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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 126-134

Clinical efficacy of Narayan Churna in alcohol addiction: a single-blinded randomized clinical trial


P.G. Department of Agad Tantra, National Institute of Ayurveda, Jaipur, Rajasthan, India

Date of Submission10-Dec-2020
Date of Decision12-Oct-2020
Date of Acceptance17-May-2021
Date of Web Publication28-Jun-2021

Correspondence Address:
Dr. Sandeep Charak
P.G. Department of Agad Tantra, National Institute of Ayurveda, Amer Road, Jaipur 302002, Rajasthan.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jism.jism_115_20

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  Abstract 

Background: Alcohol, alcoholism, and alcohol withdrawal have been mentioned in Ayurveda under the heading of Madya (alcohol), Madatya (alcoholism), and Panapkaram (alcohol withdrawal), respectively. Alcohol abuse is widespread in most parts of the world, and alcohol addiction is one of the major problems in society. According to the WHO, 38.3% of the population in the world consumes alcohol. An individual older than 15 years of age consumed 6.2 liters of alcohol annually. In fact, there are dozens of risk factors that play a role in the development of alcohol addiction. Aim: To assess the clinical efficacy of Narayan Churna, Tagaradi Kwath Ghan Vati, and Bhumyamalaki Ghan Vati in alcohol addiction and withdrawal symptoms. Materials and Methods: The clinical studies were conducted by the single-blinded random control method; this method compared the clinical efficacy of Narayan Churna with Ashtang Lavan Churna. Supportive drugs such as Tagaradi Kwath Ghan vati and Bhumyamalaki Ghanvati have been given in both groups to manage the hepatotoxicity and they control the withdrawal effects such as insomnia anxiety and agitation, respectively. The clinical manifestations of alcohol withdrawal were assessed by the Clinical Institute Withdrawal Assessment-Alcohol revised (CIWA-Ar) scale before and after treatment. Clinical manifestation of alcohol withdrawals observed in between 5 and 10h of stoppage of alcohol was considered as a baseline for before treatment; clinical manifestation of withdrawals was considered after the completion of one month for after treatment. Result: In both the study and control groups, 13.3% of the patients showed excellent relief. In both the control and study groups, 26.6 % and 13.3% of patients showed moderate relief, respectively. Conclusion: Overall, 36.66% of patients were found to be de-addicted during the entire clinical trial, which is a big achievement for Ayurveda science.

Keywords: Alcohol, Ashtang lavan, Madatya (alcoholism), Narayan Churna


How to cite this article:
Charak S, Sharma M, Porte S. Clinical efficacy of Narayan Churna in alcohol addiction: a single-blinded randomized clinical trial. J Indian Sys Medicine 2021;9:126-34

How to cite this URL:
Charak S, Sharma M, Porte S. Clinical efficacy of Narayan Churna in alcohol addiction: a single-blinded randomized clinical trial. J Indian Sys Medicine [serial online] 2021 [cited 2021 Jul 26];9:126-34. Available from: https://www.joinsysmed.com/text.asp?2021/9/2/126/319460




