Issue : 01 DOI : 10.5281/zenodo.8147277
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 7
Corresponding author: Dr. Vinita Tyagi
Article Info: Published on: 02 /01/2024
Abstract
The most frequent clinical symptom of spinal pathology in musculoskeletal illnesses i.e., low back pain
(Katishoola). In developing nations, lifestyle changes have harmed biological systems. The development of
spinal illnesses is largely influenced by poor sleeping positions, sports activities, rapid movement during
travel, and improper sitting postures. Being the most delicate musculoskeletal system and supporting the full
weight of a human, the spine, especially the lumbar spine, is where this condition is most frequently
observed. It is said that the kati pradesha (lumber region) is a significant Vata dosha seat. Vata is vitiated in
the swasthana of Katishoola. The signs of the disease can be seen in a variety of diseases, including
Katishoola, Trikshoola, Prishtashoola, and Vatik shoola, even though the ancient Acharyas did not name a
single illness as Katishoola. Katishoola is mentioned by all the Acharyas under Vatavyadhi. In this study, a
total of 50 clinically diagnosed patients with Katishoola were divided into two equal groups. Patients in
group A were treated with Tryodashanaga Guggulu and Vishgarbh Tail and the patients in group B were
treated with Vishtinduk Vati and Vishgarbh Tail. Seven different parameters like Ruk (pain), Stamba
(Morning stiffness), Shopha (swelling), Sparsha Asahatva (tenderness), Restricted movement, Dehasyapi
Pravakrata (scoliosis,) and S.L.R test were analyzed for 6 visits during 3 months of the treatment. In this
study, we found that Tryodashanaga Guggulu and Vishgarbh Tail are more effective in managing katishoola
than Vishtinduk Vati and vishgarbh tail.
Keywords: katishoola, Vishgarbh Tail, Vishtinduk Vati
P
ISSN No. : xxxx-xxxx
Volume : 01
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
Issue
DOI
: 02
: 1 0 . 5 2 8 1 / z e n o d o . 1 0 4 5 1 2 3 2
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Comparative study of Trayodashng Guggulu with Vishgarbh Tail and Vishtinduk
Vati with Vishgarbh Tail in the management of Katishoola.
Dr.Vinita Tyagi
1
1
Professor/HoD, Shalya Tantra Department,
Skd Government Ayurvedic College and Hospital, Muzaffarnagar, Uttar Pradesh.
Cite this article as: - Dr. Vinita Tyagi (2024) ;Comparative study of Trayodashng Guggulu with Vishgarbh Tail and Vishtinduk Vati
with Vishgarbh Tail in the management of Katishoola ; Inter.J.Dignostics and Research 1(2),7-16,
https:/doi.org/10.5281/zenodo.10451232
G
A
R
V
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 8
Introduction:
According to Ayurveda, Kati Pradesha is where the
vitiated Vata localizes, which leads to the emergence
of Katishoola as a clinical condition
[1]
. Kaphavrita
Vyana Vayu blocks the flow of Rasa, and Rakta
Dhatu during pathogenesis, limiting the emergence of
succeeding Dhatus like Mamsa, Meda, Asthi, and so
forth, leading to gradual structural or functional
changes in Kati Pradesha
[2]
. Later, signs like Shoola,
Shopha, and Stambha appear. The two primary
therapeutic techniques employed in Ayurveda are
shodhan chikitsa and shaman chikitsa
[3]
. There are
explanations for Snehana, Upanaha, Agni Karma,
Raktamokshana, and other Shodhan chikitsa
instruments. The Shaman chikitsa formulas known as
Kwath, Vati, Guggulu, Taila, Ghrita, and others are
discussed already. Currently, Katishoola (low back
pain) is a quickly expanding bush of suffering
[1]
. For
lumbar spondylosis patients wishing to improve their
quality of life, frequent conservative treatments
include analgesics, anti-inflammatory drugs, steroid
injections, and physical therapy
[4]
. The only treatment
options for severe lumbar spondylosis are surgical
procedures like spinal fusion and spinal
decompression
[5]
. However, these operations do not
satisfy patients' expectations due to their high cost
and therapeutic limitations. Patients are frequently
forced to take analgesics for a prolonged amount of
time following surgery. In Ayurveda,
pharmacological and effect-oriented treatments like
Trayodashang Guggulu with Vish garbh tel sanehan
are recommended for diseases with similar clinical
scenarios
[6]
. Vishtindukadi vati is Ayurvedic drug
mentioned in Ras tantra sara and sidha prayoga
samgraha. The main content of vishtindukadi vati is
the kuchla, along with maricha, chincha phala, and
pugaphala, indicated in opium addiction. The main
content of vishtindukadi vati is Kupilu which has
properties like vata-shamak, chitta-avasadahar
(antidepressant properties), and hridya daurbalyahar
(cardiac tonic). Comparison studies of
“Trayodashang Guggulu and Vishgarbh Tail” with
“Vishtinduk Vati and Vishgarbh Tail” will pave the
way to understanding the efficacy of both medicines
in the management of “Katishoola”.
