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CLINICAL RESEARCH
Year : 2011  |  Volume : 32  |  Issue : 2  |  Page : 200-206  

Conceptual and applied study of Snigdha and Ruksa Guna with special reference to Rasa-raktagata Sneha (hyperlipidemia)


1 Ph. D. (Ayu.) Speciality: Maulika Siddhanta, Department of Basic Principles, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India
2 Professor and Head, Department of Basic Principles, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India
3 Ex.Head, Pharmacology Laboratory, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India

Date of Web Publication2-Feb-2012

Correspondence Address:
Sangram Mishra
C/o Mr. Nilamadhaba Nanda, Kanaka Durga lane, Nabakalebara Road, Puri - 752 002, Orissa
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.92586

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   Abstract 

Ayurveda as well as Philosophy accepted the Guna as the basic entity of the Sristi. The Maha Gunas, i.e., Sattva, Raja, and Tama are the prime energy, from where the universe evolves, along with human beings. Dravya and Guna both have a Samavayi relationship in which Gunas reside in Dravya and have a secondary place to it. Guna has multifold meanings according to its use, in social, cultural, philosophical, and literary fields. The concepts of Ayurveda are expressed with Gunas. Samanya and Visesa are usually expressed in terms of Gunas; the classification, description, and function of Dravyas depends upon Guna; Karmas are manifested forms of Guna and Samavaya is the eternal, intimate relation of Dravya and Guna. The principles like Triskandha (Hetu, linga, ousadhi) of Ayurveda also narrated by Gunas, Hetus are narrated in the terms of Guna; the Laksanas are the reflections in the status of Gunas of bodily elements, and Cikitsa is in the form of administration of Viparita Gunas. The increased elements are treated by opposite Guna. So if Ruksa Guna is increased then it is to be managed by Snigdha Guna and vice-versa. So diseases can be treated by applying the Gunas, and drugs for the required patient can be selected by applying these Gunas. In support of the above concept, a study on the persons of Rasa-raktagata Sneha (hyperlipidemia) has been carried out assuming that the condition is an increased state of Snigdha Guna and treatment is done using Ruksa property drugs. Patients were divided into two groups, i.e., treatment group (Ruksa Guna drugs) and control group (placebo). The results were assessed after 45 days with the help of a specially prepared pro forma. All the important hematological, biochemical, and urine investigations were done. According to subjective and objective criteria, significant results were found for Group A as compared to Group B.

Keywords: Ayurveda, Guna, hyperlipidemia, Rasa-raktagata Sneha, Ruksa Guna


How to cite this article:
Mishra S, Dwivedi R R, Ravishankar B. Conceptual and applied study of Snigdha and Ruksa Guna with special reference to Rasa-raktagata Sneha (hyperlipidemia). AYU 2011;32:200-6

How to cite this URL:
Mishra S, Dwivedi R R, Ravishankar B. Conceptual and applied study of Snigdha and Ruksa Guna with special reference to Rasa-raktagata Sneha (hyperlipidemia). AYU [serial online] 2011 [cited 2019 Oct 17];32:200-6. Available from: http://www.ayujournal.org/text.asp?2011/32/2/200/92586


   Introduction Top


In this clinical science, all concepts are having its practical utility. One of the concepts is Guna, which has multifold meanings according to its use, in social, cultural, philosophical clinical, and literary fields. [1]

In Ayurveda, Gunas have been classified under various categories like Adhyatmika Guna, Gurvadi Guna, Paradi Guna, Visistha Guna, etc. [3] For the treatment purpose, Gurvadi Gunas are widely used. The Guna is related with Dravya in a Samavaya relationship. Guna exists till the Dravya keeps its existence. Similarly Dravya is also related to Guna. If the Dravya has no proper quality, it has no value.

The functional property of Snigdha Guna is Sneha, Mrduta (softness), and Ardrata (malleability). [4],[5] It stimulates Kapha and normalizes Vata and also increases Mala. Similarly, the functional property of Ruksa is dryness. The property of Ruksa Guna is to increase the properties of Vata and normalizes the properties of Kapha and also decreases Bala, Varna (normal color). In the general treatment, two principles are adopted, i.e., Santarpana and Apatarpana. The increased elements are treated by opposite Guna. So if Ruksa Guna is increased then it is to be managed by Snigdha Guna and vice-versa. [2] So diseases can be treated by applying the two Gunas, and drugs for the required patient can be selected by applying these Gunas.

