J.R.A.S. Vol. XXVI, No. 1-2, (2005) pp. 66-74

A COMPARATIVE STUDY ON CLINICALEVALUATION OF ANUTAILA (DASAVARTIT) AND

KAPHA KETU RASA W.S.R.TO"ARDHAVABHEDAKA" (MIGRAINE)

Sandeep Madaan I and Medhavi La} Sharma'

(Received on 9.06.2005)

The present study includes clinicalevaluation of two classical medicines vi-sually Anu taila (Dasavartit) & Kaphaketu rasa on thirty patients sufferingfrom Ardhavabhedaka (Migraine). Thediagnosis was made purely on symptoma-tology as there is no laboratory investi-gation to confirm diagnosis. The diag-nosed patients were divided in to threegroups GJ' G], and G3, and prescribedAnu taila (Dasavartit) nasya, KaphaKetu Rasa vati orally and both to thesegroups respectively. The trial was con-ducted for a period of one month. Theresults were encouraging and maximumrelief was observed in half sided head-ache, tinnitus and intolerance to light.It can be concluded thot drugs cansafely be prescribed for the managementof Ardhavabhedaka with significantresults.

Introduction

Novel dieases are emerging in fast mod-em life due to Industrial, Environmental andother Professional hazards. Migraine is oneof such disorder, which has emerged as achallenge to Modern Medical Science andthe prevalence rate is still rising.

Ayurveda the ancient of most of themedical Science, has elaborately discussedthe entire concept of Aetiolegy (nidana),Types (bhedas), Symptoms & Signs(roopas) and treatment (chikitsa) of thisdisorder under the term Ardhavabhedaka.It is presumed to be pure Vat ik orVatkaphaj disorder occurring in paroxysms(episodes). According to Charaka, Vaalalone or along with Kapha seizes in onehalf of the head and causes acute attackof neuralgic pain in the side of neck, eye-brows, temporal region ear, eyes and fore-

1. Senior Research Fellow (Ayurveda), CCRAS, New Delhi, 1100582. Professor and Head Of Dept. Ras Shastra & Bhaishajaya Kalpana, M.M.M Govt.

Ayurvedic College, Udaipur, Rajasthan

66

A COMPARATIVE STUDY ON CLINICAL

head of one side. The pain is very agoniz-ing like that of churning rod or red hotneedles. If the condition becomes very se-vere it may even impair the function of eyeand ear.

Conventional medical treatment of mi-graine comprises of the following class ofdrugs, which have its own untoward/sideeffects.

CategoryN.S.A.I.D.s.

Side EffectsUlcers, G.T. Bleeding,Rebound Headaches.

Triptans Nausea, Dizziness,Muscle Weakness,Stroke, Heart Attack.Stroke, Vasoconstriction,Muscle cramps.

Beta Blockers Dizziness, Drowsiness,Light headness, RaisedBlood Sugar levels.

Antidepressants Spasms of blood vessels.Hypotention, Tacchycardia,Sexual Dysfunction.Nausea, Diarrhoea,Dizziness, Cramps, HairLoss.

Ergots

Antiseizures/Antiepi leptics

While Charaka has enunciated that thebest medicine is one which alleviates thedisease without causing any side-effects.The present Study is conducted to evalu-ate the effectiveness of the Ayurvedic for-mulations in alleviating and preventing thedisease.

The drugs were selected as they pos-sess vaatahar or vaatakaphar proper-ties. The first drug Anu taila (dasavrtit)Nasya is prescribed to be used in diseasesof head region and the secound oneKapha-ketu Rasa has vatakaphaharproperties and is prescribed in headaches.So, these medicines were assumed to breakthe pathogenesis Ardhavabhedaka.

Materials & Methods

The study was conducted at M.M.M.Govt. Ayurvedic College Hospital on thirtypatients suffering from Ardhavabhedakaas diagnosed on the criteria mentioned.

The Drugs, Dosages & Duration

S.No. The Drugs Reference Route of Administration Dosage DurationI. Anu Taila Charaka 6 dps. Alternate

(dasavartit) Samhita Nasya (Nasal drops) (each nostril) days for 14

S.5/63-70 days (total

28 days)

2. Kapha Bhaishajya Oral 65 mgs twice daily 30 days

Ketu Rasa Ratnavali

67

Sandeep Madan and Medhavi Lal Sharma

As already mentioned two drugs havebeen used in the trial and their dose andduration are mentioned.