Review of literature:
Worldwide, low back pain is a relatively prevalent
health issue and a key contributor to disability,
impacting both work performance and overall
well-being
[7]
. According to the 2010 Global
Burden of Disease Study, low back pain is one of
the top 10 illnesses and accidents that cause the
most DALYs globally
[8]
. Children and adolescents
have a lower prevalence rate than adults, but it is
increasing. Between the ages of 35 and 55,
prevalence rises and peaks. In many parts of the
world, low back pain is the most common reason
for activity restriction and work absence, placing
a significant financial burden on individuals,
families, communities, businesses, and
governments
[9]
. With more than 100 million lost
workdays annually, low back pain was shown to
be the most prevalent cause of disability in young
adults in the United Kingdom
[10]
.Low back pain
is thought to generate 149 million lost workdays
in the US annually, with associated expenses
estimated to range from $100 to $200 billion
[11]
.
The most common work-related musculoskeletal
condition affecting IT professionals in India is low
back pain
[12]
. The causes of 37% of low back pain
reported globally were determined to be work-
related risk factors
[13,
14,
15,
16,
17]
. The percentage
varied slightly by location (21% - 41%) and was
greater in places with a generally lower level of
health. The ancient science of life known as
"Ayurveda" has endured the test of time in a
magnificent way. According to numerous modern
scientific parameters, the manuscripts/scriptures
that are thought to have been authored 5000 years
ago contain medicines and treatment techniques
that are still effective today. The "Tridosha" and
"Panchamahabhoot" Siddhanta, which are eternal,
are what keeps our field of medicine alive
[18]
.One
of the Tridoshas, together with Pitta and Kapha,
Vata has a variety of diseases that can affect any
part of the body. Pain, or Shula in Sanskrit, is the
primary sign of Vata vitiation. In "Vatadrite
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 9
Rujah Nasti" The most frequent symptom for
which a person seeks medical help is this pain,
which is well-recognized as a sign of the condition
[19]
. 80 Vataja Nanatmaja Vyadhi are mentioned
by almost all of the Ayurvedic Acharyas
[20]
. A
Vataja Nanatmaja Vyadhi named Katigraha is
mentioned by Sharangadhara. He described it as
"Katisthambhana Vedana Vishesha," an illness
characterized by stiffness and pain in the Kati
pradesha (Pelvic region)
[6]
. Acharya Sodhala
defines katigraha as a situation typified by
vitiated vata, either shuddha or with Ama, taking
ashraya in the Katipradesha causing Ruja and
Graham in the area
[21]
.The Shodhala explains the
Samprapti, Lakshana of Kati Graha in the
Kayachikitsa Khanda, Vataroga Adhikara. He has
provided descriptions of numerous Kati Shoola
formulas and has especially mentioned
Trayodashanga Guggulu for Kati Graha
[22]
.
