A Randomized Controlled Trial to Study Efficacy of Amavata Pramathini Vati when given with Vaitaran Basti in the Management of Amavata

Bhairav B Tawshikar1* and Pratiksha Mohrir2

with Rheumatoid Arthritis. The prevalence of RA increases between 25-55yrs of age.

Doshas from the body and reduces the symptoms of Amavata.

Keywords: Amavata; Rheumatoid Arthritis; Amavata; Pramathini Vati; Vaitaran Basti

Introduction

Ayurveda is an ancient science. Ayurveda is not only about treating disease but also preventing its occurrence.

In Ayurveda classics, Acharyas have explained in detail the concepts of Dinacharya [1] and Ahar regimen. So many Ayurvedic medicines have been described in the Ayurvedic classical books for the treatment of Amavata. Amavata is a most common problem in the society in modern era [2]. According to Ayurveda, Ama is caused due to malfunctioning of the digestive and metabolic mechanism. The disease is initiated by the consumption of Viruddha Aharaand simultaneous indulgences in Viruddha Ahara in the pre- existence of Mandagni [3]. Vata is the chief functional operator of the all types of voluntary or involuntary movements of body. Vitiated Vata Dosha along with Ama is termed as Amavata. Derangement of the Kaphadosha, especially Shleshak Kapha occurs in the Amavata [4]. Amavata is such a disease of chronic joint pain and body ache, accompanied by swelling of some or all of the Synovial joints. Angamarda (Body pain), Aruchi (Loss of taste), Trishna (Thirst), Alasya (Lack of enthusiasm), Gaurav (heaviness), Klama (Tiredness without doing work), Apaka (Indigestion) and Jwar (fever). In the later stage pain may begin to migrate from place to place with a Vrishcika Danshavat vedana and burning sensation [5]. Amavata is not only a disorder of the loco motor system, but is also a systemic disease and named after its chief pathogenic constituents, which are Ama and Vata. Amavata is particular type of disease that is mentioned in Ayurveda since the period of Madhavkar, under the category of Vata- Kaphaja disorder. In Amavata Vata as a Dosha and Ama are chief pathogenic factor. They are exactly opposite in the properties so difficult to treat. It is the disease of Madhyam margag roga and having Chirkari Swabhava, sometimes it can also be manifested as the acute case [6].

Amavata can be correlated with Rheumatoid Arthritis. The sign and symptoms of both diseases are very similar [7]. Rheumatoid Arthritis is a chronic inflammatory disease characterized by progressive damage of Synovial joints and variable extra-Articular manifestations. Tendon and bursal involvement are frequent and often clinically dominant in early disease. RA can affect any joint, but it is usually found in metacarpophalangeal, proximal interphalangeal and metatarsophalangeal joints, as well as in the wrist and knee. Articular and Periarticular manifestation includes joint swelling and tenderness to palpation with morning stiffness and severe motion impairment in the involved joints [8].

Rheumatoid Arthritis clinically presents as polyarthritis involving small and large diarthrodial joints of the extremities usually in a symmetrical pattern [9]. The prevalence of RA is 0.5-1% in Indian population; Women affected three times more than men. The prevalence of RA increases between 25-55 yrs of age, after which it plateaus until the age of 75 and then decreases [10]. In Amavata mainly joints of Hasta (hand), Pada (foot), shira (head and neck), Gulpha (ankle) are affected. Initially Amavata starts from small joints of hands and spread.

The current available medical interventions cannot satisfy the objectives of an ideal therapy. The available pain relieving agents are associated with substantial risk of gastrointestinal ulceration and bleeding. So safety and efficacy of treatment is the need of hour. Hence present study is taken to find out efficacy of Amavata Pramathini Vati in the Amavata patients.

Aims and Objectives

To study the efficacy of Amavata Pramathini Vati when given with Vaitaran Bast.

Materials Used

In the present study following drugs were utilized.

Method of Preparation

Kalmishora, Arkamula, Shuddha Gandhaka, Lohabhasma and Abhrakbhasma are mixed with equal quantity in an iron vessel. Then add Amalatas Patra Swarasa with above mixture to make pills of 2 ratti.

Observation and Results (Tables 2-8)

Discussion

Chakradatta was first to describe in the treatment for Amavata. He gave Langhana, Swedana, Deepana, Virechana, Snehapana, and Basti as treatment module for Amavata [11]. Ama is the chief causative factor in Amavata, so treatment of Ama should be done first. In the line of treatment of Amavata, Basti chikitsa especially Vaitaran Basti is considered as the chief treatment regimen for Amavata [12]. According to Ayurveda, Ama is caused due to malfunctioning of the digestive and metabolic mechanism. The disease is initiated by the consumption of Viruddha Aharaand simultaneous indulgences in Viruddha Ahara in the pre-existence of Mandagni.

Vata is the chief functional operator of the all types of voluntary or involuntary movements of body. Vitiated Vata Dosha along with Ama is termed as Amavata. The Vaitaran Basti has been mentioned by Chakradatta. Ingredients of Vaitaran Basti Guda, Saindhava, Amlika, Gomutra and Tila Taila in the proportion of 2:1:4:16. As a whole the qualities of Vaitaran Basti can be considered as Laghu, Ruksha, Ushna, and Tikshna. Majority of the drugs have Vata Kapha shamak action. It breaks the obstructions expels out the morbid material from all over the body [13].

Amavata Pramathini Vati 500mg twice a day with Luke warm water was given to patient. Amavata Pramathini Vati contains Kalmishora, Arkamula, Shuddha Gandhak, Lohabhasma and Abhrakbhasma. Majority drugs of Amavata Pramathini Vati have Deepan, shothaghna, shoolaghna, Balya, Amavatari. It increases the Agnibala, alleviates the Ama and prevents the further Ama formation into the body. It helps in breaking the Samprapti of Amavata [14, 15].

Conclusion

It can be concluded that the combined effect of Vaitaran Basti and Amavata Pramathini Vati is the choice of drugs for the management of Amavata. But this is a single case study hence to prove its efficacy there is needed to conduct a study on large number of patient.