A prospective clinical study of Shwasa Kasa Dashemani Ghana Kashaya in...

[Full title: A prospective clinical study of Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa w.s.r. to Chronic Bronchitis]

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[Find the meaning and references behind the names: Sri, Parveen, Ayu, Kashi, Med]

Journal of Ayurveda and Integrated Medical Sciences 2025 Volume 10 Number 3 MARCH E-ISSN:2456-3110 Research Article Chronic Bronchitis Publisher www.maharshicharaka.in A prospective clinical study of Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa w.s.r. to Chronic Bronchitis Nadaf P 1* , Aniruddha 2 , Kamath T S 3 DOI:10.21760/jaims.10.3.7 1* Parveen Nadaf, Final Year Post Graduate Scholar, Department of PG and PhD studies in Kayachikitsa and Manasaroga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India 2 Aniruddha, Associate Professor, Department of PG and PhD studies in Kayachikitsa and Manasaroga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India 3 Shrilatha Kamath T, Professor and HOD, Department of PG and PhD studies in Kayachikitsa and Manasaroga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India Background: As per Ayurveda all the respiratory disorders are understood under the concept of Pranavaha Srotovikara wherein Shwasa and Kasa hold on the major role. Kaphaja Kasa is a chronic illness of respiratory tract which requires adequate treatment. The drugs mentioned in Kasahara and Shwasahara Dashemani Gana are effective in the illness Aim and objectives: To evaluate the efficacy of Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa / Chronic Bronchitis Methodology: A clinical study was conducted to evaluate the effect of Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa w.s.r to Chronic Bronchitis. The study was conducted at Sri Dharmasthala Manjunatheshwara Hospital of Ayurveda, Udupi on the subjects of diagnosed with Kaphaja Kasa/ Chronic Bronchitis irrespective of their gender, caste or creed. A total of 40 participants who met the diagnostic and inclusion criteria of Kaphaja Kasa/Chronic Bronchitis were chosen for the study wherein all of them received oral administration of 10 ml of trial drug along with 50 ml of warm water as Anupana, twice in a day. Subjects were scored based on subjective and objective parameters and were assessed on 0 th and 15 th days i.e., before and after the treatment. The data obtained was statistically analysed by ‘Paired t test’ and ‘Wilcoxon signed rank test’ for objective and subjective data respectively Results: The results revealed that there was a significant improvement in relief by a mean percentage of 55% Conclusion: Shwasa Kasa Dashemani Ghana Kashaya showed significant efficacy in reducing signs and symptoms of Kaphaja Kasa Keywords: Kaphaja Kasa, Chronic Bronchitis, Shwasa Kasa Dashemani Ghana Kashaya Corresponding Author How to Cite this Article To Browse Parveen Nadaf, Final Year Post Graduate Scholar, Department of PG and PhD studies in Kayachikitsa and Manasaroga, Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady, Udupi, Karnataka, India. Email: Nadaf P, Aniruddha, Kamath T S, A prospective clinical study of Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa w.s.r. to Chronic Bronchitis J Ayu Int Med Sci. 2025;10(3):46-53. Available From https://jaims.in/jaims/article/view/4044/ Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted 2025-02-05 2025-02-15 2025-02-25 2025-03-05 2025-03-22 Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note None Nill Yes 11.96 © 2025 by Nadaf P, Aniruddha, Kamath T S and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0] J Ayu Int Med Sci 2025 ; 10 ( 3 ) 46

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[Find the meaning and references behind the names: George, Gold, Mon, Low, Rasa, Shweta]