In this study, the condition selected is Rasa-raktagata Sneha (hyperlipidemia) for the assessment of the selected two Gunas. Though the disease is not described in Ayurveda, but the Laksanas find a scattered description. Lipids or the fat molecules can be compared to Sneha Ansa of the body, which is essential for body existence. As Susruta says

When the Sneha is in a normal condition, it gives unctuousness, invigoration, luster, strength, and corpulence to the body, but when it is in a disturbed state, disease occurs, which can be termed as Rasa-raktagata Sneha (hyperlipidemia). Cholesterol is a fatty substance (a lipid) that is an important part of the outer lining (membrane) of cells in the body of animals. Cholesterol is also found in the blood circulation of humans. It originates from two major sources: dietary intake and liver production. Dietary cholesterol comes mainly from meat, poultry, fish, and dairy products. Organ meats, such as liver, are especially high in the cholesterol content, while foods of plant origin contain no cholesterol. After a meal, cholesterol is absorbed by the intestines into the blood circulation and is then packaged inside a protein coat. This cholesterol-protein coat complex is called a chylomicron. [7],[8]

The liver is capable of removing cholesterol from the blood circulation as well as manufacturing cholesterol and secreting cholesterol into the blood circulation. After a meal, the liver removes chylomicrons from the blood circulation. Between meals, the liver manufactures and secretes cholesterol back into the blood circulation.

Hence the assessment of Snigdha Guna can be possible in hyperlipidemia patients in objective and subjective criteria and Ruksa Guna drugs can be used for treatment. So this work was done to establish the two Gunas.


   Materials and Methods Top


Conceptual study

For this study, the basic and conceptual materials were collected from the Ayurvedic classics, namely, Brihatrayee and Laghutrayee, other texts, literature in Modern science concerned with these principles, scientific journals, dissertations, research papers, etc.

Plant material

The plants selected had Ruksa, the dominant property in Rasa Pancaka. The test drug was prepared by selecting drugs, Vaca, Kustha, Haridra, Daruharidra, Citraka, and Karanja, in equal amounts. The raw drugs were made into a fine powder separately. The tablet was prepared of 500 mg each by giving Bhavana of Karanja bark decoction.

Study design

The clinical study was conducted in two groups. The first, treatment group, was prescribed with prepared tablets (4 tabs bd 500 mg each) with diet control and the control group patients were treated with placebo (wheat powder in a tablet form) and diet control. The patients were randomly selected from the OPD and IPD of the Basic Principles Department of the hospital of the Institute of Post graduate Teaching and Research in Ayurveda, Jamnagar, Gujarat.

Ethical clearance

The institutional ethics committee approved the study. The oral consent was taken from each patient who willingly participated in the study. Patients were free to withdraw from the study at any point of time for any reason and they were not forced to continue the treatment. All the benefits and possible hazards were narrated to the patients without any discrimination.

Selection of patients

The inclusion criteria were as follows:

  • patients between 20 and 60 years of age
  • Hyperlipidemic patients
  • Patients having Snigdha Guna increased in their body elements like Dosa, Dhatu, and Mala.
The exclusion criteria were as follows:

  • Patients below 20 years and above 60 years of age
  • Patients having weight more than 100 kg (overweight)
  • Obesity associated with any other complicated conditions like cardiac problems, endocrinal disorders, etc.
Assessment criteria

The overall effect was decided on the basis of improvement in Snigdha Ansa in the body and biochemical parameters (lipid profile):

  • Improvement in Snigdha Guna.
  • Improvement in the lipid profile, i.e., serum cholesterol and serum triglyceride.
In this part, percentage improvement in serum cholesterol and serum triglycerides was assessed and then the average of both the percentage improvements was taken to assess the overall effect of therapy. Thus, the total effect of the therapies was marked as following:



The special scoring pattern for Sarvangavayava Snigdhata[9],[10],[11],[12],[13] was as follows:



Drug delivery and duration

The treatment group was prescribed with prepared tablets (4 tabs 500 mg each, bd) with diet control and the control group patients were treated with placebo in a tablet form (4 tabs, 500 mg each, bd, with lukewarm water in Apana Kala) and diet control for 45 days.

Follow-up of treatment

Each patient was assessed on the basis of a special scoring pattern to provide objectivity to the subjective parameters. The clinical improvement/aggravation of the symptoms was regularly recorded.

