1. To evaluate and compare the clinical efficacy of Ashvatha Phala Churna and Palandu Swarasa Bhavita Yavani Vati on Ksheena Shukra (Oligozoospermia). Introduction
Among eight type of Shukra Dosha , Ksheena Shukra is caused due to vitiation of Vata
and Pitta and Daurbalya, Klaibya, Shukra Avisarga, Pandu etc. have been mentioned as its symptom. Ksheena Shukra, results due to Shukravaha
Strotodushti, hence all factors which lead to Shukravaha Strotodushti play an important role in producing Ksheena Shukra. This include Shukradushtikara Ahara and Vihara like excessive intake of Amla-lavana-katu-tikta-kashaya
Rasa, exposure to Vata-Atapa, Shrama, Bhaya, Shoka ,Krodha etc, which can
be considered as the primary cause of Ksheena
Shukra. Intake of Madhura and Tikta Rasa food and proper Shodhana of the body at proper time are
the major treatment for Ksheena Kshukra.
AIMS & OBJECTIVES:
To
evaluate and compare the clinical efficacy of
Ashvatha Phala Churna and Shveta Palandu Swarasa Bhavita Yavani Vati
after performing Virechana Karma
on Ksheena Shukra (Oligozoospermia).
The thesis entitled “A
Comparative study of Ashvatha
Phala Churna and Shveta Palandu Swarasa Bhavita Yavani in the management of Ksheena Shukra w.s.r to Oligozoospermia†comprises of four parts viz.
Conceptual study, Clinical study, Discussion, Summary and conclusion.
The total study was divided into conceptual contrive
and clinical contrive.
Conceptual Contrive
The conceptual study has been
presented under the heading of Disease and Drug review. In disease review, the details
of historical aspects of Shukra and Kshina shukra have been mentioned. Then concept of Shukra
which explains etymology, synonyms, definition of Shukra, Retas, Virya;
origin and production of Shukra (spermatogenesis), characters and
functions of Shukra (semen) has been discussed. This is followed by Nidana
Panchaka of Kshinashukra such as various kinds of Nidana, Rupa,
Samprapti and Chikitsa of Kshina shukra along with Pathyapathya
have been dealt in length.
For the further understanding
of pathophysiology review of oligozoospermia has been presented.
In Drug review,
pharmcognostical, pharmaceutical and other details of the drug under trial viz.
Ashvatha Phala
Churna and Shveta
Palandu Swarasa Bhavita Yavani Vati along with method of
preparation of both drugs are in detail.
Drug review of the drugs used
for Virechana Karma has also been
discussed.
Clinical Contrive:
In the second chapter entilled
clinical study embodies the methodology, selection of patients and method
adopted for present clinical trial. It is followed by presentation of the
results obtained in the clinical trial carried out on 38 patients of Kshina
shukra along with its statistical analysis. The data obtained in the
clinical study have been analysed and discussed in the detail in the third
chapter under the caption of Discussion.
For the clinical study, 40 male patients complaining
of symptoms of Ksheena Shukra or suffering from primary or secondary
infertility more than one year and having sperm count less than 15 million/ml
and willing to participate for the clinical trial were selected irrespective of
religion, caste from the O.P.D of
Kayachikitsa Department or referred from SRPT Department of I.P.G.T.& R.A.
hospital, Jamnagar. Consent
was taken from all subjects before including in the present study.
The selected patients were randomly divided
into the following two groups, and managed for duration of two month addition
to the time taken for Virechana Karma.
Patients
were first subjected to Virechana, as
per classics, for beginning 3 days 2gm of Trikatu
powder with warm water was given thrice a day before meal. After achieving
symptoms of Samyaka Deepana and Pachana Snehapana was done with Suddha Godhrita for 3-7 days in increasing dose depending upon Koshta and Agni of patient till Samyaka
Snehapana Lakshana were achieved.
