Beta Fulltext view is in preview — article structure may vary. Browse all articles
Contents
Journal of Natural & Ayurvedic Medicine Research Article 6 min read

An Ayurvedic Approach in Management of Vatarakta

Mishra P*, Sanwal S, Gupta H, Singh H, Mukeriya PK, and Anand N
* Corresponding author
ISSN: 2578-4986  10.23880/jonam-16000382  Received: February 16, 2023  Published: March 13, 2023
 — views
 16 references
 1 figure
 9 tables
PDF
Keywords
Vatarakta Santarpana Janya Vyadhi Avarana Vatavyadhi
Abstract

In present era Vatarakta is a common metabolic disorder which disturbs day-today life of the patients. It is a Santarpana- Janya Vyadhi, caused due to Avarana pathology. Compared with the other Vatavyadhi, Vata-rakta possesses a special place in the literature, due to its high prevalence (0.2 to 3.5 per 1000, with an overall prevalence of 2 to 26 per 1000) in the society, increased incidence as age advances, step-wise succession, and so on. It is correlated with gout in modern science due to similarities of symptoms between them. Incidence of Vatarakta is increasing Day by day. It is creating a lot of concern all over the world as it is causing serious complications with disabilities to human. Considering this fact, it was decided to do write an article on Vatarakta. All the material related to article has been collected from classical Ayurvedic texts and various published research article on Vatarakta. The purpose of this study was to investigate the understanding of Vatarakta with its treatment protocol and to compile the results of various Vatarakta-related studies.

Introduction

Vatarakta is a Vata pradhana Tridoshaja Vyadhi where Rakta is main Dushya [1, 2]. It is caused by vitiation of Vata and Rakta. Aggravated Vata blocked by vitiated Rakta, in turn leading to further aggravation of Vata. Thus aggravated Vata vitiates the Rakta leading to condition Vatarakta [3].

Acharya Charaka and Vagbhatta_assign a separate chapter to this disease and mentioned two types of _Vatarakta as Uttana (_superficial form) and _Gambhira (joints involved) while Sushruta described this condition under Vatavyadhi with eight types according to Dosha and said that Uttana and Gambhira are stages of it [4].

In modern science it is interrelated with Gouty arthritis due to similarities of symptoms between them. Gout is an atypical purine metabolic disorder which causes hyperuricemia and deposition of monosodium urate crystals in joint [5]. The effectiveness of different treatment protocols mentioned for Vatarakta such as Raktamokshana, Virechana and Basti Karma, in addition the Shamana, Rasayana Dravyas along with external applications like Lepa, Upanaha, Parisheka, Abhyanga showed evidence in numerous former studies. The description of Vatarakta is found in Brihattrayi

and other classical textbooks. Charaka and Sushruta Samhita describe its aetiology, epidemiology, types and sites of manifestation, clinical features, prognosis, and management in detail (Tables 1-5).

Nidana

Sr. No.Aetiological factorsCh.Su.A.S.A.H.
1Aaharaj Nidana
Ati Amla Rasa++
Ati Lavana, Katu, Tikta, KashayaRasa.+
Ati Kshara Sevana++
Snigdha+
Ushna++
Ruksha++
a.Vidahi Anna (Irritable foods)
Shaaka (greenvegetables)++
Klinna Mamsa, Shushka Mamsa, Ambuja Mamsa+
Anoop Deshiya Mamsa, Ikshu+
Vidahi Anna+++
b.Vidahi Pana (irritable drinks)
Arnala, Sourviraka , Shukta, Sura (wine)+
Aasava / Madyapan++
Dadhi, Takra+
c.Faulty dietary habits
Adhyashana, Ajeerna.+
Virudhashana (incompatible food intake)++
Alpashana, Langhana+
Mithya Aahara Vihara+++
Mishthana Bhojana+
2Viharaj Nidana
Diwaswapanama++
Ratri Jagrana++
Achakramana Sheela (sedentary habits)++
Ambukrida (Water games), Ambuplavan.+
Ativyayama (doingexcessive exercise)++
3Vegavidharana
Mala, Mutra,+
Avyavaya (abstinence)+++
Ativyavaya (excessive sexual indulgence)++
4Hasti, Ushtra, AshwaRiding++
5Kalaja Nidana
Ritu Satmya Viparayaya+
6Mansika Nidana
Ati Krodha (excessive anger)+
Shoka (grief)+
7Agantuja Nidana
Abhighata (Traumatic injury)++
8Prakirana Nidana (Miscellaneous Factors)
Sukumara+++
Stholya+
Ashodhana++
Sneha Vibhrama++
Rakta Prakopaka Nidana+++
Vata Prakopaka Nidana+
Sheetal Hetu+

