Poly Cystic Ovarian Disease and its management through Ayurvedic medicine “Kankayan vati”
Shared By Dr. Vivek Mahalwar, BAMS, MS, PhD. (Ayurved), ACLS, BLS
Existence of the human race revolves around the women to whom is also assigned the name “Janani” because of her power to bring a new life in the universe. Women are the makers of the home, the nation and world. It is indeed the woman who shapes the generation. Therefore she deserves utmost care, respect along with good health. The state of a women health is indeed completely tied up with a culture in which she lives, her position in it, as well as the way she lives her life as an individual during her span of existence, she undergoes different changes in her psyche and body. In spite of this she performs all her duties in all circumstances to stand up with the needs of society. Key word –kankayan vati , Puspaghni Jataharini, bahuputtakiya dimbajya vyadhi.
Woman’s prevalent hectic life style triggers a chronic sate of anxiety or excessive autonomous reaction which can be given a common terminology stress. Stress interfere one’s mind and homeostasis of body by several psychosomatic mechanism, responsible for many psychological are physiological disturbance which results into many disorders. All of this altered co-ordination between the nervous system, hormonal system and cardiovascular system has pushed the present day women into a precarious state of sufferings like PCOD. In old Indian classical text like Charak Samhita Shushruta Smhita there is no such direct reference of PCOD but Puspaghni Jataharini is one among those Jataharinis having sign and symptoms similar to the clinical features of PCOD, though a syndrome cannot be correlated to a particular disease. At present infrequent menstruation is treated by hormonal therapy. This therapy may lead to obesity. Herbal medicine can be of great benefit in PCOD without the negative side effect of conventional drugs. Hyperinsulinemia may play a pathogenetic part in hyperandrogenism in women with the polycystic ovary syndrome by increasing ovarian androgen production and decreasing the serum sex hormone–binding globulin concentration. Serum free testosterone concentrations decline in women with the polycystic ovary syndrome when their insulin secretion is reduced by the administration of diazoxide10 or metformin11 or by diet.
When sleshmaja prakruti stree consumes kapha prakopak ahara then it vitiates the doshas mainly kapha which causes the meda vriddhi leading to abnormality in ritu chakra. Without physical exercise and diet therapy the treatment of PCOD is incomplete. Nidan parivarjan i.e. treating obesity will correct PCOD. Sushrut samhita mentioned agneyadravyas having properties like deepana, pachana, chedana, lekhana, medohara pacifies Kapha & Vata dosha can be used to treat PCOD. Obese woman suffers mental stress due to obesity & if she suffers from PCOD it leads to infertility. Therefore correction of menstrual disorder is important.
For maintaining their health, longevity and fertility a clinical study was planned to evaluate the “Bahuputtakiya Dimbajya Vyadhi (poly cystic ovarian disease) with kankayan vati(Gulma rogadhikar. Review of the disease has been presented with the integrated approach. Clinical study was carried out adapting well established parameters, methodology, and observation. Data were analyzed, discussed properly to reach up to the conclusion. Aims and objectives of the study were to establish relation between PCOD & pushpaghani Jataharini with evaluate the efficacy of kankayan vati.
A 26 year old female patient name Smt Kashish kachawani female r/o Matipara presented with complain of delayed, scanty, painful menstruation with primary infertility on date 11/10/2013. Detail investigations were carried out for exclusive criteria and patient follow up consecutive 3 cycles done. Patient’s first sonography report showed that patient having thick endometrium with right cystic ovary of 41×35 mm
CRITERIA FOR SELECTION OF PATIENTS
Patient was selected on the basis of the symptoms that one taken as inclusion criteria:
- Obese patient with menstrual problems.
- Obese patient with Infertility.
- Female patients’ age group from 20-35 years.
- All obese patients with BMI 25 & above.
- Patients previously diagnosed as PCOD.
CRITERIA FOR DIAGNOSIS
- A special proofread was designed to register the cases mentioning the identification, chief complaints and associated complaints.
- The condition with all the symptoms was assessed before and after treatment.
- Physical examination and pelvic examination including per speculum and per vaginal and bimanual examination among married women were done before and after treatment.
- Routine hematological and USG were done before and after completion of the treatment of 3 months.
The selected patient fulfilling the criteria of selection was given Kankayan Vati (Trial drug) (Gulma Rogadhikar)
|Dose :||2 vati b.i.d|
|Duration :||3 Months|
|Anupan :||Warm Water|
|Follow up :||After 1st month, 2 nd month and 3 rd month.|
Assessment was done after every month of treatment and complaint, sign, symptom noted on the follow up chart accordingly. Second sonography report showed that thick endometrium with left sided partially cystic ovary size 37×23 mm.
Plan for Data Analysis:
The statistical analysis of this study was planned to carry frequencies, percentage, means and standard deviation for different parameters. The data are presented in tables and graphs in the result section. The statistical significance of the difference between the means of various study of parameters were derived using paired‘t’ test.
CRITERIA FOR ASSESSMENT OF THE RESULT
The criterion for assessment of treatment is based on improvement in cardinal symptoms like size of ovary, no. of cyst, menstrual irregularities, infertility, and obesity.
Chala, Sphiga, Udara & Sthana (Pendulous buttock, abdomen), Ati kshuda, .Ati pipassa, Atinidra, Kashtartava and Guruta these symptoms were taken as common for overall result. According to the severity and intensity of the cardinal symptom, these were graded on the basis of scoring system.
In Ayurvedic Classics, there is no direct reference about PCOD but in Kashyapa Samhita Revati Kalpa Chapter, he explained about Puspaghni Jataharini. This jataharini causes trouble to women. It is present with triad of typical features that includes destruction of puspa (Ovulation) with regular menstruation, appearance of facial hair and obesity.
The Nidanas of jataharini indicates the physiological and behavioral conduct of women leading to abnormalities in the body. These Nidanas like ati bhojana, ati pana, ati nidra, pathya bhojana tyagini, thyakta manglacharana, himsa priya etc. leads to puspghni jataharini.
In third sonography which was last there was no cystic disorder in both ovaries, the endometrium was normal. Patient Max. Improvement (75 – 99%) After three cycles, all the signs and symptoms were maximum improved.
Polycystic ovarian syndrome is a condition involving disorder of ovary associated with deranged metabolism and multiple hormonal involvements. Based on their action on granthi, Kankayan Vati have stigamsterol and isoflavones constituents they were found to be effective in normalizing and regularizing the ovarian morphology and menstrual irregularities. The various menstrual irregularities explained in classics. Puspaghni jataharini can closely correlate with PCOS.
The present clinical study shows effectiveness of Kankayan Vati upon PCOD. The probable action of drug may fully establish with a large sample size also.