Associate Professor
Lal Bahadur Shastri Mahila Ayurvedic College and Hospital, Department of Kayachikitsa.
Sadhaura Road P.O. Marwa Kalan, Bilaspur, Distt. Yamuna Nagar, Haryana INDIA
Author Corresponding Email: drkirandeepkaur04@gmail.com
Now–a- days it is seems that, several patients are reporting to the hospitals regularly with affected from different disorders of Mutravaha Srotas. Mutrakrichra is one of the important diseases amongst this diseases. The term Mutrakrichra comes under the disorders of Mutravaha Srotas, and mainly deals with Mutra and krichra. In Mutrakrichra, the vitiated Pita Dosha along with Vata (mainly Apana Vayu) on reaching Vasti (bladder) afflicts the Mutravaha Srotas due to which the patient feels difficulty in micturation along with symptoms like Pitttamutrata, Sarakta mutrata, Sadaha mutrata, Saruja mutrata and Muhur-muhur mutrata.
Now, the present study to evaluation of the efficacy of Badrasashma pishti yoga with and without khas sharbat to assess the effect on Mutrakrichra.
Mutrakricrha, Shool, krichra, Mutravaha Srotas, Badrasashma pishti yoga, khas sharbat.
Ayurveda is a science of life aiming at disease free society. The objective of Ayurveda is to accomplish the physical, mental, social and spiritual well being by adopting, preventive and promotive approach as well as to treat the disease with various curative measures. In the very beginning classical Ayurveda is transmission of knowledge from to God sages and then to human physicians. Ayurveda therapies have varied and evolved over millennium and typically based on complex herbal compounds, minerals, metal substances. Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, suturing, and the extraction of foreign objects [1].
From an Ayurveda point of view Mutrakrichra and Mutraghata are two broad heads defining urinary tract diseases in classical text books of Ayurveda. Although the symptom of both headings seems to be overlapping but some Acharyas has differentiate them based on the predominance of krichra andvibandhta. Mutrakrichra is characterized with painful micturation associated with different grades of obstruction.
The term is comprised of two words Muttra and krichra. Muttra means urine, krichra means painful. Thus, dysuria and painful urination called as Mutrakrichra. In most of the Ayurveda classical texts any type of discomfort during urination and especially lower tract infection problems are included under Mutrakrichra. Mutrakrichra can occur as an independent disease as well as purvarupa and rupa of some other systematic diseases. Mutrakrichra is classified into 8 types according to the nidan and lakshanas, lakshanas such as pain which can be annoying when one experience it every time on urination. It can be correlated symptomatically to dysuria[1-2].
In Vataja Mutrakrichra: Acute pain in lower abdomen and penis
In Pittaja Mutrakrichra: Burning in bladder and penis, Painful micturation
In Kaphaja Mutrakrichra: Heaviness in bladder, testis and penis, Painful micturation
In Sannipatik Mutrakrichra: Burning in body, Pain in lower abdomen
In Abhighataj Mutrakrichra:Acute pain in bladder, Distention of bladder
In shkratajMutrakrichra: Flatulence, Obstruction of urine
In Ashmarija Mutrakrichra: Chest pain, Pain in lumbar region and hypo gastric region
In Shukraj Mutrakrichra: Semen mixed urine, Pain in bladder and penis
Modern treatment of dysuria comprises of antibiotics, antispasmodics, alkalizers which have their own side effects and limitations. A detailed description of dysuria is not available in classics so a lot of exploration is needed in understanding in treatment of dysuria whereas have ample of detailed description of Mutrakrichra and number of yoga’s in Ayurveda classics which are cost effective and giving good results. A number of formulations are mentioned in classics for treatment of mutrakrichra but some specific combination; suit all age groups, effective in mutrakrichra and readily available. In present study is the need of an attempt in direction of suitable drug in mutrakrichra to be used Thus for the same purpose Badrasashma Pishti with and without Khas Sharbat was studied.
Material and Methods:
The material and methods used in the study including criteria of selection of cases and parameters for clinical assessment have been described in detail followed by observations and results of the present work.