According to research, the frequency of LBP in the
Indian population ranges from 6.2% (in the general
population) to 92% (among construction workers).
Low back pain is the most common reason for
impairment in patients under the age of forty-five
and the third most common reason for disability
in people beyond the age of forty-five
[23]
. It can
have severe medical and financial effects.
Although it can be tremendously disabling, this
issue, which allegedly has a favorable natural
history, has presented a challenge to healthcare
professionals.No direct reference is made to Kati
Shoola as a distinct illness in any of the
Brihatrayees. Acharya Charaka didn't specifically
refer to the disease, but by quoting "Hetu Sthaana
Visheshat Ca Bhavet Roga Vishesha Krit," he
implied that all conditions that can result from
Vata localization in particular bodily parts were
included. There is a smattering of different
Sandhi, Snaayu, and Peshi in the Kati area. A site
called Sandhi is where two or more structures
come together. Sandhi is seen as an organ rather
than a single structure
[24]
.There are various
structures, which contribute to preserving the
stability of the joint. Ligaments, also known as
snaayu, are those structures that aid in the
appropriate binding of the joint. They connect the
bones, aid in directing action, and help to stop
unneeded and excessive motion. The tone in the
muscles aids in keeping the joint in proper
alignment. In the joints, Shleshmadharakala,
which is supported by Shleshaka Kapha, aids in
lubrication, supplies nutrients and keeps the joint
firmly fused. Therefore, the vitiation of Vata can
result in these structures' diseases in Kati
Pradesha, which will hinder their ability to
operate
[25]
.
Objectives :
Comparison between the efficacy of
“Trayodashang Guggulu and Vishgarbh Tail”
with “Vishtinduk Vati and Vishgarbh Tail” in the
management of “Katishoola “
Methods:
It was an open-label, randomized clinical trial. A
total of 50 patients (25 patients in each group)
were randomly divided into two groups by
computer-generated randomization. The study
was approved by the Institutional Ethical
Committee (IEC).
Inclusion criteria:
Patients of either gender, having age between 18
and 70 years, willing to participate in the trial, with
clinical signs and symptoms of Katishoola, having
chronicity of disease <5 years. Patients with
traumatic vertebral disorder without paralysis or
radiating pain (only local pain) History of
Lumbosacral sprain /strain/Lumbago for more
than two months. Lumbar Disc disease without
herniation of nucleus pulposus Arthritis of the
lower spine.
Exclusion criteria:
Patients having a history of recent spinal surgery
or implanted instrumentation, long-term intake of
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 10
steroid and cytotoxic treatment, comorbidities like
uncontrollable hypertension, diabetes mellitus,
etc., evidence of malignancy, participation in any
clinical trial within the last 6 months, and pregnant
or lactating women were excluded from the study.
Patients with traumatic vertebral disorders
(suffering from paralysis) Infection of the spine
especially Tuberculosis, Brucellosis and Pyogenic
osteomyelitis, etc., Neoplasm of the spine referred
to low backache from pelvic, abdomen or diseases
of the thorax.
Grouping :
Group A: Tryodashanaga Guggulu, two tablets
(500 mg. each) twice a day after lunch and dinner
with lukewarm water with abhyangam with
Vishgarbh Tail once a day in the morning for 90
days.
Group B: Vishtinduk Vati, one tablet (30 mg.
each) twice a day after lunch and dinner with
lukewarm water with abhyangam with Vishgarbh
Tail once a day in the morning for 90 days.
Trial drugs :
1. Trayodashang Guggulu
2. Vishtinduk Vati
3. Vishgarbh Tail
Criteria for assessment:
The improvement will be assessed mainly based
on relief in the clinical signs and symptoms of the
disease. To assess the effect of treatment and
therapy procedure objectively, all the signs and
symptoms were given numbers for scoring
depending upon their severity which is as below:
Assessment:
The assessment was done based on changes in
nonparametric variables.
