A Comparative Study Of Amlapittavinashak Yoga Kwath & Bhunimbadi Kwath In...

[Full title: A Comparative Study Of Amlapittavinashak Yoga Kwath & Bhunimbadi Kwath In The Management Of Amlapitta W.S.R. To Acid Peptic Diseases.]

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 A Comparative Study Of Amlapittavinashak Yoga Kwath & Bhunimbadi Kwath In The Management Of Amlapitta W.S.R. To Acid Peptic Diseases. Dr. G. Vinay Mohan 1 , Dr.Pawar Pranita Mahendra 2 1- Principal and H.O.D-Department of Kaychikitsa, Shri Shivyogeshwar Rural Ayurvedic Medical College and Hospital, Inchal. 2- PG Scholar Department of Kaychikitsa, Shri Shivyogeshwar Rural Ayurvedic Medical College and Hospital, Inchal. SJIF Impact Factor : 5.69 ISRA Impact Factor : 1.318 ISSN:2581-785 X Research Article Volume: 3 Issue: 10 ABSTRACT: Now a day, there are so many changes in life style, behavior and diet. To achieve our desires in limited time produces different types problems like anxiety, worry, anger, depression. In modern medical science symptomatology of Amlapitta is equivalent to the features of hyperacidity. Hyperacidity and its complications pose a major threat to future public health resources throughout the world. The Ayurvedic management of Amlapitta aims not only control acid secretions in body but also to treat the root cause of the disease. People don’t follow rules like Dincharya and Rutucharya .Peoples are not awair of Rules of consumption of food which are described in “ Aharvidhivishayatan ” by Acharya Charak. Because of this all factor causes physiological disorders, which causes Annavaha stratus drusti which cause Mandagni and if the hetu sevan is goes on then it cause Ajeerna which ultimately leads to Aamvish .When Aamvish mixed with pittadi dosha , the original KattuRasa of Pitta changes to amla causes amalapitta disease. Amalapitta is characterised by features like Avipaak (indigestion), Klama (tridness), Utklesha (nausea), Tiktta Amlaa Udagar (sour and bitter belching), gauravata (Heaviness) , Hrudhkantha daha (Heart and throat burning),and Aruchi . These clinical features are closely related to functional dyspepsia. All these symptoms if left untreated may produces Gastrointestinal disorder like peptic ulcer disease .Many disease like Grahani ,skin disease like Shitpitta , Udard occurs as complication of Amlapitta . While describing the progonosis of Amlapitta , it has been stated that it can cured easily if promptly treated as earliest with proper Pathyapathya . The etiological factors like Abhojana , Atibhojana, ganigraha, PanchakarmaVyapat and seasonal variation etc. cause vitiation of Doshas and Agni which ultimately results Mandagni which is treated as mother of all the diseases. This Mandagni leads to Avipaka and due to Avipaka even light and small meals are not digested. This undigested and ill digested food gets shuktatva which leads to the formation of Annavisha . This Annavisha is manifestated in the form of Ajirna . As per Charaka it is said that when diet is not properly digested it gets formented and forms Annavisha. This Ama when mixed with Pitta then it develops the disease Amlapitta . Key word : Amlapitta , hyperacidity, Acid Peptic disease , Amlapittavinashak yoga kwath , Bhunimbadi kwath.