Table 1: _Samprapti_ _Ghataka_.

(Ch.Ch. 29/5-7, Su. Ni.1/40-42, A.S.Ni. 16/3,4, A.H.Ni. 16/-3) Table1: Showing Nidana of Vatarakta.

Samprapti [6]

Figure 1
Click to enlarge
Figure 1

Samprapti Ghataka

DoshaVata Pradhan Tridosha-Janya Vyadhi
DushyaRakta, Twak, Mamsa
AgniMandagni
Udhbhava-SthanaPakvashya
Sanchara-SthanaSarava Sharira
Vyakta SthanaSandhi(Visheshata Kara Pada Sandhi)
SrotasRaktavaha, Asthivaha, Majjavaha
Srotodushthi PrakaraSanga,Vimargagaman
RogamargaMadhyam

Table 4: _Samprapti_ _Ghataka_.

Poorva-Roopa

Poorva-RoopaC.SS.sA.sA.h
Asveda++++
Alasya+---
Atisweda+-++
Seveda-+--
Ksatae ati ruk++---
Sandhi shaithilya++++
Nistoda/toda++++
Spurana+-++
Karshnyata/vaivarnyta++--
Sadana+-++
Supti++++
Guruta++++

Table 2: Poorva-Roopa of Vatarakta.

(Ch.Ch. 29/16-17, Su. Ni.1/47, A.S.Ni. 16/4, A.H.Ni. 16/5-6) Table 3: Poorva-Roopa of Vatarakta.

Roopa

RoopaC.SS.sA.sA.h
Kandu+-++
Daha+-++
Ruja+---
Ayama+-++
Toda+-++
Spurana+-++
Kunchana+---
Shyava twaka+-++
Rakta twaka+-++
Bheda--++
Gourava--++
Suptata--++

Table 3: _Uttana Vatrakta._

(Ch.Ch. 29/20, Su. Ni.1, A.S.Ni. 16/6, A.H.Ni. 16/-9) Table 4: Uttana Vatrakta.

Gambira Vatrakta

RoopaC.sS.sA.sA.h
Svathu stabdhata+---
Svathu Kathinya+---
Brusharti+---
Shyavatha+--
Tamra twaka+---
Daha+---
Todha+-++
Spurana+---
Paka+---
Ruja+---
Vidhaha+-++
Kanajtwa+-++
Pangutwa+-++
Svayathu grathitha--++
Angasya vakrikarana+-++
Vatasy sandyasthimajjasu chindanniva charanam+---

Table 5: Gambira Vatrakta.

(Ch.Ch. 29/21, Su. Ni.1, A.S.Ni. 16/7, A.H.Ni. 16/10-11) Table 5: Gambira Vatrakta.

Chikitsa

The term Chikitsa is derived from the root “KIT ROGAAPNAYANE” [7] i.e., to adopt measures against the disease. The line of treatment has to be planned according to aetiopathogenesis, symptomatology and other aspect of the disease so that no complications can arise [8].

In the treatment of Vatarakta, both Samsodhana

Previous Researches Work

and Samsamana Chikitsa are mentioned. Vitiated Dosha is evacuated from the body using Samsodhana C_hikitsa_ (Raktamokshana, Virechana, and Basti Karma), and then Samsamana Chikitsa is given to the patients to maintain homeostasis, thereby alleviating the signs and symptoms of Vatarakta [9]. Many Herbomineralformulation are mentioned in the classical Ayurvedic Texts to alleviate the signs and symptoms of Vatarakta.

