osteoarthritis & an ayurvedic approach

CLINICAL EVALUATION OF DASHMOOLA PANCHTIKTA BALA
KSHEERA BASTI AND

JANU BASTI IN THE MANAGEMENT

OF SANDHIGATA VATA VIS-À-VIS OSTEOARTHRITS

Dr. Pravin Kumar Rai
Lecturer
J.D.Ay. College & Hospital, Bhankari, Aligarh

Dr. K.K. Sharma
Reader & HOD
Rishikul Govt. Ay. P.G. College & Hospital, Haridwar

SANDHIGATA VATA is briefly described in Ayuurvedic Samhitas. In Charaka Samhita, it has
described for the first time in the name “SANDHIGATA ANILA” and defined it as “Vatapurna driti sparsha”
(on palpation it feels like air filled bag), “Sopha” (swelling), “Prasaranakunchanyoh pravrittischa

savedana”(painful on flexion and extension movement).

(Ch. Chi. 28/37)

Acharya Susruta in nidanasthana (Su. Ni. 1/28 ) has described it as

“ SANDHIGATA VATA “ and

defined it as sandhihanti (destruction of joints), sandhisoola (painful joints ), sandhisopha (swollen joints).
Acharya Vagbhatta has described it as “ SANDHIGATA KUPITA VATA”.
(As. Hr. Ni. 16)

Clinically, it is represented as—
(A) Pain in joints during movements,
(B) Stiffness in joints especially after prolong rest and at the onset of movement,
(C) Tenderness in joints,
(D) Crepitus fine/coarse,
(E) Restricted joint movements.
Radiologically, Osteoarthritis is characterized by narrowing of joint spaces, osteophytic changes and

deformities in contour of joints.

Besides much works on this has been done but a successful treatment is yet to be discovered in allied

systems of medicine. The present work entitled “Clinical evaluation of DASHMOOLA PANCHATIKTA
BALA KSHEERA BASTI and JANU BASTI in the management of Sandhigata vata vis-a-vis Osteoarthritis”
is an attempt in this direction.
We have desined this research work to evaluate the efficacy of Basti (purificatoy measures) and Janu
basti (palliative measures) .In this research work, 59 patients were randomly selected and the whole work has
been categorized into three groups viz. A, B and C. In group A -20 patients were administered Dashmoola
Panchatikta Bala Ksheera Basti. In group B-17 patients for Janu Basti and in group C-22 patients for both
Dashmoola Panchatikta Bala ksheera Basti and Janu Basti were selected for trial period of three months.
The entire work has been presented in thesis under following heads--•Review of Ayurvedic literature.
•Review of modern literature.
•Drug review.
•Clinical study.

•Discussion.
•Summary and conclusion.
•References , Bibliography and Appendix.

DRUGS

USED

IN

DASHMOOLA

KSHEERA BASTI
 Dashmoola
 Panchatikta
 Bala
 Ksheera (Milk)
 Makshik (Honey)
 Lavana (Saindhava salt)
 Sneha (Mahanarayana oil)
 Kalka (Shatapuspa Powder)
DRUGS USED IN JANU BASTI
 Mahanarayana Oil

PANCHATIKTA

BALA

 CRITERIA

FOR

SELECTION

OF

WITH THEIR CONSTITUENTS

THERAPIES

ALONG

:

If we consider samprapti of Sandhigata Vata , it is clearly
mentioned that vitiated Vata is chiefly responsible for the disease. If we will go
through our Ayurvedic classics, we will find that Basti therapy is superior to
the other Panchakarma ther apies for vitiated Vata along with SnehanaSwedana.
Since ,the disease is Asthyaasrita and Asthi is the site of Vata.
Acharya Dalhana (on the commentary of Susruta Kalpa 4/40) has mentioned
that Purisadhara Kala (fifth Kala) is same ASTHIDHARA KALA. So, Basti
therapy is mor e valuable than the others.
Dashmoola is said to be a good combination of Vata shamaka
drugs. Tikta rasa dr ugs are Vayu and Akash mahabhuta dominant , so they
have tenden cy to reach at those places who are Vata and Akash mahabhuta
dominant like ASTHI and ASTHIVAHA SROTASA. Acharya Charaka
Sutrasthana

28/

27

has

mentioned

that

“Bastayah

in

ksheerasarpeesih

tiktakopahitani cha” . On this basis , I have selected Dashmoola Panchatikta
Bala Ksheera Basti.
Janu Basti is applied locally and

good combined ther apy

including both Snehana and Swedana in it. It is well known that SnehanaSwedana is the basic Shamana (Palliative measur es) therapy for localized Vata.
So, I have selected this therapy in my trial.

•SELECTION OF THE PATIENTS 
A series of 59 patients suffering from Sandhigata Vata vis-à-vis Osteoarthritis were
randomly selected from O.P.D. and I.P.D. of Panchkarma P.G. Department ,Rishikul Govt. Ayurvedic P.G.
College & Hospital, Hardwar, Uttarakhand, for the purpose of clinical trials of present study. The patients
were randomly selected regardless their age, sex, socio-economic status, marital status etc. but they were
fully gratifying the criteria of diagnosis of Osteoarthritis in modern medicine as well as clinical features of
Sandhigata Vata as in Ayurvedic literatures. Out of 59 patients, only 48 patients could complete their full
follow-up i.e. 3 months. 11 patients had left against their medical advice.
CRITERIA FOR INCLUSION
•Patients aged between 35 – 70 years.
•According to Ayurveda classic, to follow the literary symptomatology viz. Vatapurnadritisparsha sopha (air
filled bag like swelling), Prasaranaakunchanyoh Pravrittischa Savedana (painful flexion and extension
movements), Shoola (pain), Stambh (joint stiffness), Sankocha (muscular spasm) etc. .
•To follow the diagnostic criteria of Osteoarthritis.
•Cases of primary Osteoarthritis only.
•Patients without any anatomical deformity.
•Patients with involvement of knee joints.
CRITERIA FOR EXCLUSION
•Patients aged below 35 years and above 70 years.
•Patients without knee joint involvement.
•Patients with secondary Osteoarthritis.
•Patients having past traumatic history.
•History of systemic diseases viz. Diabetes mellitus, liver diseases, renal diseases, cardiac diseases and
endocrinal diseases etc. .
•Patients having past history of RA, Gout, Psoriasis etc. .