The Anu Taila is a sesame oil basedherbal formulation containing 32 herbs andAja Ksheer. As the dosage of marsh nasyais 10,8 or 6 drops depending on the patient'stolerance, it was started with 6 dps. andthen incresed if tolerated. Proper snehana(local) and swedana was carried out andother precautions were taken care of. Itwas administered on alternate days as men-tioned in the original texts.

Kapha ketu rasa contains Vatsanabh,Pippali, Tankan and Shankh bhasamimpregnated in Ardrak swarasa. It wasstarted twice daily with Ginger juice asvehicle.The follow - up was done on days7,14,21,28 and 30.

Selection Criteria

As there is no specific laboratory in-vestigation for diagnosis and assessmentof severity in migraine on ly the symptomsmentioned by patient during history takingwas the criteria. The symptoms mentionedin Ayurveda and Modern texts resemble alot and a combined list of them is valuablefor the diagnosis. The criteria adopted inthe present study is as follows:

1. Half sided Headache2. Pain in One Side of Neck3. Pain In Eye Brows4. Pain at Temporal Region

5. Pain in Ears6. Periodicity

7. Sudden Onset of pain8. Damage to Eye sight9. Damage to Hearing10.Giddiness11.Tinnitus12. Frozen shoulder13. Intolerance to light14. Trismus15. Nausea/Vomitting16. Parasathesia17. Family History

Exclusion Criteria

1. As the trial is to be done for 28 dayspatients having frequency of attackmore than 28 days or a month wereexcluded.

2. Patients below 7 years of age andabove 80 years age group were ex-cluded.

3. Kaph ketu Rasa as it containsVatsanabh (Aconitum ferox) was notprescribed to children & elderly.

4. Pregnant ladies and lactating motherswere excluded from the study.

5. Patients suffering from major diseaseslike Heart disease, Diabetes mellitus,Tuberulosis, Cancer were also ex-cluded.

6. Patients of Pitta prakruti were not

68

r

A COMPARATIVE STUDY ON CLINICAL

Criteria of Assessment

The assessment is based upon the symp-tomatic improvement as there is no labo-

ratory investigation to confirm the disease.The following criteria were assigned for

assessment.

Table 1

S.No. Severity CriteriaJ. ++++ Very severe, present for whole day,

disturbing daily routine.2. +++ Severe, present for most of the hours

of the day.,., ++ Moderate, bearable.j.

4. + Mild.5. - Nil.

Table 2

Excellent Used to represent the symptoms whichshowed 75-100% relief.

Good Used to represent the symptoms whichshowed 50-74% relief.

Fair Used to represent the symptoms whichshowed 25-49% relief.

Poor Used to represent the symptoms whichshowed less than 24% relief.

% Relief in Degree

S.No. Relief No. of Patient TotalTotal %No.of

Group A Group B Group C Patients1. Excellent 1 1 0 2 06.66

2. Good 7 6 7 20 66.66

3. Fair 1 3 3 7 23.33

4. Poor 1 0 0 I 03.33

I. Excellent is 75 to 100%2. Good 50 to 74%

3. Fair 25 to 74%4. Poor Less than 24%

69

Sandeep Madaan and Medhavi Lal Sharma

Clinical Obeservation & Result

Table 3Prevalence of Symptoms in Patients

S.No. Symptoms Prevalence Total PercentageGroupA Group B Groupe

1. Half Sided 10 10 10 30 100.00Headache

2. Pain in One Side 3 5 8 16 53.33of Neck

3. Pain in Eye Brows 8 7 5 20 66.664. Pain at Temporal 9 6 10 25 83.33

Region5. Pain in Ears 1 2 5 8 26.666. Periodicity 7 8 9 24 80.007. Sudden on set of 2 1 3 6 20.00

Pain8. Damage to Eye 1 1 2 4 13.33

Sight9. Damage to 0 1 0 1 03.33

Hearing10. Giddiness 0 2 4 6 20.00II. TInnitus 1 1 2 4 13,3312. Frozen Shoulder 0 0 1 1 03.3313. Intolerance to 3 2 5 10 33.33

Light14. Trismus 1 1 0 2 6.6615. Nausea! 7 7 8 22 73.33

Vomitting16. Paraesthesia 0 0 0 0 017. Family History 6 7 5 18 60.00

From the above table it is clear that all the patients were suffering from half sidedheadeche, most of them were having periodicity of attack (80.0%) with nausea ofvom- .iting (73.33%).

70

Group B

);:.

