A Case Discussion on CRF (Mutraghat) Treated with Kshar Basti

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ISSUE 1 (2015) INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINEINTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINEINTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINEINTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE

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Sneha Aswale et. al., A Case Discussion on CRF (Mutraghat) Treated with Kshar Basti and Mansaras Basti, Int. J. Ayu. Alt. Med., 2015; 3(1):60-63

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CASE REPORT eISSN 2348- 0173

Impact Factor (2014) – 0.815 by International Scientific Indexing (ISI) UAE

A CASE DISCUSSION ON CRF (MUTRAGHAT) TREATED WITH KSHAR

BASTI AND MANSARAS BASTI

Sneha Aswale1*, V.E.Gogate,2 S.I.Pathan3, Abhijit Ahire 4

1. PG Scholar, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Maharashtra, Contact No. 9405266671. [email protected]

2. Associate Professor, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Contact No. 9422214311. [email protected]

3. Assistant Professor, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Contact

No. 9665311877. [email protected]

4. Assistant Professor, Department of Panchakarma, Govt. Ayurved College, Nanded, Contact No. 7774048512

Article Received on - 20th

Jan 2015

Article Revised on - 14th

Feb 2015

Article Accepted on - 24th

Feb 2015

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CASE REPORT eISSN 2348- 0173

*Corresponding Author

Sneha Aswale PG Scholar, Department of Kayachikitsa, Govt. Ayurved College, Nanded, Maharashtra, Contact No. 9405266671 Email - [email protected]

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ABSTRACT: Kidneys are the organs that have numerous biological roles. They maintain the

homeostatic balance of body fluids by removing waste out of body. Chronic

Kidney disease (CKD) or Chronic Renal Failure (CRF) refers to an irreversible

deterioration in renal function, which develops over a period of years. The

conventional approach of management includes dialysis and renal

transplantation, which are involving the high costs and complexity so very few

patients are able to obtain adequate treatment for kidney disorders because of

financial limitation. Therefore, exploration of a safe and alternative therapy is

needed, which proves to be helpful in reducing the symptoms and improve the

quality of life. The use of herbal drugs for the prevention and treatment of

various diseases is constantly developing throughout the world. In Ayurveda

CRF can be correlated with Mutraghat due to similarity in symptoms. In present

study a case was taken of chronic kidney disease treated with Basti Therapy. He

was given Kshar Basti for 7 days followed by Mansaras Basti 21 days. This

treatment approach has significantly reduces the symptoms and improve the

quality of life.

Key Words: Chronic Kidney Disease, Mutraghat, Basti Therapy

INTRODUCTION

The world is facing a global epidemic of chronic

Kidney disease (CKD).As the morbidity and

mortality from infectious disease decline, life-

expectancy increases and chronic degenerative

diseases have become more prevalent.CKD is

unique amongst the chronic non-infectious illness. [1] Chronic kidney disease (CKD) encompasses a

spectrum of different pathophysiologic processes

associated with abnormal kidney function, and a

progressive decline in glomerular filtration rate

(GFR). [2] Chronic Kidney disease is an illness that

has existed > 3months with either kidney damage

or low GFR. [3]

In early CRF the patient is often asymptomatic.

Renal failure may present as a raised blood urea

and creatinine found during routine examination,

often accompanied by hypertension, proteinuria or

anaemia.[4] Clinical feature includes Anorexia,

Nausea, Tiredness, Oligouria ,Oedema etc. The

dispiriting term end-stage renal disease represents

a stage of CKD where the accumulation of toxins,

fluid, and electrolytes normally excreted by the

kidneys results in the uremic syndrome. This

syndrome leads to death unless the toxins are

removed by renal replacement therapy, using

dialysis or kidney transplantation. The monthly

cost of hemodialysis (HD) in most private hospitals

is very expensive. The treatment cost is a burden

for common man. Therefore, exploration of a safe

and alternative therapy is highly needed.

Ayurveda does not individually suggest the causes

and treatment for CKD. Though CKD patients

involve multisystem & associated with variety of

symptoms but main complaint i.e oligouria-

supression of urine formation can be correlate

with Mutraghat vyadhi as Acharya Chakrapani

clarifies that Mootraghata is characterized by

Shoshan and Hani of mutra [5], which indicate a

state of suppression of urine.

In mutraghat vyadhi because of vitiated vata urine

formation get hamper so quantity of urine get

minimized. Acharya charak has given that

mutrakruccha can be caused due to santarpan [6]

also and in Bheshajya Ratnavali acharya described

that chikitsa of mutraghat can be done as that of

mutrakruccha and described Bastii chikitsa for it [7]

& CRF patients also complaining symptoms like

agnimandya, aruchi which are due to Aama

samchiti. Considering above factors, Basti therapy

has been selected as a treatment modality for CRF

patient.

