.!.R.A.S Vol. XX, No. 1-2, (1999) pp. 78-82

CLINICAL EVALlJA TION OF DRlJG THERAPYASSOCIATED WITH PANCAKARMA IN THEMANAGEMENT OF GRlDHRASI (SCIATICA)

R.D. Prasad! and M.K. Tyagi'

(Received on 7.12.98)

A clinical trial was conducted on 61patients of Gridhrasi hy xiving themTrayodashang Guggulu and VishtundukVati (2 gms. & 250 mgs.), three times in aday with Maharasanadi Kwatha (30 ml. 3times)for 21 daysandPancakarma therapy(Snehana, Svedana and Vasti). Clinicallyand symptomatically 75% relief wasfoundin 19 cases & 50 % in 12 cases. There wasmild relief in 11 cases and no reliefin 1()cases.

Introduction

Gridhrasi is a specific disease(Nanatmaj Vyadhi) caused by vitiation ofVata, as given by Caraka. Clinically thedisease entity sciatica simulated the pictureof Gridhrasi .

As Grtdhrasi is a disease of lower partof the body with pain in Kati, Sakthi, Pada

etc, Apana Vayu may be considered as thechief causative factor of Gridhrasi . TheSamprapt i of Gri dhrasi may besummarised as i) Dosa-Vata (Apan Vayu),ii) Dushya-Mamsa and iii) Sthana-Kati.Sakthi, Pada Pakvashya. The main signand symptoms of Gridhrasi may besumrnarised in Caraka.

i) Sphik Purva Vedana (backache)

ii) Pain spreads towards Uru. Jangha.Pindali upto Pada

iii) Stambha (stiffness)

iv) Toda (pricking pain)

v) Sphurana (pulsation/throbbing pain).

Methods & Materials

61 patients of either sex were randomlyselected from OPD of Central Researchlnstitute of Ayurveda, clinical, pathological

1. Assistant Research Officer CAy.), CRIA, Road No. 66, Punjabi 8agh, New Delhi.2. Ex-Assistant Director CAy.).

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CLINICAL EVALUA110N OF DRUG THERAPY ASSOCIATED WITH PANCAKARMA .

and bio-chemical examination wereperformed with X-rays lumbosacralspine.

Inclusion criteria : The patients withfollowing findings were selected for thetrial:

1. Age between 12-70 yrs.

2. Either sex

3. Duration of illness upto 2 years

4. Radiating pain starting from glutealreg JOn

5. Tenderness of sciatic nerve course

6. Severe pain on squatting

Exclusion criteria : The patients withmonoplegia, paraplegia, hip joint arthritis,spine T.B., hip TB., pelvic pathology ortrauma were excluded from the presentstudy.

Procurement of the drugs : The rawdrugs were procured from the local marketof Delhi or supplied by survey unit of theCCRAS. The herbo-mineral drugs wereprepared in the pharmacy ofCRlA, Punjab!'Bagh, New Delhi.

Selection of drug : As per instruction ofthe CCRAS, the drug associated withPancakarma therapy was selected for thetrial. Snehana, Svedana and Vasti are themain measures for the pacification of Vataso Pancakarma therapy was also taken upas principle treatments. The drugs wereused for the trial.

Vistundak Vati 250 mg., TrayodashangGuggulu 2gms., Anupanibdaha RasanadiKwatha, Snehana-Maha Narayan Taila,Svedana (Vaspa Svedanj-MaharasanadiKwatha & Anuvasana Vasti-Madhu,Kwatha with Taila were used for the trial.

Duration of treatment : The treatment of21 days was fixed for the final assessment.Clinical improvement was taken as criteriafor assessment. Main signs and symptomsof Gridrasi pulling pain, pricking pain,stiffness, tenderness of the sciatic nervoustrunk, straight leg raising text, deep tendonreflexes, muscle wasting, pressing power,walking speed etc., were taken as criteriafor assessment. The symptoms weresuitably graded and numerical values wereallotted for the feasibility of assessment.The assessment was taken on admission,before and after each process and aftercompletion of the trial. The result of thetreatment was graded as :

Good response- 75% and above relief in. signs and symptoms,

Fair response - 50% and above upto 75% insigns and symptoms,

Poor response - 25% and above upto 50%in signs and symptoms,

No response - No response in presenting insigns and symptoms.

Clinical symptomatology of diseaseor otherwise patients who left the study inbetween were as Lama.