Introduction Kasa is one among Pranavaha Srotovikara (disorders of respiratory system) and Kaphaja Kasa (Chronic bronchitis) is a variety among Panchakasa (5 varieties of cough) wherein the morbid Kapha and Vatadosha (factor responsible for movement) [1 ] along with Rasa Dhatu Dushti involve in disease manifestation thus it explains the depletion in the level of nutrition in the patient suffering from this disease. The prevalence rate of Chronic Bronchitis is directly proportional to smoking and the excess usage of biomass fuels leading to low quality of air due to air pollution. In 2018, 9.0 million adults or 3.6% of those ages 18 or older had chronic bronchitis. There was an estimation that the Global prevalence of Chronic Bronchitis among people aged 30-79 years in 2019 was 10.3%, using the GOLD case definition which translates to 391.9 million people [2 ] More than 65 million people around the world have moderate to severe COPD as per 2021 study among which 35 million were observed to be cases of Chronic Bronchitis. In the past two decades, the Burden of Obstructive Lung Disease initiative and Global burden of Disease collaborators have pioneered efforts to collect country-specific population-based data on the prevalence of and risk factors for Chronic Bronchitis, providing updates on global estimates of deaths, prevalence and disability adjusted life years. In Charaka Samhita, it is mentioned that one should treat according to the severity of all types of Kasa , increases in successive order [3 ] Bronchodilators, Anticholinergic Agents, Beta Agonists, Glucocorticoids, Antibiotics, Oxygen therapy are the conventional treatments available and have modest results. The effect of these treatments last for few hours to maybe a day and if discontinued then there will be exacerbation A safe and cost-effective treatment which has to be oriented towards the Margavarana (obstructing channels) as well as Kaphaharana (removing phlegm) is the need of the hour. The formulation used in the present study contains potent drugs mentioned in Kasahara and Shawasahara Mahakashaya [4 ] in which the total efficacy of all the ingredients is been assessed. Thus, by keeping above aims this clinical trial is selected for the study Materials and Methods Source of data Patient source: Minimum of 40 patients fulfilling the inclusion, exclusion and assessment criteria from the OPD and IPD of Sri Dharmasthala Manjunatheshwara College of Ayurveda, Hospital and Research Centre, Kuthpady Drug source: Shwasa Kasa Dashemani Ghana Kashaya was prepared and collected from SDM Pharmacy, Udupi Method of collection of data: A special case proforma was prepared with all the points of preliminary data, history taking followed by assessing the signs and symptoms with St George Respiratory Questionnaire, Breathlessness Cough Sputum Scale, Peak Expiratory Flow Rate and Ayurvedic scale for assessment of Kaphaja Kasa. Design of the study: Study type: Interventional Allocation: Based on diagnostic criteria End point classification: Efficacy study Estimated enrolments: 40 participants Interventional Model: Single group Primary purpose: Treatment Masking: open label, Pre-test, and post-test design Intervention: A total of 40 participants were administered 10 ml of Shwasa Kasa Dashemani Ghana Kashaya for 15 days with 50 ml of warm water as Anupana Follow-up: 15 days after treatment Total duration of the study: 30 days Diagnostic criteria: 1. According to ICD-10-CM Code for Unspecified Chronic Bronchitis J 42 classification. It includes - Chronic bronchitis Chronic tracheatis Chronic tracheobronchitis [5 ] 2. Clinical presentation of Kaphaja Kasa such as presence of Shweta (pale), Bahala (more in quantity) , Ghana Nishtivana (thick sputum) w.s.r. to Chronic Bronchitis i.e., coughing up sputum that lasts for 3 mon. per year in two consecutive years Inclusion criteria: 1. Diagnosed case of Kaphaja Kasa / Chronic Bronchitis as per diagnostic criteria Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa J Ayu Int Med Sci 2025 ; 10 ( 3 ) 47

