Clinical Comparison of Guduchi and Gambhari in Gouty Arthritis
Journal name: Ayushdhara
Original article title: A Comparative Clinical Evaluation of Efficacy of Guduchi (Tinospora Cordifolia (Willd.) Miers) Kanda (Stem) and Gambhari (Gmelina Arborea Roxb.) Twak (Bark) in Vatarakta with special reference to Gouty Arthritis
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Ashwini S Pai
PG Scholar, Department of PG Studies in Dravyaguna, Government Ayurvedic Medical College, Bengaluru, Karnataka, India.
Dharani
Associate Professor, Department of PG Studies in Dravyaguna, Government Ayurvedic Medical College, Bengaluru, Karnataka, India.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: A Comparative Clinical Evaluation of Efficacy of Guduchi (Tinospora Cordifolia (Willd.) Miers) Kanda (Stem) and Gambhari (Gmelina Arborea Roxb.) Twak (Bark) in Vatarakta with special reference to Gouty Arthritis
Year: 2023 | Doi: 10.47070/ayushdhara.v10i1.1125
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Vatarakta, commonly associated with gouty arthritis, is a condition influenced by the imbalance of Dushita vata and Dushita rakta. These imbalances culminate in inflammation and pain in the joints. The study focuses on evaluating the efficacy of two herbal interventions—Guduchi (Tinospora cordifolia) and Gambhari (Gmelina arborea)—in managing Vatarakta. A total of 40 subjects diagnosed with gouty arthritis were randomly divided into two groups, each receiving a specific herbal preparation for 48 days. Subjective parameters including joint pain and swelling, as well as objective measures such as serum uric acid levels, were assessed before and after the interventions.
Pharmacognostic and Phytochemical Analysis
The research included a comprehensive analysis phase that involved pharmacognostic and phytochemical evaluations of both Guduchi and Gambhari. Initially, the sensory and macroscopic features of the two herbs were examined, followed by a meticulous process of extracting their compounds using an alcoholic and aqueous method. The study confirmed the presence of several beneficial phytochemicals, including alkaloids, flavonoids, and tannins, which are known for their anti-inflammatory and uricosuric properties. Moreover, HPLC analysis revealed the qualitative and quantitative presence of Quercetin, which is noted for its role in reducing uric acid levels, illustrating the significant therapeutic potential of these herbs.
Clinical Outcomes and Efficacy
The clinical evaluation revealed that both Guduchi and Gambhari significantly improved subjective symptoms such as joint pain (Sandhi shula), swelling (Sandhi shotha), and stiffness (Sandhi stabdhata). Both groups showed noteworthy reductions in serum uric acid levels and erythrocyte sedimentation rates post-intervention, with statistically significant results (p<0.01). However, comparisons indicated that Guduchi displayed a more pronounced clinical effect across all measured parameters than Gambhari, suggesting its potential as a more effective therapeutic agent for managing Vatarakta.
Conclusion
The study highlights the efficacy of both Guduchi and Gambhari in treating Vatarakta, establishing a basis for their use in clinical settings. The active phytoconstituents identified, particularly Quercetin, contribute to their therapeutic action through anti-inflammatory and uricosuric effects. While significant improvements were observed in both interventions, Guduchi emerged as the more effective treatment option, warranting further exploration in larger studies. Future research could delve deeper into the pharmacological properties of these herbs, potentially paving the way for enhanced treatment options for gout patients.
FAQ section (important questions/answers):
What is the main focus of the clinical study?
The clinical study evaluates the efficacy of Guduchi kanda and Gambhari twak in managing Vatarakta, particularly gouty arthritis, comparing their effects on subjective and objective parameters over a treatment period of 48 days.
What parameters were assessed in the study?
Both subjective parameters, such as joint pain and swelling, and objective measures like serum uric acid levels and erythrocyte sedimentation rate were evaluated before and after the treatment to assess efficacy.
What were the conclusions about the efficacy of the treatments?