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 INTRODUCTION: In this modern techno era, we all are undergoing different life style modifications related to food and lifestyle. Irregular meal pattern, work in shift duties, irregular sleep timings, craze for fast foods, anxiety and stress induced hectic unhealthy schedules causes various disorders due to which there has been an extraordinary increase in the disorders related to Annavaha Strotas or the gastrointestinal (G.I.) system. Burning sensation in chest, sour belching, abdominal discomfort, nausea, vomiting, headache, constipation are the most common complaints faced in day to day life. All these symptoms point out towards “ Urdhwag Amlapitta” in Ayurveda. If left untreated, Hyperacidity may lead to complications like ulcerations in the Gastro-intestinal Tract. Ayurveda aims at balancing the Doshas , basically, working on the root cause of Hyperacidity, not just the symptoms! According to samprapti of Amlapitta its hetu 1 is Dushta Ahar. Virudha Bhojana (incompatible diet) and Dusta Bhojana (unhygienic or improper diet), when taken by a person who regularly enjoys Pittaja Ahara such as Madya , Kulatha and Bhrista Dhanya makes the Pitta Vidagdha . This Vidagdha Pitta gets sour or acidic ( Amla How to Cite the Article :- Dr. G. Vinay Mohan Dr.Pawar Pranita Mahendra, A Comparative Study of Amlapittavinashak yoga kwath & Bhunimbadi kwath in the Management of Amlapitta w.s.r. to Acid peptic diseases.IRJAY, October: 2020 Vol- 3, Issue-10; 65-76; Doi: https://doi.org/10.47223/IRJAY.2020.3106 Article received on-26 Sept Article send to reviewer on-29 Sept. Article send back to author on-10 Oct. Article again received after correction on -16 Oct. Corresponding Author :- Dr.Pawar Pranita Mahendra, PG Scholar Department of Kaychikitsa, Shri Shivyogeshwar Rural Ayurvedic Medical College and Hospital, Inchal, Emailpranayurvedam@gmail.com

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 Bhava ) which results in Apaka (indigestion), Amlodgara 2 (Acid eructations and Pyrosis) etc. and the diseases entity Amla Pitta comes into existence. In Kashyapa Samhita, Acharya Kashypa explains that due to Mandagni,Vidagda Anna Rasa (undigested food) turns to Shukta form, this retains in Amashaya and causes Amlapitta Ayurveda emphasizes on the management of Amlapitta with Pathyakar Ahar 3 , Vyayam and Nidan Parivarjan Chikitsa along with various Kalpas. These Kalpas stated in Samhita are Hetu and Vyadhi Viparit targeting the causative Doshas and Dhatu 4 . Hence it gives us a hope that the multiple treatment modalities mentioned in Ayurveda acts on the basic pathology of the disease and help in better control AIMS AND OBJECTIVES. 1) To study the disease amlapitta in detail. 2) To study the effect of amlapittavinashak yoga kwath in Amlapitta. 3) To study the effect of Bhunimbadi Kwath in Amlapitta. 4) To compare the effect of Amlapittavinashak Yga Kwath And Bhunimbadi Kwath In Amlapitta . 5) To study Acid peptic disease. MATERIALS & METHODS: Criteria of Diagnosis : The patients were diagnosed on the basis of Symptoms of Amlapitta. Inclusive criteria- Patients between age group 18 to 65 years of either gender.  Patients with clinical signs and symptoms of Amlapitta. (Avipak, Utkesha,Hrullas,Tikta- amla udgar,Hrdkanthadaha)  Patient having above amlapitta symptoms more than 1 month and less than 2 years. Exclusive criteria-  Patients having these symptoms for more than 2 years.

VOLUME- 3 | ISSUE- 10 OCTOBER 2020  Known cases of organic diseases like gastric ulcer, duodenal ulcer, CA stomach.  Known cases of endocrine disorders like diabetes mellitus, Thyroid disorder.  Patient with severe systemic disorders.  Patients receiving any other treatment like NSAID’S, Antibiotics or other long term and continuous medication. Table no 1:- showing groups of management Trial group Control group Drug Amlapittavinashak yoga kwath Bhunimbadi kwath Dose 40 ml 40 ml Duration 21 days 21 days Sevan Kala After meal After meal Route Oral Oral Anupana Lukewarm water Lukewarm water No. of patients 20 20 Follow up study Every week and whenever needed Every week and whenever needed DRUG REVIEW Selection of Drug: Following are the main reasons to select this formulation: 1 In the preparation the ingredients are easily available. This formulation is easy to prepare and free from toxiceffect. 2 The compound drug Amlapittavinashak yoga kwath is having properties like, pitta dosha shaman, deepaneeya , raktavardhaka and kaphavatahara. 3 Agni vikriti is an important clinical condition of Amlapitta 5 `. Pachak agni is an essential factor for the proper digestion and