•DIAGNOSTIC CRITERIA OF OSTEOARTHRITIS
OF KNEE-American Rheumatism Association (ARA) has developed criteria for diagnosis of

idiopathic Osteoarthritis of Knee asCLINICAL
CRITERIA
Knee pain +
atleast 3 of 6
Age > 50 years
Stiffness < 30
minutes
Crepitus
Bony tenderness
Bony enlargement
No
palpable
warmth

CLINICAL
&
LABORATORY
Knee pain +
atleast 5 of 9
Age > 50 years
Stiffness < 30
minutes
Crepitus
Bony tenderness
Bony enlargement
No
palpable
warmth
ESR < 40 mm/Hr
RF < 1:40
Synovial fluid OAclear/ viscous/ WBCs
<2000/ mm3

CLINICAL & Xray
Knee pain +
atleast 1 of 3
Age > 50 years
Stiffness < 30
minutes
Crepitus
+
Osteophytes

Osteoarthritis of hip
•Hip pain
•At least two of the following:
•ESR (WG) < 20 mm/hr
•Radiographic femoral/acetabular osteophytes
•Radiographic joint space narrowing
Osteoarthritis of hands
•Hand pain aching and stiffness
•Three/four of the following:
•Hand tissue enlargement of 2 or more of 10 selected joints
•Hard tissue enlargement of two or more distal interphalangeal joints
•Less than 3 swollen metacarpophalangeal joints
•Deformity of at least one of the 10 selected cases

Osteoarthritis of spines :
•Pain
•Stiffness < 30 minutes
•Radiographic osteophytes
•Selected ten joints
- 2nd and 3rd distal IP joints
- 2nd and 3rd PIP joints
- 1st CMC joints

 BASAL STUDY :
The selected patients were interviewed along with their family
members and relatives to obtain detailed information about the patients as
well as the disease and collected in different data for the study as follows –
1. Demographic profile
2. Clinical profile
Then all the patients were subjected to thorough physical examination,
certain laboratory tests (TLC, DLC, ESR, Hb%, blood sugar, serium uric acid,
serum calcium and phosphate, Rheumatoid factor, CRP etc.) and radiological
investigations (plain X- ray).

 METHOD OF STUDY :
GROUPING :
Present study has been divided into three groups based on
the type of therapy to which patients were subjected 
GROUPS

TYPE OF THERAPY

GROUP A DASHMOOL PANCHTIK BAL K
A
TA
A SHEERA BASTI
GROUP B J
ANU BASTI
GROUP C DASHMOOL PANCHTIK BAL K
A
TA
A SHEERA BASTI + J
ANU BASTI

DETAILS OF THE GROUPS
DETAILS
GR
OUP
S

NO.

OF

NO.

P
AT NT
IE
S

T
HE A Y GIVE
R P
N

P
AT NT
IE
S

R GIST R
E
E D

OF

T
HE A Y
R P
DUR T
A IONS

COMP E E
L T D
F
OL OW- UP
L
S

A

20

16

DA
SHMOOL
A

10 Days for 3

PA
NCHTIK
TA B L
A A

months

K
SHE R B STI
E A A
B

17

13

JA
NU B STI
A

10 Days for 3
months

C

22

19

DA
SHMOOL
A

10 Days for 3

PA
NCHTIK
TA B L
A A

months

K
SHE R
E A

B
ASTI

JA
NU B STI
A

+

•Contents of Basti
A. Asthapana Basti:
Makshikam (Honey)

= 100ml

Lavanam

= 15gm

(Saindhava)

Sneham (mahanarayana tail)
Kalkam (soya powder)

= 175ml
= 60gm

Kwatham (with ksheera) of the following:
* Dashmoola
* Panchtikta
* Bala moola

* Ksheera

= 250ml

The contents of kwatham total 50 gm/day were taken and boiled with 800 ml. of
water and 200 ml. of milk until ¼ th (250ml) of the decoction is left.
Total amount of Basti material prepared was kept around 600ml.

B. Anuvasana Basti:

Mahanarayana tail
Saindhava lavana

= 60 ml
= 2.5 gm

(i) Procedure of Basti followed :
The Basti consisted of both anuvasana (predominantly oil based)
and asthapana of Nirooha (predominantly decoction based) measures. The
ratio of anuvasana and asthapana has been provided as per classical
referenced of KALA – BASTI .
Abhyanga (massage) and swedana (sudation) were carried out in
all the patients for Basti therapy as a preparatory procedure. Following the
above procedures, patients was advised to lie down in a left lateral position
with his left leg kept straight, whereas, right knee kept in a semi flexed
position and Basti was given. After that, patients were advised strictly to
avoid taking asta – mahadoshkara bhavas.

 GENERAL OBSERVATIONS
The observations are displayed in the tables and followed by
necessary comment. Detailed discussion has been mentioned in next chapter.
TABL : 1 AGE & SEX WISE DISTRIBUTION OF THE PATIENTS 
E
AGE GROUPS GROUP – A

GROUP- B GROUP- C TOTAL

(IN YEARS)

M

F

M

F

M

F

40 - 50

02

04

03

03

02

05

19

32.2

51 - 60

04

06

01

06

03

05

25

42.3

61- 70

01

03

01

03

05

02

15

25.4

(%)

Out of 59 patients , 22 were males and 37 were females. Incidence of
disease is found notably higher in females than in males. During the study
maximum no. of patients were belonging to age group between 51- 60 years of
age ( 42.3 %), then to group between 40- 50 ( 32.2 %) & 61- 70 years of age
( 25.4 %).

AGE & SEX WISE DISTRIBUTION
45
40
35
30
25
40 -50

20

51 -60
61-70

15
10
5
0
M

F
GROUP – A

M

F
GROUP-B

M

F
GROUP-C

(%)
TOTAL

TABLE : 2 OCCUPATION WISE DISTRIBUTION OF THE PATIENTS 
Out of 59 patients, majority of patients were House – wives (45.76 %) and Labour &
Farmer (22.03 %), followed by Service & Businessmen (20.3 %).
OCCUPATION GROUP-A

Ex-serviceman

GROUP- B

GROUP –C

TOTA
L

(%)

01

02

04

08

13.5

Service
business

&

04

03

05

12

20.3

Labour
Farming

&

05

04

04

13

22.03

10

08

09

27

45.76

House-wives

OCCPATION WISE DISTRIBUTION
50
45
40
35
30
Ex-serviceman

25

Service & business

20

Labour & Farming

15

House-wives

10
5
0
(%)
GROUP-A

GROUP- B

GROUP –C

TOTAL

TABLE : 3 RELIGION WISE DISTRIBUTION OF THE PATIENTS



Out of 59 patients, 46 (77.97 %) were hindu and only 13 (22.03 %) were muslim.
RELIGIO
N
Hindu
Muslim

GROUP-A
14
06

GROUPB
13
04

GROUPC
19
03

TOTAL

%

46
13

77.97
22.03

RELIGION WISE DISTRIBUTION
80
70
60
50
Hindu

40

Muslim
30
20
10
0
GROUP-A GROUP-B GROUP-C

TOTAL

%

TABLE :4 SOCIO–ECONOMIC STATUS OF THE PATIENTS 
This diseases is more prevalent in Lower middle class (49.15 %) followed by Lower class
(27.12 %). Though this pattern of socio-economic status can not be realistically generalized,
but it appears to be typical pattern of patients of this region.
INCO
ME
GROU
P

GROU
P-A

GROU
P-B

GROU
P-C

TOTA
L

%

Higher

01

01

02

04

6.78

Higher
middle

03

03

04

10

16.95

SOCIO-ECONOMIC STATUS
OF PATIENTS
35
30
25

Lower
middle

10

09

10

29

49.15

GROUP-A

20

GROUP-B

15

GROUP-C

10

Lower

06

04

06

16

27.12

5

TOTAL
6.78%

16.95%

49.15%

27.12%

0
Higher

Higher
middle

Lower
middle

Lower

%

TABLE : 5 DISTRIBUTION OF AREA OF PATIENTS 

AREA

GROUP-A GROUP- B GROUP-C TOTAL

%

URBAN

13

11

15

39

RURAL

07

06

07

20

AREA WISE
DISTRIBUTION

66.2
33.8

URBAN

RURAL
66.2

During this study, it has been found that this diseases is more
prevalent in Urban population (66.2 %) than the Rural (33.8 %). This may be
due to their food habits, life style and general practiced.

