effect of Akulyaabdadi Kashaya in the management Madhumeha (Type-II Diabetes Mellitus).

Hypothesis: it is assumed that Akulyaabdadi Kashaya is an effective drug to control Madhumeha (Type-II Diabetes Mellitus).

Materials and Methods

Design of the study

It is a single blind clinical study.

Total 30 patients were selected randomly Patients who are already on other anti-diabetic drugs were also taken in this study after discontinuing the treatment and after the wash out period of one week. A well-formed, printed chart given to the individuals indicating Pathya and Apathya, Yogasana according to the condition i.e., Type – II Diabetes Mellitus.


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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Duration of the study: 30 days. Assessment was done based on subjective and objective criteria before after the treatment i.e. on 0 day, 31st day.

Ethical clearance: the study has been conducted with the due approval of IEC, KAMC, Mangalore, Karnataka. The patients were given all the required information and signed consent was obtained before starting the trial.

Criteria for selection of patients

Diagnostic criteria: Patients fulfilling the following criteria:

Subjective criteria: Prabhuta Mutrata, Avila Mutrata, Pipasa, Kshudha, Kara-Pada-Tala Suptata/Daha, Swedadhikya, Daurbalya, Nidradhikya

Objective criteria:

1. Fasting Blood Sugar (FBS): ≥ 126mg/dl - ≤ 250mg/dl. Fasting is defined as no caloric intake for at least 8 Hours
2. Post Prandial Blood Sugar (PPBS): ≥ 140mg/dl - ≤ 300mg/dl.
3. Raised Fasting Urine Sugar (FUS).
4. Raised Post Prandial Urine Sugar (PPUS).

Inclusion criteria:

1. Patients diagnosed to be suffering from Type-II Diabetes Mellitus or having classical signs and Symptoms of
2. Diagnosed cases of Type-II Diabetes Mellitus within 5 years of onset.
3. Patients of either sex will be taken.
4. Both fresh & treated patients of age group between 30-70 years.
5. Patients of Diabetes Mellitus having

  • Fasting Blood Sugar: ≥126mg/dl - ≤ 250mg/dl.
  • Post Prandial Blood Sugar: ≥140mg/dl - ≤ 300mg/dl & raised urine sugar values.

Exclusion criteria:

1. Insulin Dependent Diabetes Mellitus (Type-1).
2. Patients of age group <30 and >70 years.
3. Any Systemic disorder other than Diabetes Mellitus which will interfere with present treatment.
4. Diabetic patients associated with severe complications such as Ischemic Heart
5. Disease, Diabetic retinopathy, Gestational Diabetes, PCOS.
6. Pregnant women.

Assessment Criteria:

Assessment was done based on subjective and objective criteria before after the treatment i.e., on 0 day, 31st day.

Grading of subjective criteria:

