Research

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Study of Aam Parmathini Vati & Rasna Saptak Kwath on Rheumatoid Arthritis

About Arthritis

  • Chronic
  • Systemic
  • Inflammatory disease
  • Chiefly affects the synovial membranes of multiple joints

Charactrisits

  1. Course prolongs with exacerbations & Remmission
  2. Atypical, asymmetrical & incomplete forms common

Epidemiology

  1. Occurs throughout world in all the ethnic groups
  2. Most common between 3rd & 5th decades
  3. Annual incidence of new cases is about 200/million
  4. The female : male ratio is 3:1

Aetiology of RA has not been elucidated
Possible factors may include following

  • Genetic predisposition
  • Female sex
  • Psychological stress
  • Immune response
  • Hormone interaction
  • Viral infection

Local features
Insidious onset

  • Joint involvement typically polyarticular & symmetrical
  • Edema
  • Effusion
  • Warmth
  • Tenderness to palpation
  • Destruction (a late finding)
  • Subcutaneous rheumatoid nodules
  • Swan-neck deformities
  • Ulnar deviation of fingers

Systemic features

  • General malaise
  • Weakness
  • Fever of undetermined etiology
  • Weight loss
  • Myalgias
  • Tendonitis
  • Bursitis

Pathology

  1. Factors associated with RA include
    -Possibility of infectious triggers
    -Genetic predisposition
    -Autoimmune response
  2. The primary targets of inflammation are Synovial membranes and articular structures
  3. Sequence of synovial membrane involvement
    -Inflammation
    -Proliferation
    -Degeneration
  4. Erosion & destruction of synovial membranes leads to Joint deformities and disability

Investigations

  1. Anemia – normocytic & normochromic approx. In 80%
  2. Thrombocytosis may be present
  3. ESR – elevated in approx. In 90%
  4. Serum RF – positive in approximately 70%
  5. ANA – antinuclear antibodies present approx. In 30%

About Research

Diagnostic criteria
(American Rheumatism Association)
• Morning stiffness (>1 hour)*
• Arthritis of three or more joints*
• Arthritis of hand joints*
• Symmetrical arthritis
• Rheumatoid nodules
• Rheumatoid factor
• Radiological changes
*Duration of 6 weeks or more
Diagnosis of RA made with four or more criteria

Inclusion criteria
• Patients of age group between 20 – 60 years
• Duration of disease 0 – 3 years

Exclusion criteria
• Patients having cardiac, renal, endocrine disorders
• Patients having osteo arthritis
• Patients having inconclusive diagnosis
• Patients of age <20 & >60 years

Selection of patients
25 patients were selected from OPD / IPD of Dayanand ayurvedic hospital

Research Design
A clinical study of within group comparison With pre & post test design

Aam Pramathini Vati
(Herbo Mineral Formulation)

S. No.

Sanskrit name

Eng. Name

Part used

Quantity

1

Loh bhasam

Iron

Mineral

1 part

2

Abhrak bhasam

Mica

Mineral

1 part

3

Shorak

Salt petre

Mineral

1 part

4

Shudh gandhak

Sulphur

Mineral

1 part

5

Aark

Madar

Root bark

1 part

6

Amrita

Gulanch

Stem

1 part

Processed in cassia fistula (amaltas) leaves juice

Dose : 500 mg twice / day

Rasna Saptak Kwath

S. No.

Sanskrit name

Latin name

Part used

Quantity

1

Rasna

Pluchea lanceolata

Leaves

1 part

2

Amrita

Tinospora cordifolia

Stem

1 part

3

Devdaru

Cedrus deodara

Stem

1 part

4

Anantmul

Typhora asthmatica

Roots

1 part

5

Punarnava

Boerhavia diffusa

Roots

1 part

6

Amaltas

Cassia fistula

Leaves

1 part

7

Gokshur

Tribulus terristeris

Roots

1 part

Dose : decoction 30 ml twice / day

Results

Symptoms / ESR

Mean score

Paired t test

Bt

At

S.d.
±

S.e.±

T

P

Morning stiffness

2.400

0.000

0.843

0.267

9.000

<o.001

Pain I/P joints

2.500

0.000

0.850

0.269

9.303

<o.001

Inflammation

1.400

0.000

0.516

0.163

8.573

<o.001

Tenderness

2.200

0.000

0.667

0.211

9.487

<o.001

Impaired function

3.000

0.000

0.675

0.213

12.650

<o.001

ESR

80.500

29.800

14.376

4.546

11.152

<o.001

 

Objectives

  • To assess the effect of the combination
  • Of both the formulations in patients
  • Suffering from rheumatoid arthritis

Observations

  • Majority of the patients were females
  • Belonged to the age group of 25 – 60
  • Majority of the patients were married
  • Majority belonged to middle class
  • Majority belonged urban background
  • Majority were of mixed diet

Results
Highly significant results in all the Subjective symptoms / e.s.r. Was seen Within 30 days of treatment as shown in The table.

Conclusion

  • With combined use of both the medicines progression of rheumatoid arthritis was checked in early stages of disease with minimal or no Osteoarthritis.
  • Observations & result of this study open newer vistas for further research.
  • This combination is advised as an effective regimen for the use in general practice.