1. “Study the efficacy of Gandharvahasthadi
Kwatha in the management of Grudhrasi ”
By
Dr. Christy J Thundiparambil M.D.(Ay)
Under the guidance of
Vaidya Pramod .V.Kulkarni MD (Rogvidhyan )& MD (Kayachikitsa)
Reader,
Department of panchakarma,
Rashtriya shikshan Mandal’s
Tilak Ayurveda mahavidhyalaya,
Rasta peth, Pune.

2. CONTENTS
 Aims and objectives
 Introduction
 Review of literature
Disease review
Drug review
 Clinical study
 Observations
 Results
 Discussion
 Conclusion
 Summary

3. Aims and objectives
AIM OF THE STUDY
 Study the efficacy of Gandharvahasthadi Kwatha in the
management of Grudhrasi.
OBJECTIVES
1) Establish efficacy and safety of Gandarvahasthadi kwatha, as trial
drug in the management of Grudhrasi.
2) Study the Vatahara, Agnideepana, Malashodhana properties of
Gandarvahasthadi kwatha in the management of Grudhrasi.
3) Detailed study of the individual drugs.
4) Detailed analytical study of the Gandarvahasthadi kwatha.
 HYPOTHESIS:
Null Hypothesis – Gandarvahasthadi kwatha doesn’t have
Grudhrasihara property,when administrated internally in case of
Grudhrasi.
Alternate Hypothesis - Gandarvahasthadi kwatha when
administrated internally in case of Grudhrasi have Grudhrasihara
property.

4. Part 1. Literary review
Chapter1. Disease review of Grudhrasi
A. Historical Review
B. Vyutpathi,Nirukthi &Paribhasha
C. Paryaya and Bheda
D. Nidana Panchaka
Chapter 2. Modern Disease Review
A. Anatomy of Vertebral Column
B. Vertebral Column Injuries
C. Anatomy of Disc
D. Degenerative Disc Diseases
E. Anatomy of Sciatic Nerve
F. Etiology of Sciatic Neuralgia
G. Specific Tests for Sciatica

5. Chapter 3. Management Of Sciatica
A. Naturopathy in Sciatica
B. Acupressure in Sciatica
C. Acupuncture in Sciatica
D. Diet Therapy
E. Homeopathy in Sciatica
Chapter 4. Ayurvedic Management Of Grudhrasi
A. Principles of treatments
B. Shamanoushadhi

6. Part 2 Drug study
Chapter1. Identification
Chapter2. Preparation and standardization of the
medicine
Chapter3. Individual drug study
A. Gandharvahastha/Eranda
B. Chirabilwa
C. Hutashwa/Chitraka
D. Vishwa/Shunti
E. Patdhya/Hareetakee
F. Punarnava
G. Yavasaka
H. Bhoomithalam/Musali

7. Part 3 Clinical study
 Chapter 1- Methodology of the study
 Chapter 2- Observations
 Chapter 3- Results
 Chapter 4- Discussion
 Chapter 5- Summary
 Chapter 6- Conclusion

8. Study design
Clinical trial
Prospective open labeled controlled clinical trial
Screening of subjects for inclusion
Initial assessment
Gandharvahasthadi kwatha
Assessment at before, intervals of 15days, And after follow-up
Statistical assessment
Overall assessment
Conclusion

9. CLINICAL WORK
Prospective open labeled clinical trial on Grudhrasi with
Gandhrvahasthadi Kwatha
1) Treatment Schedule
Trial group
100 patients were given Gandharvahasthadi kwatha
Dosage : 50 ml twice daily
Timing : Morning 6-am & evening 7pm ½ hour before food
Anupana : Gula and Saindhava
2) Place of Study
(a) Center for post graduate studies and research in Ayurveda,
Tilak Ayurveda Mahavidhyalaya, Rasthapet, Pune
(b) Nangelil Ayurveda Medical College Hospital,
Nellikkuzhi,kothamangalam,ernakulam,kerala.

