Studies on Urdhwaga Amlapitta (Gastritis) and its Management with Shatavari Ghruta

Abstract

Amlapitta (Gastritis) is very common ailment found in present time. Amlapitta as per Ayurveda is a disease in which excessive secretion of Amla Guna of Pitta takes place causing symptoms like burning sensation. Though there are many opinions regarding Modern interpretation of Amlapitta, specifically it can be correlate with Gastritis. There are two types of amlapitta mainly Adgoga and Urdhwaga Amlapitta. Type of Amlapitta in which the pitta takes an upward course the patient has mainly vomiting with different colors, burning sensation, headache, loss of appetite, kapha – pittaja jwara, feeling of great heat etc. is called as Urdhwaga Amlapitta. Present study is carried out to assess the efficacy of Shatavari ghruta in Urdgwaga Amlapitta and see the comparative results of Shatavari ghruta and sutshekhar ras and kamdudha rasa in Urdhwaga Amlapitta .For this study 50 patients were selected according to subjective and objective criteria of Urdhwaga Amlapitta and Details of materials and methods, observation and results, statistical analysis, results and discussion of the study with conclusion were described in detail in present article. From this study it can be concluded that Urdhwaga Amlapitta can be managed effectively with Shatavari ghruta as well as with Sutshekhara rasa and Kamdudha rasa as both the groups shows equally effective results statistically.

Full text

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [78] CODEN (USA): AJPRHS
Available online on 15.06.2019 at http://ajprd.com
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Open Access Research Article
Studies on Urdhwaga Amlapitta (Gastritis) and its Management
with Shatavari Ghruta
Sanjore (Naringe) Seema S., Kharche G. Y.
1Scholar R.T Ayurved Mahavidyalaya, Akola
2Assistant Prof. P. G. Dept. of Kayachikitsa, R.T Ayurved Mahavidyalaya, Akola
A B S T R A C T
Amlapitta (Gastritis) is very common ailment found in present time. Amlapitta as per Ayurveda is a disease in which excessive
secretion of Amla Guna of Pitta takes place causing symptoms like burning sensation. Though there are many opinions
regarding Modern interpretation of Amlapitta, specifically it can be correlate with Gastritis. There are two types of amlapitta
mainly Adgoga and Urdhwaga Amlapitta. Type of Amlapitta in which the pitta takes an upward course the patient has
mainly vomiting with different colors, burning sensation, headache, loss of appetite, kapha – pittaja jwara, feeling of great
heat etc. is called as Urdhwaga Amlapitta. Present study is carried out to assess the efficacy of Shatavari ghruta in Urdgwaga
Amlapitta and see the comparative results of Shatavari ghruta and sutshekhar ras and kamdudha rasa in Urdhwaga
Amlapitta .For this study 50 patients were selected according to subjective and objective criteria of Urdhwaga Amlapitta and
Details of materials and methods, observation and results, statistical analysis, results and discussion of the study with
conclusion were described in detail in present article. From this study it can be concluded that Urdhwaga Amlapitta can be
managed effectively with Shatavari ghruta as well as with Sutshekhara rasa and Kamdudha rasa as both the groups shows
equally effective results statistically.
Keywords: Amlapitta, Gastritis,Urdhwaga Amlapitta, H.pylori antibody detection test, Gastric Analysis test, Shatavari
Ghruta,
A R T I C L E I N F O : Received 08 May 2019; Review Completed 30 May 2019; Accepted 07 June 2019; Available online 15 June 2019
Cite this article as:
Sanjore (Naringe) S S., Kharche G. Y., Studies on Urdhwaga Amlapitta(Gastritis) and its Management with Shatavari
Ghruta, Asian Journal of Pharmaceutical Research and Development. 2019; 7(3): 78-93.
DOI: http://dx.doi.org/10.22270/ajprd.v7i3.518
*Add ress for Corres pondence:
Dr. Seema S. Sanjore(Naringe), Asso.Prof. ShriAyurved Mahavidyalaya Nagpur.
INTRODUCTION
yurveda is the science that imparts all the
knowledge of life. It is well known that,
Ayurveda had adopted a scientific methodology
and risen to great heights over 2000 years ago. New
discoveries are possible only if an idea is proposed in
scientific manner. There are many interesting field of
human ailments where in spite of rapid advances of
modern medicine, Ayurveda still be the beacon of light.
"Vagbhata I" in the Ashtanga Samgraha Sutrasthana
mentioned that “Sakaloapichayam Rogasmuh pratikarvan
ayurved vihitmupa desampeksate " that means all the
diseases can be treated and treatment of these diseases are
in Ayurveda so all the diseases required Ayurvedic
treatments.1 Amlapitta has become a common ailment in
modern civilized society in view of the irregular dietetic
habits. Modern competitive life does not permit today to
go for a systemic dietetic regimen and this unfortunately
results in several G. I. disturbances of which Amlapitta
stands first. Amlapitta is the disease of Annavaha strotasa
or G.I. tract which is classified according to pravrutti into
2 catagories viz- Urdhwaga and Adhoga.2 The present
research work is specially on Urdhwaga Amlapitta which
can be correlated with Acid gastritis (Acid dyspepsia or
Hylperchlorhydria.) Amlapitta is one of the diseases for
which no satisfactory treatment exists in Modern
Medicine. While in Ayurveda a number of result oriented
A