Nonparametric variable: - All registered patients
of “Katishoola” were assessed based on certain
symptoms such as pain, stiffness, swelling,
tenderness, and Straight Leg Raise (SLR).
Observations and results :
By analysis of data, it was observed that the
maximum number of patients were between 20
and 60 years of age group. Demographic
observations related to Nidana – a maximum of
the total patients were suffering from the disease
for 1–2 years. All patients (100%) presented with
the symptom of pain and 24 patients in both
groups were presented with restricted SLR,
followed by patients suffering from stiffness.
Some were presented with tenderness and
swelling. In both groups, only two patients have
Dehasyapi Pravakrata (scoliosis).
Among 25 patients treated with Trayodasang
Guggulu with Vishgarbha Taila 18 were female
patients and 7 were male patients of which 10
were in the age group of 20-40 years, 14 were
between 40-60 years, and 1 above 60 years. 15
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 11
patients were following a vegetarian diet while 3
were Non-vegetarian diet followers. During the
first visit, 4 patients suffered from severe pain, 18
from moderate pain, and 3 from mild pain.
Morning stiffness was severe for 1 patient,
moderate for 16 patients, mild for 4 patients, and
4 were not experiencing morning stiffness. One
patient was suffering from severe swelling, 8 with
moderate swelling, 6 with mild swelling, and 10
without swelling. Sparsha Asahatva (tenderness)
was severe for 2 patients, moderate for 16
patients, mild for 6 patients, and no tenderness for
1 patient. There was no one with severe restricted
movement but 12 patients were suffering with
moderate restricted movement, 9 patients with
mild restricted movement, and 4 patients without
restricted movement. There was only one patient
with both mild and moderate scoliosis. Thirteen
patients showed severe issues during the S.L.R
test, 7 patients with moderate issues, 4 patients
with mild issues, and 1 patient without any issues.
Among 25 patients treated with Vishtinduk vati
with Vishgarbha 18 were female patients and 7
were male patients of which 17 were in the age
group of 20-40 years, 7 were between 40-60
years, and 1 was above 60 years. 16 patients were
following a vegetarian diet while 4 were Non-
vegetarian diet followers. During the first visit, 3
patients suffered from severe pain, 19 from
moderate pain, and 3 from mild pain. Morning
stiffness was severe for 1 patient, moderate for 18
patients, mild for 5 patients and 1 was not
experiencing morning stiffness. No patients were
suffering from severe swelling, 9 with moderate
swelling, 6 with mild swelling, and 10 without
swelling. Sparsha Asahatva (tenderness) was
severe for 1 patient, moderate for 18 patients,
mild for 5 patients, and no tenderness for 2
patients. There was no one with severe restricted
movement but 14 patients were suffering with
moderate restricted movement, 11 patients with
mild restricted movement, and 1 patient without
restricted movement. There was only one patient
with mild scoliosis. Nine patients showed severe
issues during the S.L.R test, 11 patients with
moderate issues, 4 patients with mild issues, and 1
patient without any issues.
Fig.1 Ruk (pain) for visits 1-6 during the
treatment using Trayodasang Guggulu
withVishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
During Ruk (pain) (Fig.1) assessment for the
treatment using Trayodasang Guggulu with
Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila, for Trayodasang Guggulu with
Vishgarbha Taila from visit 4, there is a reduction
in pain for patients compared to the patients treated
with Vishtinduk vati with Vishgarbha Taila. In visit
5, there is a drastic reduction in pain followed by a
total reduction of pain in the 6th visit for
Trayodasang Guggulu with Vishgarbha Taila
whereas in Vishtinduk vati with Vishgarbha Taila in
visits 5 and 6 there are patients with pain.
According to One-Way ANOVA, the f-ratio value
for Trayodasang Guggulu with Vishgarbha Taila is
47.50633. The p-value is < .00001. The result is
significant at p < .05 and Vishtinduk vati with
Vishgarbha Taila the f-ratio value is 23.79813. The
p-value is < .00001. The result is significant at p <
.05.
