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CLINICAL RESEARCH
Year : 2013  |  Volume : 34  |  Issue : 3  |  Page : 249-253  

Clinical evaluation of Veerataru (Dichrostachys cinerea Linn.) in the management of Mootrakruchchhra (Dysuria)


1 Assistant Professor, Department of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurveda, Jamnagar, Gujarat, India
2 Ex-Professor and Ex-Head, Department of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India

Date of Web Publication17-Dec-2013

Correspondence Address:
Bhupesh R Patel
Assistant Professor, Department of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-8520.123105

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   Abstract 

Veerataru is quoted to be effective in various conditions of Mootravaha Srotodushti such as Mootrakruchchhra (Dysuria), Mootraghata (Anuria), Ashmari (Urinary calculi), Sharkara (Concretions) etc., by various Acharyas. Mootrakruchchhra (Dysuria) is a disease of Basti (Bladder). It comes under Mootraapravruttijanyavyadhi, where Kruchchhrata (Shoola -Pain and Daha-Burning) during mootra pravrutti is the chief symptom. As per modern view, dysuria is a leading feature of lower or mid urinary tract infection. Antibiotics have their own limitations due to re-infections and recurrence even after long-term therapy, due to development of resistance of the microorganisms to the drugs. By considering all the above facts and to fulfill the lacuna about the absence of scientific data of Veerataru, the present research work had been taken up especially to evaluate its efficacy on Mootrakruchchhra (Dysuria). Patients suffering from Mootrakruchchhra (Dysuria) were selected and divided into two groups, i.e. Group A received Kwatha (decoction) of Veerataru-Dichrostachys cinerea Linn. (Trial drug) and Group B received Kwatha of Punarnava-Boerhaavia diffusa Linn. (Standard control) respectively. The effects of therapy were assessed by a specially prepared clinical research proforma. The result showed better symptomatic relief in Group A, i.e. trial drug as compared to Group B, i.e. standard control group.

Keywords: Mootrakruchchhra , Veerataru (Dichrostachys cinerea Linn.), Mootravaha Srotodushti


How to cite this article:
Patel BR, Sharma P P. Clinical evaluation of Veerataru (Dichrostachys cinerea Linn.) in the management of Mootrakruchchhra (Dysuria). AYU 2013;34:249-53

How to cite this URL:
Patel BR, Sharma P P. Clinical evaluation of Veerataru (Dichrostachys cinerea Linn.) in the management of Mootrakruchchhra (Dysuria). AYU [serial online] 2013 [cited 2020 Jul 13];34:249-53. Available from: http://www.ayujournal.org/text.asp?2013/34/3/249/123105


   Introduction Top


Veerataru is the first drug of the Veeratarvadigana coined from its name; the drug has not achieved considerable recognition in Ayurvedic clinical practice until now. It has wide spread use in folk and tribal medicine. In Sushrutasamhita much emphasis has been given on Veerataru to treat Mootrakruchchhra, Mootraghata, Ashmari, Vatavyadhi etc., in Veeratarvadi gana. [1] Mootrakruchchhra is a disease of Basti. It comes under Mootraapravrittijanyavyadhi, where Kruchchhrata (Shoola and Daha) during Mootrapravritti is the chief symptom. [2]

The clinical evaluation of the drug Veerataru in Mootrakruchchhra is specially focused on Ayurvedic basis. Relevant observation of modern investigations like blood urea, Serum creatinine (S. creatinine), Serum calcium (S. calcium), Serum uric acid (S. uric acid) etc., was considered as supportive tools. Main aim of present study was to explore clinically the lesser-known utilized drug Veerataru. As the drug requires scientific validation for its efficacy on Mootrakruchchhra, the drug was subjected for clinical study to evaluate its therapeutic effect described in classics.


   Materials and Methods Top


Total 66 clinically diagnosed and confirmed cases of Mootrakruchchhra completed the current trial. The cases were selected from Inpatient Department and Outpatient Department of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurveda Hospital, Jamnagar. Specially prepared proforma was used to evaluate the patients during the study and follow up. Patients having clinical features of Mootrakruchchhra, aged above 5 years were included in to the trial. Patients having any anatomical defects in kidney, ureters and bladder (KUB), diabetic or cardiac patients, and patients having other severe systemic disorders or the condition where the symptoms manifests as a complication of other diseases like Arbuda (Tumor), gonorrhea, thread worms infection, hysteria etc., were excluded. In the patients of both the group routine urine examination, ultrasound abdomen X-ray KUB and hematological, biochemical investigations (S. creatinine, uric acid, S. calcium, blood urea) were carried out before and after completion of the treatment.