The present study comprises of two components as follows
Sample source:
OPD/ IPD of PG School of Ayurveda and Research and Desh bhagat hospital Mandi Gobindgarh (PB).
For clinical study:
Sample:-
Total number of patients taken for study will be 60 excluding dropouts.
Sample Size:-
60 patients will be selected .30 for A group and 30 for B group.
We have planned to study about 60 patients on the following criteria.
The Symptoms of mutrakrichra in classical text are:
Effect will also be assessed on changes in Urine parameters especially Urine culture.
Table -1: Showing Frequent Urination
|
Score |
Frequent urination status |
|
0 |
Absent |
|
1 |
Mild |
|
2 |
Moderate |
|
3 |
Severe |
Table- 2: Showing an Intense Urge To Urinate
|
Score |
an intense urge to urinate status |
|
0 |
Absent |
|
1 |
Mild |
|
2 |
Moderate |
|
3 |
Severe |
Table -3: Showing Cloudy Urine
|
Score |
cloudy urine status |
|
0 |
Absent |
|
1 |
Mild |
|
2 |
Moderate |
|
3 |
Severe |
The scores of criteria of assessment were analyzed statistically in form of mean score B.T (Before treatment), A.T (After treatment), S.D (standard deviation). The data was coded and entered into Microsoft Excel spreadsheet. Analysis was done using SPSS version 20 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The independent t test (for quantitative data within two groups) and paired t test (for quantitative data to compare before and after observations) were used for quantitative data comparison of all clinical indicators. Level of significance was set at P≤0.05.
Table- 4: Showing Urine Culture
|
Score |
Urine culture status |
|
0 |
Sterile |
|
1 |
Infective |
Overall assessment was established in terms of percentage relief obtained in criteria of assessment.
Table -5: Criteria for Overall Assessment
|
Complete remission |
75-100% relief in sign and symptoms |
|
Moderate improvement |
60-74% |
|
Mild improvement |
31-60% |
|
No improvement |
0-30% |
Subjective parameters:
GROUP A
Table-6: Frequent Urination
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.26 |
0.73 |
0.001 (S) |
36.7% |
|
AT |
1.43 |
0.62 |
Among group A, before treatment mean score of excessive thirst was 2.26 and it was reduced to 1.43 after treatment which showed statistically significant results (p=0.001).
Table -7: An Intense Urge to Urinate
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.36 |
0.66 |
0.001 (S) |
42.3% |
|
AT |
1.36 |
0.66 |
Among group A, before treatment mean score of heaviness was 2.36 and it was reduced to 1.36 after treatment which showed statistically significant results (p=0.001)
Table- 8: Cloudy Urine
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.26 |
0.69 |
0.001 (S) |
44.2% |
|
AT |
1.26 |
0.58 |
Among group A, before treatment mean score of gatra stab dhata was 2.26 and it was reduced to 1.26 after treatment which showed statistically significant results (p=0.001)
Objective parameters:
Table- 9: Urine Culture
|
AT |
Total |
|||
|
Absent |
Present |
|||
|
BT |
Absent |
7 |
0 |
7 |
|
Present |
9 |
14 |
23 |
|
|
Total |
16 |
14 |
30 |
|
Chi-square test, P value=0.001 (S)
Among group A, before treatment mean score of urine culture was 23 present and it was reduced to 14 present after treatment which showed statistically significant results (p=0.001)
Subjective parameters:
GROUP B
Table -10: Frequent Urination
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.13 |
0.73 |
0.001 (S) |
75.1% |
|
AT |
0.53 |
0.68 |
Among group B, before treatment mean score of excessive thirst was 2.13 and it was reduced to 0.53 after treatment which showed statistically significant results (p=0.001).
