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RESEARCH ARTICLE Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
Please cite this article as: Kodituwakku SI et al.,The Efficacy of Simhanada Guggulu & Local
Application (Dusturadi Lepa) In The Management of Amavata Vis A Vis Rheumatoid Arthritis. Asian
Journal of Medical and Health Research 2016.
AJMHR
AsianJournal of Medical and Health Research
Journal home page: www.ajmhr.com
The Efficacy of Simhanada Guggulu & Local Application
(Dusturadi Lepa) In The Management of Amavata Vis A Vis
Rheumatoid Arthritis
Sudharma I Kodituwakku1*, Rajendra Prasad1, N.P.Rai1
1. Department of Kayachikitsa, Faculty of Ayurveda, Institute of Medical Science, Banaras
Hindu University, Varanasi, Uttar Pradesh, India.
ABSTRACT
In the present clinical study 60 Amavata (Rheumatoid arthritis) patients were registered from
the O.P.D. & I.P.D., Department of Kayachikitsa (General Medicine), Sir Sunderlal Hospital,
Banaras Hindu University, Varanasi. 50 patients completed the treatment out of 60 and 10
patients left the treatment before completion of the therapy. The aim of the study was to
evaluate the efficacy of selected Ayurvedic medicine and local application in the
management of Amavata (Rheumatoid arthritis). The treatment schedule was that 1gm
Simhanada guggulu (Ayurvedic pill medicine) orally twice a day with lukewarm water &
Dusturadhi lepa (Ayurvedic paste medicine) applied locally over affected joints mixed with
juice of datura leaves for 3 months. On the basis of observations and the results of this
present study it can be concluded that effect of the trial drugs i.e.Simhanada Guggulu and
Local Application are almost equally effective like Standard group of Diclofenac Sodium in
majority of the symptoms of amavata.
Keywords: Amavata, Rheumatoid arthritis, Simhanada guggulu, local application
*Corresponding Author Email:sudharmako@gmail.com
Received 07 July2016, Accepted 27 July 2016
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
INTRODUCTION
Ayurveda, the most ancient wisdom today is recognized worldwide as a system of medicine
that provides sound mind in sound body1 This traditional system of medicine of India has an
un-enviable position in the field of providing remedies for the ailments and prevention of
health2 At present, man is climbing the step of success he is moving away from health.
Unhealthy diet pattern, Physical inactivity, Stress, Endless desires and Anger have become a
part of his life. All these factors have given birth to number of diseases.
Amavata was first described as an independent disease in Madhava Nidana3.It is the disease
caused by Ama (undigested food material) and vitiated Vata and occupies in sleshma sthana
(Asthi- Sandhi) and affecting Abhyantara and Madhyama Roga Marga4 The disease is a
product of vitiation of Tridosha though Ama and vata are the initiating factors in its
pathogenesis the exacerbation makes the disease more Kashtasadhya .
Amavata is one of the challenging disease for the physicians due to its chronicity,
incurability, complications and morbidity. According to the modern medicine, this disease
looks similar to Rheumatoid arthritis in its clinical appearance. It is a chronic inflammatory,
destructive and deforming symmetrical polyarthritis in which joints become swollen, painful
and stiff and associated with systemic involvement5. Allopathic system of medicine has a
major role to comback this disease. But it has cleared that it created more side effects even
after administration of drugs, and the disease has a tendency to persist progress and cripples
the patient. Therefore, they consider it as a disease of remission and relapses.
In the present era, Amavata is the most common disease affecting a large number of
population worldwide6The degenerative changes in bones and muscles arise from the age of
30 years to the age of 65 years. Male to Female ratio is 1:37. The prevalence of this disease is
such a great that it attracts the mind of a lmost all the physicians towards itself, that’s why it
becomes duty of the research scholar to work on the various aspects of this disease.
The Ayurvedic approach to the treatment of this disease is needed as no system is successful
in providing the complete remission. So, Amavata is a challenging and a burning problem of
medical science. Hence, the management of this disease is merely insufficient in other
systems of medicine and patients are continuously looking with a hope towards Ayurveda to
overcome this challenge.
In present study, Simhanada Guggulu mentioned in Bhaisjya Ratnavali (Vol.11 Cha. 29) and
Local Application (Dusturadhi Lepa) mentioned in Ayurveda Pharmeacopeia (Vol 1– Part
one published by Department of Ayurveda - Sri Lanka ) were selected for the treatment of
Amavata.