  Introduction Top


Madya (Alcohol) is the oldest preparation that is mentioned in all the main texts of Ayurveda, including Brihartiya and Laghutrayi. Though alcohol addiction, its chronic toxicity, withdrawal, and its management have been found in Ayurveda, the opinion and principles of its diagnosis and management have been scattered and vary from text to text. As per Ayurveda, alcohol is nectar,[1] if it is taken in a proper manner and in the recommended dose suggested by Ayurveda; however, it shows toxic effects if it is taken in excess doses and produces Madatyaya (alcoholism) or Panatyaya (chronic alcoholism) and Panapkarm (alcohol withdrawal syndrome).[2] Prolonged and excessive intake of alcohol leads to physical dependence[3] and mental dependence.[4] A global study has found that alcohol consumption in India has risen by 55% during a period of 20 years. Between 1992 and 2012, among a list of 40 nations, India secured the third position for alcohol intake. Taking into consideration alcohol, we have to choose a drug that has an anti-craving effect, can subside the withdrawal effect of alcohol, and can correct the deleterious effects of the chronic use of alcohol. The study drug selected for this clinical trial is Narayan Churna, stated by Achyara Charak in Udar Rog (Abdominal Disease) Chikista sthan Adhaya 13 for the elimination of Mool Visha (plant poison), Gar Visha (concocted poison), and Kritram visha (artificial poison).[5] As the Guna (properties) of alcohol and poison are the same, this drug is selected for the clinical trial. The Ashtang Lavan Churna was found to be significant in alcoholism in a previous clinical study, hence it is included in the clinical study as a control drug in madatya.[6]Tagaradi kwath ghan vati reduces clinical symptoms such as anxiety, insomnia, and agitation; it relaxes the mental status of patients. Bhumiamalaki Ghanvati exerts hepatoprotective effects. Our aim is to study the clinical efficacy of Narayan Churna, Tagaradi Kwath Ghan Vati, and Bhumiamalaki Ghan Vati in alcohol addiction, withdrawal and to compare the clinical efficacy of Narayan Churna with Ashtang Lavan Churna.


  Materials and Methods Top


  • A. Trial drug preparation was done in the Hitaayu Pharmacy, and the control drug along with other supportive therapeutic drugs had been prepared in the NIA Pharmacy.


  • B. Study drug: Narayan Churna: All the ingredients of Narayan Churna were taken and crushed into powdered form to prepare Churna.Control drug: Ashtang Lavan Churan was prepared by crushing all its ingredients into powdered form.


  • C. Supportive drugs: Bhumyamlaki Ghanvati: Bhumyamlki (Phyllanthus niruri) Panchang (whole plant) was taken for the preparation of Ghansatva (extract). Then, Vati (tablet) of 500 mg was prepared by the extract of Bhumyamalki Panchanga. Tagaradi Kwath Ghan Vati: All the 12 ingredients of Tagaradi Kwath were taken for the preparation of the extract. Then, a tablet of 500 mg was prepared by the extract of Tagaradi Kwath.


  • D. Research case sheet: A research case sheet was prepared in detail along with all clinical information that was necessary for a clinical trial.


  • E. Selection of patients: Thirty patients were desirous to withdraw from alcohol; they were selected from the National Institute of Ayurveda (OPD), Jaipur and were admitted after a proper physical examination. The selected 30 patients were randomly divided into two groups:
    1. Study group A:Narayan Churna, Tagaradi Kwath Ghan Vati, and Bhumyamlaki Ghanvati were given to 15 patients of alcohol addiction and withdrawal.


    2. Control group B:Ashtang Lavan, Tagaradi Kwath Ghanvati, and Bhumiamalaki Ghanvati were given to 15 patients of alcohol addiction and withdrawal.


  • F. Inclusion Criteria:
    1. Alcohol addiction diagnosed patients.


    2. Alcohol withdrawal patients, including vomiting, nausea, tremors, anxiety, agitation etc. that had presented at that time.


    3. Aged between 20 and 60 years.


  • G. Exclusion Criteria:
    1. Alcohol addicted patients suffering from liver failure, gastrointestinal bleeding, Mallory-Weiss tears, Wernicke Korsakoff’s syndrome (WKS), and cerebellar degeneration.


    2. Alcohol addicted patients suffering from major systemic illness such as diabetes, hypertension, myocardial infarction, ischemic heart disease, pulmonary tuberculosis etc.


  • H. Drugs and their administration:
    1. Study drug:Narayan Churna 5g twice a day with lukewarm water after meals for one month


    2. Control drug:Ashtang lavan churan 5g twice a day with lukewarm water after meals for one month


    3. Supportive drugs:Bhumiamlaki Ghanvati and Tagaradi Kwath Ghan Vati 500 mg twice a day with lukewarm water after meals for one month


  • I. Counseling: The psychological counseling was done in both groups. Simple but regular counseling at the individual, spouse, and family level was done for all patients of both the groups. Patients were made aware about the hazards of alcoholism. The nature of the disorder was explained, and reassurance was given. The patient was helped to deal with emotional problems.


