Rajimunnisa

Begam Shaik et al / Int. J. Res. Ayurveda Pharm. 9 (3), 2018

Research Article
www.ijrap.net

A CLINICAL STUDY ON EFFICACY OF SAMEER PANNADHI YOGA IN THE MANAGEMENT OF

SANDHIGATA VATA (OSTEOARTHRITIS)
Rajimunnisa Begam Shaik 1*, Sunil Kumar 2, P.Srikanth Babu 3
1
Assistant professor, Dept. of Kayachikitsa, S.J.G Ayurvedic Medical College, P.G. Studies & Research Centre,
Koppal, Karnataka, India
2
PG Scholar, P.G. Department of Kayachikitsa, Dr. B.R.K.R. Govt. Ayurvedic Medical College, Hyderabad,
Telangana, India
3
Professor & H.O.D. PG Department of Kayachikitsa, Dr. B.R.K.R. Govt. Ayurvedic Medical College, Hyderabad,
Telangana, India

Received on: 09/03/18 Accepted on: 24/04/18

*Corresponding author
E-mail: dr.razia.sk@gmail.com

DOI: 10.7897/2277-4343.09389

ABSTRACT

In Ayurveda Sandhigata vata gets its entity in the chapter of vatavyadhi which obviously are co-related with osteoarthritis affecting mainly in the weight
bearing joint. Which limits every activity such as walking, dressing, bathing etc. thus making patient disabled/handicapped. It being a vatavyadhi,
located in Marmasthisandhi and its occurrence in old age makes it kashtasadhya. Vata dosha plays main role in the disease. Shula pradhana vedana is
the cardinal feature of the disease. Osteoarthritis is wear and tear condition of the joints which causes bones to rub together, causing pain, swelling and
loss of function of the joint. OA is the most common form of arthritis among the older people. Osteoarthritis is predominant in females as compared to
the males. In radiographic survey it was observed that 2% of females who are less than 45 years old, 30% of 45 to 65 years are and 68% in older than
65 years are affected by this disease. It is a single case study. The aim of present study was to find out efficacy of Sameer pannadhi yoga in the
management of sandhigata vata. A female patient was suffering from pain, stiffness tenderness and swelling etc. of both knee joints since 1 yr, patient
was treated with oral administration of Sameer- pannadhi yoga (Sameer pannag ras. Abraka bhasma, Pravala bhasma, Rasasinddor, yogaraja guggulu,
pippali churna as a bioavailability agent) for 6 months, this sameera pannadhi yoga shown maximum results, patient got 75% relief from her symptoms.

Keywords: Sandhigata vata, vatavyadhi, osteoarthritis, Sameer pannadhi yoga.

INTRODUCTION are the clinical features of sandhigata vata3. Sthansamshraya of

vitiated vata dosha at janu sandhi (knee joint) results in the
In vriddhavastha, all Dhatus undergo Kshaya, thus leading development of a disease termed as janu sandhigata vata.
to vataprakopa and making individual prone to many diseases. This condition is closely simulating with knee osteoarthritis. The
Among them Sandhigata vata stands top in the list. The incidence line of treatment for sandhivata is mainly focused on the
of osteoarthritis in India is as high as 12%. It is estimated that alleviation of vata dosha. Acharya charaka explains that vitiated
approximately four out of 100 people are affected by it. vata dosha can be best treated with the use of oil4. Use of snehana
Osteoarthritis is the most common articular disorder begins with swedana over the affected part is also advised in the
asymptomatically in the 2nd & 3rd decades and is extremely treatment of vatavyadhi which alleviates pain, stiffness and
common by age 70. Almost all persons by age 40 have some improves flexibility 5
pathologic change in weight bearing joint1, 25% females & 16%
males have symptomatic osteoarthritis. AIMS & OBJECTIVES
Allopathic treatment has its own limitation in managing this
disease. It can provide either conservative or surgical treatment To observe the effect of Sameer pannadhi yoga (Sameer pannag
and is highly symptomatic and with troublesome side effects. ras. Abraka bhasma, Pravala bhasma, Rasasinddor, yogaraja
Whereas such type of conditions can be better treatable by the guggulu, pippali churna as a bioavailability agent) internally
management and procedures mentioned in Ayurvedic classic.2 in Sandhigata Vata.
Internal administration of Sameer pannadhi yoga (Sameer pannag
ras. Abraka bhasma, Pravala bhasma, Rasasinddor, yogaraja MATERIALS & METHODS
guggulu, pippali churna as a bioavailability agent) for 6 months,
given good results in Sandhigata Vata with their vatashamaka and Table 1: Used medications and their dose
rasayana property.
S.NO Medication Dose
SANDHIGATA VATA 1. Sameer pannag ras. 60 Tab
2. Abraka bhasma 10 gms
3. Pravala bhasma, 10 gms
Sandhigata vata is as one of the eighty types of vata vyadhi
4. Rasasinddor, 10 gms
described in various ayurvedic treatises. Foremost description of 5. Yogaraja guggulu, 60 tab
sandhigata vata is given in charaka samhita. Vatapurnadritisparsa 6 Pippali churna 30 gms
(coarse crepitation), shotha (swelling) and Prasaranakkunchana
pravriti savedana (pain during flexion and extension of the joint)