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
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formulations have been recommended in Ayurvedic
classics for its treatment in addition to Pancakarma
Chikitsa.
The description of Amlapitta as a separate disease is not
found in bruhatrai but there are many scattered references
in Charaka Samhita regarding to it. Kashyapa Samhita is
the first classical text in which details of Amlapitta is
describied.3Madhavakara has also described Amlapitta
with sub types4 and latter scholars followed them.
Amlapitta is of two types Urdhwaga Amlapitta and
Adowa Amlapitta.
Type of Amlapitta in which vomiting with different
colour before or during digestion of food, bitter or sour
belchings, heartburn, and the symptoms of pitta
kaphajaanubandha are found is called as Urdhwaga
Amlapitta.5 Urdhwaga Amlapitta is mainly caused by
intake of Amla (sour), katu (pungent), lavana (salty)
aharas, guru, snigdha, Abhishandhiaharas, addictions like
smoking, alcohol, tobacco chewing, and also by excessive
stress, condiments. The drugs like NSAID’s, corti co-
steriods, Phenyl butazone also cause this disease.
The line of treatment in Amlapitta can be mainly of 3
types 6 –
 Nidanaparivarjanam
 Samshodhana
 Samshamana.
In Samshamana Chikitsa mainly tikta rasa pradhana
pachak aushadhis & kapha pittaghna chikitsa should be
given.
Many following previous research scholars have studied
on specially Urdhwaga type of Amlapitta in different
ways like Tayade V. (1988), Kulkarni A. B. (1989),
Bhandare in (1991), Panjihade (1992), Shepal S. S.
(1992), Gogad G. (2004). They all found encouraging
results in their studies. Though lot of research work is
undergoing throughout the world to control this disease,
still there is need of more research regarding practical
aspect in the management of the disease so present study
is carried out.
AIMS & OBJECTIVES OF THE STUDY:
 To assess the efficacy of Shatavari Ghruta in the
management of Urdhwaga Amlapitta.
 To study the comparative results of Shatavari Ghruta
to Sutshekhara Rasa & Kamdudha Rasa in Urdhwaga
Amlapitta.
 To study the etiopathological aspects of Amlapitta and
Urdhwaga Amlapitta.
 To study the association of H. Pylori with Urdhwaga
Amlapitta if any.
 To study the changes of acid output in patients of
Urdhwaga Amlapitta with Shatavari ghrta and
Sutsekhara Rasa & Kamdudha Rasa.
Materials and Methods:
1) Drugs:-
Selection of drugs: - The drugs taken for study were as
follows.
 Shatavari Ghruta.
 Sutashekhara Rasa and Kamadudha Rasa.
Preparation of drug: -
The drugs were prepared in Ausadhi Nirmana Rasasala R.
T. Ayurveda Rungnalaya Akola. Sutashekhara Rasa and
Kamadudha Rasa were prepared as mentioned in
Rasayogasagara by vd. Pandit Hariprapannaji.7
Method of preparation of Shatavari Ghruta:
In this clinical trial we adopted a general method of
preparation of ghruta as described in text of
"Pharmacopiel standards for Ayurvedic formulations" 8as
follows.
Preparation of Kalka:-
Tubers of shatavari were finely chopped and immersed in
the sufficient amount of water for 12 hrs (from 6pm –
6am) then the thin layer of tubers wiped out and were
grinded into paste in mixer grinder.
Preparation of Ghruta :-
(Here preparation of 1 kg of Shatavari Ghruta was
described.)1kg of Goghruta was taken in a large steel pot
and melted with mild heat, and then Shatavari Mulakalka
250 gr and 4kg Godugdha is added & boiled together on
mild to moderate heat. Thus prepared Ghruta was filtered
and stored in a bottle.
Patient:-
Selection of patients: - In the present clinical study 53
patients were diagnosed as Urdhwaga Amlapitta and
included in study, out of which 3 drop outs during the
complete course of treatment. Patient is treated as
outdoor patient of Ayurveda Rugnalaya and Anusandhan
Kendra & Ayurveda Rugnalaya (old hospital) station
Road, Akola and indoor patient of Ayurveda Rugnalaya
and Anusandhana Kendra, Akola.
1) Subjective Criteria:-
Inclusion criteria:-
Patients suffering from Urdhwaga Amlapitta fullfilling
essential criteria were included for present study.
i) Avipaka
ii) Utklesha
iii) Tikta-amlodgara
iv) Kantha-hrut-kukshidaha
v) Agnimandya
vi) Chardi.
The patients of either sex and between the ages of 20 – 70
were selected.

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
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Detail clinical history, special findings and assessment
notes were noted in the special research Proforma.
Exclusion criteria:-
 Patients with significant hepatic, renal, hematological,
neurological or psychiatric disorders were excluded
from the study.
 Patients with concurrent gastric or duodenal ulcer or
with its complications, Gastric carcinoma or Zollinger–
Ellison syndromes were excluded from the study.
2) Objective Criteria:-
Gastric analysis test: - Free HCl more than 15-18.5
Meq/L and Total acidity level more than 25- 30 Meq/L
was considered for the patient of Urdhwaga Amlapitta.
Laboratory investigations:- 1. Hb%, 2.TLC, 3.DLC,
4.ESR, 5.Urine complete, 6. Stool complete, 7.
Serological test for detection of antibodies developed by
H. Pylori.
Research Methodology:-
Sampling method:-After complete examination and
investigation of all the Patients were divided into two
groups by simple random sampling
Treatment Group: - Present clinical study includes
group A and group B each contain 25 patients.
Group A: - This group was treated with Shatavari Ghruta.
Dose: - 10 -20 ml, BD (orally) for 12 week.
Anupana: - Lukewarm milk.
Group B: - This group was treated with Sutashekhara
Rasa and Kamadudha Rasa.
Dose: - Each 250 to 500 Mg. TDS (orally) for 12 weeks.
Anupana: - Lukewarm milk.
The patients were examined according to symptomatic
relief at every week and reporting was noted in specially
prepared research Proforma.
Duration of treatment: - Each group was treated for 12
weeks.
Controlled conditions:-
a) Dietetic regimen:-
 Patients were advised to take One cup milk and fresh
light breakfast in the morning
 Patient were allowed to take meal two times a day with
strict follow up of advised pathya apathya
 Patient was advised to take luke warm water for
drinking.
b) Exercise:-
Daily practice and Yoga was advised to the patient.
Emphasis was given on special type of Asana which was
helpful in Amlapitta like Vajrasana, Halasana,
Shalabhasana, Pawanmuktasana, Surya Namaskara etc.
c) Behavior:-
 Patients were advised to engage at least one hour in his
or her hobby like reading.
 Patients were advised not to suppress natural urges.
 Confirmatory cross check is carried out to find out
whether patient following controlled conditions or not.
Assessment of results:-
The effect of the drug under clinical trial was based on
cardinal signs and symptoms of disease and decrease in
free and total acidity level. For the every major symptom
scoring pattern was applied. Some and they are mentioned
below. The statistical analysis was done using paired t-test
and S. D., S. E. and 'T' value were calculated on the basis
of before and after treatment score and decrease in free
and total acid.
Scoring pattern: - Scoring of signs and symptoms of
Urdhwaga Amlapitta for the assessment of results:-
A) Udarshula:-
B) Avipaka :-
A
Patient is bedridden.
++++
B
Pain disturbs daily routine.
+++
C
Pain does not disturb daily routine
++
D
When keenly paid attention, notices pain.
+
E
No pain.
0
A
Patients can't digest daily even liquid diet and
daily routine is disturbed.
++++
B
Patients can't digest solid diet daily routine work
was not disturbed.
+++
C
Patients can’t digest solid diet intermittently.
++
D
Patients can’t digest occasionally 2- 3 times a
week.
+
E
No indigestion.
0