The following were the criteria of withdrawal of the patients:

  1. Irregular patients.
  2. Those failing to follow the prescribed dietary regimen.
  3. Patients who abstained from the follow-up.
  4. Any adverse/emergency condition needing immediate attention.
Statistical tests

All the observations made for various parameters were subjected to statistical analysis in terms of mean (X), standard deviation (SD), and standard error (SE). A paired t-test was carried out at P<0.05, P<0.01, and P<0.001. The obtained results were interpreted as follows: insignificant P>0.05; significant P<0.05; highly significant P<0.01, P<0.001.


   Results Top


A total of 150 persons with Rasa-raktagata Sneha were registered and randomly divided into two groups: 74 subjects in Group A and 76 in Group B. A total of 110 patients, 56 patients in Group A and 54 patients in Group B, completed the course of therapy; 40 patients discontinued it.

The maximum number of patients, i.e., 40.67% patients, belonged to the age group of 41-50 years; 54.67% patients were males, 82.00% patients were from the Hindu community, 49.34% patients were educated, i.e., educated till Higher Secondary. Socioeconomically, 56.66% subjects were from middle class, and 41.33% patients were doing business. In terms of Prakrti, 53.34% subjects of the study population belonged to Kapha-Vata Prakrti, 56.66% patients were having Rajasika Prakrti, 50.00% of patients were having Avara Vyayama Sakti, and 52.00% subjects were possessing Visamagni. A total of 48.66% patients were having a dietetic habit of Adhyasana (25.34% patients were having a habit of Atyasana). In terms of Ahara, 58.00% patients were taking a Niramisa diet; among the nonvegetarian patients, 20.67% patients were having egg-dominant nonvegetarian food. A total of 56.00% patients were using groundnut oil in their diet; 53.33% patients were taking tea and 68.00% were taking Madhura Rasa-dominant food.

Regarding the onset of the disease, 96.66% persons were having a negative family history of hyperlipidemia, and 38.00% patients were having a positive family history of obesity. Aharatamaka Nidana was reported as Snigdh Ahara in 87.24% patients, Atibhojana Matra in 61.08% patients, Guruahara in 73.16%, Atimadhura Ahara in 57.04%, Dadhi sevana in 53.69% patients, and in 39.59% patients, Atisita Ahara sevana was observed.

Viharatmaka Nidana recorded in present series was Diwaswapana in 84.56% persons, Sukhasayan and Bhojonottara Nidra each in 69.79% persons, Avyayama in 39.59%, and Avyavaya in 29.53%.

Manasa Nidana reported that in the present series 45.63% persons were having Achinta, and Manasanivriti and Priya Darsana each was found in 40.93% persons. Harsanityatvat was present in 35.57% cases.

Maximum patients, i.e., 40.00% cases, were having BMI in the range of 26-30 kg/m 2 ; 51.33% cases were having serum cholesterol in the range of 201-250 mg/dl, 44.66% were having serum triglyceride in the range of 151-250 mg/dl, 53.33% cases were having serum HDL up to 40 mg/dl, 64.00% persons were having serum LDL up to 130 mg/dl, and 50.00% cases were having serum VLDL up to 40 mg/dl.

Effect of therapy

The following observations were made:

  • It was observed that in Sarvangavayava Snigdhata in Group A, better results were seen at Sarvanga Tvak, Lalata, Karna Pradesa, etc. Reduction in Snigdha Guna was observed which was statistically highly significant. In Group B, no significant result was observed [Table 1] and [Table 2].
    Table 1: Effect of the Ruksa Guna drugs on Sarvangavayava Snigdhata Laksanas found in 56 persons of Rasa-raktagata Sneha of Group 'A'

    Click here to view
    Table 2: Effect of the control on Sarvangavayava Snigdhata Laksanas found in 54 persons of Rasa-raktagata Sneha of Group 'B'

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  • The result of serum LDL is very mild, but increasing result of serum HDL was not observed as it should be increased after treatment. According to aim of the study on the treatment of hyperlipidemia condition, serum HDL should be increased and decreasing result of LDL. The control group had no change except for the minor change in the serum cholesterol level. It can be said the hypothesis is fulfilled by the lipid profile test results. In Group A, better results could have been achieved if the duration was long, up to 3 months, as the 45-day treatment duration may be not sufficient for getting the desired results in the case of serum LDL [Table 3] and [Table 4].
    Table 3: Effect of the Ruksa Guna drugs on the lipid profile found in 56 persons of Rasa-raktagata Sneha of Group 'A'

    Click here to view
    Table 4: Effect of the control on the lipid profile found in 54 persons of Rasa-raktagata Sneha of Group 'B'