CriteriaGrading
1. Prabhoota Mootrata (Polyuria) - Frequency of urine
3-5times/day & rarely at night0
6-7 times/day & 1-2times at night1
8-10 times/day & 3-4times at night2
>10 times/day & >4times at night3
2. Avila Mutrata (Turbidity in urine)
Crystal clear fluid0
Faintly cloudy or hazy with slight turbidity.1
Turbidity clearly present and newsprint easily read through test tube2
Newsprint not easily read through test tube3
Newsprint cannot be visualized through test tube4
3. Pipasa (Polydypsia)
Feeling of thirst 7 - 9 times/24 hours, either/or Intake of water 5 - 7 times/24 hours with quantity 1.5 - 2.0 liter/24 hours0
Feeling of thirst 9 - 11 times/24 hours, either/or Intake of water 7 - 9 times/24 hours with quantity 2.0 - 2.50 liter/24 hours1
Feeling of thirst 11 - 13 times/24 hours, either/or Intake of water 9 - 11 times/24 hours with quantity 2.50 - 3.00 liter/24 hours2
Feeling of thirst >13 times/24 hours, either/or Intake of water >11 times/24 hours with quantity >3.00 liter/24 hours  3
4. Kshudha-Adhikaya (Appetite)
As usual / routine0
Slightly increased (1 - 2 meals)1
Moderately increased (3 - 4 meals) 2
Markedly increased (5 - 6 meals)3
5. Kara - Pada - Tala Suptata / Daha (Neuropathy)
No Suptata / Daha0
Kara - Pada - Tala Suptata/ Daha is continuous1
Kara - Pada - Tala Suptata/ Daha continuous but not severe2
Kara - Pada - Tala Suptata/ Daha continuous and severe3
6. Swedadhikya (Perspiration)
Sweating after some strenuous or heavy work or in hot & humid weather0
Profuse sweating after moderate work and movement1
Sweating after little extra work than routine and movement2
Profuse sweating after routine work3
Sweating even at rest or in cold climate 4
7. Daurbalya (Weakness)
Can do routine exercise/work0
Can do moderate exercise with hesitancy1
Can do mild exercise only, with difficulty2
Cannot do mild exercise too3
8. Nidradhikya (Excessive Sleep)
Normal & sound sleep for 6 - 8 hrs. /24 hrs with feeling of lightness and relaxation in the body & mind0
Sleep >8 - 9 hrs. /24 hrs with slight heaviness in the body.1
Sleep >9 - 10 hrs. /24 hrs with heaviness in the body associated with Jrimbha.2
Sleep >10 hrs. /24 hrs. with heaviness in the body associated with Jrimbha & Tandra3

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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Objective criteria: (American Diabetes Association)

Grading of Objective criteria

1.Fasting blood glucose (FBS)
CriteriaGrading
90 - 130 mg/dl0
131 - 150 mg/dl1
151 – 170 mg/dl2
>171 mg/dl3
2. Post prandial blood glucose (PPBS)
140 - 180 mg/dl0
181 - 220 mg/dl1
221 - 260 mg/dl2
>261 mg/dl3
3. Urine Glucose FUS & PPUS (Mutramadhuryata)
Blue ppt.0
Green ppt.1
Yellow ppt.2
Orange ppt.3
Brick red ppt.4

Diagnostic investigations

  • FBS
  • PPBS
  • Urine glucose FUS & PPUS

Posology
Trial drug: Akulyaabdadi Kashaya

The drug was provided in set of three

  • The coarse powder (Kwatha Choorna) of 1-24 drugs was packed in 500g quantity along with a measuring spoon of 5gm.
  • Suddha Shilajatu in powder form packed in 240 grams quantity
  • Honey purchased from market

The Kwatha Churna was boiled with 200 ml of water and reduced to 50 ml. in the prepared Kwatha Suddha Shilajatu powder and honey was added using measuring spoon.

Dose: 48ml BD before food

Diet and exercise: A well-formed, printed chart given to the individuals indicating Pathya and Apathya, Yogasana according to the condition i.e., Type – II Diabetes Mellitus.

Design of the study: It is a single blind clinical study. Total 30 patients were selected randomly Patients who are already on other anti-diabetic drugs were also taken in this study after discontinuing the treatment and after the wash out period of one week.

Criteria for overall effect of therapy

Complete Remission100% Relief in the Subjective and Objective criteria.
Marked ImprovementMore than 75% Relief in the Subjective and Objective criteria.
Moderate Improvement50% -74% Relief in the Subjective and Objective criteria.
Mild Improvement25%-49% Relief in the Subjective and Objective criteria.
UnchangedResult below 25% was considered as unchanged.

Results and Discussion

Effects on subjective parameters:

ParametersBTAT
Prabhoota Mootrata1.830.70
Avila Mutrata1.260.27
Pipasa0.270.30
Kshudha 1.700.33
Kara-Pada-Tala Suptata/Daha0.430.53
Swedadhikya0.270.17
Daurbalya0.630.47
Nidradhikya 0.600.43

jaims_3824_01.JPG

Percentage relief after treatment

Parameter% relief
Prabhoota Mootrata61.81
Avila Mutrata78.92
Pipasa76.29
Kshudha 80.41
Kara-pada-tala Suptata/Daha62.80
Swedadhikya37.49
Daurbalya71.463
Nidradhikya 27.78

jaims_3824_02.JPG


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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Effects on objective parameters:

Mean score difference in before and after treatment.

