(eczema) by panchatikta ghrita gugglu and lepa of
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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RESEARCH ARTICLE eISSN 2348- 0173
Impact Factor (2014) – 0.815 by International Scientific Indexing (ISI) UAE
A CLINICAL STUDY ON THE MANAGEMENT OF VICHARCHIKA
(ECZEMA) BY PANCHATIKTA GHRITA GUGGLU AND LEPA OF
GAIRIKA
Gaikwad Madhavi Dattatray1*, Deshmukh Avinash Madhav2
1. Assistant Professor, Dept. of Rognidan and Vikrutivigyan, C.S.M.S.S. Ayurved College,
Aurangabad, Maharashtra, Contact No. +91 9970431387, Email: [email protected]
2. Associate Professor, Dept. of Rognidan and Vikrutivigyan, C.S.M.S.S. Ayurved College, Aurangabad, Maharashtra, Contact No. +91 9822363522, Email:[email protected]
Article Received on - 9th
Jan 2015
Article Revised on - 12th
Jan 2015
Article Revised on - 29th
Jan 2015
Article Accepted on - 18th
Feb 2015
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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RESEARCH ARTICLE eISSN 2348- 0173
*Corresponding Author
Gaikwad Madhavi Dattatray Assistant Professor, Dept. of Rognidan & Vikrutivigyan, C.S.M.S.S. Ayurved College, Aurangabad, Maharashtra, Contact No. +91 9970431387, Email: [email protected]
QR Code IJAAM
ABSTRACT: All skin diseases can be included under the umbrella of kustha roga. Vicharchika is a
variety of kshudra kustha. The features of eczema are somewhat similar with that of
vicharchika mentioned in ayurveda. Symptoms of vicharchika mentioned by
Charaka correlate with wet eczema & symptoms mentioned by Susruta correlate
with dry eczema. Due to its chronic and recurrent nature, it has a great impact on
the quality of life of the patients. The present study was aimed to compare the
effect of Panchatikta Ghrita Gugglu tablets along with local application of lepa
containing Gairika mixed with Karanja Tailam in patients of dry and wet eczema
(vicharchika). For this study, selected patients were divided into two groups-dry
group & wet group. 17 patients were registered under dry group and 20 patients
were registered under wet group. The duration of the study was 1 month with
follow up for 15 days. Dry group showed highly significant results in all signs and
symptoms. Insignificant results were recorded in wet group for shrava, vaivarnya
and raji, so it was concluded that trial formulation is quite effective in management
of dry eczema (vicharchika).
Key Words: Kustha, Vicharchika, Dry Eczema, Wet Eczema, Panchatikta Ghrita
Gugglu, Gairika, Karanja Tail.
INTRODUCTION
Skin is the largest protective organ of the body. A
healthy skin is the mirror image of a good health.
The colour of the skin is important biologically,
cosmetically and socially. The unbroken skin is the
nature’s dressing over the body. It acts as an
effective barrier against the entry of diseases. Skin
diseases though afflicts bodily but gives lot of
psychological conflicts and can harm affected
individual in a number of ways like discomfort,
disfigurement, disability and death. Though the
disease, vicharchika is not a life threatening, it
makes the patient worried due to its appearance,
severe itching, disturbing routine and its chronic
nature. Almost all the scholars of Ayurveda of
modern era consider vicharchika as eczema in
modern parlance. Vicharchika is described under
kshudra kustha in ayurvedic textual also
mentioned as a curable disease, yet the relapsing
nature of this disease makes it much harassment
for patient and troubles some for physician too.
Vicharchika as considered by Charaka, the ancient
medical authority, is characterized by kandu
(itching), shyavapidika (skin eruption with dark
discolouration), bahusrava (profuse discharge)
involving the domination of kapha which
correlates wet eczema. [1] Whereas Sushruta, the
father of surgery has mentioned the symptoms as
rajyo (thickening of skin), atikandu, ruja (pain) and
rukshata (dryness of skin) involving the
domination of pitta which correlates dry eczema. [2] A similar clinical presentation in modern
dermatology is seen eczema which is defined as a
non-contagious inflammation of the skin
characterized by erythema, scaling, oedema,
vesiculation and oozing. Eczema, or dermatitis, is a
reaction pattern that presents with variable
clinical and histological findings and is the final
common expression for a number of disorders,
including atopic dermatitis, allergic contact and
irritant contact dermatitis, dyshidrotic eczema,
nummular eczema, lichen simplex chronicus,
asteatotic eczema, and seborrheic dermatitis.