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  • On comparison of effects of therapy on Groups A and B in terms of Sarvangavayava Snigdhata, Group A showed significant results in all the Laksanas compared to Group B. So the therapy was more effective in Group A.
  • On comparison of the effects of therapy on Groups A and B in terms of the improvement in serum cholesterol, serum triglyceride, serum HDL, serum LDL, and serum VLDL, serum triglyceride and serum VLDL had statistically significant results in Group A compared to Group B.
  • In terms of Sarvangavayava Snigdhata in Group A, 23.21% patients markedly improved, 69.64% cases moderately improved, while 1.78% persons showed minor improvements, and rest 5.36% persons remained unchanged.
In the case of Sarvangavayava Snigdhata in Group B, 61.12% persons remained unchanged, 25.92% persons showed minor improvement, 12.96% persons moderately improved [Figure 1].
Figure 1: Effect of therapy in Groups A and B on Sarvangavayava Snigdhata

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The serum cholesterol level in Group A showed that 57.14% persons remain unchanged, 37.5% persons showed minor improvement, and 7.14% persons showed a moderate improvement.

The serum cholesterol level in the control group revealed that 70.37% persons remain unchanged, 14.81% persons showed minor improvement, 12.96% persons showed a moderate improvement [Figure 2].
Figure 2: Effect of therapy in Groups A and Group B on serum cholesterol

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Data for serum triglycerides in Group A showed that 25.00% persons remained unchanged, 23.22% persons showed a minor improvement, 30.36% patients showed a moderate improvement, and 19.64% persons showed a marked improvement.

Data for serum triglycerides in Group B showed that 55.55% persons remained unchanged, 14.82% persons showed minor improvements, 24.07% persons showed moderate improvements, and 3.71% persons showed marked improvements [Figure 3].
Figure 3: Effect of therapy in Groups A and B on serum triglycerides

Click here to view



   Discussion Top


In Ayurveda, Gunas are described as the way of presentation or action without which no Karma can be performed. The Karanasatak and Hetu, Linga, and Ausadha Skandha have also been described in terms of Gunas. Though the very science keeps a similarity view on Samkhya and Vaisesikas Darsanas, the description of the concept of Guna differs. Ayurveda has provided new connotations to every Guna so that they become useful in clinical practice. Coming to the Ayurvedic concept of Guna, Caraka's view seems closer to Darsana Sastras.

In this clinical study, an attempt was made to evaluate the effect of Ruksa Guna drugs on Snigdha Guna of the body under the conditions like Rasa-raktagata Sneha (hyperlipidemia), assuming that this is the case of increased Snigdha Guna.

After observing the Snigdha Guna of Dosa Dhatu and Mala, externally Snigdhata was assessed in each part of the body. For this, one specific scoring pattern was prepared for 15 criteria for 15 areas of the body and implemented on the persons to observe the role of Ruksa Guna in the body. After the proper administration of test drugs (Ruksa Guna) and control, the results were as follows. In the the treated group, better results were seen for Snigdhata on Sarvanga Tvak, Lalata, Karna Pradesa, etc.; up to 52.13% reduction in Snigdha Guna was observed which is statistically highly significant (P<0.001). In the control group, no Snigdhata result was observed and all the results were statistically insignificant (P>0.05).

In the treated group, better results were observed, because Ruksa Guna had a good action on Snigdha Guna of body. The principle adopted by Caraka is



Again Arunadutta advocates that



Tvaca has covered all over the body. Rasa Dhatu flows interruptedly on the, Tvaca as well as whole body with the help of Srotas . If Snigdha Guna increases in Rasa Dhatu, then the Snigdhata of the skin increases too. So the Snigdhata will be seen in the body. In this study, maximum Snigdhata was seen at Lalata and Karna Pradesa.

According to the aim of the treatment of hyperlipidemia, serum HDL should be increased. The change in serum LDL was very mild, but an increase in serum HDL was not observed. In the control group, there was no change except for a minor change in serum cholesterol. It can be said the hypothesis is positively supported by the result of lipid profile test. In the treated group, better results could have been found if the duration was increased, up to 3 months, as the 45-day treatment duration may be not sufficient for getting the desired result in the case of serum LDL.

As weight and BMI both are interrelated, as weight reduced, BMI also reduced. In the medicinal Group A, results were seen due to the exercise, diet control, and the Ruksa drugs.

The prepared drug was not toxic to the body as after the administration of Group A, there was a decrease in serum uric acid with the decrease in weight. So it is a safe drug and is helpful in peripheral arterial diseases.

The Ruksa Guna prepared drug in Group A was able to decrease the Snigdha Guna of the body as well as helpful in increasing the Dipana Pacana activity of liver. As the serum alkaline phosphatase level reduced by 14.94%, it seems the liver function was increased during the period of medication.


