Keywords

Mutrakruchcha, Gokshur, Dysuria, Tribulus terrestri

Introduction

Ayurveda, the indigenous system of medicine of India, dating back to the vedic ages has been an integral part of Indian culture. In his long struggle to acheive mastery over powerful forces of nature, man has always turned to plants for help. The fame of Ayurveda stands mostly on the magnificent edifice of vegetable materia medica and it can be said that herbs and herbal products occupied a prime place in all ages and in all civilizations on the earth, totally unconcerned with the development of synthetic and chemotherapeutic agents. The plants kingdom has proved to be a fruitful ground for the discovery of effective remedies. Ancient acharyas had developed the knowledge of use of medicinal plants but unfortunately due to the lack of continuity and organization there had been many drawbacks in the application of this knowledge in the present day. Some of the shortcomings are as follows.

Aim of the Standardization

The main aim of standardization is to confirm the quality, safety and efficacy of the drug while quality and safety can be known by pharmacognostic and toxicological studies clinical studies are considered as the markers to establish the efficacy of the drug. One such clinical study was done to evaluate the comparative efficacy of both Laghu Gokshura and Brihat Gokshur. In samhita period we find reference only for Laghu Goshur, also called simply as ‚Gokshura‛. But for the first time we find in Rajanighantu reference for Brihat Gokshura also called ‚Gokshur dvaya‛. Botanically Laghu Gokkshura is called Tribulus terrestris of Zygophyllaceae family and Brihat gokshura is called Pedalium murex belonging to family Pedaliaceae. Morphologically Tribulus terrestris is a procumbent herb and Pedalium murex is a much branched herb. Though both the do not look alike the fruits of Pedalium murex look almost similar to Tribulus terrestris i.e/ laghugokshura. If we take a look about its paharmacological aspect also, it is almost similar to laghu gokshura. Hence it can be assumed that by having similarity in pharmacological properties, in fruits and as it is bigger than Laghu goshur in size, Pedalium murex was named as Brihat Gokshur. In Ayurvedic classics Gokshur has been started as diuretic lithotropic and urinary tract antiseptic drug. But the problem arises when we have to choose among different type of Gokshur for the above purpose. Hence clinical study was done to establish the comparative efficacy of both Gokshur

Aims & Obejectives of Study

  • To study the pharmacogonstic characteristics of birhat goshur and laghu gokshur which Is established drug as per textual reference for the treatment of mutrakrichchra.
  • Pharmacological evaluation of brihat gokshur & laghu gokshur, and its efficacy in treating mutrakrichchra. So as to establish it’s utility as a best drug.
  • To provide a drug which is efficacious having low cost, short duration action and safe for the treatment of mutrakrichchra
  • To provide a drug which produces no side effect.
  • To Determinate the original gokshur as mentioned in Ayurvedic literatures on Ayurvedic parameters.

Materials & Methods

The study was done on 20 patients which were divided in two groups and the patients were selected randomly.

Group A: In this registered patients were treated with Gokshur kwath no.1 in the dosage of 15 ml twice daily for 10 days.

Group B: In this 10 registered patients were given Gokshura Kweth no-2 in the dosage of 15 ml for 10 days twice daily.

Gokshura Kwath No.1: Consist of Kwath of Pendalium murex.

Gokshura Kwath No.2: Consist of Kwath of Tribulus terrestris.

A detailed history of the patients was taken and examination was done properly. The parameters selected for the study are as follows:

Critieria of Assessment

Clinical improvement

  • Pain in vankshan , vasti and mutrendriya
  • Burning sensation in Mutramarga
  • Yellow urine or harmaturia.
  • Heaviness in muska, mehan and vasti.
  • Whiteness, slimness in urine.
  • Appearance of different colours in urine long with burning and pain.
  • Appearance of darkness in front of eyes while micturition.
  • Presence of adhman, school and mutrasang.
  • Other pathologies like- Ashmari, Sarkara, etc.

Improvement in Lab.parameter

  • Routine urine examination
  • Daily urine output

GROUP A

Criteria of assessment by clinical improvement

S.No. SYMPTOM Exam. Of Pat. 1 2 3 4 5 6 7 8 9 10 Total Imp %
1 Pain in Vakshan,vasti and Mutrendriya. BT + + + + + + + + 8 5 62.5
AT + + + 3
2 Burning sensation in Mutramarg. BT + + + + + + + + 9 9 78
AT + + 2
3 Yellow urine or Haematuria. BT + + + + + + + 7 6 86
AT + 1
4 Heaviness,in Muska,Mehana and Vasti. BT + + + + + + 6 3 50
AT + + + 3
5 Whiteness, Sliminess in Urine. BT + + + + + + 6 2 50
AT + + 3
6 Appearanceof different in colours in urine with burning pain. BT + + + + + 5 4 40
AT + + + 3
7 App.of darkness in Eyes while micturiation. BT + + + + + + + 7 4 57
AT + + + 3
8 Presence of Adhman,shool,and Mutrasang. BT + + + + + + + 7 4 57
AT + + + 3
9 Othor pathologies like Ashmari Sharkara etc.. BT + + + 38 2 67
AT + 1
Total BT 6 5 7 5 6 4 7 8 3 7 58 36 62
AT 0 3 1 3 3 3 3 2 1 3 22
IMP. 6 2 6 2 3 1 4 6 2 4
% 100 40 86 40 50 25 57 75 67 57