Primary lesions may include papules,
erythematous macules and vesicles, which can
coalesce to form patches and plaques. In severe
eczema, secondary lesions from infection or
excoriation, marked by weeping and crusting, may
predominate. Long-standing dermatitis is often dry
and is characterized by thickened, scaling skin
(lichenification). Eczema is a specific type of an
antigen-specific immune response and results due
to an antigen-antibody reaction. It is resultant of
delayed type hypersensitivity mediated by
memory T lymphocytes in the skin and the clinical
lesions may be acute (wet and oedematous) or
chronic (dry, thickened and scaly) depending on
the persistence of the insult. [3] The modern
treatments given for eczema have their own
limitations and side effects. The trial formulation
Panchtikta Ghrita Gugglu used for internal therapy
is taken from the reference found in
Bhaijyaratnavali [4] and the fine powder of Gairika [5] mixed with Karanja Tail [6] used for local
A CLINICAL STUDY ON THE MANAGEMENT OF VICHARCHIKA
(ECZEMA) BY PANCHATIKTA GHRITA GUGGLU AND LEPA OF
GAIRIKA
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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application is anubhuta yoga (non-classical
formulation). The same trial drugs used in both dry
and wet group. Considering all these points, the
present study was planned with the aim to
evaluate the role of above trial drug in the
management of wet and dry eczema.
Aim and Objectives –
1. To find out an easily available and considerably
low cost, safe and effective remedy for the
treatment of vicharchika.
2.To evaluate the clinical efficiency of Panchatikta
Ghrita Gugglu orally and the fine powder of Gairika
mixed with Karanja tail used for local application
in the management of dry and wet eczema.
3. To compare the effects of above mentioned
therapy on dry and wet eczema.
4. To ascertain different clinical aspect of
vicharchika described in Ayurveda as well as
modern medical science.
Inclusion Criteria –
1. Age 16-70 yrs, irrespective of sex, religion, socio-
economic status.
2. The patients having the classical signs and
symptoms of Vicharchika (both dry and wet)
described in Ayurvedic classics.
3. Duration of lesion less than 1 year.
Exclusion Criteria-
1. Age less than 16 years and more than 70 years.
2. The lesion which is infected and having p
collection or secondary infection.
3.Known cases of systemic disease like Diabetes
Mellitus, Cancer, AIDS,TB etc…and other skin
diseases like scabies, psoriasis, lichen simplex
chronicus etc.
Materials and Methods-
For the present study, after institutional ethical
committee clearance, the patients having the
symptoms of vicharchika were randomly selected
from OPD of Rog nidan dept. R.A. Podar Ayurved
College, worli, mumbai. A special proforma was
made for assessing all the patients.
Grouping – Diagnosed patients were divided
into two groups.
1. Dry Group – patients with dry lesion (dry
eczema)
17 patients registered under this group. among
them 6 patients discontinued the treatment.
No. of. patients – 17
Completed patients – 11
Drop out patients – 6
2. Wet Group – patients with wet lesion (wet
eczema)
20 patients registered under this group. among
them 7 patients discontinued the treatment.
No. of. Patients – 20
Completed patients – 13
Drop out patients – 7
The patients of both groups were administered
internally Panchatikta Ghrut Gugglu tablets in a
dose 2 tablets of 500 mg twice a day after meal
with lukewarm water and fine powder of Gairika
mixed with Karanja Tail used externally for local
application. Required quantity as per the area of
distribution of the lesion, the lepa was used.
Duration of the study – One month. Follow up
was done for 15 days after the completion of the
treatment.
Criteria for assessment –
The following criteria or variables were assessed
before and after the drug administration-
1) Kandu (itching)
2) Pidika (skin eruption)
3) Shrava (profuse discharge)
4) Vaivarnya (depigmentation)
5) Raji (lichenification)
6) Rukshata (dryness)
Laboratory Investigations-
1. Routine hematological investigations- Hb%, TLC,
DC, RBC, ESR.
2. Urine – Routine and Microscopic examination
3. Random blood sugar.
Above examinations were carried out before and
after treatment to rule out the other associated
pathology as well as to assess and evaluate the
effect of therapy.
Dietary Restrictions –
The Patients were advised to follow the
pathyapathya available in Ayurvedic literature for
kustharog. [7] The Patient suffering from
Vicharchika were advised to take following types
of diet: Light and wholesome food, leafy vegetables
having bitter taste, old (not freshly harvested)
cereals, food preparations and medicated ghee
prepared by boiling with bhallataka, triphala and
nimba, meat of animals inhabiting arid land and
preparations of mudga mixed with patola. Intake of
heavy and sour food, milk, curd, excess salt, meat
of animals inhabiting marshy land, fish, guda
(jaggery) and tila (sesame) is prohibited for
patients of vicharchika.
Follow up –
A follow up study was carried out for fifteen days
after completion of treatment. For this purpose,
cardinal signs and symptoms were given scores
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according to their severity before and after the
treatment.
Statistical Analysis –
The information gathered on the basis of above
observations was subjected to statistical analysis
in terms of mean (X), standard deviation (S.D),
standard error (S.E), paired ‘T’test were carried out
at p<0.05,p<0.01 and p<0.001.
