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ABSTRACT
The study was conducted on 40 clinically diagnosed patients of hyperglycemia with an objective
of clinical evaluation of the efficacy of Katak Khadiradi Kashyayam and Niruryadi Gulika in the
management of Madhumeha (Hyperglycemia). These patients were randomly divided into three groups of
10 patients each. Out of that 30 patients has been completed clinical trial and 10 patients was drop out.
The study confirms that Katak Khadiradi Kashyayam and Niruryadi Gulika is effective in
management of Madhumeha and definitely reduces the symptoms of illness that includes Prabhuta
mutrata (Polyuria), Klama (early fatigue), Alasya (Lassitude), Vibandh (Constipation) (In Group 3)
including Ati sweda (Sweating), Mukha shosha (Dryness of mouth) (In Group 1).
The chosen drug is effective (laboratory parameters) in reducing Post Prandial Blood Sugar and,
Post Prandial Urine Sugar (In group 2 and 3) (highly significant in group 3 and significant in group 2),
only PPBS in Group 1 (significant result). No adverse effects were noted in any of the patients during the
trial period.
Keywords: Mudhumeha, Hyperglycemia, Katak Khadiradi Kashyayam, Niruryadi Gulika
increase to $335 billion in the next ten years. Surajmal Bombewala Hospital, Kishanpole
These estimates are based on lost productivity, Bazar, Jaipur . Out of which 30 patients has
resulting primarily from premature death. been completed clinical trial and 10 patients was
Diabetes mellitus is a growing health drop out during the trial period. A regular record
hazard in developing countries. As a of the assessment of all patients was maintained
psychosomatic disease and due to most according to proforma prepared for the purpose.
dangerous complications, diabetes mellitus has Following inclusion and exclusion criterias
grabbed the attention of health community all were used for registration of the patients for
over the world. Globally, diabetes affects 246 present clinical trial.
million people, which is about 6% in the total (a) Inclusion criteria
adult population .It is the 4th leading cause of Patient with clinical history of DM.
death by disease and every 10 sec a person dies Patient having hyperglycaemia
from diabetes related causes in the world. The
confirmed by laboratory investigation.
Top ten countries, in numbers of sufferers, are
Presence of Cardinal symptoms of
India, China, USA, Russian Federation, Brazil,
Germany, Pakistan, Japan, Indonesia and Madhumeha as described in Ayurveda
Mexico. texts.
AIMS AND OBJECTIVES (b) Exclusion criteria
The present research trial has been undertaken Patient having Type 1 DM.
with the following main objectives- Age below 20 and above 70 years.
Conceptual and clinical studies on Patient of Type II DM who were on
Mudhumeha W.S.R. to Hyperglycemia and insulin therapy.
its management with time tested Ayurvedic Complication with DM.
principles. Patient having any serious illness.
To evaluate Antihyperglycemic effects of Patient having a FBS >250 AND PPBS
the Katak Khadiradi Kashyayam (Sahasra >300.
Yogam, CCRAS publication, pratham 2. Selection of drugs
prakaran kashyaya yog 71, page no.16 ) Taking the symptoms and the
and Niruryadi Gulika (Sahasra Yogam, Samprapti of Madhumeha into
CCRAS publication, duvitiya prakaran consideration, a Katak Khadiradi
gutika yoga 69, page no.142 ) in a series of Kashyayam and Niruryadi Gulika has been
patients suffering from Madhumeha on selected. The drug selected for the study a
various scientific parameters. Katak Khadiradi Kashyayam were mainly
To compare the efficacy of having Tikta, Katu, Kashaya rasa, Katu
Antihyperglycemic effects of the Katak Vipaka, Laghu, Ruksha & Tikshna Guna
Khadiradi Kashyayam and Niruryadi Gulika pradhana aoshdhi. All the selected drugs
MATERIALS AND METHODS were having Mutrasagrahaniya, Jatharagni
1. Selection of cases vardhak, vayasthapana, chakshushya,
The study recruited a population of 40 rasayan, vrishya, grahi, lekhana, deepana,
clinically diagnosed patients of Madhumeha oja vardhana and pachana.
(hyperglycemic) selected from O.P.D. / I.P.D.
unit of P.G. Department of Kayachikitsa,
National Institute of Ayurveda, Jaipur and Seth
Dose and Anupana: Dose of Niruryadi of 500 mg) with lukewarm water twice daily
gulika was 2 tablets (each of 500 mg) in the for a period of 30 days before meal.
afternoon before lunch and at night before GROUP- III: 10 patients of Madhumeha
the dinner with Luke warm water for 30 (Hyperglycemic) were administered Katak
days. Khadiradi Kashyayam in a dose of 20 ml
3. Pre Treatment Observations twice daily for a period of 30 days before
All the patients have been studied meal and Niruryadi Gulika in a dose of 2
along with the registration by noting down tablet (each of 500 mg) with lukewarm
their demographic profile including their water twice daily for a period of 30 days
age, sex, address, occupation, education, before meal. All the patients were advised to
socio economic status, marital status, life undergo following laboratory investigations
style, addictions, dietary habits etc. After before starting the trial to rule out a
preliminary registration, patients were hyperglycemia and other illness; if present
subjected to detailed case history taking, then exclude them from the trial.
physical, general and systemic a) Blood Examinations
examinations. In history and examination (i) F.B.S. (Fasting Blood Sugar)
importance was given to symptoms of (ii) P.P.B.S. (Post Prandial Blood Sugar)
Madhumeha. During this all other relevant (iii) C.B.C. and E.S.R.
informations like Ashtavidha Pariksha and b) Urine Examination
Dashvidha pariksha including assessment of (i) Routine Examination
Sharirika Prakriti and Manasika Prakriti (ii) Microscopic examination.