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 12
Fig.2 Stamba (Morning stiffness) for visits 1-6
during the treatment using Trayodasang Guggulu
with Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
In stamba (Morning stiffness) (Fig.2) for
Trayodasang Guggulu with Vishgarbha Taila
from visit 3, there is a reduction in morning
stiffness for patients compared to the patients
treated with Vishtinduk vati with Vishgarbha
Taila. From visit 4, there is a drastic reduction in
morning stiffness followed by a total reduction of
pain in the 6th visit for Trayodasang Guggulu
with Vishgarbha Taila whereas in Vishtinduk vati
with Vishgarbha Taila there are patients with
morning stiffness till visit 6. According to One-
Way ANOVA, the f-ratio value for Trayodasang
Guggulu with Vishgarbha Taila is 26.21691. The
p-value is < .00001. The result is significant at p <
.05 and Vishtinduk vati with Vishgarbha Taila the
f-ratio value is 30.47904. The p-value is < .00001.
The result is significant at p < .05
Fig.3 Shopha (swelling) for visit 1-6 during the
treatment using Trayodasang Guggulu with
Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
For Shopha (swelling) (Fig.3) patients treated with
Vishtinduk vati with Vishgarbha Taila show more
swelling than Trayodasang Guggulu with
Vishgarbha Taila. From visit 4, there is a
reduction in swelling for patients treated with both
medicines. From visit 5, there is a reduction in
swelling for Trayodasang Guggulu with
Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila. According to One-Way
ANOVA, the f-ratio value for
Trayodasang Guggulu with Vishgarbha Taila is
8.15299. The p-value is < .00001. The result is
significant at p < .05 and Vishtinduk vati with
Vishgarbha Taila the f-ratio value is 8.25301. The
p-value is < .00001. The result is significant at p <
.05.
Fig.4 Sparsha Asahatva (tenderness) for visits 1-6
during the treatment using Trayodasang Guggulu
with Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
Sparsha Asahatva (tenderness) (Fig.4) for the
treatment by Trayodasang Guggulu with
Vishgarbha Taila from visit 3, there is a reduction
in tenderness for patients compared to the patients
treated with Vishtinduk vati with Vishgarbha
Taila. In visits 5 and 6, the tenderness is reduced
in Trayodasang Guggulu with Vishgarbha than in
Vishtinduk vati with Vishgarbha Taila. According
to One-Way ANOVA, the f-ratio value for
Trayodasang Guggulu with Vishgarbha Taila is
31.91362. The p-value is < .00001. The result is
significant at p < .05 and Vishtinduk vati with
Vishgarbha Taila the f-ratio value is 23.47406.
The p-value is < .00001. The result is significant
at p < .05.
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 13
Fig.5 Restricted movement for visits 1-6 during the
treatment using Trayodasang Guggulu with
Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
Restricted movement (Fig.5) assessment for
Trayodasang Guggulu with Vishgarbha Taila from
visit 3, there is a reduction in restricted movement
issues for patients compared to the patients treated
with Vishtinduk vati with Vishgarbha Taila. In
visit 5 only 2 patients shows restricted movement
at a mild level for Trayodasang Guggulu with
Vishgarbha Taila whereas in Vishtinduk vati with
Vishgarbha Taila, there are 5 patients. According
to One-Way ANOVA, the f-ratio value for
Trayodasang Guggulu with Vishgarbha Taila is
21.28205. The p-value is < .00001. The result is
significant at p < .05 and Vishtinduk vati with
Vishgarbha Taila the f- ratio value is 19.19761.
The p-value is < .00001. The result is significant
at p < .05.