The study concluded that both Guduchi kanda and Gambhari twak are effective for Vatarakta, with Guduchi kanda demonstrating superior efficacy across all evaluated parameters compared to Gambhari twak.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Clinical Comparison of Guduchi and Gambhari in Gouty Arthritis”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Gambhari:
Gambhari is a key ingredient in the study, identified by the botanical name Gmelina arborea. It has been used to manage Vatarakta (gouty arthritis) through its anti-inflammatory and uricosuric activities.
2) Vatarakta (Vata-rakta):
Vatarakta is an Ayurvedic condition comparable to gouty arthritis, characterized by symptoms such as joint pain (Shula), swelling (Shotha), and burning sensation (Daha). It is believed to be caused by vitiated Vata and Rakta doshas.
3) Sandhi (Shandhi, Samdhi):
Sandhi refers to joints in the body. In the context of Vatarakta, symptoms like Sandhi Shula (joint pain), Sandhi Shotha (joint swelling), and Sandhi Stabdhata (joint stiffness) are critical for diagnosis and evaluation of treatment efficacy.
4) Kanda (Kamda):
Kanda means 'stem' in Sanskrit and in this study, Guduchi Kanda refers to the stem of Tinospora cordifolia, which was used to prepare Kwatha (decoction) for treating Vatarakta.
5) Drug:
Drug refers to the medicinal herbs used in the study such as Guduchi (Tinospora cordifolia) and Gambhari (Gmelina arborea). These drugs were analyzed for their efficacy in treating Vatarakta through clinical evaluation.
6) Shula (Sula):
Shula refers to pain, specifically joint pain in the context of Vatarakta. It is a critical subjective parameter used to assess the efficacy of treatment interventions like Guduchi and Gambhari in relieving joint pain.
7) Gmelina arborea:
Gmelina arborea, commonly known as Gambhari, is an herb whose bark is used in Ayurvedic treatments for Vatarakta. It exhibits properties such as anti-inflammatory and uricosuric activities.
8) Shotha (Sotha):
Shotha means swelling, another primary symptom of Vatarakta. It is used as a subjective parameter in the study to assess the effectiveness of Guduchi and Gambhari in reducing joint swelling.
9) Daha:
Daha refers to a burning sensation, particularly in the joints during Vatarakta. It is considered a subjective parameter in the study to evaluate the efficacy of the herbal interventions in alleviating this burning pain.
10) Tinospora cordifolia:
Tinospora cordifolia, known as Guduchi, is a medicinal plant whose stem (Kanda) is used in Ayurvedic treatments for Vatarakta. The stem exhibits properties such as anti-inflammatory and xanthine oxidase inhibition activities.
11) Vata:
Vata is one of the three doshas in Ayurveda. Vitiated Vata is a primary cause of Vatarakta, leading to symptoms such as joint pain and stiffness. Treatments aim to balance Vata to manage the condition.
12) Pain:
Pain, or Shula, often manifests in the joints during Vatarakta. It is a crucial parameter in assessing the effectiveness of treatments like Guduchi Kanda and Gambhari Twak interventions.
13) Diet:
Diet plays a significant role in the pathogenesis of Vatarakta. Mixed diets, especially those high in purines, can exacerbate conditions like gouty arthritis by increasing serum uric acid levels.
14) Rakta:
Rakta means blood and is one of the three doshas involved in Vatarakta. The condition is caused by the vitiation of both Vata and Rakta, leading to symptoms such as joint pain, swelling, and burning sensation.
15) Powder:
Powder refers to the form in which medicinal herbs like Tinospora cordifolia and Gmelina arborea were processed for analysis. The powder was used for various types of microscopic and physico-chemical studies.
16) Kashaya (Kasaya):
Kashaya means decoction. In this study, Guduchi Kanda and Gambhari Twak were prepared as Kashaya to be administered to subjects with Vatarakta to assess the efficacy in managing the condition.
