E-ISSN:2456-3110

Research Article

Mutra Ashmari (Urolithiasis)

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 6 JUNE
Publisherwww.maharshicharaka.in

Etiopathological study of Mutra Ashmari and evaluation of efficacy of Shwadranshtadi Kwath in the management of Mutra Ashmari (Urolithiasis)

Jhariya M1, Singh R2, Vishwakarma N3*
DOI:10.21760/jaims.10.6.9

1 Monica Jhariya, Post Graduate Scholar, Department of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

2 Rita Singh, Reader and Head of Department, Department of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

3* Nidhi Vishwakarma, Post Graduate Scholar, Department of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

Calculus formation in human body is very common in all ethnic groups around the world, which depends upon the geographical location and nature of dietetics. The most common site of calculus formation is gall bladder and kidney. In Ayurvedic classics clear and broad description of Mutrashmari is available under the umbrella of Mutravaha Srotas which means the presence of stone in urinary system i.e. Kidney, Ureter, Urinary Bladder, and Urethra. In this study, 40 patients who were having the signs, symptoms of Mutrashamri (urolithiasis) were registered from Pt. Khushilal Sharma Government Autonomous Ayurveda College and Institute, Bhopal, and randomly selected patients were kept in a group i.e. "Clinical Trial Group". The patients were adviced for Shwadranshtadi Kwath in the dose of 30 ml with equal quantity of lukewarm water twice a day along with Nidana Parivarjan for duration of 90 days. Patients were advice to follow the dietetics as described in Ayurvedic classics.

Keywords: Calculus, Mutrashmari, Mutravaha Srotas, Shwadranshtadi Kwath

Corresponding Author How to Cite this Article To Browse
Nidhi Vishwakarma, Post Graduate Scholar, Department of Rog Nidan Evum Vikriti Vigyan, Pt Khushilal Sharma Government (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.
Email: 		Jhariya M, Singh R, Vishwakarma N, Etiopathological study of Mutra Ashmari and evaluation of efficacy of Shwadranshtadi Kwath in the management of Mutra Ashmari (Urolithiasis). J Ayu Int Med Sci. 2025;10(6):59-62.
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https://jaims.in/jaims/article/view/4801/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-05-07 2025-05-27 2025-06-05 2025-06-17 2025-06-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.36

© 2025 by Jhariya M, Singh R, Vishwakarma N and 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 2025;10(6)59
Download PDFBack To ArticleIntroductionMaterials and MethodsObservation and ResultsDiscussionConclusionReferences
Monica J et al. Efficacy of Shwadranshtadi Kwath in Mutra Ashmari (Urolithiasis)

Introduction

Renal stone disease is common, affecting individuals of all countries and ethnic groups. In UK, the prevalence is about 1.2%, with a lifetime risk of developing of a renal stone at age 60-70 of about 7% in men. In some regions, the risk is higher, most notably in countries like Saudi Arabia, where the life time risk of developing a renal stone in men aged 60-70 is just over 20%.[1]

In ayurveda, the term Mutrashmari resembles with the disease Urolithiasis as described in modern medical science. It is characterized by Nabhi Basti Sevni Mahti Vedana (Pain in inguinal region), Ayasat Atiruk (Pain increase with jerks), Mutra Daha (Burning micturition), Mutrakrichha (Dysuria), Muhu Mehta (Increased frequency of micturition), Visheernadhara or Mutra Vikiran (Bifurcated stream of urine), Mutra Dhara Sanga (Interrupted stream of urine), Avil Mutrata, Gomed Prakasham (Turbid urination), Sarudhir Mutrata (Haematuria). Scientific description of Ashmari is available in Sushruta Samhita. The treatment of Ashmari is very difficult that is why it is called as Yama and it is considered as one of the Mahagada by Sushruta owing to its potentiality to disturb the urinary system as well as life of a person. The scientific description of its etiology, classification, symptomatology, pathology, complications along with its management are available in Sushruta Samhita.[2]

