AAMJ / Vol. 2 / Issue 5 / September – October 2016

A A M J Anveshana Ayurveda Medical Journal

www.aamj.in ISSN: 2395-4159

Research Article

Efficacy of Ārohaṇa Krama Mātrābasti in Knee Osteoarthritis

Sumit R Patil 1 Swarup P Kulkarni 2 Chintamani A Kodolikar 3

A b s t r a c t

Sandhigata Vāta is grouped under Nānātmaja Vāta Vyādhis. Dhātu kśaya which is a part of

aging process is the main causative factor for this clinical entity. Basti is the best modality of

treatment for Vāta diseases and Osteoarthritis of Knee comes under Asthipradoṣaja Vikāra, in

which the Basti given with Tikta sādhita Ghrita (Vātapittahara) is said to be best as Tikta

dravyas helps in Asthi Vriddhi and in combination with Ghrita which does not allow to get

Vāta Vriddhi due to Snigdha guna and helps in Samprāpti vighatana of Osteoarthritis of

Knee.

Objectives of the study are to evaluate the efficacy of Mātrābasti with Panchatikta sādhita

Kśīrasarpi administered in Ārohaṇa Krama (Increasing dose) in the Management Osteoarthri-

tis of Knee.

Study design: 15 patients of Osteoarthritis of Knee have received one course (9 days) of

Ārohaṇa Krama(Increasing dose) Mātrābasti with Panchatikta sādhita Kśīrasarpi.

Key Words: Osteoarthritis of Knee, Ārohaṇa Krama Mātrābasti (Sha.Utt.Kha.5), Panchatikta

dravyas, Kśīrasarpi, Dhātu Kśaya.

1 Asso.Prof. Dept. of Panchakarma, 2 Asso.Prof. Dept. of Rachana Sharir, Dr. J. J. Magdum Ay-

urved Medical College, Jaysingpur. 3 Asst.Prof. Dept. of Samhita Siddhant, Dr.N.A.Magadum

Ayurved Medical College, Ankali.

CORRESPONDING AUTHOR

Dr. SUMIT R PATIL

Associate Professor,

Department of Panchakarma,

Dr. J. J. Magdum Ayurved Medical College,

Jaysingpur, Maharashtra, (India).

Email: dr.sumit.ayu@gmail.com

Sumit R Patil et.al : Efficacy of Ārohaṇa Krama Mātrābasti in Knee Osteoarthritis

AAMJ / Vol. 2 / Issue 5 / September – October 2016 988

INTRODUCTION

n this present clinical work Mātrābasti (Oil enema)[i]

has been administered in Ārohaṇa Krama (increas-

ing dose) in Knee OA. As degenerative joint dis-

ease[ii] is one among the Asthivaha srotogataa vyādhi

for which Acharya Charaka has told ‘Tiktaka ghrita’[ii]

said to be the Best. Also Acharya Shusruta specifically

mentions Snehana [ii] (Internal/External) in the manage-

ment of degenerative joint disease. In this work

Mātrābasti (Oil enema) given with Kśīrottha tiktaka

ghrita[i]. As Kśīrasarpi (Kśīrottha Ghrita- Extracted direct-

ly from milk)[i] also holds the better qualities compared

to Ghrita (Dadhyokta Ghrita- Transformed from Curd)

which is to be told to be used by Charaka in context of

Asthivaha srotogata vyādhi (Tiktaka ghrita Basti)[i]. As

Asthi dhātu has Khara Swabhāva[iii] So, by this we can

say how this Kśīrottha tiktaka ghrita administered in

Ārohaṇa karma[iv] helps in combating the disease pro-

cess & helps to bring the normalcy in dhātu.

Osteoarthritis is a Degenerative joint disorder character-

ized by breakdown of joint cartilage. According to

WHO Osteoarthritis is the 2nd commonest problem in

the world population i.e 30%. The major risk factors

associated with Knee joint are Age, female sex, obesi-

ty, occupational Knee bending, & making it an im-

portant cause of disability. As in the conventional sys-

tem of medicine administration of pain killers like

NSAIDS (non steroidal anti inflammatory drug) Narcot-

ics, Corticosteroids, intra articular injections etc. which

gives temporary relief & lastly surgery (Knee replace-

ment), which are quite expensive, need hospitalization

also causes adverse effects.

Materials required for the Study:

Panchatikta Sādhita Kśīrasarpi (Ghrita), Glycerine sy-

ringe (100 ml capacity), Rubber catheter (no. 12), Śa-

tapuśpa cūrṇa, Saindhava lavaṇa, khalwa yantra,

Measuring jar.

Inclusion Criteria:

1. Patients with classical signs and symptoms of Knee

O.A.

2. Patients in the age group of 41 years to 70 years

3. Patients fit for Mātrābasti (Oil Enema).

4. Patients with Radiographic evidence of Osteoarthri-

tis of Knee joint.

Exclusion Criteria:

1. Patients below 40 yrs of age and above 70 yrs.

2. Patients suffering from Osteoarthritis of Knee joint

with bony deformity.

3. Patients having BMI more than 31.

4. Patients suffering from Rheumatoid Arthritis, Rheu-

matic Heart disease, Gouty Arthritis.