39
13

7

11

15
6

33.8
20

7

TABLE : 6 FAMILY HISTORY OF THE DISEASE 

FAMILY HISTORY

NO. OF PATIENTS

PERCENTAGES (%)

Present

11

18.64 %

Absent

48

81.36 %

FAMILY HISTORY WISE
DISTRIBUTION
Present

In present study, family history was present only in 11 patients

Absent

48

(18.64 %). It reveals some specific genetic interactions in etiopathogenesis of
diseases.
11
18.64% 81.36%
NO. OF PATIENTS

PERCENTAGES (%)

T
ABL
E : 7 DUR
AT
ION OF IL NE
L
SS 

CHR
ONICIT
Y

GR
OUP A
-

GR
OUP B
-

GR
OUP C
-

T
OT
AL

%

(IN Y AR
E
S)
< 1

Y AR
E
S

04

02

03

09

15.25

1- 3

Y AR
E
S

05

03

03

11

18.64

3– 5

Y AR
E
S

07

08

09

24

40.68

>5

Y AR
E
S

04

04

07

15

25.43

In pr esent study, maximum cases h ave dur ation of pr esent illness in
gr oup of 3- 5 year s (4 0.68 %), followed by the gr oup of > 5 year s (25.4 3 %)

CHRONICITY WISE DISTRIBUTION
45
40
35
(IN YEARS)

30
25

<1

YEARS

20

1-3

YEARS

15

3– 5

YEARS

10

>5

YEARS

5
0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABLE : 8 DRUG HISTORY



Out of 59 patients, 39 patients had taken irregular dose of drugs whereas 20 patients had regular doses only.
DRUG
HISTORY
REGULAR
IRREGUL
AR

GROUP-A

08
12

GROUP-B

GROUP-C

07
10

05
17

TOTAL

20
39

%

33.8
66.2

DRUG HISTORY WISE DISTRIBUTION
70
60
50
GROUP-A

40

GROUP-B
GROUP-C

30

TOTAL
%

20
10
0
REGULAR

IRREGULAR

TABLE :9 NATURE OF DIET



In present study, it is found that most of the patients were vegetarian (61.01 %) and their diet nature of diet
was irregular (62.71 %). Rest of the patients had mixed and regular nature of diet
NATURE
DIET

OF GROUP-A

GROUP-B

GROUP-C

TOTAL

%

VEGETARIAN

13

12

11

36

61.01

MIXED

07

05

11

23

38.98

REGULAR

08

06

08

22

37.29

IRREGULAR

12

11

14

37

62.71

DIET WISE DISTRIBUTION
70
60
50
VEGETARIAN

40

MIXED
30

REGULAR
IRREGULAR

20
10
0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABLE : 10 BOWEL PATTERN 
Out of 59 patients, 67.8 % patients had irregular bowel pattern. 40.7 % patients were sufferer of constipation
BOWEL
PATTERN
REGULAR
IRREGULAR
CONSTIPATIO
N

GROUP-A

GROUP-B

GROUP-C

TOTAL

07
13
05

06
11
07

06
16
12

19
40
24

32.2
67.8
40.7

BOWEL PATTERN WISE DISTRIBUTION
70
60
50
REGULAR

40

IRREGULAR

30

CONSTIPATION

20
10

0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

%

TABLE : 11 % DISTRIBUTION OF ADDICTION



During study, it was found that only 37.3 % of cases had tobacco addiction and 27.1 % cases had alcohol
addiction. 57.6 % cases had no addiction
ADDICTIO
N
TOBACCO

GROUP-A GROUP-B GROUP-C TOTAL

%

08

05

09

22

37.3

ALCOHOL

09

03

04

16

27.1

NOT
PRESENT

11

13

10

34

57.6

ADDICTION WISE DISTRIBUTION
60

50

40
TOBACCO
30

ALCOHOL
NOT PRESENT

20

10

0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABLE : 12 % DISTRIBUTION OF PRAKRITI



Assessment of deha prakriti was done in all 59 patients. Majority of cases were belonging to the vata-kaphaja
prakriti (28.8 %) ,kaphaja prakriti (20.3 %) and vataja prakriti (18.6 %). Thus, these three prakritis are most
vulnerable to the disease.

PRAKRIT
I
VATAJA
PITTAJA
KAPHAJA
VATAPITTAJA
PITTAKAPHAJA
VATAKAPHAJA
TRIDOSAJ
A

GROUP-A GROUP-B GROUP-C

TOTAL

%

04
02
05
01

03
03
04
02

04
03
03
01

11
08
12
04

18.6
13.6
20.3
06.8

02

01

01

04

06.8

05

04

08

17

28.8

01

00

02

03

05.1

30
VATAJA
25
PITTAJA
KAPHAJA

20

VATA-PITTAJA
15

PITTA-KAPHAJA
VATA-KAPHAJA

10
TRIDOSAJA
5

0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABLE : 13 % DISTRIBUTION OF SAARA



Table reveals that most of the patints were belonging to the madhyama saara (74.6 %) followed by avara saara (16.9 %
SAARA

GROUP-A

GROUP-B

GROUP-C

PRAVARA
MADHYAM
A
AVARA

02
14

02
13

01
17

TOTA %
L
05
08.5
44
74.6

04

02

04

10

16.9

SAARA WISE DISTRIBUTION
80
70
60
50

PRAVARA
MADHYAMA

40

AVARA
30
20
10
0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABLE : 14 % DISTRIBUTION OF SAMHANANA 
Out of 59 patients, most of the patients had madhyama samhanana (69.5 %) followed by avara samhanana (18.6 %).
SAMHANAN
A
PRAVARA
MADHYAMA
AVARA

GROUP-A

GROUP-B

GROUP-C

01
14
05

02
12
03

TOTA
L
07
41
11

04
15
03

SAMHANANA WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA

69.5

41

14
1

12
5

GROUP-A

2

18.6

15
3

GROUP-B

4

3

GROUP-C

7

TOTAL

11

11.9

%

%
11.9
69.5
18.6

TABLE : 15 % DISTRIBUTION OF SATMYA



Table reveals maximum cases of madhyama satmya (71.2 %) followed by avra satmya (16.9 %).
SATMYA

GROUP-A

GROUP-B

GROUP-C

PRAVARA
MADHYAM
A
AVARA

02
14

02
12

03
16

TOTA %
L
07
11.9
42
71.2

04

03

03

10

16.9

SATMYA WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA

71.2

42

14
2

4

GROUP-A

2

16.9

16

12
3

GROUP-B

3

3

GROUP-C

7

TOTAL

10

11.9

%

TABLE : 16 % DISTRIBUTION OF SATVA



Out of 59 patients , 41 patients had madhyama satva (69.5 %) ,whereas, 18.6 % and 11.9 % patients had
pravara and avara satva respectively
SATVA