  • J. Diet: Normal light diet was suggested to all the patients of both the groups.


  • K. Withdrawal criteria: Patients who had developed seizure, severe agitation, severe anxiety, and delirium tremens (DTs) after admission.



  Observation Top


Clinical trial registration number is CTRI/2018/01/011858; in this study, 37 patients were registered. The result was obtained during this study and the signs and symptoms of the registered patients were assessed statistically. Observations made during the course of study are presented as follows:

[Table 1]: In Group A, totally 16 patients were registered, out of whom one patient quit treatment due to unavoidable circumstances; hence, this patient withdrew from the trial. In Group B, totally 21 patients were registered for the trial; however, six patients quit their treatment and withdrew from the trial. In both groups, a total of 15 patients completed the trial.
Table 1: Group-wise distribution of patients

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[Table 2]: The age profile of the registered patients shows that the maximum number of patients, that is 43.3% (13 patients) were in the 31–40 year age group, followed by 26.6% (eight patients) in the 41–50 year age group, 16.6% (five patients) in the 21–30 year age group, and only 13.3% (four patients) in the 51–60 year age group. Patient older than 60 years and younger than 20 years were not registered in the trial.
Table 2: Age-wise distribution

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[Table 3]: In this study, 40% (12 patients) were laborers, 23.3% (seven patients) were businessmen, 16.6% (five patients) were doing their studies, and 16.6% and 3.3% patients were holding government jobs and private jobs, respectively.
Table 3: Occupation-wise distribution

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[Table 4]: In this trial, a maximum of 33.3% of patients had been consuming alcohol for the past 16–20 years whereas 30% of patients had been consuming alcohol for the past 6–10 years and 11–15 years. Only 3.33% of patients were found to have been consuming alcohol for the past five years. The percentage of patients who had been consuming alcohol for more than 20 years is also 3.33%.
Table 4: Duration of drinking-wise distribution

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[Table 5]: This study shows that maximum people (36.6%) consumed liquor in a mixed manner: 33.3% of people consumed whisky, 23.3% of people had country liquor, and only 3.3% people had rum and whisky.
Table 5: Variety of alcohol-wise distribution

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[Table 6]: This study shows that maximum people (73.3%) consumed liquor daily, 10% of people had alcohol on alternate days and twice in a week, and only 6.6% people consumed alcohol four times in a week.
Table 6: Frequency of alcohol-wise distribution

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[Table 7]: This study shows that the maximum patients (40%) consume three to five units of alcohol and six to eight units of alcohol daily whereas 13.3% of patients consume eight to 10 units and 6.6% patients consume 11 and above units of alcohol in a day.
Table 7: Distribution of quantity of alcohol consumed in one day

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[Table 8]: Out of the total patients, 36.6% were having Madhyam Koshtha, 40% were having Kroor koshtha, and only 23.3% were having Mridu Koshtha.
Table 8: Koshtha-wise distribution

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[Table 9]: Overall, 43.3% of patients belonged to Vatapittaj Prakriti, 36.66% of patients belonged to Vatakaphaj Prakriti, and only 20% of patients belonged to Pittakaphaja Prakriti. No patient belonging to Vataja, Pittaja, Kaphaja, and Sannipataj Prakriti were found in the trial.
Table 9: Sharirik Prakriti (physical constitution) wise distribution

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[Table 10]: In this trial, 0% patients belonged to Satvik Prakrati, 33.33% to Rajasik, and 66.66% to Tamsik Prakrati.
Table 10: Mansik Prakriti (mental constitution) wise distribution

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  Result Top


The results of therapy have been evaluated in two steps with the help of statistical methods. The first step involves evaluating within the group before and after treatment in both groups separately. The second step involves the intergroup evaluation or between-group evaluation of both therapies.