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 assimilation of ahara rasa , with the mandagni avastha samyakahara rasa formation will not take place. 4 The etiological factors like Abhojana, Atibhojana , ganigraha,PanchakarmaVyapat and seasonal variation etc. cause vitiation of Doshas and Agni which ultimately results Mandagni which is treated as mother of all the diseases. 5 This Mandagni leads to Avipaka and due to Avipaka even light and small meals are not digested. This undigested and food gets shuktatva which leads to the formation of Annavisha. This Annavisha is manifestated in the form of Ajirna 6 . As per Charaka it is said that when diet is not properly digested it gets formented and forms Annavisha . This Ama when mixed with Pitta then it develops the disease Amlapitta . 6 In Amlapittavinashak yoga guduchi , nimba ,patol ,haritaki , bibhitaki ,amalaki mainly possess the properties of pitta dosha shaman , agnideepana , pachana. therefore, helps in the production of intrinsic factor and assimilation of extrinsic factor which will help to enhance the process of Samprapti Bhang of Amlapittaroga . 7 Anupana of Madhu has been told in the reference which will purify Rasawaha Srotasa of patient.

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 Criteria for Assessment Patients were assessed on the basis of the following criteria: The assessment was made based on following subjective and objective parameters and the assessment of the result was made on the basis of improvement in clinical findings as well as laboratory investigations, which were repeated after the completion of treatment also. The improvement in the clinical signs and symptoms were assessed by adopting. The following scoring method. Symptoms Grade 0 Grade 1 Grade 2 Grade 3 Grade 4 DAHA No complaints Complaints relieved by taking small amount of water Complaints continue for more than 1 hour even after having cold water or milk and settles down without medicines Complaints continue for more than 1 hour even after having cold water or milk and settles down with medicines Complaints not responding to cold water or cold milk intake and requires medical treatment CHARDI No event 0 Less than 1 episode a week More than 1 episode a week 2 More than 1 episode for 3 to 4 days More than 1 episode a day SHULA Absent 0 Occasional 3 to 4 times a day 5 to 6 times a day Persistent throughout the day AVIPAK (Dyspepsia) (Jeernaaharlakshana - udgarshoodhi, utsaha, yathochitvegotsarga, laghuta, kshut, pipasa) Absence 5 to 6 jeernaahara lakshanas 4 to 5 Jeernaahara lakshanas 3 to 4 Jeernaahara lakshanas 3 to 2 Jeernaahara Lakshanas Absence of jeernaahara lakshanas

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 TIKTA AMLODGAR Clear belching after two hours of food or no belching at all Mild belching after food intake and requires no treatment to settle down 1 Belching starts after 1 hour of food intake and settles down with or without treatment Belching starts after 2 hours of food intake and settles down with or without treatment Belching starts within 2 hours of food intake requires treatment or belching without taking food 4 KLAM Routine daily work without weakness Routine daily work for 2 hours causes weakness but relieves after rest Grade 1 Routine daily work for 1 hour causes weakness but relieves after rest Grade 2 Daily work for 1 hour causes weakness which is not relieved after Grade 3 Weakness without any work & not relieved even after rest for 6 hr garade 4 UTKLESH No symptoms For 1 hour and requires no medicine For 1 hour and requires medicine For more than 1 hour but settles down with or without medicine For more than 2 hours & requires medicine 4 AMLA UDGAR No symptoms For 1 hour and requires no medicine For 1 hour and requires medicine For more than 1 hour but settles down with or without medicine For more than 2 hours & requires medicine 4 GAURAVATA No complaints Sometimes feels tastelessness, but can have food Sometimes feels tastelessness, but cannot have food Continuous sensation of tastelessness, but able to eat food Continuous sensation of tastelessness & unable to eat food