GROUP-A

GROUP-B

GROUP-C

PRAVARA
MADHYAM
A
AVARA

04
13

03
12

04
16

TOTA %
L
11
18.6
41
69.5

03

02

02

07

11.9

SATVA WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA
69.5

41

4

18.6

16

13

12
3

GROUP-A

3

11.9

11
2

GROUP-B

4

7
2

GROUP-C

TOTAL

%

TABL : 17 % DISTRIBUTION OF AHARA- SHAKTI 
E

AHARA- SHAKTI GROUP- A GROUP- B GROUP- C TOTAL %
PRAVARA

05

03

03

11

18.6

MADHYAMA

10

12

16

38

64.4

AVARA

05

02

03

10

16.9

Out of 59 patients, 38 patients had madhyama ahara shakti (64.4 %),
whereas, 18.6 % and 16.9 % patients had pravara and avara ahara shakti
respectively

AHARA-SHAKTI WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA

64.4

38

5

10

5

GROUP-A

3

18.6

16

12
2

GROUP-B

3

11

16.9

10

3

GROUP-C

TOTAL

%

TABL : 18 % DISTRIBUTION OF VYAYAMA- SHAKTI 
E

VYAYAMA- SHAKTI GROUP- A GROUP- B GROUP- C TOTAL

%

PRAVARA

01

01

02

04

06.8

MADHYAMA

17

13

17

48

81.3

AVARA

02

03

03

08

13.6

In present study , it was found that 48 patients had madhyama vyayama
shakti i.e. 81.3 %, followed by avra vyayama shakti patients (13.6 %).

VYAYAMA-SHAKTI WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA

81.3

48

17
1

17

13
2

GROUP-A

1

3

GROUP-B

2

13.6
3

GROUP-C

4

TOTAL

8

6.8

%

TABL : 19 % DISTRIBUTION OF VAYA 
E

VAYA

GROUP- A

GROUP- B

GROUP- C

TOTAL

BAL
YA

00

00

00

00

00.0

MADHYAMA 16

13

15

44

74.6

J
EERNA

04

07

15

25.4

04

%

Out of 59 patients , 74.6 % patients were belonged to madhyama vaya and
25.4 % were belonged to jeerna vaya. It reveals that it is age- related diseae
and mostly in madhyamavastha and jeernavstha of life

VAYA WISE DISTRIBUTION
80
70
60
50
BALYA
40

MADHYAMA
JEERNA

30
20
10
0
GROUP-A

GROUP-B

GROUP-C

TOTAL

%

TABL : 20 % DISTRIBUTION OF PRAMANA 
E
PRAMANA

GROUP- A

GROUP- B

GROUP- C

TOTAL

PRAVARA

01

01

02

04

06.8

MADHYAMA 15

12

17

44

74.6

AVARA

04

03

11

18.6

04

%

Out of 59 patients, 44 patients had madhyama pramana (74.6 %) followed
by avara pramana (18.6 %).

PRAMANA WISE DISTRIBUTION
PRAVARA

MADHYAMA

AVARA
74.6

44

1

18.6

17

15

12
4

GROUP-A

1

11
4

GROUP-B

2

3

GROUP-C

4

TOTAL

6.8

%

T B E
A L

:

21

% DIS R UT
T IB
ION OF NIDA
NA 

NIDA
NA

GR
OUP A
-

GR
OUP B
-

GR
OUP C
-

TOTA
L

%

A
HA A
R JA
Usn a

06

08

05

19

3 2 .2

Tiksh n a

06

08

05

19

3 2 .2

Madya

09

03

04

16

2 7 .1

L
avan a

11

13

08

32

5 4 .2

K
atu

07

06

05

18

3 0 .5

A
mla

08

06

03

17

2 8 .8

K latth a
u

05

03

06

14

2 3 .7

Taila

12

10

08

30

5 0 .9

Mamsa

07

05

11

23

3 8 .9

Dadh i

04

07

11

22

3 7 .3

V
isamasan a

08

11

10

29

4 9 .2

V u ddh asan a
ir

05

07

03

15

2 5 .4

A
tyasan a

03

02

05

10

1 6 .9

A
dh yasan a

01

04

02

07

1 1 .9

A
jir n asan a

02

06

03

11

1 8 .6

R
atr ijagar an a

12

09

07

28

4 7 .5

S r ama
h

16

14

10

40

6 7 .8

A
bh ighata

01

02

01

04

0 6 .8

A
tich an kr aman a

08

07

12

27

4 5 .8

K odh a
r

06

04

02

12

2 0 .3

S
an tapa

01

02

04

07

1 1 .9

V
IHA A
R JA

MA
NA IK
S
A

NIDANA WISE DISTRIBUTION
80

70

60

50

40

30

20

10

0

Series1

Series2

Series3

Series4

Series5

Series6

Series7

Series8

TABL : 22)
E

%DISTR
IBUTION OF SIGN & SYMPTOMS IN GROUPS 

SYMPTOMS

& GROUP- A GROUP- B GROUP- C

TOTAL

%

SIGNS
PAIN

20

17

22

59

100

SWEL ING
L

18

12

17

47

79.7

TENDER
NESS

18

14

19

51

86.4

RESTR
ICTION OF 15

12

17

44

74.5

MOVEMENT
STIFFNESS

16

14

18

48

81.4

CR
EPITUS

20

17

22

59

100

In present study, it was found that in case of pain and crepitus ,
distribution of cases were 100 %. Tenderness was present in 86.5 % cases,
stiffness in 81.4 % cases, swelling in 79.7 % cases and restriction of movement
in 74.5 % cases. It reveals that these are major sign and symptoms in
osteoarthritis.

SYMPTOMS & SIGNS WISE DISTRIBUTION
100
90
80
70
60
50
40
30
20
10

0

GROUP-A
GROUP-B
GROUP-C
TOTAL
%

TABL
E

: 23) % OF EFFECT OF THERAPY IN SEVERITY OF PAIN ,BEFORE AND AFTER

THERAPY 
GROUP

MEAN
BT

GROUP- A 2.5

X
AT

%

S.D.

S.E.

t

P

RELIEF

0.9375 1.5625 62.5

0.5123 0.1281 12.199 <.001

GROUP- B 2.2308 0.9231 1.3077 58.6

0.4804 0.1332 09.815 <.001

GROUP- C 2.4737 0.5789 1.8947 76.6

0.5671 0.1301 14.563 <.001

In Group- A, out of 16 patients, observed % relief was 62.5 %, t- value was
12.199, p- value was < .001. It shows that the relief was highly significant
statistically. In Group- B , out of 13 patients, observed % relief was 58.6%, tvalue was 9.185 & p- value was < .001 ,that shows highly significancy
statistically. In Group- C, out of 19 patients , observed % relief was 76.6 %, tvalue was 14.563, p- value was < .001. It shows that effect of therapy was
highly significant statistically.