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2. Men and women between the age group of 40 and 80 years. 3. No severe exacerbation of Kaphaja Kasa / Chronic Bronchitis requiring hospitalization in the last 3 months. 4. Participants who are willing and able to provide informed Exclusion criteria: 1. Chronic persistent Bronchial Asthma. 2. History of a clinically relevant abnormal findings on physical examination, laboratory testing or CT scan, which of the opinion of the investigator may compromise the safety of the participant in the study or interfere with the evaluation of the study intervention. 3. History of a clinically significant infections (viral, bacterial or fungal) within 4 weeks. 4. Participants with a recent history of, or who have a positive test for, infective hepatitis or unexplained jaundice. 5. Evidence of active or untreated latent Tb. 6. As judged by the investigator, any evidence of active medical or psychiatric condition which in the investigator’s opinion makes it undesirable for the participant to participate in the study Assessment criteria: Both subjective and objective criteria were assessed by standard methods before and after the treatment i.e., 0 th day and 15 th day. The data was statistically analyzed by Wilcoxon signed rank test and Paired t test respectively Subjective criteria 1. Kasa (cough) 2. Kaphashtivana (frequency of sputum) 3. Ghana Nishtivana (consistency of sputum) 4. Heaviness of Chest 5. Nasal Discharge 6. St George Respiratory Questionnaire [6 ] This is a designed scale to measure health improvement in patients with Asthma and COPD and other respiratory conditions such as bronchieactasis, sarcoidosis where the quality of life of a person is affected Total score ranges from 0 to 100, where 0 indicates best health and 100 indicates worst health. The structure of SGRQ scale consists of two parts where part 1 covers the patients’ recollection of their symptoms over a preceding period that may range 1 month to 1 year Part 2 addresses the patients’ current state (i.e., how they are these days). The activity score measures the disturbances to daily physical activity of the patients 7. Breathlessness Cough Sputum Scale [7 ] The breathlessness, cough and sputum scale (BCSS) is a threeitem questionnaire rating breathlessness, cough and sputum on a 5- point scale from 0 (no symptoms) to 4 (severe symptoms) Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa No cough - 0 Occasional cough but not disturbing -1 Cough troublesome during attacks - 2 Frequent and troublesome cough - 3 Cough distress most of the time - 4 No sputum - 0 Cough with occasional sputum < 3 times per day - 1 Cough with frequent sputum > 3 times per day - 2 Sputum during every bout of cough - 3 No sputum - 0 Sputum expelled with a bout of cough without difficulty - 1 Sputum expelled on clearing throat/on expectorants - 2 Unable to expel sputum - 3 No feeling of heaviness - 0 Occasional feeling of heaviness of chest but not affecting daily routine - 1 Occasional feeling of heaviness of chest affecting daily routine - 2 Feeling of heaviness of chest throughout the day hampering daily routine - 3 No Nasal Discharge - 0 Occasional runny nose but not affecting daily routine - 1 Occasional runny nose affecting daily routine - 2 Nasal discharge throughout the day hampering daily routine - 3 J Ayu Int Med Sci 2025 ; 10 ( 3 ) 48

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Observations and Results Administration of Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in decreasing Kasa . All the 40 patients had this symptom, the mean score for Kasa prior to treatment was 2.525 which decreased to 1.725 after treatment with mean difference of 0.8. The analysis by applying the Wilcoxon signed rank test showed that the improvement was statistically significant with ‘P’ value of P<0.001. Details are shown at full length in the table no. 1 Table 1: Effect of treatment on Kasa Kasa Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Median Z value P value 2.525 1.725 0.8 31.6% BT 0.554 0.087 3.000 5.333 <0.001 AT 0.640 0.101 2.000 Effect on Frequency of Sputum The initial mean score of frequency of sputum was 1.650 which came down to 0.875 after the medication. Thus, recording the improvement by 46.9%. Also showing the test for statistical significance proves that the result is statistically significant with the value of P< 0.001 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no. 2 Table 2: Effect of treatment on Frequency of Sputum Frequency of sputum Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Medi an Z value P value 1.65 0 0.87 5 0.77 5 46.9% B T 0.66 2 0.10 5 2.000 5.089 <0.00 1 A T 0.64 8 0.10 2 1.000 Effect on Consistency of Sputum Administration of Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in reducing thick consistency of sputum. Mean score for consistency of sputum prior to treatment was 1.425 which decreased to 0.875 after treatment with mean difference of 0.55 and improvement by 38.5%. Analysis by applying Wilcoxon signed rank test showed that improvement was statistically significant with ‘P’ value of P< 0.001 showing definite beneficial therapeutic effect of medicine. Details are shown at full length in table no. 3 Table 3: Effect of treatment on Consistency of Sputum Consistency of sputum Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SE M Medi an Z value P value 1.4 25 0.87 5 0.55 38.5% B T 0.8 13 0.12 9 1.000 4.315 < 0.001 A T 0.7 57 0.12 0 1.000 Effect on Heaviness of Chest The initial mean score of Heaviness of Chest was 0.750 which came down to 0.350 after the medication. Thus, recording the mean difference of 0.4 and improvement by 53.3%. Also showing the test for statistical significance proves that the result is statistically significant with the value of P< 0.001 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no. 4 Table 4: Effect of treatment on Heaviness of Chest Heaviness of chest Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Medi an Z value P value 0.75 0 0.35 0 0.4 53.3% B T 0.74 2 0.11 7 1.000 3.771 <0.00 1 A T 0.53 3 0.08 4 0.000 Effect on Nasal Discharge The initial mean score of Nasal discharge was 0.375 which came down to 0.175 after the medication. Thus, recording the mean difference of 0.2 and improvement by 53.3%. Also showing the test for statistical significance proves that the result is statistically significant with the value of P=0.02 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no. 5 Table 5: Effect of treatment on Nasal Discharge Nasal Discharge Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Medi an Z value P value 0.37 5 0.17 5 0.2 53.3% B T 0.74 0 0.11 7 0.000 2.309 =0.02 A T 0.38 5 0.06 08 0.000 Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa J Ayu Int Med Sci 2025 ; 10 ( 3 ) 49

