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CLINICAL RESEARCH
Year : 2011  |  Volume : 32  |  Issue : 4  |  Page : 507-511  

A clinical study on the effect of Rishyagandha (Withania coagulans) in the management of Prameha (Type II Diabetes Mellitus)


1 Ex. Professor and Head, Department of Kaya Chikitsa, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
2 Ph.D. Scholar, Department of Kaya Chikitsa, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Date of Web Publication14-May-2012

Correspondence Address:
Vandana Gupta
w/o Dr. Bipin Bihari Kesari, North Market, Town area, Saidraja, Chandauli - 232 110, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.96124

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   Abstract 

The study was conducted with an objective of evaluating the role of Rishyagandha (Withania coagulans) powder in clinically diagnosed cases of Prameha. 53 Registered cases were divided into 3 groups; Group A (Rishyagandha fruits powder), Group B (Oral Hypoglycaemic Agent i.e. OHA), and Group C (Rishyagandha fruits powder and OHA both). Statistically significant improvement was observed in objective and subjective parameters in all 3 groups after completion of the course of treatment. Based on the results, it has been concluded that, Rishyagandha fruits powder is an effective therapeutic regimen in the management of uncomplicated cases of Prameha.

Keywords: Diabetes mellitus, oral hypoglycaemic agents, Prameha, Rishyagandha


How to cite this article:
Upadhyay B N, Gupta V. A clinical study on the effect of Rishyagandha (Withania coagulans) in the management of Prameha (Type II Diabetes Mellitus). AYU 2011;32:507-11

How to cite this URL:
Upadhyay B N, Gupta V. A clinical study on the effect of Rishyagandha (Withania coagulans) in the management of Prameha (Type II Diabetes Mellitus). AYU [serial online] 2011 [cited 2019 Jun 27];32:507-11. Available from: http://www.ayujournal.org/text.asp?2011/32/4/507/96124


   Introduction Top


Ayurveda recognized, Prameha as a disease entity in distant past. Among several health problems Prameha, is considered as one of the arch enemy of the mankind. Prameha comprises a number of diseases with various physical and chemical changes in urine. The manifestation of the disease is described as "Prabhutavilmutrata," which means frequent and copious urine with turbidity. [1],[2] It is also believed that, if not cured or treated properly in due course of time, Prameha changes in Madhumeha, which is very similar to diabetes mellitus, the most debilitating disease. [3]

Diabetes mellitus is a metabolic disorder characterized by polyurea, polydipsia, hyperglycemia, glycosuria, and generalized weakness may be associated with weight loss. This is the disease that affects every tissue and every organ of the body and is responsible for significant morbidity, reduced life expectancy, and diminished quality of life. It has been seen that there is no any organ or system spared from the diabetic complications, such as nephropathy, neuropathy, retinopathy, and so on. So there is a need for effective drugs for controlling Diabetes and preventing undesirable complications.

Although the introduction of many oral hypoglycemic agents and insulin in modern medical science have great importance in the management of Diabetes, the hazardous effects of these drugs after long term use are incurable or proves many times fatal, hence an ideal therapy is still obscure. Ayurvedic management of Diabetes aims not only to achieve a euglycemic state but also to treat the root cause of disease. There are many medicinal plants mentioned in Ayurvedic texts, particularly in Nighantus having Pramehahara property. In the present work, the drug "Rishyagandha" (Withania coagulans) has been used for the management of Prameha. The selected trial drug Rishyagandha is mentioned in Charaka Samhita in Brihaniya Mahakashaya[4] and Madhur a skandha dravya. [5]

Aims and objectives

Clinical evaluation of Rishyagandha fruit powder in the management of Prameha.

Drug review

The drug Rishyagandha (W. coagulans Dunal, family Solanaceae) is mentioned in Charaka samhita in Brihaniya Mahakashaya and Madhur skandha dravya. In northern India, its fruits are used in the treatment of Prameha. [6] This plant has the property of coagulating milk, and has been used for preparing a vegetable rennet ferment for making cheese.