ProcedureNo.of patient
1Guduchi Siddha Yoga Basti [9,10] (Sa-Ghrita Guduchi Ksheera Siddha Niruha) (Guduchi Siddha Taila Anuvasana)No. of Patients 20 Niruha 50 gm- Guduchi Ksheera paka- Guduchi Kwath Choorna +400 ml milk=1600ml water = Ksheera avashesha (400ml), Madhu, Saindhav, Shatpuspha and Total duration -24 days Madanphala Kalka
2Jalouka-Avcharana [9,11]No. of patient 10 3 times at interval of 1 week
3Siravyadha [9,10]No. of patient 20 Siravyadha twice a day with an interval of 11 days
4Ardhamatrika Basti [3]No. of patient 50
5Virechana [3] (Nimbamritadi Eranda Thailam)No. of patient 50

Table 6: Showing Previous researches work done on various Panchkarma procedures.

SymptomGuduchi Siddha
Yoga Basti11
(in %)		Jalouka-
Avcharana12
(in %)		Siravyadha11
(in %)		ArdhamaTrika
Basti13 (in %)		Virechana13
(Nimbamritadi-Eranda
Thailam (in %)
Sandhi Shool9560.89599.8548.97
Sandhi Shotha2561.56573.3372.09
Sparsh -Asahtva75-7590.172.15
Twak Vavarnya---86.4467.18
Raag(Erythema)9565.3875--
Vidaha8566.685--
Effect On Serum
Uric Acid		21.4 reduction4.4 Reduction13.33
reduction		43 reduction32.83 reduction

Table 7: Showing % result of _Panchkarma_ procedure.

No. of patients
Bodhivruksha Kashaya [12]Total no. of pt. 10
Bodhivruksha Kashaya [12]Trial 45 days
Guduchi Kwath [12]Total no of pt. 10
Guduchi Kwath [12]Total trial 45 days
Trikarshika Kwath [13]Total no. of pt 30
Trikarshika Kwath [13]Total trial 45 days
Punarnava Amrita Guggulu [14]Total no. of pt. 10
Punarnava Amrita Guggulu [14]500mg thrice each day with Anupaanas of Amritadi Kashaya
Amrita Guggulu [15]Total no of pt. 30
Amrita Guggulu [15]500 mg thrice each day
Amrita Guggulu With Amrita Kashaya [15]Total no of pt. 30
(Amrita Guggulu Contain Punarnava + Chitraka)500 mg thrice each day with Anupaanas of Amritadi Kashaya 72 ml
Patoladi Kwath [1]Total no of pt. 25
Patoladi Kwath [1]Trial 90 days
Patoladi Kwath [1]40 ml Kwath twice each day
Combination of Kaishore Guggulu with Punarnavadi Guggulu [16]No of pt 32
Combination of Kaishore Guggulu with Punarnavadi Guggulu [16]2 tabs {500mg} twice each day
Combination of Kaishore Guggulu with Punarnavadi Guggulu [16]Total trial 42 days

Table 8: Showing various Shamana yogas in previous researches work.

SymptomsBodhi
vruksha
Kashaya14
(in %)		Guduchi
kwath14
(in %)		Trikarshik
kwath15
(in %)		Punarnava
Amrita
guggulu16
(in %)		Amrita
guggulu17
(in %)		Amrita guggulu
with amrita
Kashaya17 (in %)		Patoladi
kwath18 (in %)		Combination of
Kaishore guggulu
with Punarnavadi
guggulu19 (in %)
Sandhi Shool858046.5665.1166.7565.1168.9680
Sandhi Shotha86.6681.2540.0187.585.7187.579.587
Sparsh
-Asahtva		77.7766.6634.6291.4878.3591.4870.281
Twak Vavarnya8558.33-43.4738.8843.4729.94-
Raag
(Erythema)		84.618031.4355.5588.7555.5579.584
Vidaha82.3378.5735.787.563.6687.573.8576
Effect on
serum uric
acid		39.04
reduction		23.93
reduction		42.57
reduction		43.43
reduction		38.09
reduction		43.43 reduction20.76
reduction		17 reduction

Table 9: Showing % result of various Shamana yogas in previous researches work.