10. 3) Study pattern
a) 30% patents were taken at Saith Tharachand Hospital
Rasthapeth, Pune.
b) 70 % patents were taken at Nangelil Ayurveda
Medical College Hospital, Nellikkuzhi, Kothamangalam,
Ernakulam, Kerala.
4) Duration of the study – 45 days
5) Follow up period
Every 15 days, 30 th day and 45 th day after the
treatment
MATERIAL AND METHODS
1. Study population
All patients attending Kayachikitsaout patient department
with cases of Grudhrasi.
2. Sampling method and sample size
All Grudhrasi patients were selected as per exclusion
and inclusion criteria,100 patients were selected.

11. INCLUSION CRITERIA
 Patients of both sex with the age group between 18-60
years
 Grudhrasi diagnosed on the basis of signs& symptoms
described in Ayurveda
 Patients with a positive SLR test.
EXCLUSION CRITERIA
 Congenital Deformities
 Disease developed due to any post surgical
complications.
 Grudhrasi due to IVDP with bowel and bladder
involvement.
 Patients suffering from other systemic diseases like
Renal failure, Vertebral T.B, Diabetes, Neoplasm.
 Patients with R A test are positive
 During pregnancy, lactation period & during breast
feeding

12. STATISTICAL ANALYSIS
All data were recorded before the treatment, after the treatment and
after follow up. The mean, Percentage, S.D, S.E,
t-Value(Paired t- Value) and P value were analyzed statistically
using student ‘t’ test. The total result including the over all effect of
the therapy is presented in tables
ASSESSMENT OF THE OVER ALL EFFECT
The overall effects of therapy is assessed in the following manner
Unchanged - Less than 25% relief in the complaints
Mild Improvement -More than 25% and up to 50% relief
Moderate Improvement - More than 50% and up to 75% relief
along with improvement in SLR test
Marked Improvement - More than 75% relief as well as
significant improvement in SLR test
Complete Relief - 100% relief in the complaints along with
best S.L.R. test

13. RESULT & SUMMARY
1)Effect of Gandharvahasthadi Kwatha on mainsymptoms of
100patients of Grudhrasi after 45 days of treatment.
Gandharvahasthadi Kwatha provided highly significant relief
( P<0.001 ) for all symptoms,
%of relief for the symptoms are given as below
In Sthambham by 50.00%, in Ruk and Gruhnam by 80.00% each,
in Todam it was 78% 75%relief shown in Spandanam.
2)Effect of Gandharvahasthadi Kwatha on main symptoms of 100
patients of Grudhrasi after Follow up.
Gandharvahasthadi Kwatha provided highly significant relief
( P<0.001 ) for all symptoms
%of relief for the symptoms are given as below
In Sthambham by 60.00%. In Ruk by 90.00% In Todam,
Spandanam and Gruhnam, by82%,81%&85% respectively.
In short after follow up the percentage of relief was increased in all the
main symptoms and the trial drug Gandharvahasthadi kwatha is
providing long lasting result

14. 3)Effect of Gandharvahasthadi Kwatha on associated
symptoms of 100 patients of Grudhrasi after 45days of
treatment.
Gandharvahasthadi Kwatha provided highly significant
relief(P<0.001)) in all symptoms
%of relief for the symptoms are given as below
In Aruchi by 40.00%,
In Gouravam and Tandra,by 30% & 36.36% respectively
4)Effect of Gandharvahasthadi Kwatha on associated
symptoms of 100 patients of Grudhrasi after Follow up
Gandharvahasthadi Kwatha provided highly significant relief
(P<0.001) in all symptoms
%of relief for the symptoms are given as below
In Aruchi, Gouravam and Tandra by 72.00%, 80% and
72.72.% respectively.
In short the trial drug is relieving the associated symptoms after
therapy and follow-up. This is clear that the trial drug
Gandharvahasthadi kwatha is providing long lasting result.

15. 5)Effect of Gandharvahasthadi Kwatha on SLR test of 100
patients of Grudhrasi after 45days of treatment.
Gandharvahasthadi Kwatha provided highly significant
improvement (p<0.001) in patients suffering from positive Right
and Left leg S.L.R.Test ,where as moderately significant
improvement (P<0.010) was achieved in those patients suffered
from positive S.L.R test of both legs
%of relief for the SLR Test are given as below
In positive Right and Left leg S.L.R.Test by 50 %&51.16%
respectively,
Positive S.L.R test of both legs is by 41.17%.
6)Effect of Gandharvahasthadi Kwatha on SLR test of 100
patients of Grudhrasi after Follow up
Gandharvahasthadi Kwatha provided highly significant
improvement(P<0.001) in patients suffering from positive Right leg
Left leg S.L.R.Test and for those patients suffering from both legs
%of relief for the SLR Test are given as below
In positive Right and Left leg S.L.R.Test by75%&76.74%
respectively.
Patients suffered from positive S.L.R test of both legs by 64.70%.