Fig.6 Dehasyapi Pravakrata (scoliosis) for visits
1-6 during the treatment using Trayodasang
Guggulu with Vishgarbha Taila and Vishtinduk
vati with Vishgarbha Taila
In Dehasyapi Pravakrata (scoliosis) (Fig.6) from
visit 1 itself the patients with scoliosis are very
less in both cases. From visit 2, there are no
notable changes in the scoliosis for both
medicines. According to One-Way ANOVA, the
f-ratio value for Trayodasang Guggulu with
Vishgarbha Taila is 0.41026. The p-value is
.800968. The result is not significant at p < .05 and
Vishtinduk vati with Vishgarbha Taila the f-ratio
value is 0.75. The p-value is .559894. The result is
not significant at p < .05.
Fig.7 S.L.R test for visits 1-6 during the
treatment using
Trayodasang Guggulu
with
Vishgarbha Taila and Vishtinduk vati with
Vishgarbha Taila
Straight leg raising (Fig.7) test for treatment by
Trayodasang Guggulu with Vishgarbha Taila there
were 12 patients with level 3 S.L.R issues. Only 1
patient has a level 3 problem on the second visit. In
visit 4 there is only 2 patients with S.L.R issue and
in the 6th visit, S.L.R is completely reduced. There
are 9 among 25 patients treated with Vishtinduk
vati with Vishgarbha Taila who have extreme
S.L.R issues during visit 1, for 3 among them the
issues continue in visit 2 and 1 patient suffered the
level 3 problem in visit 3 also. In visit 5 there are
patients with level 2 and level 1 SLR issues and 9
patient shows level 1 issue in visit 6. According to
One-Way ANOVA, the f-ratio value for
Trayodasang Guggulu with Vishgarbha Taila is
41.83953. The p-value is < .00001. The result is
significant at p < .05 and Vishtinduk vati with
Vishgarbha Taila the f-ratio value is 22.57732. The
p-value is < .00001. The result is significant at p <
.05
Fig.8 Group A
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 14
The t-test value for Trayodasang Guggulu with
Vishgarbha Taila except for Ruk (pain) and S.L.R
test is < .05. The rest of the results are significant at
p < .05. Except Dehasyapi pravakrata (scoliosis)
other six parameters show significant relief (95.8% -
97.81%).
Fig.9 Group B
The t-test value for Vishtinduk vati with Vishgarbha
Taila only Ruk (pain) and S.L.R test are <.05. The
result is significant at p < .05. All the parameters
show relief at the final visit than the first visit (72%
- 100%).
Fig.10 Comparison between group A and Group B
According to the comparison study, the patients in
Group A, treated with Tryodashang guggulu show
significant relief in the health conditions which are
assessed in this study. The pain relief is
94.117647% in Group A while in Group B it is
72%, the relief to stamba is 97.311% in Group A
but in Group B it is 84.69945%. Restricted
movement shows 96.81% relief in Group A in
which Group B it is 87.01299%. In S.L.R test
Group A have 96.631579% relief and the relief
percentage in Group B is 83.63636%.
Discussion :
Pain intensity, morning stiffness, swelling,
tenderness, restricted movement, and S.L.R test
during the treatment with both medicines were
compared, which showed the patients treated with
Trayodashanga Guggulu with Vishgarbha Taila is
better than Vishtindukadi vati with Vishgarbha
Tail. Many people suffer from the joint condition
katishoola. Provocation of the Vata Dosha has a
major effect on Sandhi in this illness. To sustain a
Sandhi's range of motion, the Vyana Vayu is an
essential functional component. The roles of
Shleshaka Kapha and Sleshmadhara Kala are
influenced by the annulus fibrosus and nucleus
pulposus, which serve as a cushion and promote
healthy spinal joint function. The majority of
Trayodashang Guggulu's contents are Ushna and
Vata-Kapha Doshahara in nature because 71.42
percent of the drug constituents have Tikta rasa,
57.14 percent have Katu rasa, 57.14 percent have
Laghu guna, and 42.85 percent have Ruksha
guna.71.42 percent of pharmaceuticals have Ushna
Virya, while 57.14 percent of medications contain
Vata-Kapha Hara. The Vata-Kapha hara
components of Trayodashang Guggulu, as
previously mentioned, help to alleviate
Katishoola, a condition that is brought on by the
vitiation of the Vata and Kapha doshas. Shashtra
claims that Guggulu is a Vatamedo hara and that
it is more potent at calming Vata and reducing
Katishoola when taken with Ghrita. Vishgarbh
Tail is referred to as Shoolahara and Vata
shamana in numerous places in Shahstra. Thus, it
is discovered that guggulu is more successful at
calming katishoola when used in conjunction with
Vishgarbh Tail Trayodashang.