Discussion

Vatarakta is a more upsetting and painful disease that is commonly found in the modern era. Intense pain is a major symptom of Vatarakta, interfering with the affected patient’s daily lives. The Shodhana and Shamana Chikitsa is not only an essential component of Ayurvedic treatment, but it also serves as the ultimate foundation of Ayurvedic treatment. Previous Shodhana therapy research has revealed Ardhamatrika Basti has a highly significant result in Sandhi Shoola, Twak Vavarnya and Effect on serum uric acid , with values of approximately 99.85%, 86.44% and 43% (reduction) respectively, Guduchi Siddha Yoga Basti has a 95% success rate in Sandhi shoola and Raga and an 85% success rate in Vidaha, Siravyadha has a significant improvement in Sandhi Shoola of approximately 95% and in Vidaha of approximately 85%, Jaluka Avcharana has a significant improvement in Vidaha of approximately 66% and Virechana (Nimbamritadi Eranda Thailam) has a significant improvement in Sandhi Shotha and Sparsh -Asahtva of approximately 72%.

In the Shamana Chikitsha Bodhivruksha Kashaya showed maximum effect in Sandhi Sotha about 86.66% , Guduchi Kwath showed maximum effect in Sandhi Sotha about 81.25%, Trikarshik kwath showed maximum effect in Sandhi Soola about 46.56%, Punarnava Amrita Guggulu showed maximum effect in Sparsh -Asahtva about 91.48%, Amrita guggulu showed maximum effect in Raag (erythema) about 88.75%, Amrita Guggulu with Amrita Kashaya showed maximum effect in Sparsh - Asahtva about 91.48%, Patoladi Kwath showed maximum effect in Sandhi Sotha and Raag (erythema) about 79.50%, Combination of Kaishore Guggulu with Punarnavadi Guggulu showed maximum effect in Sandhi Sotha about 87%. Punarnava Amrita Guggulu and Amrita Guggulu with Amrita Kashaya showed maximum reduction (43.43%) on serum uric acid.

Conclusion

Due to the desk-bound regime, Vatarakta is one of the common illnesses in modern medical practise. Therefore, it is imperative to investigate the function and uses of Ayurvedic medicines in Vatarakta. After reviewing various previous research studies on Vatarakta management, it was discovered that, Ardhamatrika Basti, Siravyadha, Guduchi Siddha Yoga Basti and Jaluka Avcharana as Shodhana therapy and Punarnava-Amrita Guggulu, Guduchi Kwath, Amrita guggulu, Combination of Kaishore guggulu with Punarnavadi guggulu, Amrita Guggulu with amrita Kashaya as Shamana _Chikitsha_showed significant improvement.

However, Ardhamatrika Basti, Guduchi Siddha Yoga Basti, Kaishore guggulu combined with Punarnavadi guggulu, and Bodhivruksha Kashaya are more effective in improving the signs and symptoms of Vatarakta.