Aims and objectives
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
1. To study the etiopathogenesis of Amavata as per ayurveda and modern.
2. To evaluate the therapeutic efficacy of selected formulae
3. To compare the efficacy of Simhanada Guggulu and local application with controlled
group (Diclofenac sodium)8
4. To study the safety profile of the trial drug
MATERIALS AND METHOD:
A total number of 60 patients of Amavata were randomly selected for the present study, from
the Kayachikitsa OPD and IPD of Sir Sunder Lal Hospital, Institute of Medical Sciences,
Banaras Hindu University, Varanasi. The cases were selected randomly regardless of age,
sex, occupation and socio-economic conditions. Both acute and chronic phase of Amavata
patients were taken for the present study.
Inclusion Criteria:
Diagnosed cases of Amavata based on symptoms and signs described in
Madava Nidana and ACR 1987
Sero positive & Sero negative both cases are included
Patients willing to participate for this trial
Age between 20- 60yrs both sexes
Exclusion criteria
Patients having severe deformities
Patients of Rheumatic arthritis, Gouty arthritis, Septic arthritis, Osteoarthritis &
Ankylosing Spondylitis
Immune suppressive patients like HIV, Tuberculosis, Hypertension, D.M. & other
systemic problems
Pregnant & lactating women
Patients with major complications are also excluded
Patients on corticosteroid therapy
Plan of Study
Patients
treatment
Follow up
Group– 1
30
Tab Simhanada Guggulu 500mg twice
daily with lukewarm water
Local Application for apply over
affect joints twice daily.
Every month for
3 months period
Group-11
30
Tab Diclofenac sodium 50mg twice
daily with luke warm water.
Every month for
3 months period
Preparation of Simhanada Guggulu:
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
This is one of the well-known therapeutic preparation described in Baisajya Ratnawali –
Amavata adhikara or the treatment of Amavata. It contains - Haritaki (Terminalia chebula) ,
Bibhitaka (Terminalia belerica), Amalki (Emblica officinalis) , Sudda Gandhaka (Purified
Sulphur) , Suddha Guggulu (Prified Commiphora mukul), Eranda Taila (Ricinus communis)
Seed Oil. Prepared the drug according to guggulu paribasha.
Local Application: Contents:-
Cuttled bone fish,Hing powder, Alovera extraction, Domestic soot (Grihadhuma). Equal
quantity of these drugs were taken and mix with juice of the Dhatura leaves and made the
paste (Local application).
Clinical Assessment of the Disease:
Assessment on Clinical Features:
The relief of the clinical features was assessed on the basis of clinical features of Amavata
(Rheumatoid arthritis) described in the Ayurvedic classics and criteria fixed by the American
Rheumatology Association in 1988 and implemented after some modification. Sandhishula
(Joint pain), Sandhishotha (Joint swelling), Sandhi-sthabdhata (Joint stiffness), Sandhi-
sparsha-asahyatva (Joint tenderness), Angamarda (Body ache), Gaurava (Heaviness of the
Body), Angmarda (Bodyache), Aruchi (Loss of taste), Trishna (Thirst), Alasya (Lack of
enthusiasm), Gaurav (Heaviness), Jwara (Fever) , Apaka (Indigestion)9were selected for
assessment of clinical features and the scoring pattern was adopted separately for assessment
of those clinically.
Assessment on Functional Capacity: a) Walking time b) Grip Strength c)Foot pressure d)
Rang of motion and Joint circumference 10III) Assessment on Overall Effect of the Therapy :
Effect of therapy on cardinal symptoms
Group-1
Group-11
Pain
56.9%
64%
Swelling
65.67%
64%
Stiffness
52.2%
55%
Tenderness
66.6%
62.06%
The relief observed in all the cardinal symptoms was statistically significant in both the
groups. This proves trial drug Simhanada Guggulu and Local Application is highly effective
in alleviating the cardinal symptoms of Amavata.