Intragroup Study

Effect on subjective parameters within group

For evaluating the effect of therapy within a group before treatment and after treatment for the subjective parameters, Wilcoxon matched-pairs signed-ranks test was used.

[Table 11]: Finally, in total CIWA-Ar score, the percentage of relief was 45.35% and the effect of the therapy was very significant at P = 0.0039.
Table 11: Effect of therapy on CIWA-Ar score group A

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[Table 12]: Finally, in total CIWA-Ar score, the percentage of relief was 34.83% and the effect of the therapy was significant at P = 0.0156.
Table 12: Effect of therapy on CIWA-Ar score group B

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Intergroup comparison of objective parameters

The objective parameters of both groups A and B were evaluated by the unpaired T-test.

[Table 13] and [Table 14]: In group A (study group), 13.3% of patients showed excellent relief, 13.33 of patients showed marked relief, 33.33% of patients showed mild relief and 0% patients showed no relief. In group B (control group), 13.3% of patients showed excellent relief, 40% of patients showed marked relief; 20% of patients showed mild relief and 26% patients showed no relief.
Table 13: Intergroup comparison of objective parameters

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Table 14: Distribution of patients according to relief in alcohol withdrawal symptom s

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  Discussion Top


Alcoholism is a disease condition that is characterized by long-term and improper consumption of alcohol. Indiscriminate and repeated use of alcohol produces a gradual physical and moral deterioration of the individual and also leads to crime or perversion.[7] Alcohol, especially ethyl alcohol, is an inebriant cerebral poison, because in acute poisoning it affects mostly the brain.[8] When a person consumes ethyl alcohol in excess, regardless of the variety, be it beer, wine, brandy, jinn, rum, vodka, or whisky, it causes acute toxicity, which is also called acute alcoholism.[9] People found solutions to all their problems by various addictions and one of these common addictions is alcohol. Many types of alcohol have been described in Ayurveda. Acharya have described 10 properties of alcohol, such as Ruksh (dry), Laghu (light), Suksham (subtleness), Vishad (non-sliminess), Ashuga (swiftness), Amala (sourness) etc.[10]; however, Sushruta has mentioned only eight properties of alcohol and it has not mentioned the light and sour properties. Most of the properties of alcohol are similar to those of poison, but they are directly opposite to the Ojus (strength).[11] Hence, the alcohol produces toxicity along with Ojus Vikriti (abnormality in strength) in the human body, if taken in an unscheduled manner.[12] In modern science, alcohol, acute alcoholism, chronic alcoholism, and alcohol addiction and withdrawal have been described in detail along with their clinical management. Alcohol withdrawal symptoms, which means that clinical manifestation appears due to a sudden stop of alcohol, can be directly correlated with alcohol withdrawal syndrome. Clinical manifestation of alcohol withdrawal symptom is not mentioned in Ayurveda texts whereas in modern medical science the clinical manifestation is described in detail along with its valid assessment during the clinical management of patients experiencing alcohol withdrawal. Though the clinical manifestation of alcohol withdrawal symptoms and addiction has not been mentioned directly in Ayurveda, Acharya Charak stated that when the person had overall control of their senses, psychosomatic disease is not produced in those people after sudden stoppage of alcohol. It means that a person who does not have any control over their own senses may produce psychosomatic disease after the sudden stoppage of alcohol. Today, the maximum people belonging to the second category are not able to control their senses; hence, there is a need for the clinical management of such people.

