scholar laveena kumari

DEPARTMENT OF PANCHKARMA

INSTITUTE FOR POST GRADUATE TEACHING AND RESEARCH IN

AYURVEDA

GUJARAT AYURVED UNIVERSITY, JAMNAGAR. (INDIA)

Year 2015-2018

GUIDE

Prof. P. K. Prajapati

M.D(Ayu), Ph.D

SCHOLAR

Laveena Kumari

Tamaka Shwasa has been mentioned as Pittasmudbhava

Vyadhi, occurs due to the vitiation of Kapha and Vata Dosha

and manifested through Pranvaha Srotasa. In this particular

menifestaion, Vitiated Vata along with vikruta Kapha gets

sthana sannshraya in Pranavaha Srotas and results in a

separate entity viz. Tamaka Shwasa.

Asthma is defined as a chronic inflammatory disease of airway that

is characterised by increased responsiveness of the

tracheobronchial tree to a multiplicity of stimuli. It is manifested as

paroxysmal attacks of dyspnoea, cough and wheezing, resulting

from narrowing of the air passages, which may be relieved

spontaneously or as a result of therapy. In most of the aspects like,

etiopathogenesis and symptomatology, Bronchial Asthma is similar

to that of Tamaka Shwasa mentioned in Ayurvedic classics.

The global prevalence of Asthma is anticipated to be

approximately 4.5 percent. A recent survey suggests that the

prevalence in India varies between 2.05 to 3.5 per cent (17-

30million patients). Asthma is one of the distressing ailment

which is not easy to cure.

Considering wide magnitude of disease phenomenon in

Indian subcontinent and absence of promising therapy with

safety; suffering population is turning towards certain other

systems for safe and effective remedies. In current attempt, a

short compilation work is done to frame the best possible line

of treatment for the satisfactory management of Tamaka

Shwasa

Total 66 research works has been carried-out on Tamaka

shwasa in different departments of IPGT&RA, Gujarat

Ayurved University, Jamnagar. Out of them seven works were

with shodhana therapy. In present study five works are

compiled and screened to revalidate the therapeutic attributes

of Panchkarma on Tamaka Shwasa.

Sr no. Name of author Group A Group B

1 Dr Sangeeta et al

(2002- Jamnagar)

Virechana with Trivrit, Draksha

followed by Pippalayavleha

Pippalayavleha

2 Dr. Mali Pavan et al

(2004- Jamnagar)

Virechana with Triphala, Kutaki kwath

& Castor oil followed by

Shireeshavleha

Shireeshavleha

3 Dr. Vinod Kumar Yadav et al.

(2009- Jamnagar)

Virechana with Snuhibhavit katuki

followed by Vasadi Vati

Vasadi vati

4 Dr. Kundan Gadhvi et al.

(2011- Jamnagar)

Vamana with Madanaphala Dadhi

Yoga followed by Drakshadileha

Virechana with Trivrit

Leha followed by

Drakshadileha

5 Dr. Shweta Patil et al.

(2013- Jamnagar)

Vamana with Ikshvaku Ksheer

followed by Kantakari ghrita

Virechana with Trivrit

Leha followed by

Kantakari ghrita

STUDY 1

Dr. Sangeeta G et al- A clinical study on effect of Pippalyavaleha

&Virechana Karma in the management of Tamaka Shwasa.(2002-

Jamnagar)

Group A- 16 Patients were treated with Virechana karma with Trivrit,

Draksha followed by Pippalyavaleha 10gm with milk BD for 30 days.

Group B- 17 Patients were treated with Pippalyavaleha 10gm with milk

BD for 30 days.

S.

No

Symptoms GroupA

(%improvement)

p value GroupB

(%improvement)

p value

1 Shwasakashta 77.7 <0.001 66.6 <0.001

2 Ghurghuraka 69.4 <0.001 43.7 <0.001

3 Peenasa 79.3 <0.001 73.5 <0.001

4 Kasa 75 <0.001 36.2 <0.001

5 Asinolabhte

sokhyam

54.3 <0.001 33.3 <0.01

6 Duration of

Shwasavega

81.8 <0.001 73.6 <0.001

7 Hb +3.6 >0.05 +2.9 >0.05

8 ESR -45.5 <0.01 -36.1 <0.01

9 AEC -48.9 <0.001 -40.7 <0.01

10 PEFR +24.7 <0.001 +16.6 <0.001

STUDY 2

Dr. Mali Pavan et al- A clinical study on effect of

Shireeshavaleha &Virechana Karma in the

management of Tamaka Shwasa. (2004-Jamnagar)

Group A- 10 Patients were treated with Virechana

karma with Triphala, Kutaki kwath & Castor oil followed

by Shireeshavaleha 10 gm BD with luke warm water for

30 days.