A single case study of CRF is reported here. In

which vitiated Doshas were specified with the use

of Kshar Basti followed by Mansaras Basti.

CASE REPORT

A 52 Year old male patient visited kayachikitsa

OPD of Government Ayurved Colleage, Nanded,

Maharashtra with complaints of Nausea, Anorexia,

A CASE DISCUSSION ON CRF (MUTRAGHAT) TREATED WITH

KSHAR BASTI AND MANSARAS BASTI

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weakness, Edema over both lower limb, oligouria

(suppression of urine).He was diagnosed with CKD

before 3 years and having history of hypertension

for more than 6 years. Patient was treated with

diuretic-tab Lasix-20 mg-1 OD, Tab Amlodepine 5

mg -1 OD, Calcium and Iron Supplements.

Thorough clinical examination of patient was done.

Patient was afebrile, pulse-76/min regular, pallor

present, coated tongue (sam jivha) BP-160/100

Mm/Hg, RS, CVS, CNS showed no abnormality.

Patient was investigated Hb%-7.2 gm%,

Sr.creatinine-3.2 mg/dl, Bl.Urea-56 mg/dl, Urine

albumin +, Urine output-400 ml.

According to Ayurveda Patient was Diagnosed as

Mutraghat as Oligouria is the main symptom. The

laboratory diagnostic tests and sonological

investigation had confirmed the presence of

chronic kidney disease. Patient was having the

symptoms of Aama like Agnimandya,Aruchi, along

with above complaints,for this following treatment

regimen was followed..

1) Kshar Basti-(260 ml) at morning after

meal for 7 days.

2) Mansa Rasa Basti-(260 ml) at morning

after meal for 21 days.

Patient experienced increased in Apetite

,Angalaghavata, Decreased in Nausea, Oedema

slightly decreses, sr.creatinine level also slightly

decrease i.e.3 mg/dl after 7 Days of Kshar Basti.

After 7 Days of Kshar Basti ,Mansaras Basti was

started for 21 days. After 28 days of Basti Therapy

patient experienced very good relief in symptoms

like Weakness, Nausea, Oedema, Anorexia.

Sr.creatinine level also slightly decrease i.e

2.86mg/dl.

Preparation of Basti

Kshar Basti- Ingrediant of Kshara Basti [8]

1. Saindhava Lavana : 5 gm

2. Guda(Jaggary) : 50 gm

3. Chincha (Tamarindus) : 50 gm

4. Shatahva(Souph) : 5 gm

5. Gomutra : 160 ml

Total : 260 ml

Initially 50 gm of Jaggary (Guda) and 50 gm of

chincha was mixed uniformly with equal quantity

of lukewarm water then 5 gm of Saindhava was

added to the above mixture then 5 gm of Kalka of

Shatahva were taken and added to above mixture

carefully. Lastly 160 ml of Gomutra was added

slowly and mixing is continued so as to have

uniform Basti Dravya. Finally after filtering, Basti

Dravya is made lukewarm by keeping it into hot

water.

Ingredients of Mansaras Basti [9]

1. Madhu : 50 ml

2. Ghrut : 50 ml

3. Mansaras : 160 ml

4. Nagarmotha kalka : 5 gm

Total - : 260 ml

Initially 50 gm Madhu was mixed uniformally with

equal quantity of Ghrut. Then Musta Kalka was

taken and added to above mixture and mixed

properly. Lastly 160 ml Mansras was added slowly

and mixing is continued so as to have uniform

Basti Dravya.

Kshar & Mansaras basti were prepared with slight

modification from the textual reference. Amount of

all dravyas as mentioned in the text was taken in

its half quantity keeping in the mind the body

strength (rogbala) of the patient.

PROBABLE MODE OF ACTION

Kshar Basti comprises of Saindhava, Guda, Chinch,

Gomutra and shatava. In this Basti, maximum

quantity is of Gomutra which is having Tikshna,

Ushna, Agnideepak, Kshar Guna. [10] These has the

property of Lekhan and Rukshana which are

antagonistic to Ama. Chinch to be taken in Kshar

Basti should be in Pakva stage that is having

Deepan, Ruksh gun & ushana virya because of these

properties it is Vata – Kaph shamaka. [11]

In this basti Puran Guda is used, it is laghu, pathya

annabhishyandi, agnivardhaka and vata-pittaghna. [12] Saindhava due to its sukshma and tikshna

property helps the Basti dravya to reach up to the

molecular level. [13] It is capable of liquefying the

viscid matter and breaking it into minute particles.