The clinical studies were conducted by a control randomized single-blinded method; these studies compare the clinical efficacy of Narayan Churna with Ashtang Lavan Churna, in which the study drug is Narayan Churna and the control is Ashtang Lavan churna. The supportive drugs such as Tagaradikwath ghan vati and Bhumiamalaki Ghanvati were administered in both the groups to manage the hepatotoxicity and to control the withdrawal effects such as insomnia anxiety and agitation, respectively. Most of the patients who were addicted to alcohol who were registered for clinical trial were from the de-addiction unit, NIA Hospital, Jaipur. The PG department of Agadtantra also organized various de-addiction and awareness camps in various rural areas in Jaipur, and some patients were registered in these camps. This study was conducted in two groups: The first is the study group, and the second is the control group. In the study group, Narayan Churna was given to 15 patients of alcohol addiction with withdrawals; however, in the control group, Ashtang Lavan Churna was given to 15 patients of alcohol addiction with withdrawals. Tagaradi kwath ghan vati, Bhumiamalaki Ghanvati, psychological counseling, and normal diet were given in both groups. Patients who were diagnosed as having alcohol addiction along with clinical manifestation of alcohol withdrawals were assessed by using various methods, such as the Alcohol Use Disorders Identification Test (AUDIT); alcohol withdrawals were assessed by using the Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) protocol scale before and after treatment. Some subjective clinical manifestations that are not included in CIWA-Ar but are presented constantly in most of the patients, such as insomnia icterus, hepatomegaly, pain in the abdomen, and constipation, have also been assessed clinically before and after treatment. Hemoglobin and LFT, including Serum Bilirubin (T), Serum Bilurubin (D), SGOT, SGPT, and serum protein, have been assessed pathologically before and after treatment.

Discussion on Result

The clinical manifestations of alcohol withdrawal were assessing by using CIWA-Ar scale before and after treatment. Clinical manifestation of alcohol withdrawals observed in between 5 and 10h of stoppage of alcohol was considered as a baseline for before treatment, and clinical manifestation of withdrawals was considered after completion of one month for after treatment.

CIWA-Ar criteria scale of study group

To measure the clinical effects on CIWA-Ar, Wilcoxon matched-pairs signed-ranks test was used in both study and control groups. The clinical effect of the study group on CIWA-Ar has shown mixed results. In case of nausea, vomiting, and tremors, the study group shows extremely significant results; in case of anxiety and headache, the study group shows very significant results. In case of tactile disturbance, only significant results are seen; in clinical manifestation such as agitation, paroxysmal sweat, auditory disturbance, and visual disturbance, no significant result is observed. None of the patients of this group were found to belong to orientation disturbance, which is one of the symptoms of CIWA-Ar. Thus, the overall effects of the study group on CIWA-Ar were very significant, having P =0.0039.

CIWA-Ar of control group

  • The clinical effect of the control group on CIWA-Ar also showed mixed results. In the case of anxiety, tactile disturbance, and headache, the control group shows very significant results; in case of nausea, vomiting, and tremors, the control group shows only significant results; and in clinical manifestation such as agitation, paroxysmal sweat, auditory disturbance, and visual disturbance, no significant result is seen. None of the patients of this group were found to belong to orientation disturbance, which is one of the symptoms of CIWA-Ar. Thus, the overall effects of the control group on CIWA-Ar were only significant, having P =0.0156.


  • Effect of therapy on other subjective parameters of the study group: The effect of other subjective parameters that was not mentioned in CIWA-Ar was also found to be significant. In case of anorexia, icterus, and pain in the abdomen, the clinical effect of the study group was found to be extremely significant; however, in the case of insomnia and constipation, the clinical effect of the study group was found to be very significant. In case of hepatomegaly, only the clinical effect of the study group was found to produce significant results. Thus, overall, the study group exhibits very good clinical effects from subjective parameters.


  • Effect of therapy on other subjective parameters of the control group: In case of anorexia, the clinical effect of the study group was found to be extremely significant; however, in the case of insomnia Icterus, pain in the abdomen, and constipation, the clinical effect of the study group was found to be very significant. In case of hepatomegaly, only the clinical effect of the study group was found to produce significant results. Thus, overall, the control group also shows very good clinical effects from subjective parameters.