Group B- 13 Patients were treated with Shireeshavaleha

10 gm BD with luke warm water for 30 days.

S. No Symptoms Group A p value Group B p value

1 Shwasakashta 61.11 <0.001 42.71 <0.001

2 Ghurghuraka 66.66 <0.001 45.67 <0.001

3 Peenasa 63.40 <0.01 42.71 <0.01

4 Kasa 54.90 <0.01 51.51 <0.001

5 Asinolabhte sokhyam 61.90 <0.001 32.80 <0.05

6 Duration of Shwasavega 52 <0.01 38 <0.01

7 Hb -7.79 >0.05 -2.38 >0.05

8 ESR -2 >0.05 +11.78 >0.05

9 AEC -24.79 >0.05 -25.57 >0.05

10 PEFR +21.32 <0.001 +6.30 >0.05

STUDY 3

Vinod Kumar Yadav et al. A clinical study on the effect of

Virechana karma in the management of Tamaka Shwasa.

(2009-Jamnagar).

Group A- 10 Patients in this group were treated with

Virchana Karma with Snuhibhavit katuki followed by Vasadi

vati 3tabs 4times a day for 1month.

Group B- 10 Patients were treated with Vasadi vati 3tabs

4times a day for 1month.


1 Shwasakashta 78.94 <0.001 66.66 <0.01

2 Ghurghuraka 84.61 <0.001 80 <0.01

3 Peenasa 63.63 <0.001 66.66 <0.05

4 Kasa 70.58 <0.001 71.42 <0.001


6 Duration of Shwasavega 68.75 <0.001 100 <0.05

7 Hb -1.7 >0.05 +2.1 >0.05

8 ESR -45.83 <0.05 -13.79 >0.05

9 AEC -21.42 >0.05 -43.47 >0.05

10 PEFR +64.48 <0.001 +58.86 <0.01

STUDY 4

Kundan Gadhvi et al. A comparative study between the

efficacy of Vamana & Virechana Karma in the management

of Tamaka Shwasa (Bronchial Asthma).(Mar-2011)

Group A- 14 Patients in this group were treated with Vamana

Karma with Madanaphala Dadhi Yoga followed by

Drakshadileha 20 gm BD for 30 days.

Group B- 15 Patients in this group were treated with

Virechana Karma with Trivrit Leha followed by

Drakshadileha 20 gm BD for 30 days.


1 Shwasakashta 56.60 <0.001 43.59 <0.001

2 Ghurghuraka 77 <0.001 55.56 <0.001

3 Peenasa 66.67 <0.001 70.59 <0.001

4 Kasa 62.5 <0.001 58.33 <0.001


6 Duration of Shwasavega 41.51 <0.001 46.67 <0.001

7 Hb -0.63 >0.05 +0.71 >0.05

8 ESR -23.61 >0.05 -17.59 >0.05

9 AEC -15.94 <0.01 +11.68 >0.05

10 PEFR +21.20 <0.001 +10.21 <0.01

STUDY 5

Shweta Patil et al. A comparative study on effect of Vamana

& Virechana karma followed by brumhana snehpana

(Kantakari ghrita) in the management of Tamaka Shwasa

w.s.r. Bronchial Asthma. (2013-Jamnagar).

Group A- 13 Patients in this group were treated with Vamana

Karma with Ikshvaku Ksheer followed by Kantakari Ghrita

20 ml OD with breakfast for 1 month.

Group B-- 14 Patients in this group were treated with

Virechana Karma with Trivrit Leha followed by Kantakari

Ghrita 20 ml OD with breakfast for 1 month.


1 Shwasakashta 73.31 <0.001 80.54 <0.001

2 Ghurghuraka 75.03 <0.001 79.17 <0.001

3 Peenasa 75 - 90.91 <0.01

4 Kasa 96.6 <0.001 97.24 <0.001

5 Asinolabhte sokhyam 77.78 - 96.99 <0.001

6 Duration of Shwasavega 92.44 <0.001 85.49 <0.001

7 Hb -1.88 <0.01 +3.23 >0.05

8 ESR -7.37 >0.05 -31.78 >0.05

9 AEC -20.66 >0.05 -32.16 >0.05

10 PEFR +26.33 <0.001 -29.46 >0.05

Sr.no. Symptoms Study 1

(Dr. Sangeeta)

Study 2

(Dr. Pavan

Mali)

Study 3

(Dr. Vinod

Yadav)

Study 4

(Dr. Kundan

Gadhvi)

Study 5

(Dr. Shweta

Patil)

