Ayurveda medicinal plants for Asthikshaya (Osteoporosis): A review

[Find the meaning and references behind the names: Lal, Low, Ayu, Main, Asia, Mohan, Mala, Mass, Mana, Med, Richa]

229 Journal of Ayurvedic and Herbal Medicine 2016; 2(6): 229-235 Review Article ISSN: 2454-5023 J. Ayu. Herb. Med. 2016; 2(6): 229-235 November- December © 2016, All rights reserved www.ayurvedjournal.com *Corresponding author: Dipti PG Scholar, PG Department of Dravyaguna Vigyana, National Institute of Ayurveda, Jaipur, Rajasthan-302002, India Email: dipti 9235[at]gmail.com Ayurveda medicinal plants for Asthikshaya (Osteoporosis): A review Dipti 1 , Richa Khandelwal 1 , Ankita Aggarwal 2 , Mohan Lal Jaiswal 3 1 PG Scholar, PG Department of Dravyaguna Vigyana, National Institute of Ayurveda, Jaipur, Rajasthan-302002, India 2 PG Scholar, PG Department of Maulik Siddhanta, National Institute of Ayurveda, Jaipur, Rajasthan-302002, India 3 Associate professor, PG Department of Dravyaguna Vigyana, National Institute of Ayurveda, Jaipur, Rajasthan- 302002, India ABSTRACT Ayurveda is an ancient science of life deals with the preventive as well as curative aspect. It explains human body as a ‘congenial homeostasis’ of doṣa, dhatuand mala . The function of dhatu is dharaṇa (maintain the structure) of the sharira (body). Among the dhatu , asthidhatu is responsible for maintenance of structural frame work of the body. It gives shape to the body and protects the vital organs. Concept of osteoporosis has explained under 18 types of kṣaya by Acharya Carakain sutra sthan kiyantahshirasiya adhyaya. Asthikṣaya pathogenesis can be explained in many ways in Ayurveda. According to the principles of ashrayaashrayibhava, asthidhatu is the seat of vata doṣa and inversely related to each other. Increase of vata is the main factor responsible for asthikṣaya . Acharya Caraka has opined increase of vata may follow two patterns; one is from margavaraṇa and another is from dhatukṣaya which can further lead to asthikṣaya . Osteoporosis or porous bone is a global problem characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures of the hip, spine and wrist. Men as well as women are affected by osteoporosis but females are at higher risk. This risk even increases at the time of menopause, which is the period of hormonal imbalance. Treatment available in modern science is mainly symptomatic and not devoid of adverse effects. Ayurveda treatment visualizes the human body as a single unit and this approach has opened many innovative approaches for treatment. On this background present study was taken to analyze the fundamental concept of asthikshaya and to find out single herbs beneficial for it. Drugs from classical texts along with commonly used in practice have been analyzed in context of asthikshaya . Study reveals that drugs like guduchi, ashwagandha, prishnaparni, samanga, vacha etc. possess kaphavatashamak properties which helps in breaking the pathogenesis by clearing and nourishing the srotas (channels). Drugs like madhuyasti, priyangu, vidarikanda, shatavari etc. have vatapittashamak , balya (tonic), brimhan (nourishing) properties works directly on dhatukshaya Keywords: Doṣa, Dhātu, Mala, Asthi kṣaya, Mārgāvaraṇa, Tarpak . INTRODUCTION A yurveda is a “Divine science” due to its origin as well as its incredible strength[1]. It has two aims; one deal with the preventive way that is to safeguard the health of the healthy individual and another is the curative way that is to treat the disease[2]. The three pillars of life are mana (mind), atma (soul) and sareera (body) and their perfect balance considered as complete health in Ayurveda [3]. Ayurveda explains this human body as a homeostasis of dosha , dhatu and mala [4]. The function of dhatu is dhāraṇa (maintain the structure) of the śarīra (body). Among the dhātu , asthidhātu is responsible for maintenance of structural frame work of the body. It gives shape to the body and protects the vital organs. Asthi dhātu is the seat of vāta doṣa [5]. Asthi and vāta are reciprocalto each other. Asthi kshaya is explained in 18 types of kshaya by acharya charak [6]. It