Blood Sugar:      

ParameterBTAT
Fasting Blood Sugar184.40149.23
Post Prandial Blood Sugar215.43181.37

jaims_3824_03.JPG

Urine Sugar: 

ParameterBTAT
Fasting Urine Sugar0.900.33
Post Prandial Urine Sugar0.830.40

jaims_3824_04.JPG

Percentage relief after treatment:

Parameter% of relief
Fasting Blood Sugar19.07
Post Prandial Blood Sugar15.81
Fasting Urine Sugar62.96
Post Prandial Blood Sugar51.99

jaims_3824_05.JPG

Fasting Blood Sugar was reduced by 19.07%, Post Prandial Blood Sugar was reduced by 15.81%. Fasting Urine Sugar Reduced by 62.96%, Post Prandial Urine Sugar was reduced by 51.99%.

Assessment of total effect of the treatment:

The total effect of the therapy was assessed taking into consideration the total improvement in sign and symptoms and was calculated.

Overall effect of Akulyaabdadi Kashaya:

CategoryNo. of patientsPercentage
Complete Remission0310.00%
Marked Improvement0723.33%
Moderate Improvement0826.67%
Mild Improvement0826.67%
Unchanged0413.33%

It was seen that considerable no. of patients were shown complete remission in their sign and symptoms i.e., 10%, marked improvement shown in 23.33%, moderate improvement was observed in 26.67, mild improvement was observed in 26.67, and 13.33% patient remained unchanged. So, the results show Akulyaabdadi Kashaya has shown significant effect in reversal of the symptoms in Madhumeha.

Discussion on Results

The given treatment was effective. The effect of the treatment in subjective and objective parameters in Madhumeha are explained as follows:

Prabhut Mutrata & Avila Mutrata

Statistical analysis reveals that the mean score of Prabhoota Mutrata was 1.833 before treatment and reduced to 0.7000 and this change that occurred with the treatment is statistically highly significant with an improvement by 61.811% and difference in mean was 1.133.

Mean score of Avila Mutrata was 1.267 before treatment and reduced to 0.2667 and this change that occurred with the treatment is statistically highly significant with an improvement by 78.92% and difference in mean was 1.000. Prabhoota Mutrata is seen due to Mutravaha Srotodusti which is corrected by the Pramehagna effect and the Rasayana effect to rectify the Srotodusti. Excessive formation of Kleda and Ama (hyperglycemia) in the body causes increased frequency and quantity of urination in the patients of diabetes mellitus.


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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Ingredients of Akulyaabdadi Kashaya have dominance of Katu-Tikta-Kashaya Rasa, Laghu-Ruksha Guna, Ushna Veerya. Thus, all these properties act on Dosha Vishesha i.e., Bahu Drava Sleshama and Dooshya Vishesha i.e., Kleda (BSL lowering effect of ingredients below renal threshold), hence showed highly significant results on Prabhut Mutrata and Avila Mutrata in patients.

Pipasa

Statistical analysis reveals that the mean score of Pipasa was 1.267 before treatment and reduced to 0.3000 and this change that occurred with the treatment is statistically highly significant with an improvement by 76.29%.

And difference in mean was 0.9667. As there is excessive urination symptom patients feel thirstier and its due to Pitta Dosha Vruddhi and Teekshnagni. It is a result of excessive loss of Drava Dhatu due to Prabhutmutrata, Akulyaabdadi Kashaya reduces Prabhut Mutrata simultaneously reduces Pipasa. The drugs act as Trisdoshashamaka, Trishnanigrahana and Rasayana effect.

Kshudha

Statistical analysis reveals that the mean score of Kshudha was 1.700 before treatment and reduced to 0.3333 and this change that occurred with the treatment is statistically highly significant with an improvement by 80.411 %. And difference in mean was 1.367.