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
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C) TiktaAmlodgara:-
D) Kantha- hrut –kukshi-daha(burning sensation in throat,chest,abdomen) :-
E) Aruchi:-
F) Chardi :-
A
Severe Tikta – amlodgara disturbing sleep.
++++
B
Tikta -Amlodgara only in a day with
disturbing sleep.
+++
C
Tikta -Amlodgara sometimes in a day.
++
D
Tikta -Amlodgara sometimes in a week.
+
E
No Amlodgara at all.
0
A
Burning sensation in throat, chest and upper
abdomen and does not relieved without
medicine.
++++
B
Burning sensation in throat chest and upper
Abdomen and relieved after digestion of food or
vomiting.
+++
C
Burning sensation in one or two of the above
mentioned area's& relived after digestion of food
or vomiting.
++
D
Burning sensation in one of the above Mentioned
areas and relieved by intake of milk or cold
drink.
+
E
No burning sensation and upper abdomen.
0
A
Unable to identify the any of the rasas with
efforts.
++++
B
Able to identified the one or two of the rasas
with efforts.
+++
C
Able to identify the one or two of the rasas
without efforts.
++
D
Able to identify all of the rasas without
efforts.
+
E
Able to identify all the rasas.
0
A
Frequency of vomiting after every meal or once
in a day.
++++
B
Frequency of vomiting between 4 to 5 per week.
+++
C
Frequency of vomiting not more then 1 or 2 in a
week.
++
D
Feels sense of nausea but vomits occasionally.
+
E
No vomiting at all.
0

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [82] CODEN (USA): AJPRHS
RESUTLS AND DISCUSSION
The present clinical study has been carried out on 50
patients of Urdhwaga Amlapitta and divided in to two
groups, 25 patients in each group. The data collected were
distributed according to age, sex, religion, income,
occupation etc. and tabulated. The tabulated data is
discussed and graphically presented as follows:-
Table 1: Age wise classification of 50 patients of Urdhwaga Amlapitta
Sr. No.
Age in Yrs.
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
10 – 20
02 (08%)
03 (12%)
05
10
2.
21 – 30
13 (52%)
10 (40%)
23
46
3.
31 – 40
04 (16%)
05 (20%)
09
18
4.
41 – 50
04 (16 %)
03 (12%)
07
14
5.
51 – 60
01 ( 4%)
02 (8%)
03
06
6.
61 – 70
01 ( 4%)
02 (8%)
03
06
Figure 1: Age wise classification of 50 patients of Urdhwaga Amlapitta
Above observation shows that incidence of Urdhwaga Amlapitta is maximum in 20-30 Age Group followed by 31 to 40
Age group, both these groups belongs to pitta predominant period.
Table 2: Sex wise classification of 50 patients of Urdhwaga Amlapitta :-
Sr.N
o.
Sex
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Meal
08 (32%)
07 (28%)
15
30
2.
Femeal
17 (68%)
18 (72%)
35
70
Above Table indicates that, incidence of Urdhwaga Amlapitta is more in femeal then meal, the higher chances are due to
mental stress, suppression of natural urges.
Figure 2: Sex wise classification of 50 patients of Urdhwaga Amlapitta
0%
20%
40%
60%
80%
Male
Female
Group 'A'
Group 'B'
0%
10%
20%
30%
40%
50%
60%
10 –20
21 –30
31 –40
41 –50
51 –60
61 –70
Group 'A'
Group 'B'

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [83] CODEN (USA): AJPRHS
Table 3: A etiological factors wise distribution of 50 patients of Urdhwaga Amlapitta
Sr.
No.
A etiological factors
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Dietetic factors
10 (40%)
09 (36%)
19
38
2.
Behavioural factors
06 (24%)
07 (28%)
13
26
3.
Psychological factor
09 (36%)
09 (36%)
18
36
Above observation indicates that 38% patients were
having dietetic factor as main cause of the disease
followed by 36% patients having psychological factor &
26% patients were having behavior factor as a main cause
of the disease. These tables clarify the importance of
dietetic factor in Urdhwaga Amlapitta.
Figure 3: A etiological factors wise distribution of 50 patients of Urdhwaga Amlapitta
Table 4: Associated symptoms wise distribution of 50 patients of Urdhwaga Amlapitta :-
Sr.
No.
Associated symptoms
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Udarshula
22 (88%)
16 (64%)
38
76
2.
Sirshula
17 (68%)
11 (44%)
28
56
3.
Aruchi
08 (32%)
14 (56%)
22
44
4.
Karcharandaha
22 (88%)
11 (44%)
33
66
5.
KaphapittajaJwara
09 (36%)
05 (20%)
14
28
6.
Twakpidika
06 (24%)
03 (12%)
09
18
Above observation indicates that among the associated
symptoms the symptom found in highest patients is
Udarshula (76%) followed by symptom Karcharandaha
(66%). Twakpidika is found in least patient’s i. e. (18%).
Figure 4: Associated symptoms wise distribution of 50 patients of Urdhwaga Amlapitta
0%
5%
10%
15%
20%
25%
30%
35%
40%
Dietatic factors
Behavioural
factors
Psychological
factors
Group 'A'
Group 'B'
0%
20%
40%
60%
80%
100%
Udar sula
Sirsula
Aruci
Karcarandaha
Kaphapittaja Jwara
Twak pidika
Group 'A'
Group 'B'