16. 7)Comparative effect of therapies on main symptoms of
100 patients of Grudhrasi after 45 days of treatment and
after follow up (in % wise of relief)
100
90 90
85
80 82 81 80
80 78 75
70
60 60
50 50 af ter treatment
af ter f ollow up
40
30
20
10
0
sthambham ruk todam spandanam gruhnam

17. 8)Comparative effect of therapies on main symptoms of
100 patients of Grudhrasi after 45 days of treatment and
after follow up (in statistical way )
The Sthambham shown moderately significant (p-value <0.010)
results which means after follow up the result of the treatment is
better than the result after the treatment period.
While other symptoms, shown in significant result (P>0.100) from
this data it is clear that, the treatment shown not significant
improvement after the follow up period than the therapy time.
From the statistical studies it is clear that the trial drug
Gandharvahasthadi Kwatha provided long lasting results on the
main symptoms even after the follow up period ie, the results
obtained during the treatment period were well maintained.

18. 9)Comparative effects of therapies on the associated
symptoms of 100 patients of Grudhrasi after 45 days of
treatment and follow up(in % wise of relief)
100
90
80 80
72 72.72
70
60
50 after treatment
40 40 36.36 after f ollow up
30 30
20
10
0
aruchi gouravam tandra

19. 10)Comparative effects of therapies on the associated
symptoms of 100 patients of Grudhrasi after 45 days of
treatment and follow (in statistical way )
Aruchi shown Highly significant (p-value <0.001) results which
means after follow up the result of the treatment is better than
the result after the Treatment period.
While other symptoms, shown in significant result (P>0.100) from
this data it is clear that the treatment shown not significant
improvement after the follow up period than during therapy time.
From the statistical studies it is clear that the trial drug
Gandharvahasthadi Kwatha provided long lasting results on the
associated symptoms even after the follow up period ie, the
results obtained during the treatment period were well
maintained.

20. 11)Comparative effect of therapies on the S.L.R. Test of
100 patients of Grudhrasi after 45 days of treatment and
follow up (in % wise of relief)
100
90
80
75 76.74
70
64.7
60
50 50 51.16
after treatment
40
41.17 after followup
30
20
10
0
rt leg lt leg both legs

21. 12)Comparative effect of therapies on the S.L.R. Test of
100 patients of Grudhrasi after 45 days of treatment and
follow up (in % wise of relief)
Left leg , SLR Test Positive shown Highly significant (p-value
<0.001) results which means after follow up the result of the
treatment is better than the result after the Treatment period.
While Right leg and Both legs SLR Test Positive shown in
significant result (P>0.100) from above data it is clear that the
treatment shown not significant improvement after the follow up
period than the therapy time
From the statistical studies it is clear that the trial drug
Gandharvahasthadi Kwatha provided long lasting results on the
S.L.R.Test even after the follow up period ie, the results obtained
during the treatment period were well maintained.

22. TRIAL DRUG
The ingredients of trial drug Gandharvahasthadi kashaya are
Gandarvahastha, Chirabilwa, Hutaswa, Viswa, Pathya, Punarnava,
Yavasaka, and Bhumithala.
“Gandharvahastha chiruvilwa huthaswa viswa|
Patdhya punarnava yavashaka bhoomithalai: ||
Kwatha:sasaindhavagulampavanasyashanthair|
Vahnerbalaaya ruchaye malasodhanaya||” (SAHASRAYOGA )
Reference : SAHASRAYOGA
Context : Vatavikara, kashayayoga
Anupana : Saindhava & Gula