Due to impaired Agni (insulin resistance or decreased insulin sensitivity) formation of vitiated Kapha and Meda Dhatu (fat) occurs which accumulates & obstructs the nutrient channels of remaining Dhatus along with channels of Vata, which is presented as Kshudhaadhikya (polyphagia).

Constituents of Akulyaabdadi Kashaya improves the status of Agni by its Deepana-Pachana action & maintain the optimum nutritional status of Dhatus thus improving the symptom of Kshudhaadhikya.

Kara-Pada-Tala Suptata / Daha

Statistical analysis reveals that the mean score of Kara-Pada-Tala Suptata/ Daha was 1.433 before treatment and reduced to 0.5333 and this change that occurred with the treatment is statistically highly significant with an improvement by 62.80 %. And difference in mean was 0.900.

Here these symptoms are caused to vitiation of Vata and Pitta Dosha and due to Avarana pathology caused by excessive Kapha Dosha and Meda Dhatu including all 10 Dushya and these are corrected by Trishnanigrahana, Kaphanissaraka, Dahaprashamana, Balya, Mridurechana, Nadi Balya, and Vatanulomana etc. effects. It is common neurological complications of diabetes described in Ayurvedic literature as Purvarupa of Prameha. It reflects one’s glycemic control. Therefore, when hyperglycemia is corrected with hypoglycemic activity of Amalaki, Daruharidra, Asana, Tiphala, Haridra, Shilajatu, Akuli etc. ingredients of Akulyaabdadi Kashaya the relief was obtained in these neuropathic complications like Kara-Pada-Tala Suptata/ Daha Amalaki, Kataka, Vibhiitaki, Haritaki, Akuli and Musta are having Nadibalya effect, thus beneficial in neurological symptoms.

Swedadhikya

Statistical analysis reveals that the mean score of Swedadhikya was 1.2667 before treatment and reduced to 0.16687 and this change that occurred with the treatment is statistically insignificant with an improvement only by 37.49%. And difference in mean was 1.1667. there is not much relief in this part but whatever achieved was due to the Lekhana property of Akulyaabdadi Kashaya. Drug of kashaya, tikta rasatamaka which reduces excessive Kleda & Meda.

Dourbalya

Statistical analysis reveals that the mean score of Dourbalya was 1.633 before treatment and reduced to 0.4667 and this change that occurred with the treatment is statistically highly significant with an improvement by 71.463%. And difference in mean was 1.167. These were conditions found in many of diabetic patients because of less glucose uptake by muscle tissue for the energy. In Prameha Apyamsha of Dhatus get converted in Sharir Kleda & excreted through urine as a result Dhatukshaya occurs causing Daurbalya. It is rectified by Rasayana, Balya, Jeevaneeya, Varnya, Dhatuvardhaka and Vrishya effect.

Nidra

Statistical analysis reveals that the mean score of Nidra was 1.600 before treatment and reduced to 0.433 and this change that occurred with the treatment is statistically significant with an improvement by 27.78%.


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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

And difference in mean was 1.1667. Nidra is produced due to Bahudrava Shleshma, Medodushti and Medodhatvagnimandya (Ch.ni.4/8) mainly. As drugs of Akulyaabdadi Kashaya are Deepana, Pachana Lekhana, and Rasayana so they help to reduce this symptom.

FBS: The statistical analysis revealed that the mean FBS score before treatment was 184.40 and after treatment 149.23. This is statistically significant with an improvement by 19.07%. And difference in mean was 35.23.

PPBS: The statistical analysis revealed that the mean PPBS score before treatment was 215.43 and after treatment 181.37 with an improvement by 15.81%. And difference in mean was 34.067.

FUS: The statistical analysis revealed that the mean FUS score before treatment was 0.900 and after treatment 0.3333. This is statistically significant with an improvement by 62.96%. And difference in mean was 0.5667.

PPUS: The statistical analysis revealed that the mean PPUS score before treatment was 0.8333 and after treatment 0.4000. This is statistically significant with an improvement by 51.998%. And difference in mean was 0.4333.