can be compared to osteoporosis in contemporary era. Osteoporosis is a systemic skeletal disease characterized by the low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture[7]. It is a growing public health problem worldwide. Worldwide osteoporosis causesmore than 8.9 million fractures annually[8]. It affects both genders; however is more prevalent in women, particularly after the menopause[9]. Osteoporosis affects 200 million women worldwide. Worldwide, 1 in 3 women and 1 in 5 men over age 50 will experience osteoporotic fracture. It is projected that more than about 50% of all the osteoporotic hip fractures will occur in Asia by the year 2050[8]. Osteoporosis is the second most common metabolic bone disease in India[10]. Bone loss is only partly reversible and treatment available in the contemporary science is mainly symptomatic and later surgical interventions were done but these all are not devoid of adverse effects. Prevention and early intervention can prevent osteoporosis in majority. On this background present study was taken to analyze the fundamental concept of asthikshaya (osteoporosis) and to find out single herbs which are safe, cost effective from Ayurveda classics for the

[Find the meaning and references behind the names: Guna, Karma, Sara, Vega, Ansh, Long, Ata, Guru, Full, Tejas, Kala]

J Ayu Herb Med ǀ Vol 2 Issue 6 ǀ November- December 2016 230 betterment of life. Drugs from classical texts along with commonly used in practice have been analyzed in context of asthikshaya with special reference to margavarana and dhatukshaya . Ayurveda concept of asthi-kshaya Interpretationof word ‘ Asthikshaya’ : The word Asthikshaya is composed of twowords Asthi and Kshaya . The word Asthi is derived fromthe root ‘As’ + ‘Kthin’ meaning “To Stay” or in thesense of “Stability”[11]. The definitions of asthi are ‘ asyate kshipyateyat’ ; ‘ asyate iti asthi’; ‘mamsabhyantarasthah-sharirastha sapta dhatvantargata dhatuvisheshaha ’[12]. That which is present in its own state fora long time is called asthi . Sushruta mentions that twacha , mamsa etc. tissues gets destroyed soon (after death), but asthi persists in its own state for a long time. Hence, it is called as the sara of the Sharira [13]. Similarly the definitions of Kshaya are ‘ Kshiyate anena iti Kshaya ’;‘ Kriya kshayakaratwat tu Kshaya ityucyatebudhaihi ’; ‘ Kshaya vyadhi visheshaha ’[14]. That which decreases is called as Kshaya or the kriya which causesthe decrease either qualitatively or quantitatively is knownas Kshaya and it is a vyadhi vishesha . So, the combinedmeaning of a sthi kshaya is decrease in bone tissue. Asthi Dhatu Guna and Karma Asthi is guru (heavy) , khara (rough) [15], kathina (hard) , sthula (bulkiness) , sthira (stable) and murtimad . Its function is deha dharana (provides structural framework to the body) , Majja pushti (nutrition to the bone marrow) andit is the seat of vata [16]. The etiological factors for asthi kshaya are notmentioned separately in the texts. However, Charaka has explained the samanya nidana (general etiological factors) which lead to the kshaya of 18 types[17] which includes mostly the vataprakopak nidan like excessive exercise and intake of dry vegetables, irregular dietary habits which includes excessive fasting, dieting and limited foods, excess of food also, excess of worry, grief, fear, hunger, waking at nights, letting out excess of blood, dosha , dhatumala and time factor ( adana kala and vridhavastha ). Majja dhatu which is present inside the asthi dhatu provides nutrition to asthi . The factors responsible for the vitiation of asthivaha and majjavaha srotas are also responsible for asthi kshaya . The dietary factor such as intake of abhishyandi and incompetent foods of majjavaha sroto dushti [18] provocates v ata due to obstruction leads to vitiation of vata . Vitiation ofa sthivaha srotas directly leads to aggravation of vata ,resulting in asthi kshaya . Symptoms: Asthikshaya symptoms described in different samhita are asthibheda , asthishula , keshalomanakhasmashrudanta vikara and paata (disorders of hair, nails, teeth), sandhi shaithilya , rukshta (dryness)[19,20]. Samprapti: Similarly, samprapti of asthikshaya has not been explained directlyin Ayurvedic classics, keeping in mind all the etiological factors explained under vatavyadhi , asthikshaya pathogenesis can be explained in several ways. According to the principles of ashrayaashriyabhavaasthidhatu is the seat of vatadoṣa , while majjadhatu which is present inside the asthi provides nutrition to asthi . Provocation of vata is the main factor responsible for asthi kṣaya . Itmay follow two patterns one is from margavaraṇa and another is from dhaatukṣaya [21]. Hence the causes of vitiation of vata may be further classified into sakshatdhatu and margavaranakarakanidana . Chakrapani has explained dhatu kshaya as sarakshaya and margavarana as vega pratibandha leading to vata prakopa [22]. By the over indulgence in these nidan, the srotas become rikta (devoid of unctuousness) because of decrease of body tissues and obstruction in thechannels. This leads to provocation of vata and this vitiated vata fills in the channels which are devoid of unctuousness and vitiate them further leading to thestronger provocation of its own. Beside this, proper nourishment of dhatu is verymuch essential in maintaining the qualitative and quantitative normalcy of the dhatu . Proper functioning of jatharagni , bhutagni and dhatwagni is essential in performing this important function. Due to the improper functioning of jatharagni , it can lead to formation of aam (indigestion) which can further cause strotorodh (obstruction in channels) leads to improper nourishment of asthi resulting in asthikshaya . As asthi is composed of parthiv , tejas and vayu mahabhuta [23]; any functionaldeformity in any of these bhutagni leads to improper conversion of parthiv , tejas and vayavya ansh which can further lead to nutritional deficit resulting in asthikshaya . Dhatwagni leads to the deformity in the transformation of poshakadhatu ( Dhatu specific nutrients) into poshya/sthayi dhatu , resulting in dhatu vikriti . Mental factors and kala (age factor) also play a vital role in the pathogenesis of asthikshaya . Thus, there is no single pathogenetic mechanism leading to asthikshaya . Samprapti of asthikshaya is therefore a complex mechanism. Asthikshaya in contemporary era In present era, on the basis of above mentioned etiological factors, symptoms and pathogenesis, asthikshaya can be correlated to osteoporosis. The word “Osteoporosis” was coined by Pommer in 1885 which means “porous bones”. The word osteoporosis is composed of two words i.e. ‘Osteo’ and ‘Porosis’. ‘Osteo’ is derived from the Greekword ‘Osteon’ means the ‘bone tissue’ and ‘Porosis’ isderived from the Latin word ‘Porosus’ which means‘full of pores’[24] It may be localized to a certain bone or region, as in disuse osteoporosis of a limb, or may involve the entire skeleton, as a manifestation of a metabolic bone disease. Generalized osteoporosis may be primary or secondary[25]. It may be seen as a consequence from the involutional losses associated with aging and also from the additional losses related to natural menopause in women. This condition is called as the ‘Primary Osteoporosis’. Osteoporosis caused or worsened by other disorders or medication exposures is referred as ‘Secondary Osteoporosis’[5]. In 1994 World HealthOrganization (WHO) defined osteoporosis operationally to be femoral neck bone mineral density (BMD) value 2.5 standard deviations or more below the mean for normal young white women, or t-score of -2.5[26]. There are many risk factors related to lifestyle for developing bone loss and osteoporosis such as a diet havinglow calcium, magnesium and vitamin-D; smoking or tobacco in any form, lack of exercise (sedentary life style), alcoholism, advanced age, history of fracture as an adult, female gender, caucasian race (White origin), menopause, surgical menopause (radical hysterectomy or oophorectomy in early age)[27,28,29]. Additionally, genetics is a factor. Women after 35 yearswith a family history of osteoporosis have almost twice the risk of developing the disease, compared to women without a family history[30].