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[Find the meaning and references behind the names: Good]

Effect on Shortness of Breath The initial mean score of Shortness of Breath was 0.075 which came down to 0.000 after the medication. Thus, recording the mean difference of 0.075 and improvement by 100%. Also showing the test for statistical significance proves that the result is statistically significant with the value of P=0.02 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no. 6 Table 6: Effect of treatment on Shortness of Breath Shortness of Breath Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Medi an Z value P value 0.07 5 0.00 0 0.07 5 100% B T 0.26 7 0.04 2 0.000 1.732 =0.02 A T 0.00 0 0.00 0 0.000 Effect on SGRQ Score Administration of Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in the reduction of SGRQ Score. The mean score for SGRQ Score prior to treatment was 24.550 which decreased to 19.075 after treatment with mean difference of 5.475 and improvement of 22.3%. The analysis by applying the Wilcoxon signed rank test showed that the improvement was statistically significant with ‘P’ value of P< 0.001 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no. 7 Table 7: Effect of treatment on SGRQ Score SGRQ Score Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Media n Z value PValu e 24.55 0 19.07 5 5.475 22.3% B T 7.21 1 1.14 0 23.50 0 5.383 <0.00 1 A T 6.58 8 1.04 2 18.50 0 Effect on PEFR value Administration of Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in increasing the Peak Expiratory Flow Rate[PEFR] value. The mean score for PEFR value to treatment was 209.000 which increased to 221.750 after the treatment with mean difference of 12.750 and improvement by 6.1% The analysis by applying the paired ‘t’ test showed that the improvement was statistically significant with ‘P’ value of P=0.015. Details are shown at full length in the table no.8 Table 8: Effect of treatment on PEFR Value PEFR value Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Medi an ‘t’ value P value 209.0 00 221.7 50 -12.7 50 6.1% B T 70.8 12 11.1 96 200.0 -2.226 =0.01 5 A T 74.5 89 11.7 94 200.0 Effect on BCS Scale Administration of Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in decreasing BCS scale score. The mean score for BCS Scale value prior to treatment was 6.075 which decreased to 4.425 after the treatment with mean difference of 1.65 and improvement by 27.1%. The analysis by applying the Wilcoxon Signed Rank test showed that the improvement was statistically significant with ‘P’ value of P< 0.001 showing definite beneficial therapeutic effect of the medicine. Details are shown at full length in the table no.9 Table 9: Effect of treatment on BCS Scale BCS Scale Mean Wilcoxon signed rank test BT AT BT- AT % of improvement SD SEM Media n Z value P value 6.07 5 4.42 5 1.65 27.1% B T 0.97 1 0.15 4 6.000 4.996 <0.001 A T 1.23 8 0.19 6 4.000 Overall assessment in response to treatment In the study 0% had excellent improvement, 5% had moderate improvement, 55% had good improvement, 27.5% had a fair improvement, 10% had no improvement and 2.5% had negative response. Details are shown at full length in the table (table no. 10) and figure (fig no.10) Table 10: Overall assessment SN Improvement Scale No. of Patients % of Patients 1. Excellent 75-100% 0 0% 2. Moderate 50-74% 2 5% 3. Good 25-49% 22 55% 4. Fair 0-24% 11 27.5% 5. No Response 0% 4 10% 6. Negative Response 1 2.5% Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa J Ayu Int Med Sci 2025 ; 10 ( 3 ) 50