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [84] CODEN (USA): AJPRHS
Table 5: Distribution of 50 patients of Urdhwaga Amlapitta according to Upashaya
Sr.
No.
Upahsaya
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Vomiting
12 (48%)
09 (38%)
21
42
2.
Milk
03 (12%)
04 (16%)
07
14
3.
Antacids
05 (20%)
06 (24%)
11
22
4.
Cold drinks
02 (08%)
0 (0%)
02
04
5.
Langhana
03 (12%)
06 (24%)
09
18
In the present study the patients of Urdhwagam Amlapitta
reported various dietary articles & other measures which
provide temporarily relief. 42% patients reported that
vomiting relieves the pain. 22% patients showed relief by
Antacids, 18% patients showed relief by Langhana, 14%
patients showed relief by milk & only 4% were reported
upsaya by cold drinks.
.
Figure 5: Distribution of 50 patients of Urdhwaga Amlapitta according to Upashaya
Table 6: Distribution of 50 patients of Urdhwaga Amlapitta according to H. Pylori Antibody Detection Test
Sr.
No.
H. Pylori Antibody
Detection Test.
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Positive
08 (32%)
06 (24%)
14
28
2.
Negative
17 (68%)
19 (76%)
36
72
Above observation indicates that 72% patient's H. Pylori antibody detection test is negative and only 28% patientsare with
positive results. this clarify that there is no association between Urdhwaga Amlapitta& H. Pylori but for final conclusion,
the H. Pylori detection must be done with more sensitive method &with more clinical data.
.Figure 6: Distribution of 50 patients of Urdhwaga Amlapitta according to H. Pylori Antibody Detection Test
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Vomitting
Milk
Antacids
Cold drinks
Langhana
Group 'A'
Group 'B'
0%
20%
40%
60%
80%
Positive
Negative
Group 'A'
Group 'B'

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [85] CODEN (USA): AJPRHS
Table 7: Comparative effect of group 'A' & group 'B' on 50 patients of Urdhwaga Amlapitta
Sr.
No.
Result
No. of Patients
Total
%
Group 'A'
Group 'B'
1.
Cured
19 (76%)
18 (72%)
37
74
2.
Improved
06 (24%)
07 (28%)
13
26
Above observation indicates that in group 'A' 76% patients are Cured & while in group 'B' 72% patients are Cured & in
group 'A' 24% patients are Improved while in group 'B' 28% patients were Improved.
Figure 7: Comparative effect of group 'A' & group 'B' on 50 patients of Urdhwaga Amlapitta Statastical Analysis
The data obtained after present clinical study was statistically analyzed. Analysed data is tabulated and discussed as
follows:
Table 8: Statistical Analysis of effect of the group ‘A’ on Subjective parameters in UrdhwagaAmlapitta :-
Symptoms
T/T
Mean
S. D.
S. E.
M. D.
S. D.
S. E.
't' value
Avipaka
BT
20.80
2.79
0.554
19.60
4.546
0.909
21.557
AT
1.20
3.317
0.663
Utklesha
BT
27.60
4.359
0.872
26.00
5.00
1.00
26.00
AT
1.60
2.742
0.748
Tikta-amlodgara
BT
27.60
4.359
0.872
23.60
5.686
1.137
20.752
AT
4.00
5.00
1.00
Hrut –
KanthaKukshi Daha
BT
28.80
3.317
0.663
26.00
5.00
1.00
26.00
AT
2.80
4.583
0.663
Mahati
Ushmanubhuti
BT
9.60
10.198
2.040
16.80
5.568
1.114
15.087
AT
2.40
4.359
0.872
Agnimandya
BT
17.24
7.019
1.303
16.90
7.123
1.323
12.774
AT
0.34
1.857
0.345
Chardi
BT
14.80
5.099
1.020
14.40
5.066
1.03
14.22
AT
0.40
2.00
0.400
From the above table it is revealed that group 'A' treatment is highly effective in reducing almost all the symptoms. As
't'cal> 't'tab at 0.01 & 0.001 Level of significance at 24 degree of freedom.
Group 'A' is more effective in reducing the symptom like Utklesha& Hrt-kantha-kukshidaha & Avipaka as compare to
other symptoms.
0%
20%
40%
60%
80%
Cured
Improved
Group 'A'
Group 'B'