Administration of drugs

66 patients of Mootrakruchchhra were randomly divided in two following two groups.

Group A (trial group)

35 patients were administered with Kwatha (Decoction) form of Veerataru (made by 15 g. of Yavakut Churna) for 21 days, twice daily.

Group B (standard control group)

31 patients were administered with Kwatha (Decoction) form of Punarnava (Boerhaavia diffusa Linn.) made by 15 g. of Yavakut Churna for 21 days, twice daily. Patients were advised to avoid Ativyayam, Madyapan, Tikshna Ahara and Aushadha, Anupa Mamsa Sevana, Adhyashana, Ajirnashana and Drutgati Yana.

Criteria of assessment

All the patients registered for the current study were assessed on following parameters before and after the course of therapy to work out the efficacy of the treatment produced in the patients of both groups.

A: Subjective improvement

A specific rating scale for subjective parameters was utilized to assess the efficacy of the therapy. Changes found in signs and symptoms like Sashoola (painful micturation), Sadaha (burning micturation), Abhikshna (increased frequency) and Alpamootrapravrutti (Oliguria) related to Mootrakruchchhra were analyzed statistically.

B: Pathological and biochemical changes

The results were assessed based on the changes observed in biochemical and pathological parameters.

Criteria for overall assessment of therapy

The total effect of therapy was assessed considering overall improvement in signs and symptoms derived by following formula:

  • Complete remission: 100% relief
  • Marked improvement: >75% relief
  • Moderate improvement: 50-75% relief
  • Mild improvement: 25-50% relief
  • Unchanged: <25% or no relief.


Statistical analysis

The information gathered based on observation made about various parameters was subjected to statistical analysis in terms of mean, standard deviation and standard error. t-test was carried out and calculated values are compared with t table value at P < 0.05, P < 0.01, P < 0.001 to find out the level of significance. The obtained results were interpreted as Insignificant: P >0.05, significant: P <0.05, highly significant: P <0.01, P < 0.001.


   Results Top


Effect of therapy on Sashoolmootrapravrutti

In Group A, the relief reported by the patients for pre, during and post-Sashoolamootrapravritti was 68.18%, 79.41% and 83.33% respectively. In Group B, the relief got by the patients for pre, during and post-Sashoolamootrapravritti was 51.61%, 58.20% and 63.15% respectively. The effect of the therapy of both the drugs on Shoola was found to be statistically highly significant, though the test drug was slightly more effective than the standard control [Table 1].
Table 1: Effect of therapy on Sa‑Shoolamootrapravrutti

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Effect of therapy on Sadahamootrapravrutti

Relief noted by the patients in Group A for pre, during and post-Sadahamootrapravritti was 87.50%, 59.40% and 83.33% respectively. In Group B for pre, during and post-Sadahamootrapravritti was 52.77%, 38.67% and 39.13% respectively. The effect of the therapy of both the drugs on Daha was found to be statistically highly significant, though the test drug was slightly more effective than the standard control [Table 2].
Table 2: Effect of therapy on Sa‑Dahamootrapravrutti

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Effect of therapy on Alpa and Abhikshanamootrapravrutti

Data shows that 92.30% and 70.59% relief was found in Alpa (Oligouria) and Abhikshana (increased frequency) Mootrapravritti respectively in group A Whereas 86.96% and 72.41% in Group B. the effect of the therapy of both the drugs on Alpa and Abhikshana Mootrapravritti was found to be statistically highly significant, though the effect of standard control drug was slightly more effective than the test drug [Table 3].
Table 3: Effect of therapy on Alpa and Abhikshna mootra pravrutti

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Total effect on the patients of Mootrakruchchhra

The data regarding the total effect of the therapy by the both groups are shown in above table in Group A. 45.71% patients observed marked improvement, 37.14% patients observed moderate improvement, 11.42% observed complete remission from the disease while 5.71% observed mild improvement while in Group B, 41.93% patients showed moderate and mild improvement, 9.67% patients showed marked improvement, 3.22% showed completed remission from the disease while 3.22% remained unchanged, i.e. showed no improvement [Table 4].
Table 4: Total effect on the patients of Mootrakruchchhra

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Pathological investigation

In Group A erythrocyte sedimentation rate (ESR) decreased by 6.40% while monocyte count decreased by 3.67% but there was no changes in Group B which was statistically significant. No remarkable changes were found in other pathological parameters. In Group B, total count decreased by 1.72%, differential count decreased by 2.67%, monocytes decreased by 8.16% while ESR decreased by 5.55%. Eosinophils increased by 18% whereas hemoglobin increased by 1.12%. This increase and decrease was within normal range except ESR and the changes were statistically non-significant [Table 5] and [Table 6].
Table 5: Group A effect of therapy on pathological investigations