Preparation of drug and dosage

Trial drug preparation consists of Rishyagandha fruit powder in dose of 10 g daily in 2 divided doses.


   Materials and Methods Top


A series of 53 patients with Diabetes Mellitus were selected from the Outpatient Department (OPD) and Inpatient Department (IPD) of the Department of Kaya Chikitsa, S.S. Hospital, B.H.U. Most of these cases were known diabetics while some were diagnosed for the first time when they came with other complaints.

Inclusion criteria

  • Symptoms of diabetes along with random blood glucose concentration ≥11.1 mmol/L (200 mg/dL).
  • Fasting plasma glucose ≥7.0 mmol/L (126 mg/dL).
  • Two-hour plasma glucose ≥11.1 mmol/L (200 mg/dL) during an oral glucose tolerance test. [7]
Exclusion criteria

  • All type 1 Diabetes Mellitus cases.
  • Cases with complications of the disease or having other associated diseases.
  • Cases were excluded from the study which developed complications during the study.
Grouping of the patients

Registered patients were into 3

  • Group A: Patients who were taking no drug before initiation of therapy, were kept on trial drug.
  • Group B: Patients were permitted the OHA with unmodified dose which they were taking before initiation of therapy were treated as the control group.
  • Group C: Patients were given a trial drug with the ongoing OHA in the same dose whatever they were taking before the initiation of the treatment.
Criteria to assess the effect of trial drugs

All the selected patients have been advised to come for the follow-up for 3 months at regular intervals of 1 month. The clinical grades were decided as follows:



Objective assessment

  • Fasting and postprandial blood sugar have been done in each followup to the completion of study (3 months).
  • Routine urine examination in each follow-up.
  • Lipid profile in selected cases before and after completion of treatment.
  • Regular checkup of body weight in each follow-up.

   Observation and Results Top


The observations and results in the study are made on the basis of demographic, constitutional, and clinical profiles of 53 patients having type II diabetes mellitus. Out of 53 patients, 13 patients dropped out the treatment [Table 1].
Table 1: Therapy wise details of the groups

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Maximum cases reported in the study were male (72%). Maximum cases (36%) were of the age group 40-50 years. Most cases (about 77%) were from middle socioeconomic group and maximum cases (about 34%) were businessmen. 32% cases registered were from above graduation group. The study revealed that higher incidence was found in urban dwellers (58%), and incidence in dietary habits was found more in persons with mixed diet (51%). Regarding incidence in physical activities, more patients are mild active (49%). Maximum cases found (53%) in the study were obese (body mass index >30 kg/m 2 ). About 53% cases belonged to Tamasa Prakriti, and about 43% cases were belonging to kapha Pittaja prakriti. Maximum cases were reported with a positive family history (64%), and the duration of illness was more than 5 years in maximum cases (about 40%).

About 82% cases were presented with weakness followed by about 70% with tingling or burning sensation followed by 62% with polyurea. About 43% cases registered with complaints of joint pain and 32% cases with weight loss. Polyphagia was found in 28% cases and polydipsia in 21% cases, least number of cases (9%) were registered with the complaints of loss of libido.

Effect of treatment

As per paired t test all the 3 groups (group A, B, and C) showed statistically significant results in the above-mentioned subjective and objective parameters.

Group A showed highly significant relief on polyurea (56.07%), polyphagia (82.50%), weakness (66.67%), burning and tingling sensation (62.99%) and joints pain (82.50%). Group B showed significant result on polyurea (33.33%), polyphagia (78.57%), weakness (58.45%), burning and tingling sensation (21.36%), and joints pain (30.12%). Group C also showed highly significant relief on polyurea (63.88%), polyphagia (65.21%), weakness (52.05%), burning and tingling sensation (41.30%), and joints pain (50.00%) [Table 2],[Table 3],[Table 4],[Table 5] and [Table 6]. Effect on blood biochemical parameters of the treatments in all the groups were placed in [Table 6],[Table 7],[Table 8],[Table 9],[Table 10],[Table 11],[Table 12] and [Table 13].
Table 2: Mean change in polyurea