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R.D. PRASAD AND M.K. TYAG

Table No.1

Age group distribution of 61 patientsof Gridhrasi

Table 3

Distribution of patients on the basis ofoccupation

Age (in years) M F Total

12-19 0 Name of occupation No.ofpatients

20-29 2 8 10 Students 12

30-39 7 5 12 Teachers 1040-49 13 11 24

Farmers 1250-59 5 4 9

5 Businessmen 1460-70 2 3

Housewives 1330 31 61

M = Male, F = Female 61

Table 2Table 4

Distribution of the patients on theHistory of trauma in 61 patients ofbasis of diet

Gridhrasi

Diet Number of patients TotalHistory Number of

Male Female patients

Vegetarian 18 15 3323Present

Non-vegetatian 12 16 28Absent 38

30 31 61

Observation and Results

Maximum no. of patients were foundbetween the age group 40-49, implying theaggravation of Vata in this age groupultimately resulting in the development ofGridhrasi .

It is visible from the (Table 1) thatpatients of the both sexes are equallyaffected from the disease or we may saythat the disease distribution is irrespectiveof sex.

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Although Gridhrasi is found in thepeople from all the occupations, yetbusinessmen were found to be most affectedwhich may be attributed to their tensions,running schedule and busy life, ultimatelycausing aggravation of Vata.

Out of 61 patients, 23 patients werehaving positive history of trauma implyingthat trauma may be a predisposing factorfor Gridhrasi .

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CLINICAL EVALUAT10N OF DRUG THERAPY ASSOCIATED WITH PANCAKARMA .

Table 5

Signs and symptoms of the patientsof Gridhrasi

Signs and Present Absent

symptoms

Sphik Purva, Vedana 38 23

Katiprastli Rukjanu 41 20Jangha, Pada

Stambha 38 23

Toda 42 19

Sphurana 26 35

Outof61 patients 19got good response,12 fair response and 30 patients weredropped out from the study and rest treatedas Lama due to various causes. II patientsgot poor response and 10 got no response.

Results

Bio-chemical and pathologicalinvestigations of blood, stool and urine didnot show any significant change as a resultof treatment. X-ray will show lateraldeviation of spines loss of lumberlordosis.

Discussion

As CCRAS has made some efforts toevolve some effective remedies for thedisease, so the therapy was selected on thebasis of Siddhanta of Vata Roga. Carakahas described symptomatology of VataVikara esSransa (displacement of organs),Bhransa (dislocation of organs), Vyas(dilataion of the organs), Sanga (retention

of urine and stool), Bheda (lancinatingpain), Sada (depression in the body),Harsha (erection of hair follicles), Kampa(tremor), Varta (mole becomes roundedshaped), Chala (hyperactivity of the limbsorgans), Toda (pricking pain), Vyatha(compressing pain), Chesta (flutteringmind of movement of organs).

Apan Vayu has main role to developthe disease of Trika Pradesha (Lumbosecral region) because Pakvashaya is mainAshraya of Vayu and also GudaAggravation of Vata has main role todevelop Gridhrasi Roga So the Snehanaand Svedana has a role in pacification ofVata. Snehana has also been described bvVagbhata as Uttam Chikitsa for the VataRoga.

Vasti has also major role to control thealleviated Vata Dosa in Pakwasaya andGuda. As Vagbhata has emphasised thatthe Vasti is the main treatment of VataRoga

Conclusion

The result of study was encouragingand may also be extended with principletherapy of Pancakarma.

Acknowledgement

The authors are highly indebted to theDirector, CCRAS, New Delhi for hisguidance and encouragement. Specialthanks are extended to Pancakarmadepartment and other laboratory personnelof the Institute for their co-operation andhelp.

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R.D. PRASAD AND M.K. TYAGI

REFERENCES

Caraka Carak Samhita, Chikitsa SthanaChapter XXVIII, Sloka 55-56, & 79-81; Sutra Sthana, Chpter XX, Sloka 11,Chapter XIIl, Sloka 24, 26 & 35,(Vidyotani Hindi Commentary byPandit Kasinath Sastri). ChowkhambaSanskrit Series Office, Varanasi.

Madhavakara 1976 Madhava Nidan (Commentary bySudarshan Sastri), ChowkhambaSanskrit Sansthan, Varanasi

Nadkarni, K.M. 1976 Indian Meteria Medica, 3rd Edn .. Vol.I & II,

Ramachandra Nair. P. 19RO The Role of Sodhana Therapy inGridharasi, JRAS Vol.-I, No.4, 519-549.

Sharrna,P.V. 1975 Dravyaguna Vijnana, IInd Edn., Part [(& Ill, Chowkhamba Sanskrit Sansthan,Varanasi.

Vagbhata Ashtanga Hrdayam (Moolam) SutraSthana, Chapter XV, Sloka 25-26;Chapter XI, Sf oka 5; Chapter XVI, Sf oka15 & 16, Chowkhamba SanskritSansthan, Varanasi.

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