Sugar in blood as well as in urine is the result of either deranged metabolism, lowered urinary threshold point, production of Ama Dosha, or due to their cumulative effect. Results indicate that reduction in urine sugar was well managed by Akulyaabdadi Kashaya. FBS, PPBS, FUS & PPUS had a marked reduction after the treatment in both groups. As the Kwatha contains drugs having Pramehagna, Rasayana, Kapha-Medohara effect. The drugs also proved to have hypoglycemic effect in clinical and experimental studies individuals.

Discussion on Akulyaabdadi Kashaya

Probable mode of action of drugs

Akulyaabdadi Kashaya[9] - is mentioned in Prameha Chikitsa, Kashaya Prakaran of Sahasrayog as an effective treatment in Prameha. The formulation Akulyaabdadi Kashaya consists of Akuli[10], Abdha[11], Triphala[12-14], Rajani[15], Daruharidra[16], Jambu[17], Arjuna[18], Vata[19], Udumbara[20], Ashvatha[21], Plaksha[22], Paarish[23], Patha[24], Kataka[25], Agnimantha[26], Khadira[27], Ambastha[28],

Asana[29], Indradrum[30], Varida[31], Kola[32], Kinsuka[33], Madhu[34], and Adrija Tuttha (Shilajatu[35]). Most of drugs like Akuli, Haritaki, Amlaki, Jambu Agnimantha, Asana, Shilajatu, Madhu and Daruharidra were having Pramehara property directly acting on etiopathogenesis of Apathyanimittaja Prameha. Tikta, Katu, Kashaya Rasa, Laghu, Ruksha Guna, Ushna Virya and Katu Vipaka might have corrected Kapha Dushti and Medo Dhatu Dushti. Tikta Rasa and Sheeta Virya Dravyas might have corrected vitiation of Pitta. In this way preparation acted on Kapha-Pitta and Kapha Vargiya Dushya providing significant relief on various parameters. The alleviation of Kapha-Pitta leads to removal of obstruction to path of Vata and Tridosha Shamaka drug also alleviates Vata Dushti, thus cause normal functioning of Dhatus relieves the symptoms of Prameha.

In Akulyaabdadi Kashaya maximum drugs present in the formulation have a act as lekhaniya, Balya, Kaphahara & Medohara Deepaniya - Pachaniya, Rasayana and Pramehaghna property. Amalaki, Musta and Vibhitaki, Haritaki, Asana, Palasha and Shilajatu have Balya, Rasayana and Dhatuvardhaka property, thus helps in rejuvenation of the cells and rectifying the Khavaigunya in the Rogadhisthaana.

Amalaki, Hareetaki, Vibheetaki, Ambastha, Haridra and Patha present in the formulation is Tridoshahara and help in rectifying Dosha Dushti and thus helps in Samprapti Vighatana.

Akuli, Musta, Amlaki, Hareetaki, Vibheetaki, Haridra Daruharidra, Vata Udumbar, Plaksha, Agnimantha, Khadira, Asana and Samudraphena have Ruksha Guna thus is Kapha, Medohara helping in the Samprapti Vightana help in Kaphameda Harana and thus helps in removing Margavarana, thus helps in the Avaranaja variety.

Hareetaki, Vibheetaki, Haridra, Daruharidra, Patha, Kataka, Ambastha, Asana, Indradruma, Palasha and Madhu have Ushna Virya and thus helps in Vata Kaphaharana and reversal of Samprapti.

Daruharidra, Akuli, Abdha, Amlaki, Haritaki, Vibhitaki, Amlaki and Kataka have Chakshushya property. The complications of diabetes like retinopathy, if any present can be helped by the formulation.

Abdha, Haritaki, Samudraphena has a Lekhana property, thus helping in the Srotoshodhana and in turn helpful in Sthula patients.


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Pavitra M. The therapeutic effect of Akulyaabdadi Kashaya

Abdha, Amlaki, Haritaki, Kataka and Agnimantha have Nadibalya effect and thus useful when there is neuropathy as a complication of diabetes.