5. Patients suffering from Diabetes mellitus, Haemor-

rhoids and Fissure in Ano.

6. Patients who are not fit for Basti Karma.

Methodology of study:

The patients who fulfilled the inclusion criteria were sub-

jected for routine Haematological examination and AP

& Lat view X-ray of affected Knee joints. Before com-

mencement of the treatment an informed consent was

taken from the patients, and the patients were evaluated

for both

Panchatikta Sādhita Kśīrasarpi in Ārohaṇa Krama (In-

creasing order) Starting with 24ml increased 6ml daily

for 09 days.

OBSERVATIONS & RESULTS

Index of severity of Osteoarthritis of the Knee by

Lequesne et al. was taken as subjective parameter as;

Pain (Ruk), Stiffness (Graha), Prasarana ākunchanayo

sa Vedana, Standing for 30 mins, Maximum distance

walked, Able to climb up standard flight of stairs, Able

to climb down standard flight of stairs, Able to

squat/bend at knee, Walking aids required. Tender-

ness, Crepitus, Knee circumference, Range of movement

of Knee and time taken to walk 50 meters distance,

were taken as objective parameters. In this study out of

15 patients, 7 patients (46.67%) showed marked im-

provement, 5 patients (33.33%) showed moderate im-

provement, 2 patients (13.33%) showed mild improve-

ment, and only one patient registered no change.

DISCUSSION

Knee O.A. is a disease where potential involvement of

vāta doṣa is seen, this O.A occurs in vardhakya

avastha, it is interpreted that whenever vāta doṣa viti-

ates it leads to Dhātukśaya, in such condition Kapha

kśaya will also prevail; here it is Śleśaka kapha kśaya.

According to general principle Dhātu parināma i.e.

Kedārakulya nyāya in Vārdhakya stage Rasādi Dhātu

undergoes Kśaya, Asthidhātu is formed out of

I

Sumit R Patil et.al : Efficacy of Ārohaṇa Krama Mātrābasti in Knee Osteoarthritis

AAMJ / Vol. 2 / Issue 5 / September – October 2016 989

medhadhātu, it is possible here that meda kśaya also

may leads to asthi kśaya and other abnormalities per-

taining to asthi and sandhi as sandhi śūnyatha and

Sandhisputana are the lakśaṇas of medokśya. By keep-

ing these points, here an attempt is made to explain

“Efficacy of Ārohaṇa krama Mātrābasti with

Panchatikta sādhita kśīrasarpi in Knee O.A.

Acharya Parashara opines that; Guda is the main root

of the body and having blood vessels in it, if we admin-

ister the basti through guda it nourishes the limb and

organs of the body and Basti eliminates the vitiated

doṣas from the rectal route.

Probable Mode of action of Panchatikta sādhita

Kśīrasarpi:

Acharya Charaka Sutra 27/28 in the context of

Asthimajjāpradoṣaja Vikāras mentioned that:

Basti given with tikta dravya sādhita is best; based on

this concept and other theories as- Jānusandhigata vāta

is one among the, Asthimajjāpradoṣaja Vikāra, Ghrita-

vātapittahara.

CONCLUSION

The ingredients of the basti dravya are chiefly having

1. Vedanāsthāpana/Shūlapraśamana & Jwaraghna

effect (Guduchi, Nimba, Vasa, Kantakāri,

kśīrasarpi)

2. Śothahara (Nimba, Vasa, Kantakari) Vātahara

(Patola, Kantakari, kśīrasarpi) Balya/Bhrimana

(Guduchi, Nimba, Patola, kśīrasarpi)

3. Rasāyana effect (Guduchi, Nimba, Vasa,

kśīrasarpi).

4. This aim of incorporating kharatva property of tikta

rasa without letting it to cause vāta vrudhi is served

by processing it with kśīrasarpi (Kśīrottha ghrita) to

get tikta sādhita Ghrita. The Ghrita nullifies the ef-

fect of rūkśata and laghuta of tikta rasa retaining

the kharatva, which in turn help correcting the Asthi

Dhātu in turn corrects the disease process.

Ghrita is having property like Yogavahi which is helpful

in increase bio-availability of other drugs without losing

its own property. Ghrita also contains vitamin D which

plays an important role to utilize calcium and phospho-

rous in blood and bone building.

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REFERENCES

i. Charaka Samhita, By Agnivesh, Ayurved dipika

Chakrapani, edited by vaidya Yadavji Trikamji Acharya

of Choukhamba Orientalia 2007

ii. Sushruta Samhita with Nibandhsangraha commentary of

Dalhanacharya edited by Vaidya Jadhavji Trikamji

Acharya & Narayan Raam Acharya Kavyatirtha of

Choukhamba surabharati Prakashan, Varanasi, 2010

iii. Ashtanga hrudaya, Sarvanga Sundara vyakhya,

choukhamba Orientalia nineth edi 2005

iv. Sharangdhara Samhita, Adhamalla and Gudharth

dipika commentary, Krushnadas Academy Varanasi, re-

print 2000

Source of Support: Nil.

Conflict of Interest: None declared

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How to cite this article: Sumit R Patil et.al : Efficacy of

Ārohaṇa Krama Mātrābasti in Knee Osteoarthritis. AAMJ

2016; 5:987 – 989.