[Find the meaning and references behind the names: Gold, Rasa, Ray, Rich]

J Ayu Herb Med ǀ Vol 2 Issue 6 ǀ November- December 2016 231 Bone metabolism occurs throughout life. It involves repetitive turnover cycles for formation of bone osteoclasts and osteoblast. Osteoclast, breaking downthe bone structure, referred as bone resorption andbone osteoblast building up the bone structure, known as bone remodeling[31]. In both sexes, peak bonemass is reached within three years after linear growth stops[32]. In women estrogen is needed to keep a healthy balancebetween bone resorption and bone remodeling[31]. Perimenopausal women are mainly susceptible to bone lossdue to the fluctuating and declining estrogen levels. Duringthe perimenopausal transition, serum estradiol levels can fall from 10% to 20%, and the level of serum estrone which is a four fold weaker than estrogen falls to about 25% to 35% of the premenopausal level. During this time, bone resorption can increase by 90%, whereas bone formation increases by only 45%. This imbalance in bone resorption and remodeling leads to accelerated bone loss[31]. In the first five to seven years after menopause, a woman can lose up to 20% of herbone density, and this loss can lead to osteoporosis[29]. Most of the patients are asymptomatic until they develop a complicating fracture (most common in hip, humerus, ribs and wrist) which often occurs with minimal trauma. The most frequent symptoms are pain in the back, tenderness, general debility, muscular weakness, abdominal distension, insomnia, loss of appetite, osteo-arthritis, constipation and ileus and deformity of spine (kyphosis and scoliosis) and loss of height[5,33]. Prevention and treatment is possible if it is diagnosed early and accurately. But, it often remains undiagnosed until a fracture occurs. So, screening of people must be increased for this disease. Bone mineral density (BMD) is the most important criteria for the diagnosis of osteoporosis. The gold standard for measuring BMD is the dual-energy X-ray absorptiometry (DEXA) densitometer, a specialized X-ray device that precisely quantifies BMD at the spine, femur, and other skeletal sites[34]. Management Modern treatment is mainly intended at preventing further bone loss and fractures. It maintains thebone mass through calcium and vitamin D supplementation, hormone replacement therapy (HRT), and use of certain drugs like bisphosphonates, selective estrogen receptor modulators (SERMs), anabolic steroids but usually produce long term side/adverse effects[35]. Ayurveda treatment visualizes the human body as a single unit and this holistic approach has opened many newer methods for treatment. The treatment of asthikshaya includes nidana parivarjana (Avoidance of etiological factors), shodhana (Biopurification), shamana (Palliative treatment), rasayana (Rejuvenation), pathyapathya (Proper diet). Nidana parivarjana :Avoid the excessive indulgence in etiological factors responsible for provocation of vata , vitiation of asthi , majjavahasrotas and also the psychic factors. Shodhana : It is indicated in bahudoshaavastha .Vaghbhatta had mentioned the asthikshayachikitsa [36] as: Asthi Sankshayat Jatan Kshira Ghritaihi Tikta Samyutaihi Bastibhistatha || Acharya charak has given the similar line of treatment for asthi pradoshaja vikara w hich includes panchakarma , especially basti which contains kshira , ghrita and tikta dravya [37]. Table no. 1 is having drugs which are mostly tikta in rasa . Asthyashrayanam vyadhinam pancakarmani bheshajam | Bastayaha kshira sarpishi tiktakopahitani cha || (C.Su.28/27) || Shamana : The main aim of Ayurvedic therapy in asthigatvata includes vatashamak ( asthi is the seat of vata ), tarpak and brihman [38] treatment. Sushrut explained the principle of asthikshaya as Tatra Swayoni Vardhana Dravya Prayogaha Pratikaraha (Su.su.15). Below described herbs in table no. 2 have mainly Vatahar , tarpan , brihman , balya and asthisandhankar property. Research studies have also showed that drug like guduchi, samanga, ashwagandha, vacha, dadima have antiosteoporotic and phytooestrogenic properties which strengthen the bone. Similarly drugs in table no. 2 were mostly rich in calcium[42,43] as proven by their nutritional values. According to modern science there is calcium deficiency in asthikshaya (osteoporosis). So, it can be used in osteoporosis. Few recent experimental studies for supporting the study were given below: Guduchi [44] Study was carried out on ethanolic stem extract of Tinospora cordifolia (TC) (10, 50, 100 mg/kg b.wt.) subcutaneously for 4 weeks on ovariectomized rats. Study reveals that ovariectomized rats treated with TC (10 mg/kg b.wt.) showed estrogen like effects in bone as the bone loss in tibia was slower than ovariectomized control and thus has the potential for being used as antiosteoporotic agent. Samanga [45] – In vitro study was done on four medicinal plants for evaluation of antiresorptive activity in the treatment of bone loss disease. All the four drug decoction inhibited osteoclastogenesis similarly to standard alendronate at the highest doses, but Hemidesmus indicus was found effective at lower concentrations also. Shatavari [46,47]- Study was carried out on aqueous and methanolic extracts of Asparagus racemosus root in ovarectomized rats to evaluate the antiosteoporotic activity. Study showed significant effect on mineralization, ossification and osteoclastic activity suppression in histopathological examination. It showed significant results in biochemical parameters, also reduced serum alkaline phosphatase activity, serum calcium significantly and also inhibited the ovariectomized induced excessive loss of calcium in urine. Studies of ashwagandha [48], vacha [49], dadima [50], madhuyashti [51,52], vidarikanda [53], parushak [54], padmabeeja [55] also shows antiosteoporotic properties. DISCUSSION Sampraptivighatana (breaking of pathogenesis) is the prime line for the treatment of any disease in ayurveda. So, treatment of asthikshaya should be done considering both the facts for vata prakopa that is margavaran and dhatu kshaya.

[Find the meaning and references behind the names: Seed, Prakash, Flower, Mukul, Ham, Clarke]

J Ayu Herb Med ǀ Vol 2 Issue 6 ǀ November- December 2016 232 In margavaran , strotoshodhak treatment should be given which clears the channels and nourishes the next dhatu . Drugs or medicinal plants given in table no.1 are mostly having katu , tikta rasa, snigdha guna . tikta rasa is having strotoshodhak property which acts on margavaran. But tikta rasa is vata propaka . So, it shouldnot be used in asthikshaya as vataprakopa increase the asthikshaya . It can be explained like this; as vaghbhat have mentioned that asthikshaya treatment with tiktaksheer sadhita basti . Arundatta