()

~"1l~:::!~en

§<o~p~~r-

S 1 :2 3 4 5 6 7 8 9 10 11 12 13 14no1 Symptoms Half Pain in one Pain Pein at Pain in Demag e Damage Giddiness Tinmt Frozen In Trism Nausea

Sided side of neck in temporal ears to eye to us Shoulder Tolera- usHead ache Eye brow region sight hearing nee to

Light2 Severit I B.T. 32 4 17 14 01 01 00 03 01 00 05 01 14

Y I AT. 13 2 5 06 01 01 00 01 01 00 02 01 03

3 Reher 19 2 12 08 00 00 00 02 00 00 03 00 11

4 Relief ~. 59.37 50.00 70.58 57.14 0.00 000 00.00 66.66 00.00 000 60.00 0000 78.57

Table 4Group-A

;:::!

S 1 2 3 4 5 6 7 8 9 10 11 12 13 14no

1 Symptoms Half Pain in one Pain Pain at Pain in Damage Damage Giddiness Tinnit Frozen In Trism NauseaSided side of neck in temporal ears to eye to us Shoulder Tolere. us

Headache Eye brow region sight hearing nee toLight

2 Seventy B. 30 09 12 14 u2 01 or 02 01 00 Uj 02 10

T.A. 13 03 04 06 02 01 01 02 00 00 01 00 U~1.

3 Relier 17 06 08 08 0 00 00 00 01 00 02 02 08

4 Reher 1'. )0.00 00.00 00.00 ) .J4 UU.UU UU.UU uu.uu UU.UU JUU.UU UU.UU 00.00 !uu.uu 80.00

Group C

S. 1 :2 j 4 5 6 7 8 9 10 11 12 13 14no1 Symptoms Half PaiJl in one Pain Pain at Pain in Damage Damage Giddiness Tinnit Frozen In Trism. Nansea

Sjded side of neck in temporal ears to .ye to us Shoulder To lera, usHead ache Eye brow region sight hearing nee to

Light2 Severity B. 31 14 05 15 05 02 00 05 02 01 08 00 09

T.

A. 15 04 01 06 03 02 00 04 00 00 03 00 03

T.

3 Relier 16 10 04 09 0:2 00 ; 00 01 0:2 01 U) 00 os4 Relier-/. 51.61 71.42 80.00 60.00 40.00 00.00 00.00 20.00 100.00 100.00 62.50 00.00 66.66

B.T.-- Before treatment AT.-- After tre atm ent

Sandeep Madan and Medhavi Lal Sharma

It is clear from the above (Table 4) thatGroups A is showing maximum relief inNausea (78.57%). Groups B is showingmaximum relief in Tinnitus (100%) andTrisms (100%) Groups, C is showing maxi-mum relief in Frozen Shoulder (100%).

GoodP 100E 90R 80C 70

E 60N 50 ExcellentT 40A 30 10 10

G 20E 10 '-------1

0GLA GLB

70

60

As the present work of clinical trial hasbeen conducted on a small number of pa-tients and for a short duration of time andwith limited resources the results showsthat the medicines are well tolerated by thepatients without side effects or toxicity

70

10

Fair

30 30 Poor

10

GLA GLB Gr.C Gr.A Gr.B Gr.C Gr.A

('/0 Relief in Patients Vs Degree)

Group A & B are showing excellentresults in 10 % of cases. Good relief forGroup A & C is 70 %, while for Group Bis 60 %. Fair relief for Group B & Cis 30% while for Group A is 10 %. Only GroupA is showing poor results in 10 % of cases.

Discussion

It is well evident from the study that GroupA showed maximum relief in Nausea &Pain in eye brows. Group B showedmaximum relief in tinnitus & trismus.Groups C showed maximum relief intinnitus & frozen shoulder.

observed clinically. The results shown inthe present study are based upon datascollected and criteria fixed on 30 patients.It can be concluded that the drugs are welltolerated by the patients without sideeffects or toxicity observed clinically.

Acknowledgement

The author is grateful to the principal,M.M.M. Govt. Ayurvedic College, Udaipurfor providing necessary facilities andencouragement.

72

A COMPARATIVE STUDY ON CLINICAL

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2. Ambika Oatt Shastri 1969

Charaka Samhita l st Edi. Hindicommentary, chowkhamba Bharti Acad-emy VaranasiBhaishajya Ratnavali 3rd Edi. Hindicommentory Chowkhamba Sanskrit,

Series, Varanasi

I . Satyanarayan Shastri

4. Howard F.Conn.

5. F. Clifford Rose, M. gawel6. v.P. Sharma

198919841999

Principles of Internal Medicine.14th EditionMigraine-Current TherapyMigraine The FactsCharak samhita Eng. TranslationChowkhamba orientalia, Varanasi

3. Harrison

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