The obtained results were measured according to
the grades given below:
Complete Remission -100% relief
Marked Improvement -75%-99% relief
Moderate Improvement -51%-74% relief
Mild Improvement -25%-50% relief
Unchanged -<25% or no relief
OBSERVATIONS
Table 1: Distribution of 37 registered patients
Patients No. of. Patients
Total Dry group Wet group
Completed patients 11 13 24
Dropouts patients 06 07 13
Total 17 20 37
Table 2: Age wise distribution of 37 patients
Age Group
(years)
No. of. Patients Total %
Dry group Wet group
16-30 06 05 11 29.73
31-50 08 13 21 56.76
51-70 03 02 05 13.51
Table 3: Sex wise distribution of 37 patients
Table 4: Habitat wise distribution of 37 patients
Habitat No. of. Patients
Total % Dry group Wet group
Urban 14 15 29 78.38
Rural 03 05 08 21.62
Table 5: Desha wise distribution of 37 patients
Desha No. of. Patients
Total % Dry group Wet group
Aanup 15 13 28 75.68
Jagnal 00 01 01 02.7
Sadharan 02 06 08 21.62
Table 6: Ahara wise distribution of 37 patients
Ahara No. of. Patients
Total % Dry group Wet group
Vegetarian 06 07 13 35.13
Mixed 11 13 24 64.87
Table 7: Recurrence of disease wise distribution of 37 patients
Recurrence
of disease
No. of. Patients Total %
Dry group Wet group
Recurrence Present 14 12 26 70.27
Recurrence Absent 03 08 11 29.73
Sex No. of. Patients
Total % Dry group Wet group
Male 11 10 21 56.76
Female 06 10 16 43.24
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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Table 8: Dosha Lakshana wise distribution of 37 patients
Dosha Lakshan No. of. Patients
Total % Dry group Wet group
Vata-Pitta 00 02 02 05.40
Pitta-Kapha 02 16 18 48.64
Kapha-Vata 12 01 13 35.14
Tridosha 03 01 04 10.81
Table 9: Rupa (signs and symptoms) wise distribution of 37 patients
Desha No. of. Patients
Total % Dry group Wet group
Kandu 17 20 37 100
Pidika 08 18 26 70.27
Shrava 00 20 20 54.05
Vaivarnya 17 20 37 100
Raji 15 04 19 51.35
Rukshata 17 00 17 45.95
Table 10: Distribution of 37 patients according to Part involve
Part involved No. of. Patients
Total % Dry group Wet group
Upper extremities 05 05 10 27.03
Lower extremities 11 12 23 62.16
Head, Neck, Face 01 02 03 08.11
Abdomen(middle) 00 01 01 02.70
Table No.11: Overall effect of Treatment in Dry Group
Sr.No Symptoms BT AT X SD SE T P
1 Kandu (n=11) 2.273 0.2727 2.003 0.6325 0.1907 10.488 <0.001
2 Pidika (n=8) 2.500 0.6250 1.875 0.6409 0.2266 8.275 <0.001
3 Vaivarnya(n=11) 2.273 0.5455 1.727 0.6467 0.1950 8.859 <0.001
4 Raji(n=9) 2.444 1.000 1.444 0.7265 0.2422 5.965 <0.001
5 Rukshata(n=11) 2.455 0.6364 1.818 0.6030 0.1818 10.00 <0.001
Table No.12 : Overall effect of Treatment in Wet Group
Sr.No Symptoms BT AT X SD SE T P
1 Kandu (n=13) 1.846 1.231 0.6154 0.6504 0.1804 3.411 <0.001
2 Pidika (n=11) 1.615 1.308 0.3077 0.4804 0.1332 2.309 <0.001
3 Vaivarnya(n=13) 2.231 2.000 0.2308 0.4385 0.1216 1.897 >0.001
4 Raji(n=10) 1.900 1.600 0.3000 0.4830 0.1528 1.964 >0.001
5 Shrava(n=13) 1.846 1.692 0.1538 0.3755 0.1042 1.477 >0.001
Table No.13 % Relief in Dry Group
Sr.No Symptoms % Relief
1 Kandu 88.00
2 Pidika 75.00
3 Vaivarnya 76.00
4 Raji 59.08
5 Rukshata 74.05
Table No.14 % Relief in Wet Group
Sr.No Symptoms % Relief
1 Kandu 33.33
2 Pidika 19.05
3 Vaivarnya 10.34
4 Raji 15.78
5 Shrava 08.33
Overall effect in Dry Group – 74.426%
Overall effect in Wet Group – 17.366%
RESULTS –
• The details of patients registered in dry group
and wet group are given in table 1.
• Out of 37 patients registered, 11 patients in
dry group and 13 patients in wet group
completed the study.