  • Effect of therapy on objective parameters: For evaluating the effect of therapy within groups before treatment and after treatment for the objective parameters, Paired t test is used separately in both study and control groups.


  • Effect on study group: The clinical effect of the study group on pathological investigations was not found satisfactory, which was assumed. Only SGOT and SGPT were found to be very significant, whereas Serum Total Bilirubin, Serum Direct Bilirubin, Serum Total Protein, and Hemoglobin did not produce significant results.


  • Effect on control group: In case of the control group, only Serum Total Bilirubin was found to be very significant; however, Serum Direct Bilirubin, SGOT, SGPT, and Serum Total Protein were found to be significant. Hemoglobin does not show significant results. Though the pathological investigation in the study as well as control groups was not found to be significant as per our assumption, the maximum patients were found to have improved clinically. This is due to the chances of human or mechanical or chemical error before or during the measurement of pathological investigations.


  • Intergroup effect of therapy on subjective parameters: The intergroup comparisons of clinical effects between study group and control group on CIWA-Ar score were assessed by using Mann-Whitney test for a statistical analysis. The statistical difference was not significant, as both groups showed no variable difference except in terms of nausea and vomiting. In case of nausea and vomiting, the effect of the study group showed significant difference compared with the control group. It means that the study group drugs and control group drugs have similar effects on CIWA-Ar. The other subjective parameters, such as anorexia, insomnia etc., have also shown no statistically significant difference between the study group and control group.


  • Intergroup effect of therapy on objective parameters: The intergroup comparison of objective parameters of the study group and control group was evaluated by using the unpaired T test. Similar to subjective parameters, there is also no statistically significant difference in the clinical efficacy of both the study group and the control group, except SGPT. It means that in the case of SGPT, the study group shows somewhat significant results than the control group.


  • Discussion on Percentage Relief in Patients

    1. Clinical institute withdrawal assessment—alcohol revised (CIWA-Ar) Score: In both study and control groups, 13.33% of patients showed excellent relief; 40% and 13.3% of patients showed marked relief in the study group and control group, respectively; 26.6% of patients in the control group and 13.33% of patients in the study group showed moderate relief; 26.6% of patients in the control group showed no relief; and there has been no patient in the study group who has shown no relief. In total, 13.33% of patients showed excellent relief; 26.6% of patients showed marked relief; 20% had moderate relief; 26.66% had mild relief; and 13.33% had no relief during the entire clinical trial in both study and control groups.


    2. Severity in alcohol withdrawal symptoms: No one patient belonging to severe withdrawals (having CIWA-Ar score more than 20) was found during the entire clinical trial on alcohol addiction in both study and control groups. Mild to moderate withdrawal scores of CIWA-Ar were found in 12 patients before treatment, which results in three patients after the compilation of clinical trials in the study group. Minimal withdrawals of CIWA-Ar were increased from three to 12 in the study group. Mild to moderate withdrawal scores of CIWA-Ar were found in nine patients before treatment, which results in four patients after the compilation of the clinical trial in the study group. Minimal withdrawals of CIWA-Ar were increased from six to 11 in the study group. Totally mild to moderate withdrawal scores of CIWA-Ar were found in 21 patients before treatment, which results in seven patients after the compilation of clinical trials in both study and control groups. Minimal withdrawals of CIWA-Ar were increased from nine to 23 in both groups.


    3. Result of clinical trial on alcohol addiction: Only 33.33% of patients were found to be de-addicted, whereas 66.66% of patients were found to be not totally de-addicted in the study group. In the control group, only 40% of patients were found to be de-addicted whereas 60% of patients were found to be not totally de-addicted. Totally, only 36.66% of patients were found to be de-addicted whereas 63.33% of patients were found to be not totally de-addicted during the entire clinical trial in both study and control groups. Though the percentage of de-addicted patients was slightly less than our assumption, yet it was a good effort on behalf of the team to de-addict the patients during the clinical trial of one month.