GROUP B

S.No. SYMPTOM Exam. Of Pat. 1 2 3 4 5 6 7 8 9 10 Total Imp %
1 Pain in Vakshan,vasti and Mutrendriya. BT + + + + + + + + 8 5 62.5
AT + + + 3
2 Burning sensation in Mutramarg. BT + + + + + + + + + + 10 8 80
AT + + 2
3 Yellow urine or Haematuria. BT + +- ++ + + + + 7 6 86
AT + + 1
4 Heaviness,in Muska,Mehana and Vasti. BT + + + + + 6 4 67
AT + + + + 2
5 Whiteness, Sliminess in Urine. BT + + + + + 7 4 57
AT + + + + 3
6 Appearanceof different in colours in urine with burning pain. BT + + + + + 5 2 40
AT + + + + 3
7 App.of darkness in Eyes while micturiation. BT + + + + + 6 3 50
AT + + + + 3
8 Presence of Adhman,shool,and Mutrasang. BT + + + + + + 7 5 71
AT + + + 2
9 Othor pathologies like Ashmari Sharkara etc.. BT + + + 4 3 75
AT + 1
Total BT 6 8 5 6 7 7 4 4 7 6 60 40 67
AT 1 2 3 2 3 2 2 2 5 0 20
IMP. 2 4 4 5 2 2 4 6
% 40 67 57 71 50 50 57 100

Criteria of assessment improvement in laboratory parameter

Group No.of Pt. No.of OPD/IPD Quantity of Urine B.T. Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 Imp. A.T. %
Group A 1 8655 800 870 950 1020 1050 1070 1100 1100 1120 1120 1130 330 41.5
2 8651 1070 1150 1220 1280 1350 1470 1530 1650 1750 1820 1870 800 87
3 8653 750 800 840 910 950 950 970 1000 1000 1010 1020 270 60
4 8654 600 710 820 880 950 1040 1050 1100 1120 1140 1170 570 95
5 8773 900 970 1050 1100 1170 1230 1300 1350 1380 1400 1450 550 61.11
6 8772 1050 1100 1170 1200 1250 1270 1300 1450 1500 1540 1600 550 52.38
7 8767 650 700 770 810 860 920 980 1040 1100 1150 1180 530 81.53
8 8770 740 800 860 890 930 980 1000 1050 1100 1120 1500 410 55.4
9 8771 670 710 730 780 800 820 820 870 870 900 900 230 34.32
10 8788 1100 1200 1270 1340 1400 1520 1610 1680 1730 1800 1830 730 66.36
Group B 11 341 1100 1180 1240 1280 1330 1400 1510 1590 1650 1780 1840 660 67.27
12 361 900 1000 1130 1190 1250 1360 1430 1540 1620 1770 1870 970 107.7
13 353 1030 1080 1120 1210 1280 1320 1400 1450 1490 1500 1530 500 48.54
14 360 700 800 890 940 990 1050 1110 1140 1170 1170 1200 500 71.4
15 366 900 1000 1150 1240 1330 1420 1510 1630 1700 1750 1800 900 100
16 367 950 1000 1080 1120 1180 1230 1300 1370 1420 1460 1500 550 57.89
17 8563 820 880 970 1000 1010 1010 1050 1100 1080 1100 1100 280 34.14
18 370 650 740 790 850 940 990 1050 1100 1120 1150 1150 500 76.9
19 376 376 800 840 880 930 980 1000 1050 1100 1150 1170 430 58.1
20 8710 850 910 980 1020 1080 1190 1280 1350 1460 1570 1620 770 90.5

Results

The data obtained after the study was analysed statistically and the results were presented scientifically.

  • In group ‘A’ the percentage of relief in” Pain in vavankshana, vasti and mutrendriya “ is 62.5% and in group ‘B’also it is 62.5% only.
  • The percentage of relief in” in group A is 78% whereas in group ‘B’ is 80%
  • The percentage of decrease in yellowishness of urine and haematuria in group A is 86% ‘B’ the percentage is 86%
  • In group ‘A’ the % of relief in heaviness of mushka, mehana and vasti iis 50% and in group ‘B’ the percentage is 67%
  • In group ‘A’ the decrease in slimness and hotness of urine is 50% whereas in group ‘B’ it is 57%
  • The percentage of decrease in appearance of different colours in urine along with burning and pain in group ‘A’ is 40% which is similar to the percentage in group ‘B’
  • The percentage of relief in tama while micturition in group A is 67 % and in group B it is group 50%
  • Relief in pathologies like ashmari & sarkara in group A is 67 % and ingroup B it is 75 %
  • The overall relief in all the sympotes of the patients of group A is 62 % and in group ‘B’ it is 67 %
  • The percentage of increase in daily urine output is 63.43% in group ‘A’ while the percentage of increase in group ‘B’ is 71.40%

Conclusion

  • The laghu gokshur is clinically more efficacious then brihat gokshur UTI symptoms are mainly Pitta predominant, Gokshur with its Shita veerya cools and soothes the urinary tract membrane by pitta shaman. It reduces inflammation and pain. Gokshur with its Madhur rasa- vipaka and Snigdha guna increase Sharirastha kleda. Kleda increases urine formation. It also has Balya action on Basti (urinary bladder).
  • The diuretic action of Tribulus terrestris (Laghu) is more pronounced than pedalium murex (birhat)
  • The symptomatic relief of Tribulus terrestis (Laghu) is more efficacious than pedalium murex (birhat) in mutrakrichchra rog.
  • So laghu gokshur (Tribules terrestis) can be used effectively in the management of mutrakrichchra without any side effect.