VOLUME- 3 | ISSUE- 10 OCTOBER 2020 Table :-showing Comparative results of Group-A and Group Signs and Symptoms Group A (Mean Score) Group B (Mean Score) T Value P Value Avipaka 1.43 1.33 0.49 >0.05 Utklesh 1.42 1.57 0.69 >0.05 Utklesha 1.30 1.63 2.13 <0.05 Tikta-Amla Udgara 1.32 1.17 0.69 >0.05 Hrud-Kant Daha 1.35 1.30 0.26 >0.05 Abdominal Pain 1.07 0.77 1.26 >0.05 Heart Burn 1.38 1.13 1.58 >0.05 Acid Regurgitation 1.23 1.22 0.11 >0.05 Sucking Sensation in Epigastrium 1.00 0.62 2.08 <0.05 Nausea and Vomiting 1.23 1.20 0.23 >0.05 Borborygmus 0.72 0.73 0.10 >0.05 Abdominal Distention 0.62 0.65 0.21 >0.05 Eructation 0.33 0.67 2.05 >0.05 Increased Flatus 0.52 0.50 0.12 >0.05 Decreased Passage of Stools 0.03 0.18 1.70 <0.05 Increased Passage of Stool 0.10 0.10 0.00 >0.05 Loose Stools 0.10 0.20 1.13 >0.05 Hard Stools 0.10 0.35 2.04 <0.05 Urgent need of Defecation 0.12 0.10 0.19 >0.05 Feeling of incomplete Evacuation 0.20 0.32 0.99 >0.05

IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 73 VOLUME- 3 | ISSUE- 10 OCTOBER 2020 OBSERVATION AND RESULT: Effect of treatment in group A class Grading No. of Patients 0-25% No change 0 26-50% Mild 0 51-65% Moderate 8 76-100% Marked 12 Effect of treatment in group B Class Grading No of patients 0-25% No change 0 26-50% Mild 1 51-75% Moderate 17 76-100% Marked 2 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 Comparative results of Group-A and Group B Group A Group B

IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 74 VOLUME- 3 | ISSUE- 10 OCTOBER 2020 Statistical analysis Group A Group B Mean Difference SE (±) T Value P value 78.78 65.84 12.94 2.84 4.39 <0.05 Comparative analysis of the overall effect of the treatments in both the groups was done by statistically with Mann Whitney test. The test shows that the treatment is significant in Group A when compared to Group B. Group A overall result is 78.78% and Group B overall result is 65.84%. DISCUSSION: A scientific discussion on the study gives rise to some fruitful conclusions As per the observation drawn from this study, we can conclude that, Ayurveda in fact is the first medical science which identified, diagnosed and managed Amlapitta Amlapitta is co related with Hyperacidity which is having similar pathogenesis and manifestations. The various hetus of Amalapitta Ahara Vidhi Viruddha Hetus like Adhyashan 7 and Pramitashan,,Samashan,Vishamashan,Ajir nashan .Jalapana Vidhiviruddha Hetu like Atyambupana Viharaj Hetus like Divaswap Ratro jagaranAvyayam Mansik Hetu like Chinta Shok All these were findings of study which indicate Santarpanjanya and Apathyanimmitaja origin of disease.So this study revalidates the Nidan Parivarjan is mandatory for the results in the treatment, need of Hetu Viparit Chikitsa. Both Group A ( Amlapittavinashak yoga kwath ) and Group B ( Bhunimbadi kwath) shown highly significant result in reduction of the subjective parameters quantity of urine like Avipak , Utklesh ,Hrud kanth daha,Hrullas symptoms (p<0.05). The Group A was found significant when compared with Group B. Both the Group had highly significant result in reduction in the Nausea (p<0.05) and in the comparison between both groups, Group A was not significant when compared with Group B Both the Group had highly significant result in reduction in the sucking sensation in epigastrium (p<0.05) and in the comparison between both groups, Group A was found significant when compared with Group B.It is observed that in this study that Pathyakar Ahara, Vihara with lifestyle modification and some Ayurvedic medication gives

IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 75 VOLUME- 3 | ISSUE- 10 OCTOBER 2020 better result in reducing complications of Amlapitta. CONCLUSION Thus the Amlapittavinashak yoga kwath have shown better effect on the patients of Amlapitta by Samprapti Bhanga of disease, with significant reduction in the symptoms of Amlapitta like . Avipak ,Aruchi,Hrudkanthdaha,chardi,Utklesha etc. The study has shown fairly good changes in symptoms throughout the follow up of 21 days .The present study was carried out on the small sample size for limited period and it showed encouraging results in patients of Amlapitta. So further study is needed with modification in groups. Acknowledgement:- Nil Financial Assistant:- Nil Conflict of interest :- Nil

IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 76 VOLUME- 3 | ISSUE- 10 OCTOBER 2020 REFERENCES 1 Prof. BanvariLal Gaur. AshtangHridya ( Sanvartika Hindi Commentary).Varanasi: ChaukambhaOrientalia. P. 362, 363, 364 2 KavirajAtridevGupt AshtangSangraha . Vol.1 st . Varanasi: ChaukambhaKrishnadas Academy. P. 223 3. SharangdharAcharya . Pandit. SharangdharSamhita ( GudarthDipikaAndDipika ). Uttar khanda. Varanasi: ChaukambhaOrientalia. P.354,355 4 VaidhyaShriSatyanarayanShastri. Charak samhita (VidhyotiniHindi Commentary). Vol 2 nd . Varanasi: ChaukambhaBharti Academy. Suthrasthan P 456 5 Dr AmbikaDuttShastri . SusruthSamhita (Ayurvedtatvasandipika Hindi Commentary). Vol.1 st . ChikitsaSthan . Varanasi: Chaukambha Sanskrit Sansthan . P. 229, 230 6 VaidhyaShriSatyanarayanShastri. Charak samhita (VidhyotiniHindi Commentary). Vol 2 nd . Varanasi: ChaukambhaBharti Academy.Chiktsa sthan 15/45-60 7 VaidhyaShriSatyanarayanShastri. Charak samhita (VidhyotiniHindi Commentary). Vol 2 nd . Varanasi: ChaukambhaBharti Academy, Sutrasthan p. 230

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Kalpa, Amalaki, Amasaya, Nimba, Haritaki, Grahani, Utklesha, Mandagni, Kulatha, Klama, Madya, Ajirna, Amlapitta, Pachana, Guduchi, Atibhojana, Abhojana, Aruchi, Avipaka, Amlodgara, Pathyapathya, Pittavidagdha, Gauravata, Vyayam, Atyambupana, Dincharya, Patol, Nausea, Bibhitaki, Skin disease, Lukewarm water, Functional dyspepsia, Lifestyle modification, Seasonal variation, Fast-food, Control group, Etiological factor, Abdominal discomfort, Assessment criteria, Follow up study, Scoring Method, Ayurvedic Management, Exclusive criteria, Sour belching, Laboratory investigation, Hyperacidity, Gastrointestinal system, Vitiation of Dosha, Viharaj Hetu, Ahara Rasa, Subjective parameter, Rutucharya, Objective parameter, Kaphavatahara, Agnideepana, Agni Deepana, Drug review, Trial Group, Annavaha Strotas, Mann-Whitney test, Amla Bhava, Ajeerna, Life style modification, Urdhwag Amlapitta, Acid peptic disease, Annavisha, Samprapti Bhanga, Dincharya and Rutucharya, Samprapti Bhang, Inclusive Criteria, Peptic ulcer disease, Vitiation of Agni, Samprapti of Amlapitta, Burning sensation in chest, Adhyashan, Raktavardhaka, Pathyakar Ahar, Clinical finding, Shift duties, Divaswap, Pachak agni, Mansik hetu, Gastrointestinal disorder, Vishamashan, Shuktatva, Agni Vikriti, Hetu sevan, Scientific discussion, Virudha Bhojana, Samashan, Apaka (indigestion), Dusta Bhojana, Utklesha (Nausea), Aamvish, Panchakarmavyapat, Pittaja Ahara.