In modern medical science, only surgery is only curative treatment of choice for Mutrashmari (Urolithiasis). In Ayurveda, drug having the properties of Kapha Vata Shamak, Mutral, Ashmari Bhedak are helpful in its management. In the context of Ashmari Chikitsa, Shwadranshtadi Kwath (B. R. 36/30) is herbal formulation described in Bhaishajya Ratnavali, which is a popular book of Ayurvedic formulations. It contains Shwadranshta {Gokshura (Tribulus terrestris)}, Erand Patra (Ricinus communis), Nagar (Zingiber officinale) and Varuna Twak (Crataeva religiosa).

In the view of above, present study "Etiopathological study of Mutrashmari and evaluation of efficacy of Shwadranshtadi Kwath in the management of Mutrashmari (Urolithiasis)" was planned with aim "To study the etiopathology of Mutrashmari" and "To evaluate the efficacy of Shwadranshtadi Kwath in the management of Mutrashmari".

Materials and Methods

In this study, 40 patients were having the signs, symptoms of Mutrashamri (urolithiasis) were registered from Pt. Khushilal Sharma Government Autonomous Ayurveda College and Institute, Bhopal, and randomly selected patients were kept in a group i.e. "Clinical Trial Group". The patients were adviced for Shwadranshtadi Kwath in dose of 30 ml with equal quantity of lukewarm water twice a day along with Nidana Parivarjan for duration of 90 days. Patients were adviced to follow dietetics as described in Ayurvedic classics. The Consent of patients was taken in prescribed consent format, designed by Institutional Ethics Committee (IEC) before starting therapy. The etiological study was carried in a special designed proforma incorporating various Nidana (etiological factors) described in Ayurvedic classics, dietetics and life style habits etc.

Drug Intervention

Shwadranshtadi Kwath (Bhaishajya Ratnavali Ashmari Chikitsa 36/30) has been used for management of the Mutrashmari.

Principle: Kwath Kalpana[3]

Ingredients of Shwadranshtadi Kwath are given below:
1. Shwadranshta {Gokshura (Tribulus terrestris) - 1part
2. Erand Patra (Ricinus communis) - 1 part
3. Nagar (Zingiber officinale) - 1 part
4. Varun Twak (Crataeva religiosa) - 1 part

Study Design

RegimenShwadranshtadi Kwath
Dose30 ml twice daily with equal quantity of Luke warm water
Time of administrationMorning & Evening
Duration of therapy03 Months
Follow-upEvery Month

Criteria for Diagnosis

Following diagnostic criteria were used for the diagnosis of patients.

1. Signs and symptoms of Mutrashmari (urolithiasis) as described in Ayurvedic classic as well as modern medical science viz.

  • Nabhi Basti Sevni Mahti Vedana (Pain in inguinal region)
  • Ayasat Atiruk (Pain increase with jerks)

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Monica J et al. Efficacy of Shwadranshtadi Kwath in Mutra Ashmari (Urolithiasis)

  • Mutra Daha (Burning micturition)
  • Mutrakrichha (Dysuria)
  • Muhu Mehta (Increased frequency of micturition)
  • Visheerna Dhara or Mutra Vikiran (Bifurcated stream of urine)
  • Mutra Dhara Sanga (Interrupted stream of urine)
  • Avil Mutrata Gomed Prakasham (Turbid urination)
  • Sarudhir Mutrata (Haematuria).