Table -11: An Intense Urge to Urine
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.26 |
0.78 |
0.001 (S) |
75.2% |
|
AT |
0.56 |
0.67 |
Among group B, before treatment mean score of heaviness was 2.26 and it was reduced to 0.56after treatment which showed statistically significant results (p=0.001)
Table -12: Cloudy Urine
|
Mean |
Std. Deviation |
P Value |
% relief |
|
|
BT |
2.13 |
0.62 |
0.001 (S) |
71.8% |
|
AT |
0.6 |
0.67 |
Among group B, before treatment mean score of gatrastabdhata was 2.13 and it was reduced to 0.6 after treatment which showed statistically significant results (p=0.001)
Objective parameters:
Table - 13: Urine Culture
|
AT |
Total |
|||
|
Absent |
Present |
|||
|
BT |
Absent |
10 |
0 |
10 |
|
Present |
15 |
5 |
20 |
|
|
Total |
25 |
5 |
30 |
|
Chi-square test, P value=0.001
Among group B, before treatment mean score of urine culture was 20 present and it was reduced to 5 present after treatment which showed statistically significant results (p=0.001)
Table- 14: Pre comparison of study variables among group (inter-comparison)
|
Mean |
SD |
Std. Error |
P value |
||
|
Excessive urine |
A |
2.26 |
0.73 |
0.13 |
0.48 |
|
B |
2.13 |
0.73 |
0.13 |
||
|
An intense urge to urine |
A |
2.36 |
0.66 |
0.12 |
0.59 |
|
B |
2.26 |
0.78 |
0.14 |
||
|
Cloudy urine |
A |
2.26 |
0.69 |
0.12 |
0.43 |
|
B |
2.13 |
0.62 |
0.11 |
Table showed before treatment comparison of study variables among group (inter-comparison). Group A showed slightly high mean treatment score among all study variables as compared to group B which showed statistically non-significant results.
Table -15: Shows Urine Culture
|
urine culture |
Total |
|||
|
Absent |
Present |
|||
|
Groups |
A |
7 |
23 |
30 |
|
B |
10 |
20 |
30 |
|
|
Total |
17 |
43 |
60 |
|
Chi-square test, P value=0.39
Before treatment group A showed 23 patients as compared to group B (20) which showed statistically non-significant results (p=0.39)
Table -16: Post comparison of study variables among group (inter-comparison)
|
Mean |
SD |
Std. Error |
P value |
||
|
Excessive urine |
A |
1.43 |
0.62 |
0.11 |
<0.001 (S) |
|
B |
0.53 |
0.68 |
0.12 |
||
|
An intense urge to urine |
A |
1.36 |
0.66 |
0.12 |
0.01 (S) |
|
B |
0.56 |
0.67 |
0.12 |
||
|
Cloudy urine |
A |
1.26 |
0.58 |
0.106 |
0.01 (S) |
|
B |
0.6 |
0.67 |
0.12 |
Table showed after treatment comparison of study variables among group (inter-comparison). Group B showed less mean treatment score among all study variables as compared to group A which showed statistically significant results. Group B showed more effect on patients which provide good results.
Table No-.17: Shows Urine culture
|
Urine culture |
Total |
|||
|
Absent |
Present |
|||
|
Groups |
A |
16 |
14 |
30 |
|
B |
25 |
5 |
30 |
|
|
Total |
41 |
19 |
60 |
|
Chi-square test, P value=0.01 (S)
After treatment group A showed 14 patients as compared to group B (5) which showed statistically significant results (p=0.01). Group B showed more improvement than group A.
The group A is not so much effected than the group B. hence the Badrasashma Pishti combined with Khas Sharbat is given the best results than the Badrasashma Pishti alone.
The above studies shows the 41% of group A patients got relief from the disease and 74% of group B patients got relief from the disease. So Group B showed more effect on patients which provide good results.
It may be concluded from the present clinical study that the Badrasashma Pishti with khas sharbat has more effect than the Badrasashma Pishti alone.
Statistically, the drug in both group individually showed highly significant results. On the basis of all the observation of the study, we can conclude that Badrasashma Pishtiyoga is effective in relieving most of the sign and symptoms of urinary problem, but when it is given with khas sharbat results found are more effective in solving urinary related problems.
On the basis of Descriptive statistics included computation of percentages, means and standard deviations. The independent t test (for quantitative data within two groups) and paired t test (for quantitative data to compare before and after observations) were used for quantitative data comparison of all clinical indicators. Level of significance was set at P≤0.05.the values came after treatment is very significant according to the p <0.001.