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [86] CODEN (USA): AJPRHS
Table 9: Statistical Analysis of effect of the group ‘B’ on Subjective parameters in Urdhwaga Amlapitta
Symptoms
T/T
Mean
S. D.
S. E.
M. D.
S. D.
S. E.
't' value
Avipaka
BT
20.80
4.00
0.800
17.60
4.359
0.872
20.189
AT
3.20
4.761
0.952
Utklesha
BT
27.20
4. 583
0.917
23.20
4.761
1.00
24.365
AT
4.00
5.00
1.00
Tikta-
amlodgara
BT
27.60
5.228
1.046
20.80
4.933
0.987
21.083
AT
6.80
4.761
0.952
Hrut –
KanthaKukshiD
aha
BT
29.60
2.00
0.400
23.20
5.568
1.114
20.834
AT
6.40
4.899
0.980
MahatiUshman
ubhuti
BT
5.60
8.699
1.740
17.60
4.359
0.872
20.189
AT
0.40
2.00
1.740
Agnimandya
BT
16.90
7.603
1.413
15.17
6.336
1.177
12.895
AT
1.72
3.844
0.714
Chardi
BT
14.80
5.099
1.020
14.40
5.066
1.03
14.22
AT
0.40
2.00
0.400
From the above table it is revealed that group 'B' treatment
is also highly effective in reducing almost all the
symptoms of Subjective parameters as 't'cal> 't'tab at 0.01 &
0.001 Level of significance at 24 degree of freedom.
Group 'B' is more effective in reducing the symptom like
Utklesa & Tikta- amlodgara as compare to other
symptoms.
Table 10: Comparative result of group 'A' & group 'B' on free HCl and Total Acidity level
Acid
T / t
Group
fasting
10th
Free HCl
B. T.
Group 'A'
38.50 + 8.50
47.80 + 3.183
Group 'B'
40.25 + 7.30
49.96 + 2.992
't' value
-1.331,P>0.05
-1.435,P>0.05
A. T.
Group 'A'
14.67 + 8.28
19.04 + 1.26
Group 'B'
21.33 + 7.70
19.04 + 1.26
't' value
1.43,P>0.05
't' can't cal. as SE.of
difference is 0
Total acid
B. T.
Group 'A'
61.33 + 8.81
57.67 + 8.22
Group 'B'
58.67 + 7.14
58.00 + 2.74
't' value
-1.40,P>0.05
-1.14,P>0.05
A. T.
Group 'A'
14.67 + 8.28
20.67 + 1.16
Group 'B'
21.33 + 7.70
21.33 + 9.68
't' value
1.43,P>0.05
-1.431,P>0.05
Result of group 'A' & group 'B' on free HCl and Total
Acidity level indicates that both the groups shows statistically no significant difference in reducing the Free
& Total Acidity level.

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [87] CODEN (USA): AJPRHS
Table 11: Effect of group 'A' on Serum Cholesterol & Serum Triglycerides
T/t
Mean
SD
SE
MD
SD
SE
't'
11chole-
st11erol
B. T.
168.08
19.621
3.924
0
4.252
0.850
0
A. T.
168.08
18.237
3.647
S.Trigly-
cerides
B. T.
107.84
21.704
4.341
-0.8
4.627
0.925
-086
A. T.
107.92
19.881
3.976
Above table shows that theiris statistically no effect on Serum Cholesterol & Serum Triglycerids of before & after
treatment as statistically there is no significant difference at P > 0.05.
Table 12: Effect of group 'A' & group 'B' on H. Pylori
Group
T/t
Mean
SD
SE
MD
SD
SE
't'
Group
'A'
B. T.
0.32
0.476
0.095
0.24
0.436
0.087
2.753
A. T.
0.08
0.276
0.055
Group
'B'
B. T.
0.24
0.436
0.87
0.16
0.374
0.075
2.138
A. T.
0.08
0.277
0.055
Above table shows that group 'A' is effective in eradication of H. Pylori ('t'=2.753 P.< 0.02) and group 'B' is effective in
eradication of H. Pylori ('t'=2.138 P.< 0.05).
Table 13: Effect of group 'A' & group 'B' on presence of bacteria in stool
Group
T/t
Mean
SD
SE
MD
SD
SE
't'
Group
'A'
B. T.
0.72
0.458
0.72
0.720
0.458
0.092
7.856
A. T.
0.00
0.00
0.00
Group
'B'
B. T.
0.56
0.00
0.101
0.480
0.510
0.102
4.707
A. T.
0.00
0.00
0.00
Above table shows that group 'A' is highly effective on eradication of bacteria in stool ('t' = 7.856 P.< 0.001) and group 'B'
is also highly effective on eradication of bacteria ('t'=2.138 P.< 0.05).
Table 14: Statistical Analysis of effect of the group ‘A’ on associated symptoms of Urdhwaga Amlapitta :-
Symptoms
T/T
Mean
S. D.
S. E.
M. D.
S. D.
S. E.
't' value
Udarshula
BT
19.60
6.758
1.352
18.80
6.00
1.2
15.667
AT
1.20
3.317
0.663
Shirsula
BT
19.60
8.888
1.77
18.80
8.317
1.665
11.289
AT
0.80
2.76
0.554
Aruchi
BT
10.40
7.985
1.579
09.60
6.758
1.352
7.103
AT
0.80
2.769
0.554
Karcharanadaha
BT
12.40
9.69
1.93
11.60
9.43
1.88
6.14
AT
0.80
2.76
0.55
Kaphapittajajwa
ra
BT
9.60
10.198
2.040
7.20
8.42
1.68
4.27
AT
2.40
4.359
0.872
Twakpidika
BT
6.40
8.103
1.621
06.00
7.63
1.52
3.92
AT
0.40
2.00
0.400
Above table shows that group 'A' is highly effective in reduction of all the associated the symptoms of Urdhwaga
Amlapitta and result is significant at P.< 0.001.

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [88] CODEN (USA): AJPRHS
Table 15: Statistical Analysis of effect of the group ‘B’ on Associated Symptoms of Urdwaga Amlapitta
Symptoms
T/T
Mean
S. D.
S. E.
M. D.
S. D.
S. E.
't' value
Udarshula
BT
16.80
1.497
7.483
16.40
7.572
1.514
10.830
AT
0.40
0.40
2.00
Shirsula
BT
22.00
9.12
1.82
18.40
9.434
1.887
9.752
AT
3.60
4.899
0.980
Aruchi
BT
15.20
8.226
1.645
11.20
7.257
1.451
7.716
AT
4.00
5.00
1.00
Karcharanadaha
BT
12.40
11.64
2.33
10.00
10.00
2.00
5.00
AT
2.40
4.35
0.872
Kaphapittajajwa
ra
BT
5.60
8.69
1.740
5.20
8. 226
1.645
3.161
AT
0.40
2.00
0.40
Twakpidika
BT
6.00
8.16
1.63
04.80
6.532
1.306
3.674
AT
1.20
3.31
0.66
Above table shows that in associated symptom like Udarshula, Shirsula, Aruchi, Karcharandaha group 'B' is highly
effective and result is significant P. < 0.001 & in symptom like Kapha-pittaja-jwara &Twakapidika treatment is effective
and significant at P. < 0.01.
From above two table of we can say that group 'A' is comparatively more effective in reducing the associated symptoms of
Urdhwaga Amlapitta than Group 'B'.
Table 16: Comparative result of group 'A' & group 'B' in Urdhwaga Amalapitta
Sr. No.
Group
Number of Patients
Total
Cured
Improved
1
Group 'A'
19
06
25
2
Group 'A'
18
07
25
Total
37
13
50
Let us presume that group ‘A’ & group 'B' are equally effective.
By applying Chi-Square test on this hypothesis we get following results.
Degree of freedom or V
Table value of Chi-square for 3 degree of freedom at 5%
level of significant is 3.84 which is more than calculate value of Chi-square. Therefore we accept the nul
hypothesis. Thus our presumption is proved to be correct.