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PROCEDURE lethargy, generalized weakness she previously took medications

from modern hospital for the same problem. Her radiographic
Take all ingredients in kalva and make into fie powder and mix findings of left knee joint include osteophyte formation, joint
well and divide it into 60 equal part. Advised her to take 1 part of space narrowing and degenerative changes. She was diagnosed
medicine morning1 part of medicine evening on empty stomach with osteoarthritis of left knee joint. She is advised to take pain
with honey. Up to 3 months, review once in 10 days. relieving and anti-inflammatory medicine regularly for some
initial time period, followed by sos. she is also a known case of
Ethical clearance: This study was carried out with patient hypertension since 2.5 years and taking Ayurvedic medicine i.e.
consent. Study is carried out as per international conference of Tab. Abana (Himalaya Herbal Health care) twice daily under
Harmonization – good clinical practices guidelines (ICH-GCP) or respective medical supervision. There is no other significant
as per declaration of Helsinki guidelines. history of personal and family systemic illness. On examination
of left knee joint, joint crepitation is palpable as well as audible
CASE PRESENTATION on joint movement associated with pain. Skin over the knee joint
is hot and slightly inflamed. There is a visible swelling over the
A 50-year-old female patient came to our SJGAMC KC OPD on joint which is confirmed by positive patellar tap test. Joint was
24/12/16 with Reg. no.11023 complaining of pain in left knee tender over its medial side. After clinical examination and
joint on movement, joint pain at rest, restricted movement of assessment, patient is advised to take Sameer pannadhi yoga with
joints, crunching in the joints, swelling, stiffness, she cannot able honey.
to climb the upstairs, tenderness etc. Associated complaints are

Table 2: Subjective and objective parameters of the study

S.NO Subjective parameters for this study Objective parameters for this study
1. Vatapurnadritisparsa (joint crepitation) X-Ray— AP &Lateral views
2. Shotha (joint swelling)
3. Sandhi shoola (joint pain)
4. Prasaranakkunchanapravriti savedana (pain during flexion and extension of joint)

Table 3: Assessment parameters

1. Vatapurnadritisparsa (joint crepitation)

2. Shotha (joint swelling)
3. Sandhi shoola (joint pain)
4. Prasaranakkunchanapravriti savedana (pain during flexion and extension of joint)

GRADING OF PARAMETER

Table 4: Grading of Vatapurnadritisparsa (joint crepitation) Table 5: Grading of Sandhi Shotha (joint swelling)

Grade 0 No crepitus Grade 0 No swelling

Grade 1 Palpable crepitus Grade 1 Mild swelling
Grade 2 Audible crepitus Grade 2 Moderate swelling
Grade 3 Always audible crepitus Grade 3 Severe swelling

Table 6: Grading of Sandhi Shoola (joint pain) Table 7: Grading of Prasaranakkunchanaana pravriti savedana
(pain during flexion and extension of joint)
Grade 0 No pain
Grade 1 Mild pain Grade 0 No pain
Grade 2 Moderate pain Grade 1 Pain without winching of face
Grade 3 Severe pain Grade 2 Pain with winching of face
Grade 3 Prevent complete flexion

Table 8: Results of the present study

S.NO Subjective Parameters Before Treatment After Treatment

1. Vatapurnadritisparsa (Joint Crepitation) 3 1
2. Shotha (swelling) 3 0
3. Sandhi shola (Joint pain) 3 1
4. Prasaranakkunchana pravriti savedana (Pain during flexion and extension of joint) 3 1