This was followed by Sarvanga Abhyanga
and Swedana for 3 days were patient
was kept on normal diet. On the 4th day, Abhyanga and Swedana in
the morning Virechana Yoga which
consisited of Kwatha( Triphala + Trivritta)
with Danti Churna was given. Average
8 hour and 8 minute were taken by the patients for Virechana and maximum
patients (92.5%) reported Madhyama Shuddhi. After completion of Samsrjana Krama
, there patients were randomly divided into two groups. After this patient of
group A were given Ashwattha Phala Churna
3 gm twice a day orally daily in morning
and evening before meal with a cup of warm milk with Sharkara
for the duration of 60th day,
while in group B Shveta Palandu Swarasa Bhavita
Yavani Vati was given in the dose of 4 Vati(
500mg each ) twice a day orally morning and evening
before meal with Anupana of 5ml of Godhrita for duration of 60th day.
It
is though that drugs which are administered after Shodhana provides better and quicker effect as Shodhana helps to enhance the bioavailability of drugs.
The observation found on the
basis of generated data have been presented in brief which are as below:
40 male patients were studied in this series out
of which maximum patients belonged to 21-30 years age group (52.5%), were to
Hindu (92.5%);coming from urban area ( 67.5%), belonging lower middle class
(47.5 %); with secondary level education (60%); factory laborers (27.5 %); and doing
heavy physical work (67.5%). Maximum patients had Vishamagni (77.5%), Vata
Pittaja Prakriti (52.5%), habit of Vishamashana (87.5%) and taking Lavana Rasa dominant diet (60%). All the
patients (100%) of this study were found with well developed secondary sexual character
and having good relationship with their partner.
Maximum patients were found to
be habituated to Tobacco (52.5%) and most of the patients wearing cotton
undergarments (97.5 %), but tight underwear (67.5 %), and taking habit of warm
water bath (67.5 %). Maximum number of patient complaint of disturbed sleep
(62.5%) and 52.5 % of the patient had irregular bowel habit. Stress and worry
(37.5%) was also reported in the patients.
Maximum number of patients were having Primary
infertility (90%) with Moderate
oligozoospermic conditions (52.5%) with 1-3 years of chronicity (37.5%)
Associated symptoms of Kshina Shukra reported by the patients were Shrama
Maithuna (80%), Alpa Cheshta (75%),
Daurbalya (67.5%), Alpa Shukra Pravritti (57.5%), Mukha
Sosha (20%), Sadana (15%), and Bhrama (75%).
Analysis of generated data to
find the effect of therapies on oligozoospermia showed that in Group A ( Ashwattha Phala Churna) 38
patients were treated with Ashvatha Phala
Churna 3gm twice a day with warm milk and Sharkara for 60 days after performing of Virechana Karma provided increase
in Sperm count of 59.78 %, 16.18% decrease in Abnormal forms, and increase in Semen volume by 36.81%.
In Group B (Shveta
Palandu Swarasa Bhavita Yavani Vati ); 38 patients were treated with 4 Vati twice a day with
Goghrita for 60 days. Provided increase in sperm count (65%), and abnormal form of sperm (20.74%).
On assessing the effect of
therapies on associated symptoms it was found that
Ashvatha Phala Churna and Shveta
Palandu Swarasa Bhavita Yavani Vati administered
after Virechana Karma provided statistically highly significant improvement (p<0.0001) in Daurbalya,
Sandhi Shula,Shrama, Maithune Ashakti,AlpaShukra Pravriti, as well as subjective criteria i.e. sexual
desire, erectile function , erectile rigidity, ejaculatory function, orgasm,
overall satisfaction, frequency of coitus, duration of coitus.
In addition
in group B (Shveta
Palandu Swarasa Bhavita Yavani Vati) provided 24.08% increase in
the S.LH. In this group one patient was able to conceive his partner in the
second month of treatment.
Overall effect of
therapies which was assessed on the basis of changes in semen parameters as
well as on subjective parameters. In Group A, (Ashvatha Phala Churna) given after Virechana Karma, 20% patients reported moderate improvement, 60%
showed mild improvement and 20% patients remained unchanged. Whereas in Shveta Palandu Swarasa Bhavita
Yavani Vati group 10% patients showed moderate improvement, 70 %
showed mild improvement and remaining 20% were remained unchanged.
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