17) Dharani (Dharanimamdala):
Dharani is one of the authors of the study, specifically serving as the Associate Professor in the Department of PG Studies in Dravyaguna at the Government Ayurvedic Medical College in Bengaluru, Karnataka.
18) Dravya:
Dravya means substance or medicinal herb in Ayurveda. In the study, Guduchi and Gambhari are the primary Dravya used for evaluating their efficacy in treating Vatarakta.
19) Dosha (Dosa):
Dosha refers to the three fundamental bio-elements in Ayurveda: Vata, Pitta, and Kapha. Vatarakta is primarily caused by the vitiation of Vata and Rakta (a component of Pitta), needing specific therapeutic measures to balance these doshas.
20) Pitta:
Pitta is one of the three doshas in Ayurveda and consists of elements that govern heat and metabolism in the body. In Vatarakta, both Vata and Rakta (related to Pitta) are vitiated, requiring specific interventions like cooling and anti-inflammatory herbs.
21) Phytochemical:
Phytochemical analysis involves studying plant compounds like alkaloids, flavonoids, and tannins. The study includes such analyses for Guduchi Kanda and Gambhari Twak to identify anti-inflammatory and uricosuric properties.
22) Gambhira:
Gambhira Vatarakta is a severe form of Vatarakta that affects deeper tissues and presents with more chronic and intense symptoms like extreme joint pain and inflammation.
23) Disease:
Disease in this context is Vatarakta, an Ayurvedic term correlated with gouty arthritis, characterized by joint pain, inflammation, and hyperuricemia. The study aims to find effective treatments using Ayurvedic herbal interventions.
24) Hara:
Hara means 'remover' or 'destroyer' in Sanskrit. In the text, Vataraktahara refers to herbs such as Gambhari that specifically act to alleviate symptoms of Vatarakta (gouty arthritis).
25) Rasa (Rasha):
Rasa refers to the taste of a substance in Ayurveda, which influences its therapeutic action. Guduchi has a Tikta (bitter) Rasa, while Gambhari has Madhura (sweet) Rasa and is used to balance doshas like Vata and Pitta.
26) Guna:
Guna means quality or property in Ayurveda. The therapeutic action of an herb can be attributed to its Guna. Guduchi and Gambhari both possess properties crucial for treating Vatarakta, such as anti-inflammatory and analgesic qualities.
27) Aushadha (Ausadha):
Aushadha refers to medicinal drugs in Ayurveda. In the study, Guduchi and Gambhari are the Aushadha used to treat Vatarakta. These herbs were analyzed for their efficacy through clinical trials and phytochemical studies.
28) Prabhava:
Prabhava signifies the intrinsic potency or unique action of a substance in Ayurveda. The therapeutic effects of Guduchi on Vatarakta can be attributed to its Prabhava, alongside its rasa, guna, virya, and vipaka.
29) Madhura:
Madhura is a taste or Rasa in Ayurveda, meaning sweet. Gambhari has Madhura Rasa, which helps in Pitta and Vata pacification, contributing to its effectiveness in treating Vatarakta.
30) Anupana:
Anupana is the substance taken along with or after medicine to assist in its absorption and effectiveness. In this study, Jala (water) is used as the Anupana for both Guduchi Kanda and Gambhari Twak Kashaya.
31) Dusita (Dushita):
Dushita refers to being vitiated or corrupted. In Vatarakta, both Vata and Rakta are described as Dushita, meaning they are imbalanced, leading to symptoms like joint pain and inflammation.
32) Nature:
Nature in this context refers to the characteristics or qualities of the herbs or the disease. For instance, the nature of pain in Gambhira Vatarakta is described as extremely unbearable.
33) Jala:
Jala means water in Sanskrit. It is used as the Anupana, or accompanying agent, for taking Guduchi Kanda and Gambhari Twak Kashaya in the study to help with the absorption and efficacy of the treatment.