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[Find the meaning and references behind the names: Bala, Main, Angelica]

Based on Symptoms Significant differences were observed in the mean scores of symptoms. The mean score of St. George Respiratory Questionnaire scale decreased from was 24.550 before treatment to 19.075 after treatment with mean difference of 5.475 and improvement of 22.3%. The mean score for PEFR value to treatment was 209.000 which increased to 221.750 after the treatment with mean difference of 12.750 and improvement by 6.1%. The mean score for BCS Scale value prior to treatment was 6.075 which decreased to 4.425 after the treatment with mean difference of 1.65 and improvement by 27.1%. Statistically significant improvements were observed in various symptoms after the intervention. The mean score for Kasa prior to treatment was 2.525 which decreased to 1.725 after treatment with mean difference of 0.8. The initial mean score of frequency of sputum ( Bahala Kapha ) was 1.650 which came down to 0.875 after the medication. Thus, recording the improvement by 46.9%. The mean score for consistency of sputum ( Ghana Kapha ) prior to treatment was 1.425 which decreased to 0.875 after treatment with mean difference of 0.55 and improvement by 38.5%. The initial mean score of Heaviness of Chest was 0.750 which came down to 0.350 after the medication. Thus, recording the mean difference of 0.4 and improvement by 53.3%. The initial mean score of Nasal discharge was 0.375 which came down to 0.175 after the medication. Thus, recording the mean difference of 0.2 and improvement by 53.3%. The initial mean score of Shortness of Breath was 0.075 which came down to 0.000 after the medication. Thus, recording the mean difference of 0.075 and improvement by 100% Overall effect of therapy The analysis of the treatment intervention revealed significant improvement in overall relief. In the study 55% had good improvement,5% had moderate improvement, 27.5% had a fair improvement, 10% had no improvement and 2.5% i.e., 1 patient had negative response Discussion Pranavaha Srotas (Respiratory system) serves the functon of Shwasaprashwasa Kriya (act of inspiration and expiration) and during this act of respiration the air enters into the body This makes the Srotas to get exposed to environmental factors constantly. There builds up the Khavaigunyata (morbidity) and later gives rise to various Pranavaha Srotovikara (disorders of respiratory system) Kaphaja Kasa is one such Pranavaha Srotovikara which is caused due to morbid Kapha and Vata Dosha. [8 ] Shwasa Kasa Dashemani Ghana Kashaya contains Draksha ( Vitis vinifera ) , Abhaya ( Terminalia chebula ) , Amalaki ( Emblica officinalis ), Pippali ( Piper longum ) , Shrungi ( Pistachia chinensis ) , Kantakari ( Solanum xanthocarpum ) , Punarnava ( Boerhavia diffusa ) , Bhumyamalaki, Shati ( Hedychium spicatum ) , Pushkaramoola ( Inula racemose ) , Amlavetasa ( Garcinia pedunculata ) , Ela ( Elettaria cardamomum ) , Agaru ( Aquillaria agallocha ) , Hingu ( Ferula northex ) , Surasa ( Ocimum sanctum ) , Jeevanti ( Leptadenia reticulata ) , Duralabha ( Fagonia cretica) , Chanda. [9] Majority of the drugs possess Vatakapha Shamaka property which are two main Dosha involved in the disease. Some of the drugs such as Pippali [10] , Kantakari [11 ] , Surasa [12] , Shati [13] , Hingu [14] , Ela [15] , Chanda ( Angelica archangelica , As the drug was not available, its substitute Angelica glauca was used) [16] have the properties of Deepana and Pachana thus, act at the level of Agni thereby reducing the Malarupi Kapha / tenacious sputum. Pushkaramoola [17] , Kantakari , Shrungi [18] , Shati, Punarnava [19] , Agaru [20] , Pippali, Surasa, Duralabha [21 ] possess the properties of Chedana (breaking), Lekhana (scraping) , Shothahara (anti-inflammatory). The Pratyatma Lakshana (cardinal feature) of Kaphaja Kasa (Chronic bronchitis) being Bahala, Madhura (sweetish) , Snigdha (slimy) , Ghana Kapha Nishtivana hence, the above mentioned properties help in Kapha Nissarana , Kapha Chedana , reduce Shotha and clears the obstruction. It is noted that in Kaphaja Kasa Vata is obstructed downwards and takes the Pratiloma Gati (in reverse direction) hence, Anulomana (downward movement) property of certain drugs like Abhaya, Hingu, Ela, Chanda and Amlavetasa helps to restore the normal Gati (movement) of Vatadosha . Drugs such as Amalaki, Jeevanti, Abhaya, Tamalaki, Draksha, Amlavetasa possess Rasayana (rejuvenating) and Brihmana (nourishing) properties which improves Rasadi Dhatu , Ojas/Bala further improving the subject’s quality of life Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa J Ayu Int Med Sci 2025 ; 10 ( 3 ) 51