EFFECT OF THERAPIES ON PAIN
GROUP-C

GROUP-B

GROUP-A

1.8947
1.3077
1.5625

X

%

76.6
58.6
62.5

RELIEF

MEAN

AT

BT

0.5789
0.9231
0.9375
2.4737
2.2308
2.5

TABLE : 24) %OF EFFECT OF THERAPY IN SEVERITY OF SWELLING ,BEFORE AND AFTER
THERAPY 
GROUP

MEAN
BT

GROUP- A 2.125

X

S.D.

S.E.

t

P

RELIEF

AT
0.625

%

1.5

70.59

0.5164 0.1291 11.619 <.001

GROUP- B 2.0769 0.6923 1.3846 66.67

0.6504 0.1804 7.6752 <.001

GROUP- C 2.1579 0.5263 1.6316 75.61

0.7609 0.1746 9.3469 <.001

In Group- A, out of 16 patients, observed % relief was 70.59 %, t- value
was 11.619, p- value was <.001. It shows that the relief was highly significant
statistically. In Group- B ,out of 13 patients, observed % relief was 66.67 %, tvalue was 7.6752 & p- value was <.001 ,that shows highly significancy
statistically. In Group- C, out of 19 patients , observed % relief was 75.61 %, tvalue was 9.3469, p- value was <.001. It shows that effect of therapy was
highly significant statistically

EFFECT OF THERAPIES IN SEVERITY OF
SWELLING

1.6316
1.3846
1.5

MEAN

AT

BT

GROUP-B

GROUP-A

75.61
66.67
70.59

RELIEF

X

%

GROUP-C

0.5263
0.6923
0.625
2.1579
2.0769
2.125

TABLE : 25) % OF EFFECT OF THERAPY IN SEVERITY OF TENDERNESS ,BEFORE AND
AFTER THERAPY 
GROUP

MEAN
BT

GROUP- A 2.375

X

S.D.

S.E.

t

P

0.125

13.0

<.001

RELIEF

AT
0.75

%

1.625

68.4

0.5

GROUP- B 2.1538 0.6923 1.4615 67.86

0.5189 0.1439 10.156 <.001

GROUP- C 2.2105 0.5789 1.6316 73.81

0.4956 0.1137 14.35

<.001

13.0, p- value was <.001. It shows that the relief was highly significant
statistically. In Group- B ,out of 13 patients, observed % relief was 67.86 %, tvalue was 10.156 & p- value was <.001 ,that shows highly significant
statistically. In Group- C, out of 19 patients , observed % relief was 73.81 %, tvalue was 14.35, p- value was < .001. It shows that effect of therapy was
highly significant statistically

TENDERNESS
GROUP-C

GROUP-B

GROUP-A

RELIEF

1.6316
1.4615
1.625

MEAN

X

%

73.81
67.86
68.4

AT

BT

0.5789
0.6923
0.75
2.2105
2.1538
2.375

TABL : 26) % OF EFFECT OF THERAPY IN SEVERITY OF CREPITATION ,BEFORE AND
E
AFTER THERAPY 
GROUP

MEAN
BT

X

%

S.D.

S.E.

t

P

RELIEF

AT

GROUP- A 2.3125 1.875

0.4375 18.92

GROUP- B 2.1538 2.000

0.1538 10.714 0.4385 0.1216 1.8974 >.05

GROUP- C 2.3158 1.7368 .6316

27.27

0.6292 0.1573 2.785

> .01

0.8307 0.1906 3.3141 <.01

was 2.785, p- value was > .01 It shows that the relief was

insignificant

statistically. In Group- B ,out of 13 patients, observed % relief was 10.714 %, tvalue was 1.8974 & p- value was > .05 ,that shows insignificancy statistically.
In Group- C, out of 19 patients ,observed % relief was 27.27 %, t- value was
3.3141, p- value was < .01. It shows that effect of therapy was significant
statistically.

CREPITATION

0.6316
0.1538
0.4375

MEAN

AT

BT

GROUP-B

10.714

RELIEF

X

%

GROUP-C

1.7368
2
1.875
2.3158
2.1538
2.3125

GROUP-A

27.27
18.92

TABLE : 27) %OF EFFECT OF THERAPY IN RESTRICTION OF MOVEMENT ,BEFORE AND
AFTER THERAPY 
GROUP

MEAN
BT

X

%

S.D.

S.E.

t

P

RELIEF

AT

GROUP- A 1.625

0.625

1.00

61.52

GROUP- B 1.386

0.6923 0.6923 50.0

0.5164 0.1291 7.746

<.001

0.6304 0.1748 3.9595 >.001

GROUP- C 1.8421 0.5789 1.2632 68.571 0.562

0.1289 9.798

<.001

was 7.746, p- value was <.001. It shows that the relief was highly significant
statistically. In Group- B, out of 13 patients, observed % relief was 50 %, tvalue was 3.9595 & p- value was >.001, that shows significant statistically. In
Group- C, out of 19 patients, observed % relief was 68.571 %, t- value was
9.798, p- value was <.001. It shows that effect of therapy was highly
significant statistically

RESTRICTION OF MOVEMENT
GROUP-C

GROUP-B

GROUP-A

%

68.571
50

RELIEF

61.52

1.2632
X

0.6923
1

0.5789
AT

0.6923

MEAN

0.625

1.8421
BT

1.386
1.625

TABL : 28) %OF EFFECT OF THERAPY IN SEVRERITY OF STIFFNESS ,BEFORE AND AFTER
E
THERAPY 
GROUP

MEAN
BT

X
AT

GROUP- A 1.6875 0.5625 1.125
GROUP- B 2.000

%

S.D.

S.E.

0.500

0.125

T

P

RELIEF
66.72

0.7692 1.2308 61.52

GROUP- C 2.1053 0.5789 1.5263 72.5

9.0

<.001

0.5997 0.1662 7.4066 <.001
0.6867 0.1598 9.5495 <.001

was 9.0, p- value was < .001. It shows that the relief was highly significant
statistically. In Group- B, out of 13 patients, observed % relief was 61.52 %, tvalue was 7.4066 & p- value was < .001, that shows highly significant
statistically. In Group- C, out of 19 patients, observed % relief was 72.5 %, tvalue was 9.5495, p- value was < .001. It shows that effect of therapy was

EFFECT OF THERAPIES IN SVERITY OF STIFFNESS
GROUP-C

GROUP-B

GROUP-A

%

72.5
61.52

RELIEF

66.72

X

1.5263
1.2308
1.125

MEAN

AT

BT

0.5789
0.7692
0.5625

2.1053
2
1.6875

TABL
E

: 29) % OF EF E
F CT OF THE APY IN INDEX OF SE R
R
VE ITY FOR OA OF THE

K E
NE ,BEF E AND AF R THE APY 
OR
TE
R
GROUP

ME
AN
BT

X

%

S.D.

S.E
.

t

P

R IE
EL F

AT

GROUP- A 2.500

0.8125

1.6875

67.5

0.4787

0.1197

14.1

<.001

GROUP- B 2.8462

1.0769

1.7692

62.2

0.4385

0.1216

14.546

<.001

GROUP- C 2.8947

0.7895

2.1053

72.7

0.4588

0.1053

20

<.001

statistically. In Group- B ,out of 13 patients, observed % relief was 62.2 %, tvalue was 14.546 & p- value was < .001 ,that shows highly significant
statistically. In Group- C, out of 19 patients ,observed % relief was 72.7 %, tvalue was 20, p- value was < .001. It shows that effect of therapy was highly
significant statistically.

