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CLINICAL RESEARCH
Year : 2010  |  Volume : 31  |  Issue : 2  |  Page : 193-196 Table of Contents     

A clinical trial of Sri Lankan traditional decoction of Pitawakka Navaya in treatment of Kaphaja Shirsha Shoola (chronic sinusitis)


1 Ayurveda Teaching Hospital, Borella, Sri Lanka
2 Institute of Indigenous Medicine, University of Colombo, Rajagiriya, Sri Lanka

Date of Web Publication10-Nov-2010

Correspondence Address:
E.R.H.S.S Ediriweera
Senior Lecturer-Institute of Indigenous Medicine, University of Colombo, Rajagiriya
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.72390

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   Abstract 

Authentic Ayurvedic texts mention eleven types of Shiro Roga (diseases in head). Kaphaja Shirsha Shoola, which occurs due to vitiation of Kapha and Vata Dosha, is one of them. Chronic sinusitis is a chronic inflammation of sinuses. It can be correlated with Kaphaja Shirsha Shoola. Decoction of Pitawakka Navaya consists of nine ingredients. They are Bhoomyamalaka, Haritaki, Bharangi, Chavya, Pippali, Salarka, Guduchi, Shunti and Maricha. These herbs, which pacify vitiated Vata Dosha and Kapha Dosha, are used by traditional physicians in Sri Lanka to treat Kaphaja Shirsha Shoola (chronic sinusitis). However, no scientific studies have been conducted to evaluate the efficacy of Pitawakka Navaya in treatment of Kaphaja Shirsha Shoola. Hence, this clinical study has been conducted to evaluate its efficacy.. Sixty patients suffering from Kaphaja Shirsha Shoola were selected and examined. These patients were randomly divided into two groups of thirty patients each. First group was treated with 120 ml of decoction of Pitawakka Navaya twice a day for fourteen days. The second group was treated with 120 ml of placebo twice a day for fourteen days. After treatment, most of the patients' symptoms were completely or partially relieved. In less than 10% of patients, some symptoms were unchanged or aggravated. It is observed that traditional decoction Pitawakka Navaya is beneficial for Kaphaja Shirsha Shoola (chronic sinusitis).

Keywords: Chronic sinusitis, decoction of Pitawakka Navaya, Kaphaja Shirsha Shoola


How to cite this article:
Maragalawaththa M, Ediriweera E, Chandimarathne P B. A clinical trial of Sri Lankan traditional decoction of Pitawakka Navaya in treatment of Kaphaja Shirsha Shoola (chronic sinusitis). AYU 2010;31:193-6

How to cite this URL:
Maragalawaththa M, Ediriweera E, Chandimarathne P B. A clinical trial of Sri Lankan traditional decoction of Pitawakka Navaya in treatment of Kaphaja Shirsha Shoola (chronic sinusitis). AYU [serial online] 2010 [cited 2020 Apr 3];31:193-6. Available from: http://www.ayujournal.org/text.asp?2010/31/2/193/72390


   Introduction Top


In authentic Ayurvedic texts, it is mentioned that there are eleven types of Shiro Roga (diseases in head). Kaphaja Shirsha Shoola is a disease which occurs in the Urdhawajathrugatha Pradesha (area above the clavicle). The clinical features of Kaphaja Shirsha Shoola are Guru (heaviness of the head), Prathishtabdha (fullness of head), Himam (coldness of the head), Shiroabhitapa (headache), Shuna Akshikuta (swelling around the eyes), Shuna Vadanam (swelling in the face), Shuna Nasa (swelling of the nose), Suptha (numbness), Tandra (drowsiness), Alasya (lassitude), Arochaka (anorexia), Sthimitha (rigidity in head), Shiranispandatha (veins not pulsating), Karna Kandu (itching inside the ears), Ruknanda Ahanya Adikacanishi (mild pain during day time and severe at night) and Anthak Kaphaliptham (feeling of having a coating of phlegm inside the head). [1],[2],[3]

Kaphaja Shirsha Shoola can be correlated with chronic sinusitis. Chronic sinusitis is one of the most commonly diagnosed chronic illnesses in the United States, affecting 30 million to 40 million Americans each year. When sinusitis lasts longer more than twelve weeks, then this condition is known as chronic sinusitis.