(based on the features described in classical (iii) F.U.S. (Fasting Urine Sugar)
texts) etc. were noted. (iv) P.P.U.S. (Post Prandial Urine Sugar).
4. Administration of Drug & Treatment Patients were followed up after 15 days and
Schedule changes, improvements, deterioration and
40 registered, clinically diagnosed and any other effects produced after the therapy
confirmed patients of Madhumeha were noted down.
(Hyperglycemic) were selected for the 5. Criteria for Assessment
present clinical trial and randomly divided After the completion of the treatment, the
into following three groups out of that 30 results were assessed by adopting the
patients has been completed clinical trial and following criteria.
10 patients was drop out during the trial Improvement in signs and symptoms of
period. disease on the basis of symptoms score.
GROUP- I: 10 patients of Madhumeha Improvement in laboratory Investigation
(Hyperglycemic) were administered Katak (i.e. reduce levels) on the basis of lab
Khadiradi Kashyayam in a dose of 20 ml reports.
twice daily for a period of 30 days before Reduction in Objective assessment
meal. parameters.
GROUP- II: 10 patients of Madhumeha For clinical evaluation the criteria can be
(Hyperglycemic) were administered divided in to two types:
Niruryadi Gulika in a dose of 2 tablet (each 1. Subjective Assessment
56 www.iamj.in IAMJ: Volume 2; Issue 1; Jan Feb 2014
Kolhe N. S. & Joshi Ramkishor: A Comparative Study On Katak Khadiradi Kashyayam & Niruryadi Gulika in the Management of Madhumeha
its natural passages which can be alleviated Ras; Laghu, Rukshya and Guru guna; Sheeta
by Kaphahara, medohara drugs. Virya ; Madhur and Katu Vipaka.
In the compound majority of drugs According to Charak
are found to have Ushna Virya. In 1979 at Kinchidrasena kurute karma viryane
BHU, Varanasi has proved that substance chaparam |
having Ushna Virya is accountable for Dravyam gunen paken prabhaven cha
breakdown of fat at mitochondrial level. kinchan || Ch.Su. 26/71
Meda is invariably involved in pathogenesis According to above quotation, drug
of disease. According to Ayurveda principles acts in the body in various ways. The
Ushna virya helps in alleviation of Kapha Samprapti of Madhumeha is described
and Vata. earlier, for breakdown of that Samprapti the
As far as Vipaka is concerned katu action of above ras, guna, virya and vipak
vipaka enhances jatharagni, dhatvagni and are described as follows.
normalize metabolic process. Sheeta virya In the Niruryadi Gulika the Kashaya
and Madhura vipaka helps in replenishment ras (64.70%) posses a properties like
of Ojus which become depleted with disease Sangrahi, Sthambhan,
progression owing to continued exposure of Sharirkledasyopayokta due to that a polyuria
body to vitiated Vata. The drugs in is one of the main symptoms that can be
compound formulation also possess manage, and due to the
vayasthapana, chakshushya, rasayan, Sharirkledasyopayokta properties a
vrishya, grahi, lekhana, deepana and abhaddha meda and kleda that can get
pachana properties. soaked.
It has been clear from above account Tikta Ras (58.82%) having a
that Katak Khadiradi Kashyayam can well properties like Srotomukhavishodhan, Ama
disintegrated Samprapti of Madhumeha by pachaka, Murcha, Daha, Kandu, Kushatha,
acting at various levels i.e. alleviating Trushna prashamana, Dipan, Pachana,
dhatvagnimandya owing to presence of Lekana, Sharira Kleda Soshana, Meda
certain deepana pachana drugs in it like Soshana, Lasika Soshana, Swada Soshana,
Bruhati, Mustak and Haridra also rukshata Mutra Soshana. From these properties it is
and laghuta present in drug will combat very clear that in the complication of
increased Kapha and meda which similitude Madhumeha like Murcha, Daha, Kandu and
in their properties. Aamalki and Haritaki are Kushatha it plays a role. A polydypsia is one
two drugs, which are known to exert of the prime symptoms that can be subsiding
rasayan prabhava too thereby causing oja by this ras (Trushna prashamana). The
vardhana, which is being depleted in body above described Kleda, Meda, etc. soshana
of Madhumehi owing to chronic exposure to properties of this ras helps for breakdown of
Vata in body. Dosha Dushaya Samurchana.
Probable mode of action of Niruryadi Madhura Ras having a properties
Gulika like Bala-Varnakar, Marutagna, Trushana,
In Niruryadi Gulika the maximum Daha Prashaman, Prinan, Jivan,
drug having a Kashaya, Tikta and Madhur Santarpana, Brumhana, Sthryakara, Murcha
Prashamana. According to these properties
59 www.iamj.in IAMJ: Volume 2; Issue 1; Jan Feb 2014
Kolhe N. S. & Joshi Ramkishor: A Comparative Study On Katak Khadiradi Kashyayam & Niruryadi Gulika in the Management of Madhumeha