EFFECT OF THERAPIES IN INDEX OF SEVERITY OF OA
OF KNEE
GROUP-C

GROUP-B

GROUP-A

%

72.7
62.2

RELIEF

67.5

2.1053
X

1.7692
1.6875

0.7895
AT

1.0769

MEAN

0.8125

2.8947
BT

2.8462
2.5

TABL : 30) % OF EFFECT OF THERAPY IN VAS SCAL FOR PAIN ,BEFORE AND AFTER
E
E
THERAPY 
GROUP

MEAN
BT

GROUP- A 7.5

X
AT

%

S.E.

t

P

REL
IEF

2.4375 5.0625 67.5

GROUP- B 6.8462 2.8462 4.000

S.D.

58.42

1.9483 0.4871 10.394 <.001
2.0817 0.5774 6.9282 <.001

GROUP- C 7.0562 1.9474 5.1053 72.388 1.5597 0.3578 14.267 <.001

statistically. In Group- B, out of 13 patients, observed % relief was 58.42 %, tvalue was 6.9282 & p- value was < .001, that shows highly significant
statistically. In Group- C, out of 19 patients, observed % relief was 72.388 %, tvalue was 14.267, p- value was < .001. It shows that effect of therapy was

EFFECT OF THERAPIES IN VAS SCALE OF PAIN
GROUP-C

GROUP-B

GROUP-A

%

72.388
58.42

RELIEF

67.5

5.1053
X

4
5.0625

1.9474
AT

2.8462

MEAN

2.4375

7.0562
BT

6.8462
7.5

TABL : 31) %OF EFFECT OF THERAPY IN HEAL SATISFACTION ,BEFORE AND AFTER
E
TH
THERAPY 
GROUP

MEAN
BT

GROUP- A 6.125

X
AT
3.5625

%

S.D.

S.E.

T

P

REL
IEF
2.7273 44.53

2.1019 .6338 4.3033 <.001

GROUP- B 6.3077 5.000

1.3077 20.7

1.8432 .5112 2.558

GROUP- C 5.5789 2.7368

2.8421 50.9

1.4245 .3268 8.6966 <.001

>.01

statistically. In Group- B, out of 13 patients, observed % relief was 20.7 %, tvalue was 2.558 & p- value was > .01, that shows insignificancy statistically. In
Group- C, out of 19 patients, observed % relief was 50.9 %, t- value was
8.6966, p- value was < .001. It shows that effect of therapy was highly
significant statistically.

EFFECT OF THERAPIES IN HEALTH SATISFACTION
GROUP-C

GROUP-B

GROUP-A

50.9
20.7

4

44.53

2.8421
3

1.3077
2.7273

2.7368
2

5
3.5625

5.5789
1

6.3077
6.125

TABLE

: 32) % OF EFFECT OF THERAPY IN CALCIUM LEVEL ,BEFORE AND AFTER

THERAPY 
GROUP

MEAN
BT

X
AT

%

S.D.

S.E.

T

P

RELIEF

GROUP- A 6.5000 7.0600 - 0.563 - 8.654 0.6292 .1573 - 3.576 >.05
GROUP- B 7.6923 8.0000 - 0.308 - 4.000 1.1094 .3077 - 1.000 >.05
GROUP- C 7.7895 8.1053 - 0.316 - 4.054 0.6710 .1539 - 2.051 >.05

In Group- A, out of 16 patients, observed % relief was - 8.654 %, t- value
was - 3.576, p- value was >.05. It shows that the relief was insignificant
statistically. In Group- B ,out of 13 patients, observed % relief was - 4 %, t- value
was - 1 & p- value was >.05 ,that shows insignificancy statistically. In GroupC, out of 19 patients ,observed % relief was - 4.054 %, t- value was - 2.051, pvalue was >.05. It shows that effect of therapy was insignificant statistically

EFFECT OF THERAPIES IN CALCIUM LEVEL
GROUP-C

GROUP-B

GROUP-A

-4

%

-4.054
RELIEF

-8.654

X

-0.316
-0.308
-0.563

8.1053
8

AT
MEAN

7.06

7.7895
7.6923

BT
6.5

TABLE : 33) %OF EFFECT OF THERAPY IN ESR VALUE ,BEFORE AND AFTER THERAPY 
GROUP

MEAN
BT

X
AT

%

S.D.

S.E.

T

P

RELIEF

GROUP- A 17.563 16.875 0.6875 3.9

2.7011 0.6753 1.0181 >0.05

GROUP- B 17.077 16.538 0.5385 3.15

0.9674 0.2683 2.0068 >0.05

GROUP- C 16.211 14.947 1.2632 7.79

1.4848 0.3406 3.7082 <0.01

1.0181, p- value was > .05. It shows that the relief was insignificant
statistically. In Group- B ,out of 13 patients, observed % relief was 3.15 %, tvalue was 2.0068 & p- value was > .05 ,that shows insignificancy statistically.
In Group- C, out of 19 patients ,observed % relief was 7.79 %, t- value was
3.7082, p- value was < .01. It shows that effect of therapy was significant
statistically

EFFECT OF THERAPIES IN ESR VALUES
GROUP-C

GROUP-B

GROUP-A

%

7.79
3.15

RELIEF

3.9

1.2632
X

0.5385
0.6875

14.947
AT

16.538

MEAN

16.875

16.211
BT

17.077
17.563

TABLE : 34) %OF EFFECT OF THERAPY IN Hb VALUE ,BEFORE AND AFTER THERAPY 
GROUP

MEAN
BT

X
AT

GROUP- A 12.000 12.969 - 0.969

%

S.E.

t

P

RELIEF
- 8.07

GROUP- B 11.962 12.338 - 0.3770 - 3.15
GROUP- C 12.416 12.568 - 0.142

S.D.

1.3598 0.3399 - 2.85

>.05

0.5495 0.1524 - 2.473 >.05

- 1.611 0.6387 0.1926 - 1.038 >.05

In Group- A, out of 16 patients, observed % relief was - 8.07 %, t- value was
- 2.85, p- value was >.05. It shows that the relief was insignificant statistically.
In Group- B, out of 13 patients, observed % relief was - 3.15 %, t- value was
- 2.473 & p- value was >.05, that shows insignificancy statistically. In GroupC, out of 19 patients, observed % relief was - 1.611 %, t- value was

- 1.038,

p- value was >.05. It shows that effect of therapy was insignificant statistically

RELIEF

X

%

EFFECT OF THERAPIES IN Hb VALUE

GROUP-C
GROUP-B
GROUP-A

MEAN

AT

BT

-10

-5

0

5

10

15

TABL : 35)
E

EF E OF THE APIE ON SYMPTOMS & SIGNS IN DIF E E
F CT
R
S
F R NT GR
OUPS

SYMPTOMS & SIGNS

GROUP A

GROUP B

(IN %)

GROUP C

(IN %)

(IN %)