commenting on it explains dravya which have snigdha , soshana and khara property are used in asthikshaya . khara is the main property of asthi . D ravya which have both snigdha and shoshan properties are not available that’s why this principle was explained. Use of ksheera (snigdha) , ghrita with tikta rasa (shoshan) produces khara properties which helps in asthivridhi . In the same way, drugs given in table no. 1 can be given single or in combination with other drugs (table no. 2) In dhatu kshaya ( asthikshaya ) includes vatashamak ( asthi is the seat of vata ), tarpak and brihman treatment. Vata is having properties laghu , ruksha , sheeta , khara , sukshma, chala , vishada , medicinal plants described in table no. 2 are mostly vatashamak due to predominance of guru, snigdha guna , madhura vipaka and ushna virya . Hence, it can be used directly in dhatukshaya condition. Table 1: Drugs which works on margavaran Sr. No. Sanskrit name Family Botanical name Effect on Dosha & important Uses Part used Reference 1 1 . Guduchi Menispermaceae Tinospora cordifolia Willd. Tridoshahar Stem Bh.p.3/9[39] 2 3 . Prishniparni Fabaceae Uraria picta Desv. Tridoshahar Asthibhagnasandhankar Root Ch.su.25/40[40] Bh.p.3/35 3 4 . Ambashthaki Menispermaceae Cissampelos pareira Linn. Vatashleshmahar Root Bh.p.3/192 4 5 . Samanga Rubiaceae Rubia cordifolia Linn. Kaphapittahar Root Bh.p.1/189-190 5 7 . Kataphala Myricaceae Myrica esculenta Buch Ham Vatakaphahar Stembark Bh.p.1/181 6 Ashvagandha Solanaceae Withania somnifera linn. Vatakaphahar, shothakshayapaha, Balya, Rasayan Root Bh.p.3/189,190 7 1 2 . Sthira ( Shalaparni ) Fabaceae Desmodium gangeticum DC. Tridoshhar, Shoshahar, brihmana, rasayan Wholeplant Bh.p.3/31-33 Ch.su.25/40 8 6 . Vacha Araceae Acorus calamus Linn. Vatashleshmahara Root Bh.p.1/103 Dh. Ni. 9 7 . Dadima Puniceae Punica granatum . Tridoshhar Fruit Su.su.46/142 10 Arjuna Combretaceae Terminalia arjuna Roxb. Kaphapittahara, Sandhankara stembark,H eartwood Bh.p.5/27 11 . Asthishrinkhala Vitaceae Cissus quadrangularis Linn. Vatakaphahar, Stem Bh.p.3/226 12 2 . Yavani Apiaceae Trachyspermum ammi Sprague Linn. Vatakaphahar Fruit Bh.p.1/77 13 3 . Guggul Burseraceae Commiphora mukul Engl. Tridoshhar, Asthibhaghnasandhankar, balya, Gumresin Bh.p.2/39-41 14 2 4 Shunthi Zingiberaceae Zingiber officinale Roscoe. Vatakaphahar Stem Ch.su.27/296 Bh.p.1/45 15 5 . Methika Fabaceae Trigonella foenum-graecum Linn. Vatakaphahar Seed Bh.p.1/95. 16 Shimshapa Fabaceae Dalbergia sissoo Roxb. Vatakaphahar Heartwood Su.su 45/123 17 . Shirisha Fabaceae Albizzia lebbeck Benth. Tridoshhar Heartwood Bh.p.5/14 18 . kushtha Compositae Saussurea lappa C.B. Clarke Vatakaphahara Root Bh.p.1/173 19 Tila Pedaliaceae Sesamum indicum Linn Tridoshhara Seed Bh.p.8/63-65 Abbreviation: Bh.P.- Bhava prakash, Dh.ni.- Dhanvantari nighantu, Ch.su. – Charak samhita sutra sthan, Su.su. - Sushrut samhita sutra sthan, Kai. n. – kaidev nighantu Table 2: Drugs which acts on dhatukshaya Sr. No. Sanskrit name Family Botanical name Effect on Dosha & important Uses Part used Reference 1 Madhuyashti Fabaceae Glycyrrhiza glabra Linn. Vatapitakshayahara Root Bh.p. 1/145, 146 2 Jivanti Ascleipiadaceae Laptadenia reticulata W. & A Tridoshhara, balya, vrishya, rasayan Root Bh.p.2/50-51 Kai. ni. 3 Priyangu Verbenaceae Callicarpa macrophylla Vahl Vatapittahara Seed, flower Bh.p.2/104 4 Vidarikanda Fabaceae Pueraria tuberosa DC. Vatapitahara, Brihmana, Rhizome Su.su.46/301

