According to Ayurveda, freedom from disease is not only health ,but to be healthy a person should be happy mentally ,physically,socially and also spiritually .Imbalance of doshas is termed as Roga and among tridoshas ,vata dosh is responsible for almost all disease. In vriddhavastha, all dhatus undergo kshya thus leading to vatprakopa and making individual prone to many diseases .Among them sandhigata vata stands top in the list. Till to date sandhigata vata is a challenging disease and is the number one cause of disability.Acharya Charak & Madhav Nidan has explained sandhigata vata among the VATA VYADHI.
Osteoarthritis of knee joint is more prevalent in Indian population which Relates to sandhigata vata..The things existing on earth has to go through Degeneration process. Degeneration causes calcium deposit, arthritic decay,narrowing disc, bone spurs advanced nerve irritation causing pain i.eSandhigata vata compared to Osteoarthritis according to modern Science.Even though this pain is not fatal it cripples many facets of life.Classical Reference of disease:Tail being sarvashreshta vataghna,Devdarubaladi tail from sahasrayog, was administered in formed of matra basti for the treatment of sandhigata vata. Sandhigata Vata is a Vata disorders.Basti Chikitsa is indicated to be the best for management of Vata disorders.According to Acharya Charaka Basti is said to be half of the whole treatment.Matra basti is a type of Sneha Basti.It is explained that this type of Basti can be given almost to everybody, in all the seasons & it is Nishpariharya,i.e. is can be given with maximum ease and has no complication thereafter .Hence management of pain becomes first priority of physician.Current treatment for degenerative disease is purely control of symptoms, to control prolongation of the degenerative process and to pacify the pain without complication.
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The Charaka Samhita reveals that after Nidana Sevana aggravated Vata enters in the Sandhi and get established thereby producing swelling of the joints, which is felt like a bag filled with air and the pain occurs mainly during the flexion and extension the movements of the joints.
The word ‘Osteoarthritis’ is a combination of three words. ‘Osteon’,‘arthron’ and ‘itis’ respectively means bone, joint and inflammation. The meaning of this word is ‘inflammation to the bony joint’. In fact, there is no inflammation in this disease; hence, the disease is also known as Osteoarthrosis and Degenerative joint disease.
Osteoarthritis is far the most common form of arthritis. It has strong association with aging and is a major cause of pain and disability in the elderly pathological.
बलाकषायसंसिध्दं तैलं सर्वांगवातजित ॥ –सहस्रयोग
Acharya Vagbhatta has defined the Matra Basti as the Basti in which the dose of Sneha is equal to Hrsva Matra of Snehapana.Indication:According to Acharya Charaka, Matra Basti is always applicable to those emaciated due to overwork, physical exercise, weight lifting, way faring, journey on vehicles and indulgence in women in debilitated personas well as in those afflicted with Vata disorders.Ashtanga Samgrahakara, emphasized on regular administration of the Matra Basti and it can be administered at all times and in all seasons.
Morning after breakfast
Dose of Drug
Duration of trail
Duration of follow-up
after every 7 days
Total duration of treatment
It is an open non-comparative clinical study with pre and post test design where in minimum of 30 patients suffering from sandhigata vata were selected.
Methods of collection of data [including sampling procedure]
30 patients who are diagnosed as sandhigata vata according to lakshanas like sandhishoola, sputana or atopa vata poorna druti sparsa mentioned in classical text were selected for trial drug.
Trial group consisting of 30 patients was administered Devdarubaladi tail in matra basti form i.e through ano-rectal region for 21days. Selected patients were thoroughly examined subjectively. Detailed general history and physical findings were noted in a specially prepared Performa. Improvement were documented and assessed through statistical method. Subjective and objective parameters like pain while extension and flexion, swelling of joint were graded from 0-3 marks according to severity
SAMPLE SIZE : 30
OBSERVATION & RESULT
The present study reveals that among 30 patients 5 patients(16.66%) had excellent result,23 patients(76.66) had good result i.e reduction in signs and symptoms above 60%, 2 patients(6.66%) has relief more than 25% which was considered as responded to the treatment.
None of the patients had any side effect of the trial.
Probable Mode of Action of Devdarubaladi Tail
Tail is sarva shreshta vataghna and shoolaghna, its site of action is pakwashaya. According to Charaka, in Asthi Dhatu Dushti the treatment given should be Tikta Dravya. Tail siddha with tikta katu kashya dravyas by controlling the vayu at its utpattisthan proved be beneficial.Majority of drugs used in Devdarubaladi tail for Matra Basti are having Vatashamak action.owing to this property, the basti may have proved helpful in significant improvement in signs and symptom of the disease.
Due to Snigdha Guna it may also be helpful in the chronic stage of the disease after Prakopa of the Vata as Pakvashya is the main site of Vata and is the main site of disese as well, because Snigdha Guna is antagonist of Ruksha Guna of Vata it may be helpful in maintaining the Vata in the normal stage or Prakruti Avastha.
As a whole the effect of basti can be summarized as encolonic (action on tissue of colon), endocolonic(action inside colon), and diacolonic (for systemic action).thus Bati Dravya after reaching to large and small intestine get absorbed from intestine ,now due to laghu,ushna guna of matra basti dravya,it breaks the obstructions and expels out the morbid material from all over the body,thus helping in breaking down the pathogenesis of disease.Basti helps in Vatanuloman thus helps in correcting Apana.The vitiated Vata is the main causative factor of this pathology. Thus Basti proceed with tail along with drugs of Tikta Rasa is advised in Asthivaha Srotas Chikitsa.Devdarubaladi Tail contains 6 drugs, most of which are Katu, Tikta rasatmaka, Ushana veerya, Katu vipaki & Vatakapha shamaka.
The study entitled “Efficacy of Devdarubaladi Tail Matra Basti in Sandhigat Vata with Special Reference to Osteoarthritis”was undertaken. Based upon the results of the clinical study displayed in the form of tables and graphs and discussion made in previous chapters, conclusions are drawn:-
· Sandhigatavata is a Vatavyadhi commonly associated with the vardhakya avastha and dhatu kshaya is a prominent feature in its manifestation.
· Sandhigatavata is a Vatavyadhi that occurs mostly because of Asthi, Majja dhatu and Strotasdushti.
· Tail acts as vedanasthapana by promoting agnideepti, balya of dhatus & bruhana karma and ojovaradha.· However it can be concluded that Devdarubaladi Tail Matra Basti is found to be very much symptomatically effective in patients suffering from Sandhishool, Sandhishotha, Sandhigraha, Akunchan prasaranjya vedana, Sandhisputana.
· Marked relief observed in chief complaints as well as symptoms like constipation were relieved
· No any major side effect was observed even though Sneha was administered for daily for 21 daysin Matra basti form.The study shows inspiring results, it may be recommended that the study should be carried out in large number of patients to evaluate and analyse the results.