A randomised controlled clinical study to evaluate the role of Nirvapana Upakrama with Durva ointment in the management of Pittaja Dushta Vrana with special reference to fissure-in-ano

Abstract

Introduction: Fissure-in-ano is an ulcer in the longitudinal axis of lower anal canal. It is having prevalence of about 17.91%. By seeing the signs and symptoms we can consider it as one among the six varieties of Dushta Vrana i.e., Pittaja Dustavrana. Due to busy life schedules people don’t prefer hospitalization and other operative procedures. So, there is a need to find out a new and simpler medicament which enables easy and better storage, preservation and mode of application. Here an attempt was made to study the effect of Nirvapana Upakrama in the management of fissure in ano is taken. This Upakrama is used for the treatment of Vrana accompanied with Daha, Paka, Jwara and having Pitta Kopa and Raktena Abhibhuta. Since fissure is having the similar symptoms this treatment can be adopted for the management of the same. Methodology: A randomized controlled clinical study was conducted over 30 subjects in two groups.  Fifteen subjects were advised to apply Diltiazem gel and 15 subjects were advised to apply Durva ointment twice daily for a period of 14 days. Results: Rapid reduction in pain, burning sensation and length of ulcer was observed in the subjects who were given Durva ointment. Discussion: Durva ointment having Madura Rasa, Snigdha Guna and Sheeta Virya does Vatapitta Shamana and pacifies vitiated Rakta. Kashaya rasa of Durva does Vrana Ropana and Rakta Sthambana which amplifies in ulcer healing and relaxation of the sphincter.