Efficacy of Ayurvedic treatment protocol in gouty arthritis – a clinical study
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Aswathi Rajan Vaprath Kuniyil
,
Devipriya Soman
Abstract
Objectives
Gout is an inflammatory response to the Monosodium urate crystals formed secondary to hyperuricaemia. The prevalence of gout has increased in recent years. The current conventional medical management aims at symptomatic management. In Ayurveda, gouty arthritis has similarity to Vata-Pittadhika Vatarakta, owing to its comparable aetiology and clinical features and treatment was planned accordingly. The present study is designed to evaluate the combined effect of Ayurvedic formulations and therapy in reducing the signs and symptoms and uric acid level in Gouty Arthritis.
Methods
The study was a single group pre–post test design. The patients diagnosed on the basis of ACR EULAR Gout classification 2015 criteria. They were given Guduchi Siddha Ksheeravasthi (Therapeutic enema), Guduchi (Tinospora cordifolia) Kashaya (diluted decoction) and Punarnava Guggulu. Assessment of pain was done by Visual Analogue Scale and serum uric acid level was assessed on day 1 and on 31st day. Also, the change in symptoms were analyzed before and after the treatment. This study has been registered in the clinical trial registry-India.
Results
The obtained data were evaluated using paired t-test and Wilcoxon signed rank test. A significant improvement (p=0.0001) was observed in VAS scale (98.77%), serum uric acid levels (57.81%), subjective parameters. Moreover, erythrocyte sedimentation rate was observed to be normal level as compared to baseline of the therapy also with an enhancement of hemoglobin (Hb) levels.
Conclusions
Thus, the present study revealed that Ayurvedic therapeutic interventions can play a major role in the management of gouty arthritis.
Acknowledgments
The authors are thankful to Department of Kayachikitsa, Amrita School of Ayurveda and Amrita Ayurveda Hospital for providing lab facilities, study participants and their families. and also acknowledges the valuable contributions of Dr. Ratnaprava Misra and Dr. Krishnakumar.
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Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Conflict of interest: The authors declare that they have no conflict of interest.
References
1. Krishna Das, KV. Textbook of medicine, chapter: 114 (metabolic arthropathies), 6th ed., vol I:772–5 pp.Search in Google Scholar
2. Pal Munjal, Y. API textbook of medicine, chapter 5 (Gout and other crystal arthritides), 10th ed.; 2015, vol 2:2483 pp.Search in Google Scholar
3. Karan Sharma, R, Bagavan Dash, V. Agnivesha Charaka Samhita, vol 5, Chikitsa Sthana, 29th chapter, 26th ed., Chaukhambha Sanskrit Series; 2000.Search in Google Scholar
4. Acharya, VYT. Agnivesa Charaka Samhita; Siddhisthana, 8th Chapter. Chaukhambha Publications: edition; 2016.Search in Google Scholar
5. Sharma, PV. Cakradatta. Edited & translated by Priya Vrat Sharma; 23 chapter of Vatarakta Chikitsa. Chaukambha Orientaliya, edition; 2013.Search in Google Scholar
6. Neogi, T, Tim, LTA, Dalbet, N, Fransen, J, Schumacher, HR, Berendsen, D, et al.. Gout classification criteria: an American College of rheumatology/European League against rheumatism Collaborative Initiative. Ann Rheum Dis 2015;1789–98. https://doi.org/10.1136/annrheumdis-2015-208237.Search in Google Scholar PubMed PubMed Central
7. Patgiri, B, Umretia, BL, Vaishnav, PU, Prajapati, PK, Shukla, VJ, Ravishankar, B. Anti-inflammatory activity of Guduchi Ghana (aqueous extract of Tinospora cordifolia Miers. Ayu 2014;35:108–10. https://doi.org/10.4103/0974-8520.141958.Search in Google Scholar PubMed PubMed Central
8. Upadhyay, AK, Kumar, K, Kumar, A, Mishra, HS. Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies. Int J Ayurveda Res 2010;1:112–21. https://doi.org/10.4103/0974-7788.64405.Search in Google Scholar PubMed PubMed Central
9. Goel, B, Pathak, N, Nim, DK, Singh, SK, Dixit, RK, Chaurasia, R. Clinical evaluation of analgesic activity of Guduchi (Tinospora cordifolia) using animal model. J Clin Diagn Res 2014;8:HC01-4. https://doi.org/10.7860/JCDR/2014/9207.4671.Search in Google Scholar PubMed PubMed Central
10. Jadon, A, Bhadauria, M, Shukla, S. Protective effect of Terminalia belerica Roxb. and gallic acid against carbon tetrachloride induced damage in albino rats. J Ethnopharmacol 2007;109:214–8. https://doi.org/10.1016/j.jep.2006.07.033.Search in Google Scholar PubMed
11. Patil, KS, Jalalpure, SS, Wadekar, RR. Effect of Baliosperm montanum root extract on phagocytosis by human neutrophils. Indian J Pharm Sci 2009;71:68–71. https://doi.org/10.4103/0250-474x.51966.Search in Google Scholar
12. Gupta, S, Akash, V. Operculina turpethum (Linn.) Silva Manso as a medicinal plant species: a review on bioactive components and pharmacological properties. Pharmacogn Rev 2017;11:158–66. https://doi.org/10.4103/phrev.phrev_6_17.Search in Google Scholar PubMed PubMed Central
13. Bhandari, U, Ansari, MN, Islam, F, Tripathi, CD. The effect of aqueous extract of Emblica ribes burm. On serum homocysteine, lipid and oxidative enzymes in methionine induced hyperhomocysteinemia. Indian J Pharmacol 2008;40:152–7. https://doi.org/10.4103/0253-7613.43161.Search in Google Scholar PubMed PubMed Central
14. Bag, A, Bhattacharyya, SK, Chattopadhyay, RR. The development of Terminalia chebula Retz. (Combretaceae) in clinical research. Asian Pac J Trop Biomed 2013;3:244–52. https://doi.org/10.1016/s2221-1691(13)60059-3.Search in Google Scholar
15. Mishra, S, Aeri, V, Kumar Gaur, P, Jachak, SM. Phytochemical, therapeutic, and ethnopharmacological overview for a traditionally important herb: Boerhavia diffusa Linn. BioMed Res Int 2014:808302. https://doi.org/10.1155/2014/808302.Search in Google Scholar PubMed PubMed Central
16. Peterson, CT, Denniston, K, Chopra, D. Therapeutic uses of triphala in Ayurvedic Medicine. J Altern Complement Med 2017;23:607–14. https://doi.org/10.1089/acm.2017.0083.Search in Google Scholar PubMed PubMed Central
17. Jaijoy, K, Soonthornchareonnon, N, Panthong, A, Sireeratawong, S. Anti-inflammatory and analgesic activities of the water extract from the fruit of Phyllanthus emblica Linn. IJARNP 2010;3:28–35.10.1055/s-0031-1282780Search in Google Scholar
18. Lanka, S. A review on pharmacological, medicinal and ethnobotanical important plant: Phyllanthus emblica Linn. (Syn. Emblica Officinalis). World J Pharmaceut Res 2018;7:380–96.Search in Google Scholar
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