• Maximum number of patients i.e, 56.76%
were from the age group 31- 50 years,
56.76% were male, 78.37% patients were
from the urban area, 75.68% patients were
from the aanup desha, 64.87% patients were
taking mixed diet.
• Recurrences of disease (vicharchika) were
present in 70.27% patient.
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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• 48.64% patients were of pitta-kapha dosha
lakshana, 35.13% patients were of kapha-vata
dosha lakshana.
• 62.16% patients reported the lower
extremities as the commonest site of
involvement.
• Chief complaints reported were kandu, pidika,
vaivarnya, raji in all patients. Shrava was
found in wet group only and rukshta was
found in dry group only. Kandu and vaivarnya
were reported in100% patient (all patients),
pidika was reported in 70.27% patients, raji
was reported in 51.35% patients, shrava was
reported in 54.05%, rukshata was reported in
45.95% patients.
• Highly significant results were found in all
signs and symptoms of dry group. Whereas
significant results were found in kandu and
pidika of wet group and insignificant results
were found in shrava, vaivarnya, raji of wet
group.
• Insignificant results were found in laboratory
parameter in both the group.
• In follow-up study, no recurrence was found
in 90% patients of dry group and recurrence
was noted in 10% patients at the end of 15
days.
• Paired t-test was applied on the cardinal
symptoms. Significant difference was found
between effects of therapies on both the
groups which suggested that dry group
showed equally good effect on all cardinal
symptoms. Therapy was effective in kandu,
pidika of wet group.
Effect of Therapy - Overall effect of therapy in dry
group was found 74.43% and in wet group was
found 17.73%.
Table No.15 Effect of therapy in symptoms of vicharchika in dry group and wet group of the patients selected for the study
in percentage of patients showing improvement (Paired t test)
Symptoms effect in dry group
(in %)
effect in wet group
(in %)
Kandu 88.00 33.33
Pidika 75.00 19.05
Vaivarnya 76.00 10.34
Raji 59.08 15.78
Rukshata 74.05 -
Shrava - 08.33
Table No.16 Overall effect of therapy on patients enrolled in the study and divided into dry & wet group, in number of
patients and corresponding percentage of patients showing varying degrees of improvement
DISCUSSION
• Out of both groups, dry group showed
improvement in all signs and symptoms.
Insignificant results were found in wet group.
Most of the patients had reported in the
chronic stage of vicharchika. Negligence in the
early stage of eczema is observed in patients.
Relapsing nature of vicharchika is most
common which suggest that long term
intensive therapy is necessary for eradication
of the disease.
• Panchatikkta ghrut gugglu orally and fine
powder of gairika mixed with karanja tail
used for local application is low cost, safe and
effective remedy for the dry vicharchika.
• On the basis of history, maximum number of
patients were having progressive tendency of
disease and which is due to continuous
irritation to the skin and may precipitate the
disease in further progress.
• Maximum number of patients i.e, 75% felt
more itching in lesion in winter and in 50% it
aggravated due to food taken. Humid, cool
atmosphere and spicy food is much
responsible for skin disorders. Thus above
data suggests that winter served excess
dryness in the skin, which may have
aggravated the eczematous condition. (Dry
Vicharchika)
• In classics, many kusthahara single and
compound preparations have been
mentioned, but none of them has been
specifically mentioned for oral use of
vicharchika, therefore depending upon its
Effects
dry group wet group
Number of
Patients %
Number of
Patients %
Complete Remission 1 9.10 0 0
Marked Improvement 5 45.45 0 0
Moderate Improvement 5 45.45 0 0
Mild Improvement 0 0 5 38.47
Unchanged 0 0 8 61.53
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Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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symptoms and samprati a compound
preparation named as Panchatikkta Ghrut
Gugglu was selected for oral use. It contains
number of drugs which have properties like
kanduhara, kusthahara, vishahara, twakgami.
• The manifestation of eczema occurs in skin,
where in the sensitivity of the local cells is
disturbed. Further, ayurveda emphasizes on
managing the sthana (place of the lesion),
therefore Gairika mixed with karanja tail was
selected for external use as lepa (local
application on the lesion). It was anubhuta
yoga (non-classical formulation). Gairika is
well known rasadravya. Gairika and karanja
tail have properties like kanduhara,
varnaropak, raktaprasadan, vishahara,
vicharchikanashak.
CONCLUSION
From above study it was concluded that
Panchatikkta ghrut gugglu orally and gairika
mixed with karanja tail for external application is
choice of therapy for dry eczema (vicharchika)
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CITE THIS ARTICLE AS –
Gaikwad M. D. et.al., A Clinical Study on the Management of Vicharchika (Eczema) by Panchatikta Ghrita
Gugglu and Lepa of Gairika, Int. J. Ayu. Alt. Med., 2015; 3(1):21-27
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