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

J Ayu Herb Med ǀ Vol 2 Issue 6 ǀ November- December 2016 233 Balya, rasayan Bh.p.3/180,182 5 Shatavari Liliaceae Asparagus racemosus Willd. Vatapitahara Balya, shothajit, kshayanashak Rhizome Su.su.46/302 Bh.p.3/184-188 6 Bala Malvaceae Sida cordifolia Linn. Vatahara, Balya Root, Seed Ch.su.25/40 7 Atibala Malvaceae Abutilon indicum Linn. Vatahara Root, Seed Dr.vi.[41] 8 Falgu Moraceae Ficus carica Linn. Tarpan, brihmana Vatajit Fruit Ch.su.27/128 9 Parushaka Tiliaceae Grewia asiatica Linn. Vatapitahara, brihmana, kshaya nashak Fruit Bh.p.6/99 Ch.su.27/128 10 2 . Kokilaksha Acanthaceae Asteracantha longifolia Nees. Vatahar, Amashothahar Seed Bh.p.3/225 11 3 . Priyala Anacardiaceae Buchanania latifolia Roxb. Vatapittahar, Brihmana Fruit , Seedkern el Bh.p.6/84,85 12 4 . Padmabeeja Nymphaeaceae Nelumbo nucifera Gaertn. Vatahara, balya Seed Mp.ni.3/8 13 5 . Utpalabeeja Nymphaeaceae Nymphea stellata Willd. Tridoshhar Seed Bh.p.6/94 14 6 . Nikochaka Pinaceae Pinus gerardiana Wall. Vatahar, balya, brinhana Seed Mp.ni. 6/64 15 7 . Makhanna Nymphaeaceae Euryaleferox Salisb. Nymphaeaceae Vatapitahar, balya Fruit Dr.vi. 16 8 . Kharjura Palmae Phoenix sylvestris Roxb. Vatapitahara, Brimhana, kshatkshayanashak Fruit Bh.p 6/115-120 Ch.su.27/127 17 9 . Vatada Rosaceae Prunus amygdalus Batsch. Vatapitahara Seed kernel Bh.p. 6/123,124 18 1 0 . Shringataka Onagraceae Trapa bispinosa Roxb. Pittahar Fruitkern el Bh.p. 6/12,13 19 1 1 . Tavakshir Zingiberaceae Curcuma angustifolia Roxb. Vatapitahar, kshayahar Rhizome Dr. vi. 20 1 2 . Vanshalochan Poaceae Bambusa arundinacia Willd. Vatahar, brihman, balya Resin Bh.p.1/ 117 -118 21 bhallatak Anacardiaceae Semicarpus anacardium Linn Vatapittashamak,vrishya, brihman Seedkern el Bh.p.1/231 Abbreviation: Bh.P.- Bhava prakash, Ch. Su.- Charak samhita sutra sthan, Su.su. - Sushrut samhita sutra sthan, Dr.vi.- Dravyaguna vigyan, Mp.ni – Madanpala nighantu Table 3: Raspanchaka [41] of drugs given in table no.1 Sr. No. Sanskrit name Rasa Guna Virya Vipaka 1 . Guduchi Tikta, kashaya Guru, snigdha Ushna Madhura 2 . Prishniparni Madhura, tikta Laghu , snighdha Ushna Madhura 3 . Ambashthaki Tikta Laghu, tikshna Ushna Katu 4 5 . Samanga (manjishtha) Tikta , kashaya , madhura Guru, ruksha Ushna Katu 5 7 . Kataphala Kashaya , tikta , katu Laghu,tikshna Ushna Katu 6 9 . Ashvagandha Tikta, katu, madhura Laghu, snigdha Ushna Madhura 7 1 Sthira ( Shalaparni ) Tikta, madhura Guru, snigdha Ushna Madhura 8 . Vacha Katu, tikta Laghu , tikshna Ushna Katu 9 7 . Dadima Madhura, kashaya, amla Laghu , snigdha Ushna Madhura 10 Arjuna kashaya Laghu, ruksha sheeta Katu 11 . Asthishrinkhala , Madhura Laghu, ruksha Ushna Madhura 12 . Yavani Katu, tikta Laghu, ruksha, tikshna Ushna Katu 13 3 Guggul Tikta, katu Laghu, ruksha, tikshna, Ushna Katu

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