PAIN

62.50

58.60

76.60

SWE L
L ING

70.59

66.67

75.61

TE
NDE NESS
R

68.40

67.86

73.81

CR PITUS
E

18.92

10.714

27.27

R STR
E
ICTION OF

61.52

50.00

68.71

J
OINT STIF NE
F SS

66.67

61.52

72.50

SE R
VE ITY INDE OF
X

67.50

62.20

72.70

VAS SCAL OF PAIN
E

67.5

58.42

72.39

HEAL SATISF
TH
ACTION

44.53

MOVE NT
ME

DISE
ASE

HAE
MOGL
OBIN

20.7

50.9

- 8.07

- 3.15

- 1.611

E
SR

3.9

3.17

7.79

SE UM Ca
R

- 8.654

- 4.00

- 4.054

In the reference of therapies in different groups, different datas are presented
here for their effects in symptoms & signs, VAS for pain, health satisfaction, Hb
Values, ESR level and serum Ca. These shows relevancy in therapies as
described in above mentioned table

TOTAL EFFECT OF THERAPIES IN SYMPTOMS & SIGNS
80

70

60

50

40

30

20

10

0

-10

GROUP A

(IN %)

GROUP B

(IN %)

GROUP C

(IN %)

TABL - 37 :TOTAL E F CT OF THE APIE IN DIF E E
E
FE
R
S
F R NT GR
OUPS :

RESULTS

GROUP- A

%

GROUP - B

%

GROUP- C

%

COMPL TE IMPR
E
OVE NT
ME

0

0

0

0

0

0

MAR R IMPROVE NT
K D
ME

3

18.75

2

15.38

7

36.84

MODE ATE IMPROVE NT
R
ME

8

50.00

5

38.46

9

47.37

MIL IMPR
D
OVE NT
ME

5

31.25

4

30.76

3

15.79

UNCHANGE
D

0

0

2

15.38

0

0

After full observation of therapies, it was found that in Group- A, no. of
patient unchanged was 0, whereas , observed mild improvement was found in
5 patients (31.25 %), moderate improvement was observed in 8 p atients (50
%), marked improvement was observed in 3 patients (18.75 %).
In Group- B, no. of patient unchanged was 2 (15.38 %), whereas, mild
improvement observed was 4 (30.76 %), moderate improvement was 5 (38.46
%) and marked improvement was in 2 patients (15.38 %).
In Group- C, no. of unchanged patient was 0, whereas,

mild

improvement was found in 3 patients (15.79 %), moderate improvement was
found in 9 patients (47.37 %), marked improvement in 7 patients (36.48 %).

TOTAL EFFECT OF THERAPIES IN IMPROVEMENT
50
45

40
35
30
25
20
15
10
5
0
GROUP- A

%

GROUP -B

%

COMPLETE IMPROVEMENT

MARKRD IMPROVEMENT

MILD IMPROVEMENT

UNCHANGED

GROUP- C

MODERATE IMPROVEMENT

%

AGE & SE
X
In the present study, out of 59 patients registered, 37 (62.7 %) were females
and 22 (37.3 %) were males. It shows that incidence of disease is more in
females in compare to the males. The prevalence of the disease is more in 5160 years age of group (i.e. 42.3 %), followed by 40- 50 years of age group
(32.2 %). Even though the prevalence of OA increases with increase of age,
however, during the study maximum no. of patients were from 51- 60 years of
age group followed by 40- 50 years of age group. Since, there is very small
sample of patients, so such a type of pattern can’t be generalized.
OCCUPATION
In the present study, it has been found that the disease is more common in
housewives (45.76 %) followed by farmer & labour class (22.03 %), whereas,
in service & businessmen it is 20.3 %. This pattern of findings may be due to
their life styles.

RELIGION WISE DISTRIBUTION
In religion wise distribution, it has shown that maximum no. of patients
were belonging to the Hindus group (77.97 %), whereas, only 22.03 % patients
were Muslims. This data can’t be generalized due to very small sample of
patients and Hindu dominant area.
SOCIO- ECONOMIC DISTRIBUTION
On the basis of socio- economic distribution, it was found that maximum
no. of patients were belonging to the lower- middle class (49.15 %) followed by
lower class (27.12 %). This pattern of distribution can be typical of patients of
this region. It may be due to compulsion to do more strenuous work and
improper diet

AR A WISE DISTR
E
IBUTION
During this study, it has been found that this diseases is more prevalent in
Urban population (66.2 %) than the r ural (33.8 %). This may be due to their
food habits, life style and general practiced.
F
AMIL HISTOR
Y
Y
During the study, only 18.62 % patients have presented their family
history, it indicates that

there is no specific genetic interaction

in

etiopathogenesis of the disease.
DURATION OF IL NE
L SS
During the present study, maximum no. of cases has presented their
duration of illness from 3- 5 years i.e. 40.68 %, then in group of > 5 years of
duration of illness (25.43 %), whereas, 18.64 % cases were from 1- 3 years of
duration. The above data indicates the more chronicity of illness in a typical of
population of the region.

NATUR OF DIE
E
T
In present study, it is found that most of the patients were vegetarian
(61.01 %) and their nature of diet was irregular (62.71 %). Rest of the patients
had mixed and regular nature of diet. Irregular and vegetarian nature of diet
can cause nutritional deficiency that may cause age related dhatukshaya and it
may cause degenerative changes.
DE
HA PR R
AK ITI
Assessment of deha prakriti was done in all 59 patients. Majority of cases
were belonging to the vatakaphaja prakriti (28.8 %) ,kaphaja prakriti (20.3
%) and vataja prakriti (18.6 %). It shows that vatakaphaja, kaphaja and vataja
prakritis are most vulnerable for the disease.
NIDANA
Among the different Nidana of the disease it was found that vata vardhaka
and kapha vardhaka ahara- vihara and manasika nidanas were predominant
in their routine. These factors are aggravating factors for the disease

EFFECT OF THERAPIES
Out of 59 patients registered, 48 patients have completed their follow- ups.
In Group- A, there were 16 patients and they were administered Dashmoola
Panchtikta Bala Ksheera Basti only. In Group- B, there were 13 patients and
they were treated by Janu Basti only. In Group- C, there were 19 patients and
they were treated by Dashmoola Panchtikta Bala Ksheera Basti and Janu Basti
both.
SEVERITY OF PAIN
Effect of therapies in severity of pain was observed maximum in Group- C
i.e. 76.6 %, whereas, it was 62.5 % and 58.6 % in Group- A and Group- B
respectively. Study reveals that combined therapy of Basti and Janu Basti was
more effective in reducing the severity of pain. Statistical data reveals that
these therapies were highly significant either alone or in combination.

SEVERITY OF SWEL ING
L
In severity of swelling, maximum improvement was observed in Group- C
i.e. 75.61 %, whereas, it was 70.59 % & 66.67 % in Group- A & Group- B
respectively. In present study, combined therapy was found to be more
effective in reducing severity of swelling in comparison to the individual
therapy. Statistical data shows that effect of therapies were highly significant
in all the Groups.
SEVERITY OF TENDERNESS
Effect of therapy in severity of tenderness was found to be maximum in
Group- C (73.81 %), followed by Group- A (68.4 %) and Group- B (67.86 %)
respectively. Although, combined therapy was found to be more effective
rather than individual therapy, but statistically effect of therapies were highly
significant in all the Groups.