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[Find the meaning and references behind the names: Song, Long, Campbell, Adeloye, Zhu]

As per Modern perspective, the drugs used to treat Chronic Bronchitis must have bronchodilator effect, antibiotic, anti-inflammatory and immune modulatory action. Draksha ( Vitis vinifera ) contains the constituents such as flavonoids, polyphenols, gallic acid, anthocyanins act as anti-oxidative, antiinflammatory and anti-microbial. Abhaya ( Terminalia chebula ) contains high percentage of phenolics which are anti-oxidants. Studies have also showed that Ethanol and aqueous extract of Haritaki have anti-microbial and immuno modulatory effect Amalaki provides antitussive effect due to its action on the mucus glands and thereby prevents hypersecretion in the airways. Pippali ( Piper longum ) contains volatile oil, alkaloids such as piperine and piper longuminine. Piperine, the prime constituent of Pippali has a significant antiinflammatory action. Kantakari ( Solanum xanthocarpum ) contains apigenin which has anti allergic effect in addition. Also, the Glycoalkaloid and fatty acids of Solanum xanthocarpum acts as anti-histaminic. Punarnava ( Boerhavia diffusa ) contains coccineone, boeravinone, which possess the property of anti-inflammatory. Bhumyamalaki ( Phyllantus niruri ) contains ligans niranthin, phyltetralin, nirtetralin exhibit anti-inflammatory action to some extent. Rhizome of Shati ( Hedychium spicatum ) contains sitosterol, glucosides, diterpene-hedychenone and 7 hydroxy hedychenone and essential oils being the major constituents which are anti-inflammatory in nature Duralabha ( Fagonia cretica ) contains Triterpinoides, saponins, oleonolic acid possess anti-inflammatory and antibacterial properties thus reducing infection Tamalaki ( Phyllantus niruri ) contains phyllantin which shows immune modulatory action Amlavetasa ( Garcinia pedunculata ) contains Garcinol, cambogin which are anti-inflammatory Hingu ( Ferula narthex ) is a potent muscle relaxant which has an effect on tracheal smooth muscle due to muscarinic receptor blockage also causes broncho dilation. Ela ( Elettaria cardamomum ) contains flavonoids which have bronchodilator activity, antioxidant and spasmolytic activity. Pushkaramoola (Inula racemosa) contains Beta-sitosterol, Sesquiterpines lactones which are antiinflammatory. The aqueous and alcoholic extract of Inula racemosa also shows anti histaminic property Surasa ( Tulasi ) consists of flavonoids like triterpenoids and eugenol which show significant anti-inflammatory action Jeevanti ( Leptadania reticulate ) contains steroids, stigmasterol, sitosterol, triterpenoids have anti asthmatic property By the above discussion it is clear that, all the drugs mentioned in Shwasahara (relieving dysnoea) and Kasahara (relieving cough) Gana (group) have different properties such as anti-inflammatory, thereby reducing the airway inflammation and hypersecretion of mucus. Certain drugs such as Draksha, Pippali, Haritaki, Punarnava, Amalaki have immune modulatory, anti-oxidant activity which prevent the allergic responses. It can be said that on long term usage, these drugs potentiate immune system Conclusion Shwasa Kasa Dashemani Ghana Kashaya was found to be effective in reducing the symptoms of Kaphaja Kasa /Chronic Bronchitis which was statistically significant with the p value <0.001. Among 40 subjects, all of them showed decrease in the SGRQ score by 22.3% which implies reduction in severity of symptoms, improvement in the quality of daily activities, 14 subjects showed improvement in PEFR value by 6.1% within 2 weeks of intervention of Shwasa Kasa Dashemani Ghana Kashaya. Majority of subjects had good overall improvement, 11 showed fair improvement, 2 showed moderate improvement and 1 patient with negative response. Even after 15 days of treatment, the medicine can be continued as there were no any adverse effects observed during the follow up period References 1. Agnivesha. Charaka Samhita. Edited by Shukla V, Tripathi RD. Delhi: Chaukambha Sanskrit Pratishthan; 2015. Chikitsasthana, Chapter 18, p. 440 [Crossref][PubMed][Google Scholar] 2. Adeloye D, Song P, Zhu Y, Campbell H. Global, regional, and national prevalence of COPD in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022 May 1;10(5). Available from: [Article][Crossref][PubMed][Google Scholar] 3. Agnivesha. Charaka Samhita. Edited by Shukla V, Tripathi RD. Delhi: Chaukambha Sanskrit Pratishthan; 2015. Chikitsasthana, Chapter 18, p. 439 [Crossref][PubMed][Google Scholar] Parveen N et al. Shwasa Kasa Dashemani Ghana Kashaya in Kaphaja Kasa J Ayu Int Med Sci 2025 ; 10 ( 3 ) 52