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 15
Conclusion :
When managing Katishool, Tryodashanaga
Guggulu and Vishgarbh Tail perform better than
Vishtinduk Vati and Vishgarbh Tail. With the
addition of Vishgarbha Tail abhyangam, the
already well-known Trayodashang Guggulu,
particularly for Katishoola, has even more potent
effects due to the extra shoolhara qualities of
Vishgarbha Tail. Both Trayodashang Guggulu
and Vishgarbh Tail are mostly suggested for
Katishoola; hence, in this case, when the patient
was experiencing lower back discomfort, the
application of this medicine combination provided
effective alleviation.
Reference :
1. Ediriweera ER, Gunathilka HD, Weerasinghe
KD, Kalawana OT. Efficacy of traditional
treatment regimen on Kati Shoola with
special reference to lumbar
spondylolisthesis. Ayu. 2013 Jan;34(1):86-9.
doi 10.4103/0974-8520.115435. PMID:
24049411; PMCID: PMC3764887.
2. Moharana P, Roushan R. A critical review of
Vyana Vayu in modern Physiological
Perspective. International journal of basic
and applied research. 2018;8(11):75-82.
3. Kavya G, Sharma S. Panchakarma Chikitsa
in Stree Roga. Int J Res Rev. 2016
Aug;3(8):4-5.
4. Prasath RA, Prashanth D, Parthasarathy K,
Varghese M, Palani P, Kayarohanam S,
Janakiraman AK, Sriram N. Lumbar
Spondylosis: Clinical Presentation And
Treatment Approaches–A Systematic
Review. Journal of Pharmaceutical Negative
Results. 2022 Dec 31:10384-91.
5. Samuel AM, Moore HG, Cunningham ME.
Treatment for degenerative lumbar
spondylolisthesis: current concepts and new
evidence. Current reviews in
musculoskeletal medicine. 2017
Dec;10:521-9.
6. Gupta N, Choudhary K, Mangal G.
Katigraha (Lumbar Spondylosis) managed
by Katidhara and Basti: A Case report.
International Journal of Ayurveda and
Traditional Medicine. 2020 Jun 8;2(2):10-4.
7. Wu A, March L, Zheng X, Huang J, Wang
X, Zhao J, Blyth FM, Smith E, Buchbinder
R, Hoy D. Global low back pain prevalence
and years lived with disability from 1990 to
2017: estimates from the Global Burden of
Disease Study 2017. Annals of translational
medicine. 2020 Mar;8(6).
8. Hoy D, March L, Brooks P, Blyth F, Woolf
A, Bain C, Williams G, Smith E, Vos T,
Barendregt J, Murray C. The global burdenof
low back pain: estimates from the Global
Burden of Disease 2010 study. Annals of the
rheumatic diseases. 2014 Jun 1;73(6):96874.
9. Ganesan S, Acharya AS, Chauhan R,
Acharya S. Prevalence and risk factors for
low back pain in 1,355 young adults: a
cross-sectional study. Asian spine journal.
2017 Aug;11(4):610.
10. Awosan KJ, Yikawe SS, Oche OM, Oboirien
M. Prevalence, perception and correlates of
low back pain among healthcare workers in
tertiary health institutions in Sokoto,
Nigeria. Ghana medical journal.
2017;51(4):164-74.
11. Freburger JK, Holmes GM, Agans RP,
Jackman AM, Darter JD, Wallace AS,
Castel LD, Kalsbeek WD, Carey TS. The
rising prevalence of chronic low back pain.