SE
VER
ITY OF CR PITATION
E
Effect of therapies in severity of crepitation was observed maximum in
Group- C i.e. 27.27 %, whereas, it was 18.92 % and 10.71 % in Group- A and
Group- B respectively. Study reveals that combined therapy of Basti and Janu
Basti was more effective in reducing the severity of crepitation. Statistical data
reveals that in Group- C effect of therapy was significant but in Group- A &
Group- B effect was insignificant.
SE
VER
ITY OF R STR
E
ICTION OF MOVEME
NT
In severity of restriction of movement, maximum improvement was
observed in Group- C i.e. 68.57 %, whereas, it was 61.52 % & 50.0 % in
Group- A & Group- B respectively. In present study, combined therapy was
found to be more effective in reducing severity of restriction of movement in
comparison to the individual therapy. Statistical data shows that effect of
therapy was highly significant in Group- A and Group- C, but it was significant
in Group- B.

SEVER
ITY OF STIFFNESS
Effect of therapy in severity of stiffness was found to be maximum in
Group- C (72.5 %), followed by Group- A (66.72 %) and Group- B (61.52 %)
respectively. Although, combined therapy was found to be more effective
rather than individual therapy, but statistically effect of therapies were highly
significant in all the Groups.
INDEX OF SEVER
ITY FOR OA
Effect of therapies in index of severity for OA was observed maximum
in Group- C i.e. 72.7 %, whereas, it was 67.5 % and 62.2 % in Group- A and
Group- B respectively. Study reveals that combined therapy of Basti and Janu
Basti was more effective in reducing the index of severity for OA. Although,
combined therapy was found to be more effective rather than individual
therapy, but statistically effect of therapies were highly significant in all the
Groups

VAS FOR PAIN
In VAS for pain, maximum improvement was observed in Group- C i.e.
72.388 %, whereas, it was 67.5 % & 58.42 % in Group- A & Group- B
respectively. In present study, combined therapy was found to be more
effective in reducing severity of swelling in comparison to the individual
therapy. Statistical data shows that effect of therapies were highly significant
in all the Groups.
HE TH SATISFACTION
AL
In the present study of health satisfaction, maximum improvement was
observed in Group- C i.e. 50.9 %, whereas, it was 44.53 % & 20.7 % in GroupA & Group- B respectively. In present study, combined therapy was found to be
more effective in health satisfaction in comparison to the individual therapy.
Statistical data shows that effect of therapy was highly significant in Group- A
and Group- C, but it was insignificant in Group- B.

SER
UM Ca, Hb % E VAL
, SR
UE
Effect of therapies observed in the cases for Serum Ca, Hb % and ESR
value was not significant in any of the Group. It may be due to a very small
sample of Group.
TOTAL E F CT OF THER
FE
APIE IN GR
S
OUPS
In Group- A, no. of patient unchanged was 0, whereas, observed mild
improvement was found in 5 patients (31.25 %), moderate improvement was
observed in 8 patients (50 %), marked improvement was observed in 3 patients
(18.75 %). In Group- B, no. of patient unchanged was 2 (15.38 %), whereas,
mild improvement observed was 4 (30.76 %), moderate improvement was 5
(38.46 %) and marked improvement was in 2 patients (15.38 %). In Group- C,
no. of unchanged patient was 0, whereas, mild improvement was found in 3
patients (15.79 %), moderate improvement was found in 9 patients (47.37 %),
marked improvement in 7 patients (36.48 %).

was

In x- r ay of th e affected joint, after completion of thir d follow up, ther e
some

incr ease

in

th e

joint

space

within

each

gr oup

osteophytic changes and scler otic ch anges wer e decr eased in

p atients
Gr oup - A

but

&

Gr oup- C only. In ur in e, th er e was n o ch ange significantly.
 PROBABLE EFFECT OF THERAPIES
A). D s m o P n h ta B la K h e
a h o la a c tik
a
s e ra B s
a ti
Dash moola is said to h ave th e pr oper ties of sh oth h ar a as well as it is good
vatash amaka.

Tikta

dr avyas

detoxification , an algesia

an d

m ay

h ave

th e

an tibacter ial

p r op er ties

as w ell as it

of

blood

pu r ifier ,

may fascilitate th e

posh aka tatvas to th e asth ivah a an d majjavah a sr otas du e to its vata an d akash
gu n a pr edominan ce. K
sh eer a B
asti is a good n u tr itive measu r e in degen er ative
disor der s.

Hen ce,

a

combination

of

th eses

in

tr ial

th er ap y

“
Dash moola

pan ch tikta B
ala K
sh eer a B
asti” may pr ovide good r esu lts in th e disease. It may
pr odu ce r edu ction in pain, swelling, r estr iction of movemen t, stiffn ess an d a
little bit in cr epitation s, wh er eas B
asti th er apy may impr ove th e h ealth an d
may cau se th e slowing of degen er ative p r ocess of th e body.

ar ea

B). J n B s
a u a tiK
eeping th e medicated oil for specific per iod of tim e on th e affected
may n ou r ish

th e n er ves, mu scles an d

joints in

th e par ticu lar

r egion .

Mah an ar ayan a oil, u sed in th e th er apy, is famou s for its vatash amaka effect.
Du e to its sn igdh a an d

u sn a gu n as , it may be u sed in su ch a typ e of diseases.

In gen er al, it cau se vasodilatation an d impr oves gen er al cir cu lation leading to
h ealth y

r etu r n s

pr ocesses

wh ich

in

th e

ar e

con ditions.

r espon sible

ten der n ess, stiffn ess etc.

It

for

may
most

activates
of

th e

th e

r elief

local
of

pain,

metabolic

sw elling,

CONCLUSION
On the basis of above mentioned liter ary r eview, clinical study and discussion ,
the final conclusions of the pr esent work areSandhigata

Vata

vis- à- vis

Osteoarthritis

is

multi- factorial,

non-

inflammatory degenerative joint disorders.
Ther e was no appar ent change was observed in X- r ay befor e and after
treatment.
Accor ding to the literar y profile, this disease is Asadhya or incurable in
nature, this is also supported by the r ecur rence of same type of complaint
in the patient included in the pr esent clinical study. The medication can
give only symptomatic r elief for certain period.
Effect

of

Dashmoola

(Samsodhana/purificatory

Panchtikta

measur es)

for

Bala
Sandhigata

Ksheer a
Vata

Basti
(OA)

is

undoubtful due to its systemic effect on dhatukshaya and vitiated Vata,
whereas,

Janu Basti (palliative measur e) has its limitations to the local

effects on symptoms & signs of the disease. Overall effect of therapy in
combination is found to be superior than individual therapy.
Since sample size was very small, so it is very difficult to give a definite
conclusion, but it may be a better approach of management in Sandhigata Vata
vis- a- vis Osteoarthritis without any side effects.

osteoarthritis & an ayurvedic approach

osteoarthritis & an ayurvedic approach

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