22

   
( )
()( )( )( )
ad bc N
a b c d a c b d
(19x7 18x6) 50
37x13x25x25
2
= 0. 103
= (c-1) (r-1)
= (2-1) (2-1)
= 1 x 1
= 1

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [89] CODEN (USA): AJPRHS
So it may be said that both the treatments are equally effective in Urdhwaga Amlapitta.
Probable Mode of Research Drug in Urdhwaga Amlapitta.
Table 17: Probable mode of Shatavari Ghrta is tried to be described in brief as follows:
Samprapti Ghataka
By property
Action
Dosa- I) Pachaka
Pitta
Shitavirya
Ushna, tiksna, laghu, sar, gunas of pitta
ii) Sadhak pitta
Oja&Medhavardhaka
property of
Godugdha&Goghruta.
i) Ushna, tiksna, Laghuguna of sadhak pitta
ii) Snehaguna of sadhak pitta.
iii) Rajo&Tamodosa of mana
Satwaguna of mana So function of sadhaka pitta get
corrected.
iii) Samanvayu
Vatpittagna
Ruksa, Laghu, Cala, Guna of samanvayu
Udanavayu
Vatpittagna
Laghu, Cala, Guna of Udanavayu.
Apanavayu
--||--
Ruksa, Laghu, Cala, Guna of Apanvayu
Dhatu :- i) Rasa
RaktaMamsa
Balya, Rasayana
Corrects the dhatuvaisymaya
ii) Mamsa
Snigdha,
pichilmrduguna,
sitvirya
Produces a protective layer on gastric mucosa, gastric
irritation & heals the ulcer.
Agni-Jathragni
Dipanaprabhava of
goghrta
Jatharagnivardhana
Mala – Purusa
Snigdhaguna
Help in soft defecation
Shatavari Ghruta is given orally which is the safest, most
convenient and economical method of drug
administration. The oral administration allows the drug to
affect, influence & modifies the Agni and the Dohsas in
the GI tract.
It was given two times a day and on a empty stomach so
that the drug can be easily digested and absorbed, and
exert its utmost action.
Due to Madhura rasa it is digested to a great extent in
Amashaya where dipana, pachana prabhava of it helps to
improve the pachakagni. During digestion the proto
elemental composition of the drug is first broken down
and then synthesized as per the preponderance and
specific affinity of proto elemental. After such
transformation they are absorbed in general circulation
and systems where the bhautik agnis act upto them, then
they transported to dhatus or to the site of action i.e.
Amashaya where the dhatwagnis act upon them. As
Shatavari Ghruta is Rasayana (Reguvenator), Balya,
Agnibalvardhaka (Enhance Digestive Power), Medhya,
Vrusya (Aphrodiasiac) its acts on whole body and thus it
not only cures the diseases but also help the patient to
restore the health.
Modern View:-
Shatavari, the ingradients of Shatavari Ghruta though
proved valuable drug for Amlapitta and Parinam Shula
but does not exhibit any trace of Antacid activity.(9)
Chemical testing of the Shatavari Ghruta show that it has
highest Acid Neutralizing Capacity as compare to
Sutashekhara Rasa and Kamdudha Rasa i.e. 63.6 with SD
(0.05) and also having highest buffering capacity i. e. 110
min. Rossett – Rice test of this drug also shows that it
neutralizes PH. to 2.75 up to 110 min. and as we know in
Amlapitta there is excessive secretion of gastric acid. It
neutralize it gastric acid. Besides antacid property it
probably enhances the mucosal barrier, by prolonging the
life span of mucosal cells or by cyto protection and as
throughout the treatment, patient did not showed any
symptom of alkylosis or any other complications. It
reduces the HCl level but do not cause Hypo or
Achlorhydria even after their prolonged use so this proved
that it is the best drug in Urdhwaga Amlapitta.
Considering all given points, we can conclude that this
drug act on Urdhwaga Amlapitta by performing the
following functions.
1) Doshasamya
2) Dushyasamya
3) Agni vardhana
4) Correction of Sthanavaigunya
5) Nutralizing the Gastric acid.