Table1: Changes in Pain in total 50 patients of Amavata (Rhematoid Arthritis
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
0
0
0
0
20
76.9
2 =57.60
P<0.001
1
1
3.3
5
19.2
15
57.7
1
3.8
2
17
56.7
16
61.5
10
38.5
4
15.4
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3
11
36.7
5
19.2
1
3.8
1
3.8
4
1
3.3
0
0
0
0
0
0
Group II
(n=24)
0
0
0
0
0
0
0
0
0
2 = 52.59
P<0.001
1
1
3.3
4
16.7
19
79.2
19
82.6
2
23
76.7
17
70.8
3
12.5
2
4.3
3
6
20
3
12.5
2
8.3
3
13
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
3.371
p=0.338
2 =
0.562
p=0.755
2 =
0.992
P=0.319
2 =
0.989
P=0.804
At the completion of the therapy 76.9% patients were found completely relieved from pain in
Group I and 82.6% in Group II. (Table 01)
Table 2: Changes in Swelling in total 50 patients of Amavata(Rhematoid Arthritis)
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I (n=26)
0
0
0
0
0
1
3.8
17
65.4
2 = 63.68
P<0.001
1
3
10
2
7.7
9
34.6
6
23.1
2
18
60
20
76.9
16
61.5
3
11.5
3
8
26.7
4
15.4
0
0
0
0
4
1
3.3
0
0
0
0
0
0
Group II (n=24)
0
0
0
0
0
3
12.5
13
54.2
2 =51.416
P<0.001
1
6
20
8
33.3
11
45.8
6
25
2
14
46.7
1
45.8
9
37.5
5
20.8
3
10
33.3
5
20.8
1
4.2
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =2.77
p=0.436
2
=6.254
P=0.044
2 =
4.087
P=0.252
2
=0.955
P=0.620
At the completion of the therapy 65.4% patients were found completely relieved from
swelling of body in Group I as compared to 54.2% in Group II. (Table 02)
Table 3: Changes in Morning stiffness in total 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I (n=26)
0
0
0
0
0
0
0
16
61.5
2 = 46.98
P<0.001
1
1
3.3
7
28
10
38.5
2
7.7
2
21
70
15
60
15
57.7
8
30.8
3
8
26.7
3
12
1
3.8
0
0
4
0
0
0
0
6.7
0
0
0
Group II (n=24)
0
0
0
0
0
1
4.3
18
75
2 =41.84
P<0.001
1
8
26.7
10
41.7
15
65.2
2
8.3
2
15
50
9
37.5
6
26.1
4
16.7
3
6
20
5
20.8
1
4.3
0
0
4
1
3.3
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
0.7739
p=0.052
2 =
2.510
p=0.285
2 =
5.695
p=0.127
2 =
1.373
p=0.503
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
At the completion of the therapy 61.5% patients were found completely relieved from
morning stiffness in Group I as compared to 75% in Group II .(Table 03)
Table 4: Changes in Tenderness in total 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I (n=22)
0
0
0
0
0
0
0
14
53.8
2 =44.98
P<0.001
1
7
23.3
9
34.6
14
46.7
10
38.5
2
19
63.3
16
61.5
11
36.7
2
7.7
3
4
13.3
1
3.8
1
3.3
0
0
4
0
0
0
0
0
0
0
0
Group II (n=26)
0
0
0
0
0
1
3.3
14
56
2 = 40.36
P<0.001
1
9
30
9
36
14
46.7
7
28
2
14
46.7
12
48
6
20
4
16
3
7
23.3
4
16
2
6.7
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2
=1.826
p=0.401
2
=2.353
P =0.308
2 =
4.204
P=0.520
2 =
1.177
P=0.555
At the completion of the therapy 53.8% patients were found completely relieved from
tenderness in Group I as compared to 53% in Group II.(Table 4)
The relief observed in all the cardinal symptoms was statistically significant in both the
groups. This proves trial drug Simhanada Guggulu and Local Application is highly effective
in alleviating the cardinal symptoms of Amavata.
Statistical significance was observed in Group I & II in forms of Grip Power on Intra Group
comparison. Group I showed highest percentage of cured patients on symptom Grip Power.
(Table 5) But on Pressing power mild improvement showed in Group I as compared to 0% in
Group II. ( Table 6 )
Time taken to walk certain distance was reduced significantly in groups I & II after therapy.