J Ayu Herb Med ǀ Vol 2 Issue 6 ǀ November- December 2016 234 . vishada, sukshma, sara 14 4 Shunthi Katu Laghu, snigdha Ushna Madhura 15 . Methika Katu Laghu, snigdha Ushna Katu 16 6 . Shimshapa Kashaya, katu, tikta Laghu,ruksha ushna Katu 17 7 . Shirisha Kashya, tikta, madhura Laghu, rukshna, tikshna Ishad ushna Katu 18 8 Kushtha Tikta, katu, madhura Laghu, rukhsa, tikshna Ushna Katu 19 Tila Katu, tikta, madhura, kashaya Guru, snigdha Ushna Katu Table 4: Rasapanchakaof drugs given in table no. 2 Sr. No. Sanskrit name Rasa Guna Virya Vipaka 1 Madhuyashti Madhura Guru , snigdha Sheeta Madhura 2 Jivanti Madhura Laghu, snigdha, Sheeta Madhura 3 Priyangu Tikta, kashaya, madhura Guru, ruksha katu Sheeta 4 Vidarikanda Madhura Guru , snigdha Sheeta Madhura 5 Shatavari Madhura, tikta Guru , snigdha Sheeta Madhura 6 Bala Madhura Laghu, snigdha, picchila Sheeta Madhura 7 Atibala Madhura Laghu, snigdha, picchila Sheeta Madhura 8 Falgu Madhura Guru , snigdha Sheeta Madhura 9 Parushaka Madhura - Sheeta - 10 Kokilaksha Madhura, amla, tikta Guru , snigdha, pichila Sheeta Madhura 11 Priyala Madhura Snigdha, guru, sara Sheeta Madhura 12 Padmabeeja Madhura , tikta , kashaya Guru, ruksha Sheeta Madhura 13 Utpalabeeja Madhura Laghu, snigdha, picchila sheeta Madhura 14 Nikochaka Madhura Snigdha, guru Ushna Madhura 15 Makhanna Madhura Guru, snigdha Sheeta Madhura Kharjura Madhura Snigdha, guru Sheeta Madhura 16 Vatada Madhura Snigdha, guru Ushna Madhura 17 Shringataka Madhura, kashaya Guru, ruksha sheeta Madhura 18 Tavakshir Madhura Laghu , snigdha sheeta Madhura 19 Vanshalochan Kashaya, madhura - Sheeta Madhura 20 Bhallatakabeejamajja Madhura - - - CONCLUSION Asthikshaya (Osteoporosis) being a multifactorial disorder needs a holistic approach to treat it. Prevention is better than cure. So, early diagnosis, prevention and intervention should be done in order to treat it easily. Ayurveda is a system of medicine which can prevent this by considering all the etiological factors involving in its pathogenesis. Drugs given above can be given either single or in combinations considering all the factors like dosha, dushya, kala, bala, agni etc. of the patients. Use of these drugs according to Ayurveda fundamentals can become a boon for the prevention of this disease. However, most of the drugs are not studied yet; further researches should be carried out in order to confirm these effects. REFERENCES 1 Kumar DR. The Role Of Panchakarma Therapy In Musculoskeletal Disorders With Special Reference To Vatavyadhi. Global J Res Med Plants & Indigen Med 2013;2(1):23–29. 2 Agnivesha, Charaka Samhita, revised by Charaka and Dhridabala with the Vidyotini hindi commentary by kashinatha shastri, gorakhnath chaturvedi, Chaukhambha Bharati Academy, Varanasi, reprint, 2008, part one, Sutrasthana, 30/26. 3 Agnivesha, Charaka Samhita, revised by Charaka and Dhridabala with the Vidyotini hindi commentary by kashinatha shastri, gorakhnath chaturvedi, Chaukhambha Bharati Academy, Varanasi, reprint, 2008,Sutrasthana, 1/46 4 Sushruta, Sushruta Samhita, with the ayurvedatatvasandipika commentary of Ambikadutta shashtri, Chaukhambha Sanskrit Sansthan, Varanasi, reprint 2008,Sutrasthana, 15/3. 5 Kadlimatti SM, Maheshwari KS, Chandola HM. Critical Analysis of the Concept of Asthi Kshaya vis-a-vis Osteoporosis. AYU (An international quarterly journal of research in Ayurveda)2009;30(4):447. 6 Agnivesha, Charaka Samhita, revised by Charaka and Dhridabala with the Vidyotini hindi commentary by kashinatha shastri, gorakhnath chaturvedi, Chaukhambha Bharati Academy, Varanasi, reprint, 2008,Sutrasthana, 17/7,67. 7 Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94:646-50. 8 “International osteoporosis foundation”. Retrieved from http://www.iofbonehealth.org/facts-statistics. Accessed on 2015,15 december.

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