DISCUSSION having opposite gunas like sneha (oily), ushna (hot), guru (heavy)
and sthira (stable) are act as a vata shamaka 7.
Excessive intake of unctuous food items, excessive walking or
physical activity, direct injury, suppression of natural urges is In the development of vata vyadhi, it is mentioned that aggravated
some of the common factors that aggravate vata dosha6. As vata vata occupies the empty space of the body channels/body parts.
gets vitiated, its guna (properties) like ruksha (dry), shita (cold), Acharya chakrapani elaborates that this empty space is nothing
laghu (light), chala (movement) also increased from their normal but the site of body where guna like sneha etc. are absent or
levels in different combinations. Use of herbs and formulations deprived8. In Sandhigata vata, ruksha (dry) and shita (cold) guna
are mainly aggravated which leads to dhatu kshya (joint

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 Rajimunnisa Begam Shaik et al / Int. J. Res. Ayurveda Pharm. 9 (3), 2018

degeneration), so drugs chosen for this are having vata hara and 3. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
rasayana property. Sameer pannag ras is katu rasa, ushna Chakrapani Commentary, Chikitsasthan, Chapter 28,
guna,usna virya, katu vipaka and kapha vatagna9 so it acts against Vatavyadhi chikitsa, Verse no. 37, Varanasi, Chaukhambha
the shoola(pain) and sotha(oedema). Abraka bhasma having Surbharti Prakashan, p. 618, Reprint 2011.
rasayana property act against the dathu kshaya. Pravala bhasma 4. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
acts as a vata kapha shamaka. Rasasindoor fight against the Chakrapani Commentary, Chikitsasthan, Chapter 28,
degenerative changes with help of parada and gandhaka. Vatavyadhi chikitsa, Verse no.181, Varanasi, Chaukhambha
Yogaraja guggulu is having anti-inflammatory and anti- arthritic Surbharti Prakashan, p. 624, Reprint 2011.
property (Ref: Bhaishajyaratnavali), pippali churna as a 5. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
bioavailability agent. Chakrapani Commentary, Chikitsasthan, Chapter 28,
Vatavyadhi chikitsa, Verse no.79-80, Varanasi,
CONCLUSION Chaukhambha Surbharti Prakashan, p. 620, Reprint 2011.
6. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
Sandhigata vata (osteoarthritis) progresses with age and makes Chakrapani Commentary, Chikitsasthan, Chapter 28,
the person crippled and dependant. It clouds the possibilities of Vatavyadhi chikitsa, Verse no.15-17, Varanasi,
doing the easiest of daily activities and makes the person Chaukhambha Surbharti Prakashan, p. 617, Reprint 2011.
physically and mentally disturbed. But it doesn’t come without 7. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
the warning signs. Ayurveda has best remedies and treatments to Chakrapani Commentary, Chikitsasthan, Chapter 1,
offer towards effective management of sandhigata vata. From this Deerghanjeeveteeya adhyaya, Verse no.59, Varanasi,
case study concludes that the Sameer pannadhi yoga is very Chaukhambha Surbharti Prakashan, p. 16, Reprint 2011.
effective in the management of sahdhigata vata(osteoarthritis). 8. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
This study will be helpful for further collaborative research with Chakrapani Commentary, Chikitsasthan, Chapter 28,
modern medicine in the cases of end stage osteoarthritis. Vatavyadhi chikitsa, Verse no.18, Varanasi, Chaukhambha
Surbharti Prakashan, p. 617, Reprint 2011
REFERENCES 9. Trikamji Yadavji Acharya, Agniveshakrita Charaka Samhita,
Chakrapani Commentary, Chikitsasthan, Chapter 17/147
1. Harrison's Principles of Internal Medicine, Chapter no. 321. Verse no.18, Varanasi, Chaukhambha Surbharti Prakashan, p.
Chapter name ; Osteoarthritis, 15th Edition , year of 539 Reprint 2011
publication;1987. Authors; Braunward, Fauci, Kasper etc
page no.348-358 Cite this article as:
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215322/A
yu.2010Jan-Mar;31(1):53-57Author name; Babul Akhtar, Rajimunnisa Begam Shaik et al. A clinical study on efficacy of
M.D(Ayu), Title; Clinical study on Sandigatavata w.s.r. to sameer pannadhi yoga in the management of sandhigata vata
Osteoarthritis and its management by panchatikta gritha (osteoarthritis). Int. J. Res. Ayurveda Pharm. 2018;9(3):186-188
guggulu. http://dx.doi.org/10.7897/2277-4343.09389

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