    Probable mode of action of drug

    Narayan churna contains Yavani (Carum copticum Benth and Hook.), Hapush (Adiantum lunulatum Burm.), Dhanya (Coriandrum sativum Linn.), Triphala (combination of Terminalia chebula Retz., Terminalia bellarica roxb., Emblica officinalis Gaertn.), Upkunchika (Nigella sativa Linn.), Karvi, Pippalimula (root of Piper longum Linn.), Ajgandha, Shati (Hedychium spicatum Ham. Ex Smith), Vacha (Acorus calamus Linn.) etc. All these drugs had mostly Tikta, Katu, Rasa, as well as Laghu Ruksha Guna, which acted on vitiated Tridosh. The remaining drugs are used to treat the root cause of the disease, for example Aampachan Karma, Deepan Karma, Vatanulomaka, Mrudu Rechaka, Lekhana, Shulahara and Srotoshodhana. etc. Anupan (adjuvants) is also depicted for particular diseases.

    Astang Lavan churna contains Swarchal lavan, Jiraka (Cuminum cyminum), Amalvatas (Garcinia pedunculata), Vrikshamal Garcinia indica etc. It cleanses of srotas (body channels) and helps to relieve alcoholism. Since Madatyaya is a Kahapradhana Vyadhi with Agnidusti, it can be used as a medication that is effective in treating both Agni and Kapha Dosha, and is thus the best option for Madatyaya treatment. Astanga Lavana is one of those who primarily performs the roles of Deepana, Pachaka, and Kaphahara. The Lavan Kalpana method is used to make it from Sarjaakshaara and Saamudra Lavan. It is Rocaka, Deepana, Pachaka, Vaatahara, Udgarashuddhikara, and Anahahara.[13]

    Bhumyamlaki ghan Vati has Pitta Kaphahara and Dahanashak properties. It is also used in the treatment of liver disorders and fever, inflammation, jaundice, and skin disorders.

    Tagaradi Kwath Ghan Vati contains Tagar, Ashwagandha, Parpat, Shankpuspi, Brami Haritki etc. The herbs present in these Yogas have Madhura, Tikta and Kashaya Rasa, Singdha and Laghu Guna, Madhura and Katu Vipaka. Almost all ingredients are Kapha Vatashamaka and they exhibit Karma (Pharmacological Actions), such as Shothahara, Vedanasthapana, Mastishkashamaka, Deepana, Anulomana, Krimighna, Raktashodhaka, Shwasahara, Vajikarana, Mootrala, Brinhana etc. Medhya, Rasayana, and Balya actions helps in management of the Manas Vikar.

    Previous study done on Madatyaya (alcohol addiction): Clinical studies on Ashwagandhadyarishta have shown that it has a positive effect on anxiety neurosis and its symptoms such as nervousness, palpitation, tremors, headache, anorexia, exhaustion, irritability, and loss of focus, among others. All of the symptoms mentioned earlier are also seen in alcohol withdrawal.[14] Due to its contents, such as Draksa, Swetchandana, Jatamansi, Tagara, Usheera, and others, Shrikhandasava acts as Hetu vyadhi Vipreetarthkari Upsaya and also as a Samyak Pan drug for Madya. It aids in the restoration of Oja’s qualities and as the cure of Madatyaya.[15]


      Conclusion Top


    In this clinical trial, the clinical manifestation of alcohol withdrawal was well managed without any adverse action or complication. Statistically significant results are observed in both groups. There was no statistically significant difference in the clinical manifestation of alcohol withdrawal and addiction in both groups; however, before and after treatment, most of the clinical manifestation was controlled/ cured in both groups. Though there was no quite statistically significant difference found in the study group compared with the control group, yet the score of craving decreased in the study group than the control group. Overall, 36.66% of patients were found to be de-addicted during the entire clinical trial.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.



     
      References Top

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        Tables

      [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13], [Table 14]



     

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