Chronic inflammation of the sinus mucosa is a common ailment in which the maxillary sinus is mostly involved. Chronic sinusitis is usually the result of incompletely resolved acute sinusitis. Clinical features of chronic sinusitis are nasal obstruction, nasal discharge, tendency to clear one's throat frequently, abnormalities of smell, epistaxis, dryness of throat, sore throat, headache, sense of tiredness, low grade fever, feeling of being unwell, gastro intestinal discomfort, chronic bronchitis, excoriation of skin of nasal mucosa and tenderness of the sinuses. [7]

Pitawakka Navaya is a decoction used by Sri Lankan traditional physicians in treatment of Kaphaja Shirsha Shoola (chronic sinusitis). This name was given because this decoction contains nine ingredients, namely Bhoomyamalaka, Harithaki, Bharangi, Chavya, Salarka, Pippali, Guduchi, Shunthi, and Maricha. But so far no scientific studies have been conducted to evaluate the efficacy of Pitawakka Navaya in Kaphaja Shirsha Shoola (chronic sinusitis). Hence, it was decided to conduct this clinical study in order to evaluate its efficacy.


   Materials and Methods Top


Clinical studies

Sixty patients suffering from Kaphaja Shirsha Shoola (chronic sinusitis) were selected from the Ayurveda Teaching Hospital, Borella, Sri Lanka and Bandaranayke Memorial Ayurveda Research Institute, Nawinna, Sri Lanka. The clinical study was carried out on the basis of placebo controlled single blind study. These patients were examined and relevant investigations were carried out. Patients suffering from bronchial asthma, diabetes mellitus and hypertension were excluded from this study. Selected patients were randomly divided in to two groups. The first group, consisting of thirty patients, was treated with 120 ml of decoction of Pitawakka Navaya twice a day for fourteen days. Second group of thirty patients was treated with 120 ml of placebo twice a day for fourteen days. The response to the treatment was recorded by using a graded scale according to the severity of symptoms.

Preperation of medicine

Preparation of decoction of Pitawakka Navaya and Placebo are described below.

Preperation of decoction of Pitawakk Navaya

6.7 g each of root of Phyllanthus amarus (Family: Euphorbiaceae; Sanskrit name: Bhoomyamalaka), dried seeded fruit of Terminalia chebula (Family: Combretaceae; Sanskrit name: Harithaki), roots of Pygmaeopremna herbacea(Family: Verbenaceae; Sanskrit name: Bharangi), dried fruits of Pipper chavya (Family: Piperaceae; Sanskrit name: Chavya), dried entire creeper of Solanum trilobatum (Family: Solanaceae; Sanskrit name: Salarka), dried stem of Tinospora cordifolia (Family: Menispermaceae; Sanskrit name: Guduchi), dried rhizome of Zingiber officinalae (Family: Zingiberacea; Sanskrit name: Shunti), dried fruit of Pipper nigrum (Family: Piperaceae; Sanskrit name: Maricha) and Piper longum (Family: Piperaceae; Sanskrit name: Pippali) and are cut into small pieces. [4],[5],[6] A measured quantity of 1920 ml of water is added and boiled down to 240 ml.

Preperation of placebo for decoction of Pitawakka Navaya

Permitted brown food coloring was added to 240 ml of boiled and cooled water. This was used as placebo for decoction of Pitawakka Navaya.


   Observations and Results Top


Patients with Kaphaja Shirsha Shoola (chronic sinusitis) mostly complained of Guru (heaviness of head), Shiroabhitapa (headache), Prathishtabdha (fullness of head), Tandra (drowsiness), Alasya (lassitude), nasal obstruction, nasal discharge and dryness of throat. Most of them are between 10 and 30 years of age. Many of these patients lose sleep during the night due to studies or being in occupations such as security service and nursing. Most of them had the habit of bathing at night. Some of them were allergic to dust and/or mist. Some patients were allergic to foods such as pineapple, tomato, and cold foods.

In some patients, the symptoms were aggravated after treating with decoction of Pitawakka- Navaya. In 6.3% patients Guru (heaviness of head), in 11.8% Shiroabhitapa (headache), in 7.7% Manda Ruja (mild headache), in 14.3% Karna Kandu (itching inside the ears), in 6.7% nasal obstruction, in 5.9% nasal discharge, and in 66.7% abnormalities of smell were aggravated.