At the completion of therapy 19.2% patients was completely relieved in group I as compound
to 20.8% in group II, on intergroup comparison was not significant. (Table 7)
Further, It reveals that the trial drug Simhanda Guggulu and Local Application have the eq ual
effect of Diclofenac sodium in relieving the symptoms of Amavata. Table 06
Table 5 Changes in Grip power in total 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I (n=26)
0
20
69
8
30.8
5
19.2
8
30.8
2 =35.74
P<0.001
1
6
20.7
16
61.5
17
65.4
18
69.2
2
3
10.3
2
7.7
4
15.4
0
0
3
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
Group II (n=24)
0
17
68
6
25
3
12.5
11
45.8
2 = 47.67
P<0.001
1
8
32
15
62.5
14
58.3
13
54.2
2
0
0
3
12.5
7
29.2
0
0
3
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
3.250
p=0.197
2 =
0.493
p=0.803
2 = 1.531
p=0.465
2 =
1.202
P=0.273
Table 6 Changes in Pressing power in total 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
0
0
0
0
1
3.8
2 = 43.84
P<0.001
1
3
10
10
38.5
17
65.4
22
84.6
2
27
90
16
61.5
9
34.6
3
11.5
3
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
Group II
(n=24)
0
0
0
0
0
0
0
0
0
2 =48.81
P<0.001
1
1
3.3
7
29.2
16
66.7
24
95.8
2
28
93.3
17
70.8
8
33.3
0
0
3
1
3.3
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
2.018
p=0.365
2 =
0.480
p=0.488
2 =
0.009
p=0.924
2
=4.950
p=0.175
Table7: Changes in Walking time in 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
8.3
0
0
0
0
0
1
3.8
5
19.2
2 =46.5
p<0.001
1
7
23.3
7
26.9
10
38.5
11
42,3
2
14
46.74
12
46.2
13
50
10
38.5
3
9
30
7
26.9
2
7.7
0
0
4
0
0
0
0
0
0
0
0
Group II
(n=26)
0
0
0
0
0
0
0
5
20.8
2 = 45.24
p<0.001
1
3
10.7
8
33.3
12
52.2
17
70.8
2
19
67.9
14
58.3
9
39.1
1
4.2
3
6
21.4
2
8.3
2
8.7
1
4.2
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =2.892
p=0.236
2 =
2.923
p=0.232
2 =
1.732
p=0.630
2 =
9.585
P=0.022
Among general symptoms which were considered here, more relief was observed in the
symptoms of Bodyache, Thirst, Lack of enthusiasm, Heaviness and Fever in patients of
giving trial drug Simhanada Guggulu and Local Application( Group-1) at significant level.
(Table 8- Table 12)
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
Table 8: Changes in bodyache in total 50 patients of Amavata (Rheumatoid arthritis)
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
0
0
0
0
3
11.5
2 = 56.519
P < 0.001
1
3
10
3
11.5
10
38.5
16
61.5
2
15
50
17
65.4
13
50
5
19.2
3
10
33.3
4
15.4
2
7.7
2
7.7
4
2
6.7
2
7.7
1
3.8
0
0
Group II
(n=24)
0
0
0
0
0
0
0
0
0
2 = 49.63
P < 0.001
1
1
3.3
4
16.7
13
54.2
20
83.3
2
21
70
15
62.5
10
41.7
4
16.7
3
8
26.7
5
20.8
1
4.2
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2=4.222
p=0.238
2 =
2.303
p=0.512
2 =
2.039
p=0.564
2 =
5.484
p=0.140
Table 9: Changes in thirst in total 50 patients of Amavata (Rheumatoid arthritis)
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
0
0
3
11.5
9
34.6
2 = 29.931
P < 0.001
1
1
3.3
1
3.7
16
61.5
16
61.6
2
12
40
14
51.9
5
19.2
1
3.8
3
15
50
10
37
2
7.7
0
0
4
2
6.7
2
7.4
0
0
0
0
Group II
(n=24)
0
0
0
0
0
1
2
4
9.5
2 = 12.25
P < 0.002
1
1
3.3
2
9.5
15
9
14
66.7
2
7
23.3
6
28.6
10
10
6
23.8
3
18
60
13
61.9
0
0
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
7.589
p=0.180
2 =
5.257
p=0.154
2 =
5.35
p=0.148
2 = 6.8
p=0.033
Table 10 Changes in lack of enthusiasm in total 50 patients of Amavata
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
2
7.7
4
15.4
6
23.1