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Table 6: Group B effect of therapy on pathological investigations

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Biochemical investigation

In Group A, blood urea decreased by 6.41% whereas S. creatinine, S. calcium and uric acid increased by 5.73%, 1.20% and 6.92%. The changes were within the normal range except blood urea but the changes were not statistically significant. In Group B, there were no significant or remarkable changes found in biochemical parameters except 7.57% decrease in blood urea which was a significant decrease at P < 0.05 [Table 7] and [Table 8].
Table 7: Group A effect of therapy on biochemical investigations

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Table 8: Group B effect of therapy on biochemical investigations

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Overall effect of therapy on all symptoms of patients

The overall effect on all symptoms of the patients was found in Group A 80.91% and 73.68% was found in Group B, both the results were statistically highly significant [Table 9].
Table 9: Overall effect of therapy on all symptoms of patients

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   Discussion Top


In Group A the drug has shown pronounced effect in relieving Shoola. Vitiated Vata (Apanavata Vaigunys) [3] is main causative factor for Shoola. The drug Veerataru is effective on Vatadosha due to its Ushnaveerya. The same is reflected in the actions quoted for the drug by Bhavaprakashnighantu in Guduchyadivarga[4] 302/3 as Anilartijita and Rajanighantu in Shalmalyadi Varga[5] 71-72 as Vatamayavinashanaha. Daha was relieved more effectively in the patients of Group A. Daha is due to the predominance of Pitta. According to Acharya Kashyapa, Pitta acts as the chief causative factor in the pathogenesis of Mootrakruchchhra. [6] The drug, due to its Tiktarasa acts as Pittashamaka. Tiktarasa is said to be first among the three Rasas, which alleviates Pittadosha. [7] The symptoms namely Alpa and Abhikshanamootrapravrutti were relieved significantly in group A. The symptoms are mainly due to Pratilomatva of Vata[8] and the drug Veerataru is also said to be Vatamayavinashana. [9] Besides, the drug is attributed with the property of Mootravirekakara by Ashtanga Samgrahakara. [9]





From the clinical study, it has been observed that Veerataru Kwatha is effective on most of the cardinal symptoms of Mootrakruchchhra and statistically highly significant effect was observed.

 
   References Top

1.Sushrut M. Sushruta Samhita, Nibandha Samgrahvyakhya by Dalhana. In: Achaya YT, editor. Sutra Sthan 38/12, 13. Varanasi: Chaukhamba Surabharti Prakashan, Gopal Mandir Lane; 2001. p. 135.  Back to cited text no. 1
    
2.Acharya Vagbhatt. Astang Hriday Sarvang Sundarivyakhya, by Vaidya SL. 1 st ed. Reprint. Nidana sthana. 9/40. Delhi: Published by Motilal Banarasidas; 2005. p. 322.  Back to cited text no. 2
    
3.Acharya Agnivesha. Charak Samhita, Revised by Charak and Dradhabala with Ayurved Dipika commentary by Chakrapanidatt. In: Acharya VY, editor. Chikitsa sthana 26/34. Reprint. Varanasi, India: Chaukhamba Orientalia, Gopal Mandir Lane; 2009. p. 599.  Back to cited text no. 3
    
4.Pandit Bhavmishra. Commentary by Dr. Chunekar KC. Bhavaprakash Nighantu. Reprint. 302 as Anilartijita. Guduchyadi varga. Varanasi: Chaukhambha Vishvabharati; 2006. p. 473.  Back to cited text no. 4
    
5.Nighantu R. In: Dr. Tripathi I, editor. 4 th ed. Varanasi: Chaukhambha Krishnadas Academy; 2006. p. 246. 71-2 as Vatamayavinashanaha.  Back to cited text no. 5
    
6.Kashyap M, Pratisamskrit V. In: Pandit Hemraj S, editor. Vidyotini Hindi Comentary by Bhishakacharya SS. Reprint. Mootrakruchchhra chikitsadhyay 1. Varanasi: Chaukhambha Sanskrit Sansthan; 2006. p. 120.  Back to cited text no. 6
    
7.Kashyap M, Ibidem (ref. vi). Khilasthana-6/27-29, p. 264.  Back to cited text no. 7
    
8.Acharya Vagbhatt, Samgraha A. Commentary by Gupt A. Reprint. Sutra sthan, 16/18-19. Varanasi: Chaukhamba Krishnadas Academy, Gopal Mandir Lane; 2005. p. 138.  Back to cited text no. 8
    
9.Acharya Vagbhatt, Samgraha A. Ibidem (ref.ix). p. 138.  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]


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