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[Find the meaning and references behind the names: Guna, Sharma, Mar, Jones, Leidy]

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Terminalia chebula, Vatadosha, Emblica officinalis, Leptadenia reticulata, Ocimum sanctum, Piper longum, Elettaria cardamomum, Fagonia cretica, Hedychium spicatum, Solanum xanthocarpum, Daily activities, Shortness of breath, Adverse effect, Medication, Immune system, Kaphaja Kasa, Statistical analysis, Kasa (cough), Environmental factor, Rasayana properties, Respiratory system, Inclusion criteria, Exclusion criteria, Clinical study, Diagnostic criteria, Clinical trial, Assessment criteria, Overall effect of therapy, Statistical Significance, Treatment efficacy, Follow Up Period, Deepana and Pachana, Anti-inflammatory, Moderate improvement, Anti oxidant activity, Treatment intervention, Paired T test, Airway inflammation, Subjective parameter, Anti-inflammatory action, Chronic Bronchitis, Objective parameter, Muscle relaxant, Nasal Discharge, Bronchodilator activity, Anti-asthmatic, Pratyatma Lakshana, Antibacterial properties, No improvement, Overall effect, Peak Expiratory Flow Rate, Anulomana property, Modern perspective, Mean score, Wilcoxon signed-rank test, Mean Difference, Symptom assessment, Pratiloma Gati, Immune-modulatory, Antitussive effect, Bronchodilator effect, Anti-microbial, Respiratory disorder, Anti allergic effect, Anti-histaminic, Negative response, Anti oxidative, Immune-modulatory activity, Good improvement, Vatakapha shamaka, Study of, Lekhana (scraping), Pranavaha Srota, Wilcoxon signed.