Efficacy of Panchatikta Ksheera Basti in Asthisoushirya (Osteoporosis)

Introduction

Osteoporosis is defined as reduced bone mass per unit volume with a normal mineral to matrix ratio. While going through Ayurvedic classics, clinical features of Osteoporosis can be co-related, with vata dosh vriddhi and asthi majja dhatu kshaya. Vitiated vata when enters Asthi majja dhatu, the bone become poros and the disease is presented in the form of body ache, joint stiffness and insomnia [1]. Vitiation of Vata in the elderly is due to Dhatukshaya. In dhatukshayjanya vataprakopa, vata is vitiated with its ruksha property observed by hollowing bone [2]. According to Charaka, Asthisoushirya dealing with asthi majja dhatu kshaya can be corrected with Tiktarasa, kshir, Sneha and Panchakarma specially Basti [3].

Hence present clinical study was designed on the principal of Charaka and Vagbhata to see the efficacy of Panchatikta Ksheera Basti in Asthisoushriya i.e Asthi majja dhatu kshaya. 30 patients were treated with Panchatikta Ksheera Basti. Panchatikta Ksheera Basti was given daily for 30days after meal in the morning. All the ingredients of Panchatikta shir were obtained from the open market and duly verified by morphological identification and pharmacochemical analysis. Various parameters like pain, stiffness, tenderness, Doshalakshanas, Dhatukshaya lakshans were studied for evaluation of the therapy and the results were statistically analyzed. From overall view of study it was observed that Panchatikta Ksheera Basti gives satisfactory results in the symptoms of asthi majja dhatu kshaya.

Aims and Objectives

To evaluate efficacy of Panchatikta Ksheera Basti in Asthisoushirya (osteporosis).

Materials and Methods

30 patients were selected from OPD/ IPD of shalya tantra department of government ayurved college Nagpur. The selected patients were examined thoroughly as per case paper specially designed for study. Necessary investigations were carried out.

• Criteria for selection of Patients Patients having symptoms of Asthi majja dhatu kshaya like Asthibheda, Manskshaya, Parvabheda, Balakshaya were selected.
• Criteria for Rejection of Patients Patients having Lordosis, Prolapsed intervertebral disc osteomylitis, Tuberculosis of spine were rejected.

Plan of Work

• Diagnosed 30 Patients were treated with Panchatikta Ksheera Basti
• P Panchatikta Ksheera was prepared by kshirpaka method mentioned in Sharangdhar Samhita [4].
• Panchatikta Ksheera Basti contains Guduchi, Patola, Vasa, Nimba, Kantakari churna, Kshir, Ghrit.
• Dose - 120ml
• Route of Administration- Anal Route
• Duration - 30 days
• Time - After meal in Morning once in a day

Observations and Results

The main criteria of assessment in this study were based on the symptom score before and after treatment. Results were observed on Pain, Pain on extension and flexion, stiffness, tenderness, Nature of pain, dosha, dushya lakshanas. Relief in the symptoms score was calculated with the help of percentage method. This showed reduction in symptom score by treatment with Panchatikta Ksheera Basti. The effect of therapy was evaluated with the help of score system. Hence non parametric test was also used. The Difference between before and after treatment was ranked and difference was statistically analyzed with the help of wilcoxon signed ranked test and it showed significant result (Tables 1-3).

Discussion

Athisoushirya is one of the vataj and asthi majja shirt vyadhi. Acharya, charaka has stated the asthyashrit vyadhi treatment as panchakarma, tikta draya and kshir, ghrit [5]. So we choose panchatikta shir for basti. According to charaka sneha basti reaches upto grahni and gets absorbed [3]. Grahani is said to be pittadhara kala and pittadharakala is majjadhara kala [6]. Hence sneha basti results in asthi- majja dhatu vriddhi. The Ashraya ashrai bhava between vata and asthi explains the action of basti on Asthisoushirya [7]. Vitiated vata causes asthikshaya. Hence treatment of vata causes asthi vriddhi. Tikta rasa is ruksha, khara, vishada, which produces shoshan of dhatus and kharatwa in strotasas [8]. This property helps to provide kharatwa to medodhatu for production of asthi and majjadhatu. Tiktarasa is vayu and akash mahabhuta pradhan hence can reach the same vayu and akash mahabhuta pradhan asthi dhatu [9]. Individual drug properties of panchatikta kshir are as follows:

• Guduchi is vayasthapana, rasayana, balya agnidipana and tridoshghna [10].
• Patola is ruchikar, dipana, kaphapittaghna [11].
• Vasa are shosh-har, kaphapittaghna [12].
• Nimba is dipana, vatakaphaghna [13].
• Kantakari is dipana, pachana, kaphavatahar, shothhar, angamardaprashamana [14].
• Kshir is jivniya, rasayaniya, sarvarognashana [15]. It is rich source of calcium and is a complete food.

From the drug view, it was observed that panchatikta shir contain the drugs having more percentage of tikta rasa followed by katu and kashaya rasa. These all are ruksh khara & vishad guna pradhan. These all properties contribute in samprapti bhedana of Asthisoushirya [16, 17].

Conclusion

All the symptoms of asthi majja dhatu kshaya reduced by treating with basti of kshir and tikta dravya. Hence conclusion can be drawn as Panchatikta Shir Basti is effective in Asthisoushirya dealing with asthi majja dhatu kshaya.