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [90] CODEN (USA): AJPRHS
Probable mode of action of Sutsekhara Rasa:-
Table 18: According to Ayurvedic view:-
SampratiGhataka
By Property
Ingredients
Action
Dosa –Pachak pitta, Kledaka
Kapha.
i)UshnaVirya with Laghu &
Ruksa Guna
ii) GrahiGuna
Twak, dhattura.vatsnabha,
bhrungaraj swarasa.
Drava Shosana
Pachak Pitta
Madhura, Tikta, Kasaya
Rasa
Kacora, Naga kesara, Twaka,
Tankana, Gandhaka, Sankh bhasma
Ushna, Tikshna, Sara,
Amla & Dravaguna of
Pachak Pitta
Kledaka Kapha
Katu Rasa.
Tankan, trikatu, trijat, dhattur,
gandhak, kachora.
Alleviation
Samana, Udana, Vyanavayu
& Pachak Pitta.
i) UshnaVirya
Tankan,vatsnabha,shunthi,maricha,d
hatturabeej,gandhak,tamrabhasma,tw
ak,tamalpatra,nagkeshar,bilwa majja,
kachora, bhrungrajswarasa.
Shitaguna
ii) Shula Prashamaniya
Dhatura, Kacora, Pippali, Sunthi,
Vatsanabha.
Laghu, ChalaGuna of
SamanaUdana,
Vyanavayu,
Tikshna, Ushna, Guna
of Pachak Pitta.
Dhatu – i) Rasa , Rakta,
Mamsa
UshnaVirya
Tankan,vatsnabha,shunthi,maricha,d
hatturabeej,gandhak,tamrabhasma,tw
ak,tamalpatra,nagkeshar,bilwa majja,
kachora, bhrungrajswarasa.
Dhatwagnidipana,
Correct the Dhatu
vaishamya.
ii) Rasa Rakta, Mamsa.
i) Balya
Parada, Gandhaka, Bhrangaraja,
Tankana, Swarnamaksika &
Sankhabhasma
Correct the
dhatuvaishamya
ii) Rasayana
Parada, Gandhaka, Bhrangaraja,
Swarnamaksika
Correct the
dhatuvaishamya
iii) Rakta
Kandughna&Visaghna
Parada, Gandhaka, Swarnamaksika
& Sankhabhasma Bhrangaraja,
Dhatura Bija.
Dut to Rakta Sodhaka
property, correct the
dhatuvaisamya.
iv) Mamsa
i) Anticholenergic drug
DhaturaBija
Gastric secretion
ii) Ulcer healing property
Dhatura, Tankana, Parada.
Healing
Strotasa- Annavaha
Balya & Rasayana
Parada, Gandhaka, Bhrangaraja,
Tankana, Swarnamaksika &
SankhaBhasma
Corrects the stroto
vaigunya &
strengthens the Srotasa
Agni-Jatharagni
Dipaniya
Sunthi, Vatsanabha, Pimpli.
Agni vardhana
Pachhaniya
Sunthi, Gandhaka, Pippali.
Amapacana & arrest
further Amotpatti.
Mala-Purisa
Vata anulomana
Pippali, Sunthi ,Maricha, Twaka,
Tamal Patra, Tamra bhasma.
Help in soft defecation
All ingredients of[ Sutshekhara Rasa balance the each
other’s drawback and enhances the properties of each
other for ex. Vatsanabha being a toxic drug may contain
some toxic substances if some toxicity remains even after
shuddhikaran prakriya Tankana being a antidote of
Vatsanabha reduces the toxic effect of drug. Gandhaka
increases the potency of Parada & Tamrabhasma.
So considering all above points we came to conclusion
that the Sutshekhara breaks the aetio-pathological events
of Urdhwaga Amlapitta and so Sutshekhara can be used at
any stage of pathogenesis of Urdhwaga Amlapitta as it act
on each and every stage of pathogenesis and also vitiate
almost all the symptoms of Urdhwaga Amlapitta.
According to modern view:-
We know that, in Urdhwaga Amlapitta gastric secretions
are increased.
Sutsekhara, is a sulphur mercurial preparation and so
inert, in nature. Even though in the state of fine sub
division it get absorbed through the mucus membrane of

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [91] CODEN (USA): AJPRHS
stomach and intestine while getting absorbed, the drug
affect the secretions of gastric juice, HCl & the stomach
and glandular structure lining the intestines. These
modified secretions effect direct as well as indirect
influence upon the metabolism of the person by regulating
the activities of the liver, kidney and several other organs
of the body.
This drug contains the finely subdivided preparation of
Mercury & sulphur i.e. kajjali which modify or inhibit the
growth of harmful intestinal flora and also help in the
growth &multiplication of the intestinal flora
(saprophytes) which are useful for the body. It has been
clinically observed that this mercurial preparation, even if
used for considerably long time, do not produce any toxic
effects like salivation and foul breath.10
Sutshekhara is also having average Acid neutralizing
capacity 28.6 with SD. 0.05 thus neutralized the excessive
gastric acid.
Probable mode of action of Kamdudha Rasa:-
Table 19: According to Ayurvedic View
SampratiGhataka
By Property
Ingredients
Action
Dosa – Pacaka pitta,
Kledaka Kapha.
Samana Udana &
Vyanavayu.
i) Ridosaghna & Kaphavatghna
ii) Madhur, Tikta, Kasaya Katu
Rasa.
Praval, muktashukti,
varatikabhasma,
shankhabhasma,
gairik, guduchi
Alleviation
Pacaka Pitta &
Kledaka Kapha
Grahi Guna
Sankha & Swarna-
gairikabhasma
Drava shosana
SamanaUdana
&Vyanavayu.
Shulaprasamaniya
Muktasuktibhasma
Laghu, ChalaGuna
Dhatu – i) Rasa
Jwaraghna Property
Guduci, Swarnagairika
& Pravalbhasma.
Rasadhatwagnidipna,
Correct the Rakta
dhatu hai samya
ii) Rakta
Kandughna & kusthaghna
Guduci, Swarnagairika
Bhasma
Correct the Rakta
dhatu vaishamya
Mamsa
Ulcer healing property
Swarnagairika
Bhasma.
Healing
Strotasa- Annavaha
Rasayana & Balya
Guduci Praval Sankha
Corrects the stroto
vaigunya &
Strengthens the
Srotasa
Agni-Jatharagni
Dipaniya
Praval, muktashukti,
varatika bhasma,
shankha bhasma,
gairik, guduchi
Agni vardhana
Pachaniya
Guduci Praval
Shankha bhasma
Amapachana & arrest
further Amotpatti.
Maia-Purisa
Rechaka & Anulomaka
Guduchi
Help in soft defecation
According to Modern View:-
The ingredients of Kamdudha Rasa such as Pravala
bhasma has Antacid potency 242.60 mEq/10gr. + 5.23,
Varatika bhasma has 221.90 mEq/10gr + 5.90, Sukti
bhasma has 207.24 mEq/10gr + 1.93 Antacid potency. 11
Kamdudha Rasa of present study is having average Acid
Nutrralizing Capacity 42.00 + 0.05 SD and as we know, in
Urdhwaga Amlapitta their is increased gastric secretion so
Kamdudha ingredients having antacid activity neutralize
the gastric acid.
Probable mode of action of Sutsekhara Rasa and
Kamdudha Rasa on Urdhwaga Amlapitta These drugs acts
on Urdhwaga Amlapitta by performing the following
functions.
1. Dosasamya
2. Dusyasamya
3. Agni vardhana
4. Ampacana
5. Dravatasosana
This gives the total probable mode of action of Sutsekhara
Rasa and Kamdudha Rasa on Urdhwaga Amlapitta.
Going through all the observations we can say that this
drug has property of Sampraptivighatana of Urdhwaga
Amlapitta& are highly effective in Urdhwaga Amlapitta.