References

  1. Gupta D, Sachdev K, Garg R (2019) A Clinical Study to Evaluate the Efficacy of Patoladi Kwath with or without Rasnadi Pradeh in cases of Vatarakta (W.S.R. to Gouty Arthritis). Journal of Drug Delivery & Therapeutics 9(2S): 98-110.
  2. Rana V, Mishra A, Mehra BL (2017) Effect of Punarnava- amrita Guggulu with Amritadi Kwath in The Management of Vatarakta W.S.R. To Gout-a clinical trial. World Journal of Pharmaceutical Research 6(8): 1149.
  3. Prashanth AS (2019) A Pre-Test and Post-Test Design to Assess the Efficacy of Virechana and Ardhamatrika Basti in Gouty Arthritis W .S. R To Vatarakta. Ayushdhara 6(2): 2120-2127.
  4. Sushruta (2010) Sushruta Samhita (Ayurveda tatva Sandipika Hindi Vyakhya) Vol 1. Shastri KA (eds.) 1st (edn.) Chikitsha sthana Mathavatavyadhi 5/3, Chowkhamba Sanskrit Sansthana Varanasi, pp: 37.
  5. Bhavar V, Kumari J, Trivedi AB (2022) Comparative Study to Evaluate Role of Bodhi Vriksha Kashaya and Guduchi Kashaya in Vatarakta ~ Hyperuricemia. World Journal of Pharmaceutical Research 11(8): 996-1005.
  6. Charaka (2009) Charaka Samhita (Vidyotini Hindi Commentary). Shastri R, et al. (eds.) 1st (edn.) Chikitsa Sthana, 29/10-13. Chaukhamba Bharti Academy, Varanasi, pp: 820-821.
  7. Raksha Pathak KR (2002) Kaya Chikitsha Vol 1. Chaukhamba Bharti Academy, Varanasi 1(1): 5.
  8. Pathak P, Tegta N, Jagota A, Shukla U, Gupta R et al. (2020) An ayurvedic perspective of Vatarakta. World Journal of Pharmaceutical and Medical Research 6(8): 344-356.
  9. Patel P, Bhatted SK, Dharmarajan P (2020) Systematic Review on Understanding and Management of Vatarakta (Gouty Arthritis). International Journal of Health Sciences and Research 10(9): 198-204.
  10. Adithya AK, Ahalya Sharma (2013) Evaluation of the efficacy of Siravyadha and Guduchi Siddha Yoga Basti With in the Management of Vatarakta with special reference to Gout. Int J Res Ayurveda Pharm 4(3): 402- 409.
  11. Shashanka Jha, Londhe PD (2014) Role of Leech Application in Vatarakta: a pilot study. International journal of Ayurvedic Medicine 5(1): 129-132.
  12. Saini RK, Thakur A, Sharma S, Srivastva AK, Manglesh R (2018) To Evaluate the Comparative Effect of Bodhi Vriksha Kashaya and Guduchi Kashaya in The Management of Vatarakta W. S. R To Gout. World Journal Of Pharmaceutical And Medical Research 4(9): 198-209.
  13. Ansaril T, Ghosh S, Singh SK (2021) A comparative clinical study of trikarshika kwatha with and without lifestyle modification in the management of vatarakta with special reference to hyperuricaemia. International Journal of AyurvedaandPharma Research 9(1): 10-19.
  14. Sharma U, Sharma KK, Singh M, Shrivastava AK, Shukla GD, et al. (2015) Role of Punarnava Amrita Guggulu Within the Management of Vatarakta-A Clinical Trial. Ayurpharm Int J Ayur Alli Sci 4(1): 1-9.
  15. Sharma U, SharmaKK, Bohra M (2015) A Comparative Study of Efficacy of Two Different Samples of Amrita Guggulu in the Management of Vatarakta. World journal of pharmacy and pharmaceutical sciences 4(6): 589- 603.
  16. Nariyal V, Sharma OR, Dhiman KS (2017) A Combined Effect of Kaishora Guggulu and Punarnavadi Guggulu in The Management of Vatarakta (Gout): A case series. Int J Adv Res 5 (6): 1793-1798.
More from this journal

Cite this article

BibTeX
APA
RIS
@article{mishra2023,
  title   = {An Ayurvedic Approach in Management of Vatarakta},
  author  = {Mishra P, Sanwal S, Gupta H, Singh H, Mukeriya PK, and Anand N},
  journal = {Journal of Natural & Ayurvedic Medicine},
  year    = {2023},
  volume  = {7},
  number  = {1},
  doi     = {10.23880/jonam-16000382}
}
Mishra P, Sanwal S, Gupta H, Singh H, Mukeriya PK, and Anand N (2023). An Ayurvedic Approach in Management of Vatarakta. Journal of Natural & Ayurvedic Medicine, 7(1). https://doi.org/10.23880/jonam-16000382
TY  - JOUR
TI  - An Ayurvedic Approach in Management of Vatarakta
AU  - Mishra P, Sanwal S, Gupta H, Singh H, Mukeriya PK, and Anand N
JO  - Journal of Natural & Ayurvedic Medicine
PY  - 2023
VL  - 7
IS  - 1
DO  - 10.23880/jonam-16000382
ER  -