GpA GpB GpA GpB GPA GpB GpA GpB GpA GpB

1 Shwasakashta 77.7 66.6 61.11 42.71 78.94 66.66 56.60 43.59 73.31 80.54

2 Ghurghuraka 69.4 43.7 66.66 45.67 84.61 80 77 55.56 75.03 79.17

3 Peenasa 79.3 73.5 63.40 42.71 63.63 66.66 66.67 70.59 75 90.91

4 Kasa 75 36.2 54.90 51.51 70.58 71.42 62.5 58.3 96.6 97.24

5 Asinolabhte

sokhyam

54.3 33.3 61.90 32.80 87.5 84.61 68.09 53.13 77.78 96.99

6 Duration of

Shwasavega

81.8 73.6 52 38 68.75 100 41.51 46.67 92.44 85.49

Sr.no. Study 1 Study 2 Study 3 Study 4 Study 5

SymptomsGpA GpB GpA GpB GPA GpB GpA GpB GpA GpB

1 Hb +3.6 +2.9 -7.79 -2.38 -1.7 +2.1 -0.63 +0.71 -1.88 +3.23

2 ESR -45.5 -36.1 -2 +11.78 -45.83 -13.79 -23.61 -17.5 -7.37 -31.78

3 AEC -48.9 -40.7 -

24.79

-25.57 -21.42 -43.47 -15.94 +11.6

8

-20.66 -32.16

4 PEFR +24.7 +16.6 +21.

32

+6.30 +64.48 +58.86 +21.20 +10.2

1

+26.3

3

-29.46

Sr no. Status Study 1 Study2 Study3 Study4 Study5

Grp A Grp B Grp A Grp B Grp A Grp B Grp A Grp B Grp A Grp B

1 Complete

remission

0 0 20 - 0 0 0 0 0 0

2 Marked

improvement

50 11.8 40 7.6 70 40 21.42 0 0 0

3 Moderate

improvement

37.5 52.9 20 69.23 30 50 28.57 46.66 53.85 35.71

4 Mild

improvement

12.5 29.4 20 23.07 - 10 35.71 33.33 16.67 57.14

5 Unchanged 0 1 0 - - - 14.28 20 3.33 7.14

Bronchial Asthma is characterised by episodic airflow obstruction which

initially is fully reversible, clinically present as Dyspnoea, wheezing and

cough. Basically there is Bronchial hyper responsiveness which is caused

by allergens, drugs, environmental pollution etc. Mainly three pathological

changes are seen in the pathogenesis of Bronchial Asthma.

1. Localised oedema in the wall of bronchioles.

2. Secretion of thick mucus into bronchiolar lumen.

3. Spasm of Small bronchiolar smooth muscle.

In co-relation to Ayurveda, in the pathogenesis of Bronchial Asthma, the

mechanism involved in obstructive constriction of airways is similar to

Kapha dominant Samprapti and parasympathetic constrictor reflexes is

similar to Vata dominant Samprapti.

Mast cells appear to be critical "trigger" cells during episodes of acute

Asthma - eliciting acute bronchoconstriction, oedema, and mucus

secretion by the release of histamine and other vasoactive mediators,

which is similar to Srotorodha caused by vitiated Kapha.

Samshodhana: As per references different type of shodhana therapies are

recommended in the management of Tamaka Shwasa.

All studies show common observational result that all are having one

kind of Shodhana therapy in protocol followed by Shamana medicine.

In study 4 & study 5, researchers have compared specific types of

Shodhana therapy followed by common component in Shamana drug

in both groups.

Study data shows comparatively better result in group A of study 3,

group B of study 5 which are having common protocol of

Virechana followed by Shamana medicine are showing statistically

significant and better results in comparision to other studies and

their groups.

Dr. Kundan Gadhvi et al. concluded comparatively better results were

found in Vamana + Shamana drug group i.e. group A.

In comparison of both Vamana and Virechana therapies, both therapies

shows nearly same significant results in subjective parameters whereas

particularly in objective criterias like, PEFR, AEC etc. Vamana karma

shows better results in compare to Virechana.

From the above comparative review, it can be concluded that Shodhana

+Shamana therapy is better than only Shamana therapy in the

management of Tamaka Shawsa.

Vamana is having comparatively better results in objective criterias like

PEFR, AEC etc.

So, it is hereby recommended that low PEFR and increased AEC patients

should be advised for Vamana karma followed by Shamana therapy, after

being physically fit. Whereas patients with cardiac involvement and other

systemic diseases should be advised for Virechana Karma followed by

Shamana therapy for satisfactory management of Tamaka Shwasa.

scholar laveena kumari

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