2 = 49.67
P<0.001
1
2
6.7
4
15.4
9
34.6
12
46.2
2
23
76.7
16
61.5
11
42.3
8
30.8
3
5
16.7
4
15.4
2
7.7
0
0
4
0
0
0
0
0
0
0
0
Group II
(n=24)
0
0
0
0
0
0
0
2
8.3
2 = 29.76
P < 0.001
1
8
26.7
10
41.7
13
54.2
18
75
2
19
63.3
14
58.3
11
45.8
4
16.7
3
3
10
0
8
0
0
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 =
4.481
2 =
8.639
2 =
6.658
2 =
4.460
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
2 - test
p=0.106
p=0.035
p=0.084
p=0.108
Table 11:Changes in heaviness in total 50 patients of Amavata (Rheumatoid arthritis)
Group
Grade
No. and % of cases
Within the group
comparison
Friedman test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
0
0
1
3.8
1
3.8
3
11.5
2 = 44.21
P<0.001
1
2
6.7
7
26.9
10
38.5
13
50
2
17
56.7
9
34.6
10
38.5
10
38.5
3
11
36.7
9
34.6
5
19.2
0
0
4
0
0
0
0
0
0
0
0
Group II
(n=24)
0
0
0
1
4.2
1
4.2
2
8.3
2 = 47.16
P<0.001
1
3
10
4
16.7
11
45.8
18
75
2
24
80
16
66.7
11
45.8
4
16.7
3
3
10
3
12.5.
1
4.2
0
0
4
Between the group
comparison
2 - test
2 =
5.967
p=0.051
2
=5.707
p=0.127
2 =
2.686
p=0.443
2 =
3.503
p=0.173
Above table shows the improvement in symptom heaviness in subjects from initial level at
subsequent follow ups in both the group
Table 12:Changes in fever in total 30 patients of Amavata (Rheumatoid arthritis)
Group
Grade
No. and % of cases
Within the group
comparison Friedman
test
BT
F1
F2
F3
No.
%
No.
%
No.
%
No.
%
Group I
(n=26)
0
8
26.7
7
26.9
16
61.5
26
100
2 =44.77
P<0.001
1
22
73.3
19
73.1
10
38.5
0
0
2
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
Group II
(n=24)
0
7
23.3
11
9.33
20
71.4
23
96.4
2 =43.41
P<0.001
1
22
73.3
16
57.1
8
28.6
1
3.6
2
1
3.3
1
3.6
0
0
0
0
3
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
Between the group
comparison
2 - test
2 =
1.067
p=0.587
2 =
2.075
p=0.354
2 =
0.593
P=0.441
2 =
0.946
P=0.331
Significant reductions were seen in the mean titre value of RA factor, CRP and mean ESR
in both the groups. Mean Hb in Group I & II was not statistically significant.
Group
RA Factor (Mean SD)
Within the group comparison paired
t test(BT-AT)
BT
AT
Group I (n=26)
32.38+15.8
26.24+12.54
6.139+5.843 t=5.039
P<0.001
Group II (n =24)
25.30+18.20
20.78+12.02
4.513+8.132 t=2.719
p<0.012
Between the group
comparison
t=0.656
p=0.514
t=1.522
p=0.135
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
Unpaired t test
Group
CRP (Mean SD)
Within the group
comparisonPaired t-test
BT
AT
Group I (n=26)
1.55+.76
0.59 0.28
0.95+0.65
t=5.32
p<0.001
Group II (n=24)
2.11 1.36
1.04 0.92
1.07+0.81
t=6.79
p<0.001
Between the group comparison
Unpaired t-test
t = 1.73
p=0.09
t = 2.186
p=0.03
Group
ESR (Mean SD)
Within the group
comparison paired t test
BT
AT
Group I (n=26)
42.68 10.68
29.12 8.82
1.3567.87
t = 8.61
p<0.001
Group II (n=24)
37.13 13.02
26.69 9.26
1.0437.06
t = 7.08
p<0.001
Between the group comparison
Unpaired t test
t = 1.535
p=0.130
t = 1.080
p=0.286
Group
Hb changes (Mean SD)
Within the group
comparison Paired t-test
BT
AT
Group I (n=26)
11.58
1.028
11.83
1.06
0.09610.450
t= 1.13
p=0.267
Group II (n=24)
11.78 1.72
11.98 1.45
0.03 0.86
t=0.222
p=0.826
Between the group
comparison
Unpaired t-test
t = 0.354
p=0.724
t = 0.262
p=0.795
Analysis of Simhanada Guggulu and local application (Grihadhuma, Cuttle fish powder,
Alovera extraction) was carried out by using analytical parameters. with the aim of
Identification of Raw material & Analysis of the final product.