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [92] CODEN (USA): AJPRHS
CONCLUSION
1. Occurrence of Urdhwaga Amlapitta is more than
Adhoga Amlapitta.
2. The main a etiological factor of Urdhwaga Amlapitta
is related mainly with dietetic habits (50%) followed
by Psychological factors (42%).
3. The incidence of this disease is more in the age group
21 to 30 (46%) followed by 31 to 40 age group (18%).
4. Maximum incidence of Urdhwaga Amlapitta is
observed in femeal i.e. 70 %.
5. Urdhwaga Amlapitta has no relation with Marital
status.
6. Maximum patients of Urdhwaga Amlapitta belongs to
Hindu Religion i.e. 98%.
7. Incidence of Urdhwaga Amlapitta is more in
Sadharanadesha (98%).
8. Highest incidence of Urdhwaga Amlapitta is observed
in highly educated people (68%).
9. The occurrence of Urdhwaga Amlapitta is highest in
middle income group (58%) followed by lower income
group (24%)
10. Maximum incidence of the disease is in students
(44%) followed by Housewives 24 %.
11. Incidence of Urdhwaga Amlapitta is more in Urban
area (82%).
12. Maximum patients of Urdhwaga Amlapitta having
chronicity of 1-3 Yrs. (40%) followed by more than 3
Yrs. chronicity (30%).
13. Highest occurrence of Urdhwaga Amlapitta is in
Sharada Rutu (64%) followed by Varsha (12%) &
Hemanata Rutu (12 %).
14. People having addiction of tea-coffee, are more prone
to Urdhwaga Amlapitta (70%) followed by addiction
of tobacco & tea-coffee (28%)
15. Highest incidence of Urdhwaga Amlapitta is in
patients with Emotional upset 40% followed by
Worms’s infestation (20%) & Joint disorders (20%).
16. Maximum No. of patient took allopathic treatment for
Urdhwaga Amlapitta (42%) followed by Ayurvedic&
Allopathic treatment (24%).
17. Maxi. Incidence of the disease is in Pitta-kaphaja
Prakruti (35%) followed by Khapha Pittaja Prakruti
(26%)
18. Maximum incidence of the disease is in patients with
Rajasika Manas prukrti (50%) followed by Tamsik
Prakriti (46%).
19. Incidence of Urdhwaga Amlapitta is more in patients
with HinaAbhyavarnashakti (50%) followed by
Madhyama Abhyavarnashakti (40%).
20. More incidence of the Urdhwaga Amlapitta is
observed in patient with Madhyama Jaranshakti (60%)
followed by patients with Hina Jaranshakti (40%).
21. Maximum incidence of Urdhwaga Amlapitta is
observed in patient taking mixed diet (70%).
22. Highest incidence of Urdhwaga Amlapitta is in
patients with mental tension (30%) followed by
patients with Anxiety (26%).
23. Incidence of Urdhwaga Amlapitta is more in patients
with Madhyam Koshtha (56%) followed by patients
with Mrdu Kostha (40%).
24. AvaraSatva people prone to Urdhwaga Amlapitta
(64%) more than the Madhyama Satva (42%) and
Pravara Satva (4%).
25. Maximum incidence of Urdhwaga Amlapitta is in
patients having disturbed sleep (66%).
26. Highest incidence of Urdhwaga Amlapitta is in
patients having one hour's day time sleep.(48%)
27. Maximum incidence of Urdhwaga Amlapitta observed
in patients taking night sleep less than 6 hours (38%)
followed by patients sleep more than 6 hours (34%).
28. More incidence of Urdhwaga Amlapitta is observed in
patients with irregular mode of defecation (54%).
29. Highest incidence of Urdhwaga Amlapitta is observed
in patient with 'B' positive blood group (52%) followed
by 'O' positive blood group (36%). No patient is found
with 'A' positive blood group.
30. Highest incidence of Urdhwaga Amlapitta is in
patients taking Vdhahiahara (86%) followed by
Amlaahara. (74%) &Adhyasana (70%).
31. Associated symptomwise distribution of patient’s
shows that 88% patients are having Sirsula 86%
patients are having Udarsula and 80% are having
Aruci as associated symptoms.
32. Highest No. of patients (42%) shows Upasaya after
chardi followed by Langhana (18%) & Antacids
(18%).
33. More incidence of Urdhwaga Amlapitta is in H. Pylori
negative patients.
34. There is no association between H. Pylori and
Urdhwaga Amlapitta, but to draw final conclusion it
needs further clinical study in more number of cases.
35. The Bacteria present in the stool eliminate after
treatment by both the groups.
36. There is statistically no significant difference in Serum
Cholesterol and Serum Triglycrides before & after
treatment in Group 'A' patients.
37. Both the group are effective in eradication of H. Pylori
but to draw final conclusion it needs further clinical
study in more number of cases.
38. Group 'A' is more effective in relieving the associated
symptom.
39. Both the groups are highly effective in relieving all the
symptoms included in subjective criteria and results
are highly significant.
40. Both the groups are highly effective in reduction of
increased Gastric acid level & results are highly
significant.
41. Finally it can be concluded from the present Clinical
Study that Urdhvaga Amlapitta can he managed

Sanjore et al Asian Journal of Pharmaceutical Research and Development. 2019; 7(3):78-93
ISSN: 2320-4850 [93] CODEN (USA): AJPRHS
effectively with Shatavari Ghruta as well as Sutsekhara
& Kamdudha Rasa. Both groups have shown
individually highly significant results. The superiority
of either of drugs in their efficacy cannot be elicited, as
they have proved non significant difference
statistically.
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