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Table 3: Mean change in polyphagia

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Table 4: Mean change in weakness

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Table 5: Mean change in burning and tingling sensation

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Table 6: Mean change in joint pain

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Table 7: Effect of treatment on fasting blood sugar

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Table 8: Effect of treatment on postprandial blood sugar

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Table 9: Effect of treatment on serum cholesterol

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Table 10: Effect of treatment on serum triglyceride

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Table 11: Effect of treatment on serum HDL

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Table 12: Effect of treatment on blood urea

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Table 13: Effect of treatment on serum creatinine

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Probable mode of action of drugs

The plant Rishyagandha (W. coagulans Dunal) is described in Charaka Samhita in "Brihaniya Mahakashaya"(a collection of drugs, which increases body mass) and "Madhur Skandha Dravya".

Charaka has described two types of therapies for Prameha, that is, Sambrihana (process which increases body mass), for krisha and dourbala pramehi and Samshodhana (a type of therapy which eliminates impurities from body) for sthula and balvan pramehi. [8] So in krisha and dourbala patient, Rishyagandha improves the quality of dhatu production, promotes the Oja formation, and curesthe prameha by its brimhana property.

In sthula pramehi, trial drug acts by the virtue of Dravya prabhava (effect of drug). By dravya prabhava, it acts on the pathogenesis of Madhumeha and breaks down the continuity of Prameha.


   Conclusion Top


It can be concluded from the present study that Rishyagandha fruit powder can be used effectively for a long-term in the treatment of Prameha (Type II Diabetes Mellitus) without any side effects.

 
   References Top

1.Ashtanga Hridyam of Vagbhata: Vidyotini Hindi Commentary by Kaviraja Atrideva Gupta Edited by Vaidya Yadunandana Upadhyaya. Reprint ed. Nidanasthana 10/7. Varanasi: Chowkhamba Sanskrit Sansthan; 2005. p. 254.  Back to cited text no. 1
    
2.Madhava Nidana: Vidyotini Hindi Commentary by Shastri S, Upadhyaya YN. Vol. 2,31 st ed. Chapter 33/6. Varanasi: Chaukhambha Sanskrit Sansthan; 2002. p. 8.  Back to cited text no. 2
    
3.Sushruta Samhita with AyurvedaTattva Sandipika-Hindi commentary edited by Kaviraj Ambikadatta Shastri. 13 th ed. Purvardha, Nidanasthana 6/30. Varanasi: Chaukhambha Sanskrit Sansthan; 1996. p. 255.  Back to cited text no. 3
    
4.Charaka Samhita with Vidyotini Hindi Commentary. Vol. 1 and 2. Sastri KN, Caturvedi GN. (Sashtri RP, et al. editor)., Reprint: 1998 Sutrasthana 5/2, Varanasi: Caukhambha Bharati Academy;p. 72  Back to cited text no. 4
    
5.Charaka Samhita with Vidyotini Hindi Commentary. Vol. 1 and 2. Sastri KN, Caturvedi GN. (Sashtri RP, et al. editor)., Reprint: 1998, Vimanasthana 8/139, Varanasi: Caukhambha Bharati Academy;p. 789  Back to cited text no. 5
    
6.Kirtikar KR, A"D Basu BD. Indian Medicinal Plants (VoI 1-1975, VoI3-1984). Delhi-32: Periodical Expert Book Agency; 1984.  Back to cited text no. 6
    
7.Harrison's Principles of Internal Medicine. Vol. 2.ed. Chapter 333, (Diagnostic criteria for Diabetes Mellitus). U.S.A: Mc Graw-Hill Medical Publishing House; 2005. p. 2111.  Back to cited text no. 7
    
8.Charaka Samhita with Vidyotini Hindi Commentary. Vol. 1 and 2. Sastri KN, Caturvedi GN. (Sashtri RP, et al. editor)., Reprint: 1998, Chikitsasthana 6/15, Varanasi: Caukhambha Bharati Academy; p. 235.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13]


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