   Conclusion Top


In the end, it can be concluded that hyperlipidemia can be treated by Ruksa Guna property drugs assuming the condition to be an increase in Snigdha Guna. On the basis of the Guna concept, the applied medicine of Ayurveda could be developed.

 
   References Top

1.Agnivesa ,'Caraka Samhita', revised by Caraka and Drdhabala with 'Ayurveda DipikA' commentary, by Cakrapanidatta, edited by Vaidya Jadavaji Trikamaji Acharya, Krishnadas Academy, Gopal Mandir Lane,Varanasi -221 001, (India), reprint 2000, Sutra Sthana 1/53 p. 14.  Back to cited text no. 1
    
2.Agnivesa,'Caraka Samhita', revised by Caraka and Drdhabala with 'Ayurveda Dipika' commentary, by Cakrapanidatta, edited by Vaidya Jadavaji Trikamaji Acharya, Krishnadas Academy, Gopal Mandir Lane,Varanasi -221 001, (India), reprint 2000, 1/ 62 p.17.  Back to cited text no. 2
    
3.Agnivesa ,'Caraka Samhita', revised by Caraka and Drdhabala with 'Ayurveda Dipika' commentary, by Cakrapanidatta, edited by Vaidya Jadavaji Trikamaji Acharya, Krishnadas Academy, Gopal Mandir Lane,Varanasi -221 001, (India), reprint 2000, p. 507.  Back to cited text no. 3
    
4.Guna Parijnana by Dr Mohanlal Gothecha Published by Post Graduate Training Center in Ayurveda, Jamnagar, 1958, p.19-20.  Back to cited text no. 4
    
5.Susruta, 'Susruta Samhita' with 'Nibandha Sangrha 'commentary by Dallhanacharya, edited by Vaidya Jadavaji Trikamaji Acharya and Narayana Rama Aachrya, ,eigth edition, Chaukhamba Orientalia, post box. no. 1032, Gopal Mandir Lane,Varanasi -221 001, (India)2005, Sutra Sthana 1/49 Dalhana, p. 12.  Back to cited text no. 5
    
6.Susruta, 'Susruta Samhita' with 'Nibandha Sangrha 'commentary by Dallhanacharya, edited by Vaidya Jadavaji Trikamaji Acharya and Narayana Rama Aachrya, ,eigth edition, Chaukhamba Orientalia, post box. no. 1032, Gopal Mandir Lane,Varanasi -221 001, (India)2005 Cikitsa Sthana 31/3, p. 507.  Back to cited text no. 6
    
7.Vasudevan DM, Sreekuari S. Textbook of Biochemistry. 4 th ed. New Delhi: Jaypee Brothers Medical Publications (P) Ltd; 2005. p. 141-53.  Back to cited text no. 7
    
8.Braunwald E, Hauser SL, Fauci AS, Longo DL, Kasper DL, Jameson JL. Harrison's principal of internal medicine. 15 th ed., vol. 1. New York: McGraw- Hill companies; 2001. p. 2138-46.  Back to cited text no. 8
    
9.Potbhare B, Dwivedi RR, Ravishankar B., Concept of Snigdha Guna and Applied study to evolve some objective parameters",(B.P.), IPGT and RA, G.A.U., Jamnagar; 2005.  Back to cited text no. 9
    
10.Buchake A, Sharma PP, Ravishankar B, De S. "An assessment of the activities of Ruksa Guna w.s.r. to Sthaulya", (D.G.), IPGT and RA, G.A.U., Jamnagar; 2002.   Back to cited text no. 10
    
11.Mishra S, Dwivedi RR, RavishankarB.,Vyas H Fundamental and applied study of Snigdha and Ruksa gunas with special reference to Rasa- raktagata Sneha (Hyperlipidemia).(B.P) IPGT and RA, G.A.U., Jamnagar;2008  Back to cited text no. 11
    
12.Sapra UK, Thakar AB, Vyas SN, Baghel MS, Ravishankar B. "A clinical study of Hyperlipidemia and the effect of panchatikta ghana in its management-a double blind study", (K.C.), IPGT and RA, G.A.U: Jamnagar; 2007.  Back to cited text no. 12
    
13.halerao S, Dwivedi RR, Ravishankar B. "A comprehensive study of Gunas and evolution of some objective parameters in the context of Snigdha and Ruksa Gunas." (B.P.), IPGT and RA, G.A.U: Jamnagar; 1998.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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