Vata, Arjuna, Asana, Madhu, Khadira, Asana, Plaksha, Parisha and Udumbara has Sheeta Virya and Dahahara property necessary to act on the neuropathy condition.

Akuli, Amlaki, Plaksha, Parisha and Asana acts as Stambhaka, Mutrasangrahani, and Shukrastambhaka. Thus, showing effect on Prabhoota Mutrata condition

Abda, Amlaki, Haritaki, Jambu, Samudraphena, Palasha and Madhu due to their Deepaniya and Pachaniya property help in removal of Ama Avastha and better function of Strotas.

Shilajatu is mentioned by many Acharyas in Parameha Chikitsa, it has Kaphashamaka Rasayana, Yogvahi, Strotoshodhak, Pramehahara, Vrushya, Chedana properties and reduces the blood sugar level efficiently.

Haridra has a Tridoshashamaka effect useful in all varieties of Prameha. Haridra also has a Mutrasangrahaniya quality. Haridra is considered to be the best Agrya Dravya in Prameha.

Overall effects of therapy: Total no. of patients was 30 out of which 08 (26.67%) shown mild improvement (25-49%) moderate improvement (50-74%). 7 (23.33%) shown marked improvement (>75% relief), 3 patients (10%) completely improved. 4 (13.33%) had some benefit but was less than 13%, so remained unchanged.

Stress is also an important etiological factor for Type-II Diabetes Mellitus. Stress blocks the body from releasing insulin in people with Type-II Diabetes Mellitus, so relieving stress is very much essential for effective control of blood sugar level. The ingredients present in the formulation Akulyaabdadi Kashaya are having different properties which may be helpful in minimizing the stress response. As Haritaki & Vibhitaki are anti stress they might have been decreased the stress directly. Rasayana effect of Haritaki, Amalaki, Asana, Plaksha, Musta, Shilajatu antioxidant properties of Amalaki, Haridra and immunomodulatory property of Amalaki, Haridra, Shilajatu etc. might have helped in minimizing the stress response and in the manner controlling the disease.

Akulyaabdadi Kashaya clears the Strotas’ enhances the Agni, thus helps in Pachana of Ama and increases insulin sensitivity. So, it can be said that Akulyaabdadi Kashaya plays significant role in reversal of the condition faster along with Pathya. Hence the hypothesis that Akulyaabdadi Kashaya is significantly effective in treatment of Madhumeha (Type-II Diabetes Mellitus) is accepted.

Conclusion

Madhumeha is a Santarpanjanya Vyadhi afflicting the Mutravaha and Udakavaha Srotas produced due to vitiation of Vata Pradhana Tridosha. Most of the patients were females, of 40-60 years’ age group, Hindus, married, housewives, had mixed diet, few of them had positive family history and chronicity of 1 to 5 years.

There is dominancy of Kapha among Doshas, Meda among Dooshyas. Most of the patients had, Prabhoota Mootrata, Avila Mutrarata, Kshudha, and Daurbalya among the many symptoms recorded. According to Nidana, both Dhatukshaya and Avarana varieties of Madhumeha were seen in this study. Most of the patients were Sthoola Parmehi. Formulations selected for the study were easy to prepare, and easily available. The effect of Akulyaabdadi Kashaya on individual parameters showed a better relief in Prabhoota Mootrata, Avila Mutrarata, and Daurbalya Karapadatala Suptata/Daha, FBS, FUS, PPBS and PPUS & in quality of life. The effect of drug showed a statistical significance in Prabhoota Mootrata, Avila Mutrata, Kara-Pada-Tala Suptata and Daurbalya and Swedadhikya parameter and no statistical significance in the rest of the parameter. None of the patients had any untoward effects during the treatment with given formulation. No complications were seen during the management. Taking in consideration, the results obtained during the study and discussion. It can be said that provided significant results in improving signs and symptoms. Hence it is proved to be an efficient antidiabetic drug.

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