[Table 1] shows the percentage (%) of symptomatic relief during the treatment with decoction of Pitawakka Navaya. When Kaphaja Shirsha Shoola patients were treated with decoction of Pitawakka Navaya, they showed a statistically significant reduction in eosinophil count. These results are given in [Table 2]. In some patients, X-ray reports indicated that thickening of mucous membrane in para nasal sinuses, especially in maxillary sinus, was reduced.
Table 1 :Percentage of symptomatic relief during treatment of Kaphaja Shirsha Shoola (chronic sinusitis) with decoction of Pitawakka Navaya


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Table 2 :Change in white blood cell count during treatment with decoction of Pitawakka Navaya in Kaphaja Shirsha Shoola (chronic sinusitis)


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   Discussion Top


Decoction of Pitawakka Navaya is used as Samshamana decoction by traditional physicians in Sri Lanka. Kaphaja Shirsha Shoola (Chronic Sinusitis) is a disease that occurs due to vitiation of Kapha and Vata Dosha. Ingredients of Pitawakka Navaya have the properties of pacifying vitiated Vata Dosha and Kapha Dosha. They also have the Rasa properties such as Kashaya Rasa, Katu Rasa, Tikta Rasa and Amla Rasa; Guna properties such as Laghu Guna, Ruksha Guna, Teekshna Guna and Snigdha Guna and the properties of Katu Vipaka and Ushna Veerya.

The properties of Pitawakka Navaya such as Kashaya Rasa, Katu Rasa,Tikta Rasa, Laghu Guna, Ruksha Guna, Teekshna Guna, Ushna Veerya and Katu Vipaka are opposite to characteristics of Kapha Dosha and because of these, decoction of Pitawakka Navaya pacifies vitiated Kapha Dosha. Hence, this traditional decoction is beneficial for diseases originating due to vitiation of Kapha Dosha. The properties of Pitawakka Navaya such as Madhura Rasa, Snigdha Guna, Guru Guna, Madhura Vipaka are opposite to characteristics of Vata Dosha and because of these, decoction of Pitawakka Navaya pacifies vitiated Vata Dosha. Hence, this decoction is beneficial in pacifying diseases originated by vitiation of Vata Dosha and Kapha Dosha including Kaphaja Shirsha Shoola (Chronic Sinusitis). Rasa, Guna, Veerya and Vipaka of Pitawakka Navaya is given in [Table 3].
Table 3 :Ayurvedic properties of ingredients of Pitawakka Navaya


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It was observed that among 6.3% of patients Guru (heaviness of head), 11.8% patients Shiroabhitapa (headache), 74.3% Karna Kandu (itching inside the ears), 6.7% nasal obstruction, 5.9% nasal discharge and 66.7% abnormalities of smell were aggravated after the treatment.


   Conclusion Top


It is concluded that decoction of Pitawakka Navaya is beneficial for Kaphaja Shirsha Shoola (chronic sinusitis). This decoction also reduces the eosinophil count in blood.

X-rays of sinuses show that decoction of Pitawakka Navaya reduces thickening of mucous membrane in para nasal sinuses, specially in maxillary sinuses.

 
   References Top

1.Sharma AP. Chaukambha Orientalia. Varanasi, India: Charaka Samhitha; 1983. p. 116.  Back to cited text no. 1
    
2.Murthy KR. Chukambha Orientalia. Varanasi, India: Madhava Nidana; 1986. p. 217.  Back to cited text no. 2
    
3.Murthy KR. Chaukambha, Orientalia. Varanasi, India: Sustruta Samhita; 1998. p. 134.  Back to cited text no. 3
    
4.Jayaweera DM. The National Science Council of Sri Lanka. Vol. 2. Colombo, Sri Lanka: Medicinal Plants; 1980. p. 37-227.  Back to cited text no. 4
    
5.Jayaweera DM. The National Science Council of Sri Lanka. Vol. 4. Colombo, Sri Lanka: Medicinal Plants; 1985. p. 81-203, 207, 209.  Back to cited text no. 5
    
6.Jayaweera DM. The National Science Council of Sri Lanka. Vol. 5. Colombo, Sri Lanka: Medicinal Plants; 1982. p. 99-170, 217.  Back to cited text no. 6
    
7.Bull PD. Lecture Notes of the Disease of the Ear, Nose, and Throat. UK: Black Well Science; 1996. P. 101  Back to cited text no. 7
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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