34) Samprapti:
Samprapti is the Ayurvedic term for pathogenesis, the process by which a disease develops. In Vatarakta, the Samprapti involves the vitiation of Vata and Rakta, leading to symptoms like joint pain, swelling, and stiffness.
35) Vatahara (Vata-ahara):
Vata-hara refers to the property of alleviating Vata dosha. Both Guduchi and Gambhari have Vata-hara properties, making them effective in treating Vatarakta, a condition characterized by Vata and Rakta vitiation.
36) Swelling:
Swelling is a clinical symptom known as Shotha in Ayurveda. It is one of the primary indicators of Vatarakta, along with pain and stiffness, and is used to evaluate the efficacy of herbal treatments like Guduchi and Gambhari.
37) Pittaja (Pitta-ja):
Pittaja refers to conditions or constitution types related to Pitta dosha. In the clinical study, Pittaja Prakruthi subjects are analyzed for their response to treatments for Vatarakta, which involves Vata and Rakta (associated with Pitta).
38) Sevana:
Sevana means consumption or administration of medicine. In this study, the proper Sevana Kala (time of administration) is essential to ensure the effectiveness of Guduchi Kanda and Gambhari Twak Kashaya in treating Vatarakta.
39) Vipaka:
Vipaka is the post-digestive effect of a substance in Ayurveda. Both Guduchi and Gambhari have Madhura Vipaka, assisting in balancing the doshas involved in Vatarakta and enhancing the medicine's therapeutic effects.
40) Family:
Family in this context refers to the familial aggregation or history of Vatarakta among patients. In the study, family history helps in understanding the genetic predisposition and evaluating the efficacy of treatments.
41) Ushna (Usna):
Ushna refers to heat in Ayurveda. Guduchi possesses Ushna Veerya (heating potency), which helps in pacifying Vata dosha, making it useful in treating conditions like Vatarakta.
42) Agrya:
Agrya means foremost or superior. Guduchi is identified as Agrya Dravya for Vatarakta, indicating its significant efficacy and primary role in treating the condition.
43) India:
India is the country where the study took place. Both Guduchi and Gambhari, commonly found in India, were used to treat Vatarakta through Ayurvedic approaches analyzed in the clinical study.
44) Kala:
Kala in this context refers to the period or time, often related to Aushadha Sevana Kala (time of medication administration). The proper Kala ensures maximum efficacy of the treatments like Guduchi Kanda and Gambhari Twak Kashaya.
45) Food:
Food, or Ahara, plays a crucial role in Ayurvedic pathology and treatment. An improper diet is one of the causes of Vatarakta, and proper dietary guidelines are essential for the management of the condition alongside herbal treatments.
46) Pharmacological:
Pharmacological refers to the study of drugs and their effects. The pharmacological properties of Guduchi and Gambhari, such as anti-inflammatory and uricosuric activities, are critical for their efficacy in treating Vatarakta.
47) Inflammation:
Inflammation is a key component of Vatarakta, manifesting as joint pain and swelling. The study evaluates the anti-inflammatory properties of Guduchi and Gambhari in managing these symptoms effectively.
48) Prashamana (Prasamana):
Prashamana means pacification or alleviation. In the study, herbs like Guduchi and Gambhari are used for their Prashamana properties to mitigate the symptoms of Vatarakta by balancing vitiated doshas.
49) Stiffness:
Stiffness, or Sandhi Stabdhata, is one of the primary symptoms of Vatarakta. The study evaluates the effectiveness of Guduchi and Gambhari in reducing joint stiffness as part of the treatment outcomes.
50) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine that forms the basis of this study. It uses concepts of doshas, herbs, and treatments like Guduchi and Gambhari to manage conditions such as Vatarakta.
51) Madhyama:
Madhyama refers to the medium or moderate constitution or Akruthi. In the study, subjects with Madhyama Akruthi were evaluated for their response to Guduchi and Gambhari treatments for Vatarakta.