2. Ultra Sono Graphy (USG) – KUB Blood Urea
3. Serum Creatinine
4. Urine Routine & Microscopic

Criteria for Assessment

Grading Pattern for Cardinal Symptoms

Table 1: Vedana (Pain)

CriteriaGrade
No pain0
Mild Pain1
Moderate on movement2
Severe on movement3
Mild on rest4
Moderate on rest5
Severe on rest6

Table 2: Mutradaha (Burning Micturition)

CriteriaGrade
No Burning micturition0
Occasional Burning micturition do not require medication1
Occasional Burning micturition but require medication2
Severe constant Burning micturition but do not show relief even after medication3

Table 3: Mutra Krichha (Dysuria)

CriteriaGrade
No dysuria0
Occasional dysuria1
Occasional dysuria which requires medication2
Constant dysuria which requires medication3
Severe constant dysuria but do not show relief even after medication4

Table 4: Sparsh Asehyta (Tenderness)

CriteriaGrade
No tenderness0
Mild tenderness1
Moderate tenderness2
Severe tenderness3

Table 5: Stone Size

CriteriaGrade
0mm0
0.1-4mm1
4.1-7mm2
7.1-10mm3

Statistical Analysis

Statistical analysis was carried out using Wilcoxon test.

Observation and Results

Table 6: Effect of Therapy on Vedana (Pain)

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
3.3421.2112.13263.790.87520.1420W=741
P<0.0001

Table 7: Effect of Therapy on Mutra Daha (Burning Micturition)

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
1.2630.42110.842166.670.63780.1035W=378
P<0.0001

Table 8: Effect of Therapy on Mutra Krichha (Dysuria)

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
2.7371.2111.52655.750.55690.09034W=741
P<0.0001

Table 9: Effect of Therapy on Sparsha Asehyta (Tenderness)

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
2.3680.86841.50063.340.60400.09799W=666
P<0.0001

Table 10: Effect of Therapy on Stone Size

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
2.3681.1051.26353.330.64450.1045W=595
P<0.0001

Table 11: Effect of Therapy on Serum Creatinine

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
1.0590.92370.1355-0.13700.02223W=300
P<0.0001

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Monica J et al. Efficacy of Shwadranshtadi Kwath in Mutra Ashmari (Urolithiasis)

Table 12: Effect of Therapy on Blood Urea

MeanMDPercentage ReliefSDSEWilcoxon test and P value
BTAT
14.08713.3610.7259-2.5800.4186W=190
P<0.0001

Table 13: Effect of Therapy on Cardinal Symptoms

SymptomsPercentage
Vedana (Pain)63.79
Mutra Daha (Burning Sensation)66.67
Mutra Krichha (Dysuria)55.75
Sparsh Ashetya53.33

Table 14: Effect of Therapy on Stone Size

Stone sizePercentage relief
Stone size53.33

Table 15: Overall Effect of Therapy

ResultNo. of patientsPercentage of patients
No improvement (<25%)00
Mild Improvement (25-<50%)923.68
Moderate Improvement (50-<75%)2873.68
Marked Improvement (75-99%)12.63
Complete remission (100%)00

Discussion

Calculus formation in human body is very common in all ethnic groups around the world, which depends upon the geographical location and nature of dietetics. The most common site of calculus formation is gall bladder and kidney. The occurrence of kidney stone, which is very common and dependence on geographic locations, it varied greatly between ranging from 8% to 19% in males and from 3% to 5% in females in Western countries.

The etiology of Mutrashmari (Urolithiasis) is very much clear in Ayurvedic as well modern science literature. Poor dietary habits of a person can lead to the stone formation. All the above data indicates that all the patients of Ashmari were having faulty dietary patterns, inappropriate combination of different types of diet i.e., Vairodhika Ahara along with consumption of other etiological factors, which are responsible for formation of stone. Vitiate Kapha and Vata Dosha considered as chief etiological factors in the pathogenesis of Mutrashmari and results in emersion of Mutrashmari (Urolothiasis).

Conclusion

The results of this clinical study prove that Shwadranshtadi Kwath, an herbal compound is effective for the treatment of Mutrashmari. The effect of therapy was good and it is further suggested to the new researchers to study on Mutrashmari (Urolithiasis) in large sample size with some other herbal formulation along with Shwadranshtadi Kwath for better result and complete removal of the disease in short duration.

References

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