SAFETY PROFILE
The value of WBC (TC, DC), LFT/RFT (SGOT and SGPT, Serum Urea, Serum Creatinine),
and Blood sugar were observed at before treatment and after treatment.
Probable mode of action of Simhanada Guggulu :
The majority of the ingredients of Simhanada Guggulu are katu tikta rasa. Ushna Laghu
Tikshna Ruksha, guna, Ushna virya.11These properties of the drug are against the guru,
Snigdha, Pichchila, Sheeta properties of Ama and these properties help to mitigate the
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
Ama in to the body. The drug Simhanada Guggulu also increases the Agni bala i.e
Pachakagni and Dhatvagni in to the body by its Agni deepaniya action and hence it prevents
the further formation of Ama in the body.
It controls the prakopa of Vata and Ama by its Vata kapha shamaka property, because
properties of Ama are more similar to kapha dosha. It reduces the Pratyatma Lakshan
(Cardinal clinical features)12of Amavata, e.g Sandhi shula, Sandhi sotha, Sandhi
sparshasahyata and Sandhi stabdhata by its Vedanasthapana Sothahara and Mutrakaraka
action.
By antioxidant property it mitigates the Ama (i.e Free radical like substance) dueto Rasayana
effect of its some ingredients. It also replenishes and rejuvenates the impaired Dhatus by its
Rasayana effect.On the basis of above information we can say that the drug Simhanada
Guggulu is very suitable for the Samprapti Vighatana of the disease Amavata.
PROBABLE MODE OF ACTION OF LOCAL APPLICATION
DUSTURADI LEPHA is used to apply locally over the joints. The major ingredients of it
are containing katu, tikta rasa, Ushna laghu, ruksha, tikshna guna, Ushna virya and katu
vipaka 13 properties which are all against the properties of Ama. It helps to reduce the local
Sandhi shula (Jointpain), Sandhi shoth (Joint swelling), Sandhi sparsha asahayata (Joint
tenderness) and Sandhi stabdhata (Joint stiffness) by its Vedanasthapaka (Analgesic) and
Shothahara (Anti inflammatory) action when it is used locally over affected joints. It helps to
reduce the local prakopa of Vata and Ama of the affected joints by its Vata kapha shamaka
property, when it is used locally.
So it can be said that local application is very much effective to break down the Samprapti
locally of the diseases of the disease Amavata, when it is used locally over affected joints.
In the present clinical research work no side effects of the research drugs were observed
during the clinical trial and follow up study.
CONCLUSION
On the basis of observations and the results of this present study it can be concluded that
effect of the trial drugs i.e. ,Simhanada Guggulu and Local Application are almost equally
effective like Standard group of Diclofenac Sodium in majority of the symptoms. The sign
and symptoms e.g., Loss of appetite, Aruchi, Trishna, Aalasya, Jawara etc. were improved by
the Trial drugs as compared to that in Diclofenac Sodium treated group. There was neither
any side effect produced nor any unwanted effect observed during the trial drug. Though in
standard group of Diclofenac sodium, some patients developed complaint of GI upset ,
acidity and burning sensation in epigastrium.The general digestion was found to be good with
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Kodituwakku et al., Asian J Med Health Res. 2016;1(6) ISSN: 2455-8664
the Trial drugs and simultaneously quality of life was also improved in comparison to
Diclofenac Sodium Group.
REFERNCECS
1. Charaka / Sharirasthana/Purush vishaya Adhayaya
2. Charaka/Sutrasthana /xxx
3. Madhava Nidana/ 25th Chapter
4. Madhava Nidana 25th Chapter
5. Manual of Practical Medicine (R Alagappan )/page 850
6. WHO Data
7. RA NHS Data
8. Medical Pharmacology- Padmaja Udayakumar 29th chapte4
9. Madava Nidana 25th Chapter
10. Physical Examination Assessment Study Guide
11. Bhaisajya Ratnawali Vol. II-29
12. Madhava Nidana -25/5
13. Ayurveda Pharmacoepia (Sri Lanka-Vol. I – Page 272)
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