52) Lakshana (Laksana):
Lakshana means symptoms or characteristics. In Vatarakta, Lakshanas like Sandhi Shula, Daha, Shotha, and Stabdhata are used to diagnose the condition and evaluate the effectiveness of treatments.
53) Kaphaja:
Kaphaja refers to conditions or constitution types related to Kapha dosha. The study may assess such categories to understand the varying responses of Kaphaja Prakruthi subjects to Vatarakta treatments.
54) Utthana:
Utthana Vatarakta refers to the initial stage of Vatarakta, affecting superficial tissues like Twak (skin) and Mamsa (muscle). This phase can be managed effectively with early intervention using Guduchi and Gambhari.
55) Sthula:
Sthula refers to a heavy or obese constitution. In the study, subjects with Sthula Akruthi were evaluated to understand the impact of body weight on the symptoms and treatment of Vatarakta.
56) Vataja (Vata-ja):
Vataja refers to conditions or constitution types related to Vata dosha. The study includes Vataja Prakruthi subjects to analyze their specific response to treatments like Guduchi and Gambhari for Vatarakta.
57) Vyadhin (Vyadhi):
Vyadhi means disease. Vatarakta is identified as the Vyadhi in this study, with symptoms including joint pain, swelling, and inflammation, treated using Ayurvedic herbs like Guduchi and Gambhari.
58) Kapha:
Kapha is one of the three doshas in Ayurveda. Imbalances in Kapha can also influence conditions like Vatarakta, although the primary doshas involved are Vata and Rakta.
59) Karma (Karman):
Karma refers to the action or effect of a treatment. In the study, the Karma of Guduchi and Gambhari, including their anti-inflammatory and uricosuric actions, are evaluated for efficacy in managing Vatarakta.
60) Tikta:
Tikta means bitter taste. Guduchi has Tikta Rasa, which helps pacify Pitta and, indirectly, Rakta dosha due to their interrelationship, aiding in the treatment of Vatarakta.
61) Edema (Oedema):
Edema refers to swelling, known as Shotha in Ayurveda. It is one of the primary clinical symptoms of Vatarakta, and the study evaluates the effectiveness of Guduchi and Gambhari in reducing edema.
62) Guru:
Guru refers to heavy quality. Gambhari possesses Guru Guna, which helps in pacifying Vata dosha, making it effective in the treatment of Vatarakta by balancing the doshas.
63) Agni:
Agni means digestive fire. Proper Agni is crucial for digesting treatments like Kwatha, and disturbances in Agni can contribute to the pathological process in Vatarakta.
64) Beta:
Beta refers to beta-sitosterol, a phytochemical present in Guduchi, which contributes to its anti-inflammatory and possibly uricosuric activities, aiding in the treatment of Vatarakta.
65) Rheumatoid arthritis:
Rheumatoid arthritis is an exclusion criterion in the study. Pre-diagnosed cases of rheumatoid arthritis were not included to ensure a focused evaluation of Vatarakta treatments.
66) Bhavaprakashanighantu (Bhavaprakasanighantu, Bhavaprakasha-nighantu):
Bhavaprakasha-nighantu is a classical Ayurvedic text that mentions Gambhari as Vataraktahara (alleviates Vatarakta), providing historical context and validation for its use in the study.
[Note: The above list is limited to 75. Total glossary definitions available: 115]
Other Science Concepts:
Discover the significance of concepts within the article: ‘Clinical Comparison of Guduchi and Gambhari in Gouty Arthritis’. Further sources in the context of Science might help you critically compare this page with similair documents:
Vatarakta, Anupana, Statistical test, Clinical evaluation, Kwatha, Phytochemical analysis, Erythrocyte sedimentation rate, Hyperuricemia, Gouty arthritis, Sandhi Shotha, Dosage form, Guna Prabhava, Dravya prabhava, Sandhi Shula, Serum Uric Acid Level, Dosha pratyanika, Sandhi Daha, GUDUCHI KANDA.