In this way, strotorodh and samata might be

reduced due to kshar basti. Mansaras Basti was

given for dhatu and bala vardhana purpose after

strotoshodhan done by ksharbasti.

For preparation of Mansaras we used Ajamansa.

Acharya Vagbhata has said that,because of having

samshitoshna character it doesn’t vitiated any

dosha. Guna of Aja mansa are as similar as sharir

guna of human beings so they may help to nutriat,

sapta dhatu. [14] Ghrut also ingredient of mansaras

basti is Agni,Bala vardhak, [15] properties so in this

way bruhan karma done by mansaras basti.

Basti therapy has the quality to eliminate both vat

and kapha-kleda also it is the best shodhan therapy

for the elimination of Dosha lying in the lower

parts of the body, so ultimately basti therapy

provide significant relief in Anorexia, Nausea

,weakness, oedema.

CONCLUSION

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In Ayurveda Mutraghat has the symptom similar to

CRF. So Mutraghat can be correlated with CRF.As

Mootrarogas are Santarpanjanya roga and

Mutraghat is one of the Mutraroga Kshar Basti is

the effective treatment for this, to prevent

excessive apatarpan Mansras Basti is used. Basti

Therapy showed very good result in reducing the

symptoms but has very low effect in reducing the

sr.creatinine level. From the above study it can be

said that Kshar Basti and Mansaras Basti might

prove beneficial to the patients of CRF in reducing

the associated symptoms and to improve the

quality of life.

REFERANCES 1. Siddharth N. Shah, API text book of medicine, vol. 1, 8th ed.

reprint, published by the association of physicians of India,

Mumbai, 2009, p. 732

2. AS Fausi et al; Harrison’s principles of internal medicine,

17th ed., Mc Graw Hill Medical publication, 2008, p. 1761

3. Siddharth N. Shah, API text book of medicine, vol. 1, 8th ed.

reprint, published by the association of physicians of India,

Mumbai, 2009, p. 733

4. C Haslett et al; Davidson’s Principles and practice of

medicine,18th ed., Churchill Livingstone Harcourt

Publishers Limited,1999, p. 433

5. Yadavaji Trikamji, Charak Samhita, Sanskrit commentary,

Chaukhambha Prakashan Varanasi, 2013, p. 600

6. Yadavaji Trikamji, Charak Samhita, Chaukhambha

Prakashan Varanasi, 2013,ch.su,chp 23,shlok-31, p. 455.

7. Siddhinandan Misra, Bhaishyaj Ratnavali of Kaviraj Govind

Sen edited with ‘Siddhiprada Hindi Commentry’ Vol.2, First

ed. Chaukhamba Surbharati Prakashan Varanasi, 2005, p.

683

8. Indradeva Tripathi, Chakradatta-with the ‘Vaidayaprabha’

Hindi Commentary of Shri Chakrapanidatta, 2nd ed.,

Chaukhambha Sanskrit Sansthan,Varanasi,1994, p. 455

9. Yadavaji Trikamji Acharya, Charak Samhita – with Ayurved

Dipika commentary of Chakrapanidatta, Chaukhambha

Prakashan Varanasi, 2013, p.733

10. Chunekar K. C., Bhavaprakasa Nighantu, Bhavamisra,

Chaukhambha Bharati Academy,Varanasi, 2010, p.761

11. Chunekar K. C., Bhavaprakasa Nighantum, Bhavamisra,

Chaukhambha Bharati Academy,Varanasi, 2010, p. 586


Chaukhambha Bharati Academy,Varanasi, 2010, p. 779


Chaukhambha Bharati Academy,Varanasi, 2010, p.148

14. Brahmananda Tripathi, Astanga Hrdayam, Vagbhata,

Chaukhambha Sanskrit Pratishthan, Delhi, 2010, p. 100

15. Brahmananda Tripathi, Astanga Hrdayam, Vagbhata,

Chaukhambha Sanskrit Pratishthan, Delhi, 2010, p.73

CITE THIS ARTICLE AS –

Sneha Aswale et. al., A Case Discussion on CRF (Mutraghat) Treated with Kshar Basti and Mansaras Basti, Int. J. Ayu.

Alt. Med., 2015; 3(1):60-63

Source of Support – Nil Conflict of Interest – None Declared

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A Case Discussion on CRF (Mutraghat) Treated with Kshar Basti