Archives of internal medicine. 2009 Feb
9;169(3):251-8.
12. Hameed PS. Prevalence of work-related low
back pain among the information technology
professionals in India a cross-sectional
study. Int J Sci Technol Res. 2013
Jul;2(7):80-5.
Issue : 02
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Volume : 01
Copyright @ : - Dr. Vinita Tyagi Inter. J.Digno. and Research IJDRMSID0008
Page 16
13. Chowdhury MO, Huda N, Alam MM,
Hossain SI, Hossain S, Islam S, Khatun MR.
Work-related risk factors and the prevalence
of low back pain among low-income
industrial workers in Bangladesh: results
from a cross-sectional study. Bulletin of
Faculty of Physical Therapy. 2023 Jun
7;28(1):20.
14. Momeni Z, Choobineh A, Razeghi M,
Ghaem H, Azadian F, Daneshmandi H.
WorkRelated musculoskeletal symptoms
among agricultural workers: a cross-sectional
study in Iran. Journal of agromedicine. 2020
Jul 2;25(3):339-48.
15. Sintayehu DW, Giziew A, Awrajaw D,
Dawit G. Work-related risk factors and the
prevalence of low back pain among low
wage workers: results from a cross-sectional
study. BMC Public Health. 2019;19(1072).
16. Wami SD, Abere G, Dessie A, Getachew D.
Work-related risk factors and the prevalence
of low back pain among low wage workers:
results from a cross-sectional study. BMC
Public Health. 2019 Dec;19(1):1-9.
17. Kim JY, Shin JS, Lim MS, Choi HG, Kim
SK, Kang HT, Koh SB, Oh SS. Relationship
between simultaneous exposure to
ergonomic risk factors and work-related
lower back pain: a cross-sectional study
based on the fourth Korean working
conditions survey. Annals of Occupational
and Environmental Medicine. 2018
Dec;30:1-9.
18. Upadhyay D, Dinesh DK. A critical review of
fundamental principles of Ayurveda.
19. Prasad S, Rao R, Ranjan R. Marma therapy
in Katigraha WSR low back pain. Journal of
Medical Science and Clinical Research, 5
(6). 2017:23070-4.
20. Madlur A, Joshi JR. Vata-The Niyanta and
Praneta of Manas. Journal of Ayurveda and
Integrated Medical Sciences. 2023 May
25;8(4):74-7.
21. Kumar T, Sanapeti RV, Prasad BS.
Evaluation of the effect of poultice (Upanaha
Sweda) in low back pain (Katigraha): A
randomized comparative clinical trial. Ayu.
2019 Jul;40(3):159.
22. Gupta S, Patil V, Sharma R. Diagnosis and
management of Katishoola (low back pain)
in Ayurveda: A critical review. Ayushdhara.
2016;3:764-9.
23. Gupta S, Dey YN, Kannojia P, Halder AK,
Sharma D, Wanjari MM, Chougule S, Pawar
S, Kaushik A, Gaidhani SN, Gurav S.
Analgesic and Anti-inflammatory Activities
of Trayodashang Guggulu, an Ayurvedic
Formulation. Phytomedicine Plus. 2022 Aug
1;2(3):100281.
24. Bhattacharya S. Sushruta—the very first
anatomist of the world. Indian Journal of
Surgery. 2022 Oct;84(5):901-4.
25. Jayasiri AP. Ayurveda Concepts of Joint
Diseases. Rheumatoid Arthritis. 2022 Jan
19:187.
xxxx-xxxx
DOI : 10.5281/zenodo.10451232
Dr.Vinita Tyagi Inter. J.Digno. and Research
This work is licensed under Creative
Commons Attribution 4.0 License
Submission Link : http://www.ijdrindia.com
Benefits of Publishing with us
Fast peer review process
Global archiving of the articles
Unrestricted open online access
Author retains copyright
Unique DOI for all articles
https://ijdrindia.com