23. chirubilwa
bhoomithala ch
Gandharva hastha
yavasa viswa
punarnava pathya

24. PROPERTIES AND ACTION OF INDIVIDUAL DRUGS
Drug name Rasa Veerya Vipaka Guna Karma
Eranda Madhura, Ushna Madhura Snigdha, Kapha Vata
Katu, Theekshna, Shamaka, Shoola
Thiktha Sookshma, hara, Angamarda
Guru Prasamana,
Deepana,Bhedana,
RechanaVataghna,
ParswaShoolaghna
Kateeshoolaghna.
Chirabilwa Tiktha, Ushna Katu Laghu, Deepana,
Kashaya Rookha Paachana, useful in
inflammations,
dyspepsia,
flatulence,
rheumatism
Hutashwa Katu Ushna Katu Laghu, Rookha, Kaphavatahara,
Theekshna Deepana,Paachana
Arshoghna,Thripthik
hna & Shoolaghna

25. Drug name Rasa Veerya Vipaka Guna Karma
Vishwa Katu Ushna Madhura Laghu Deepaka,Paachaka,
Snigdha Ruchya, Kaphavatashama
Swarya,Shothahara,
Vedanasthapana,Truptigna
Patdhya Madhura, Ushna Madhura Laghu, Anti inflammatory.It is mild
Amla, Rooksha laxative.
Katu,Tiktha, Prabhava of Hareetaki is
Kashaya Tridosha Shaamaka
Punarnava Tiktha Ushna Katu Laghu, Kaphapittahara
Rooksha Sothahara & Visaghna.
It is effectively in dysuria,
fever, anemia and colic
Yavasaka Madhura, Sheetha Madhura Laghu, KaphapitaShamaka
Tiktha, Snigdha Sodhahara,Jwaraghna,
Kashaya Vedanasthapana, Vrushya
and Medohara
Musali Madura Sheetha Madura Guru, vatapitta Shamaka,
Snigdha Snehana, Mutrajanana,
Balya & Vrushya

26. MODE OF ACTION OF TRIAL DRUG
1)The trial drug as such provided mild laxative effect which will lead
to the vatanulomana.
 The main drugs which help for that are gandharvahastha,
hareethakee, chirabilwa & punarnava.
 These all drugs are ushna veerya drugs. Thus these three drugs
act both prakruthivighata and apakarshana drugs in the
management of grudhrasi.
2)The drugs like chitraka & shunti are helping to do the deepana
pachana of the kapha dosha which causes the srotorodha, and
leads to srotoshodhana
 These drugs mainly helpful for the vatakapha type of grudhrasi.
These drugs are having ushna veerya ,ushna & theeshna guna.
Thus these drugs also act as both prakruthivighata and
apakarshana drugs in the management of grudhrasi.

27. 3)The drugs yavasa and musali along with hareethkee punarnava and shunti
having brumhana property thus leads to the dhatuposhanam, as a result
vatashamana occur.
Thus these drugs act as prakruthivighata drugs in the management of
grudhrasi
4)Almost all the drugs have the qualities like shoolahara, vedanasthapana,
deepana , pachana, ruchya, malasodhana as well as vathashamana
property by there combined action to get the vatha dosha anulomanam.
5)Deepana, pachana, chedana properties help the drug to do
srothoshodhana thus it helps to relieve vatakopa developed due to the
margavarodha by kaphadosha –vatakapha grudhrasi
6)Malashodhana property helps the vathanulomanam which ultimately helps
to relieve vatakopa and thus it relieves pain
The above mentioned combined or synergic action of all the ingredients
help the trial drug Gandharvahasthadi Kwatha to do the effective
management in the progression of both type of Grudhrasi ie VATHIKA
and VATHKAPHAJA

28. CONCLUSION
 Grudhrasi affects persons of any age group, even though the
incidences were more in the age group of 40-50 years.
 Chronicity of the disease was definitely affecting the strength of
the patient as well as the prognosis.
 Nidana parivarjana have a major role in controlling the
progression of this disease and hence as a first step, a strict
advice against hard work, continuous sitting etc. has been given.
 The trial drug of Gandarvahasthadi kwatha has a prime role in
the management of Grudhrasi by Srotovisodhana, Pachana,
deepana, rochana, malasodhana, vatanulomana and
Dhatuposhana.

29.  The medication with the trial drug of
Gandarvahasthadi kwatha showed significant
improvement in the SLR test and did not have any
untoward effect on the patients.
 The trial drug of Gandarvahasthadi kwatha provided
long lasting result on almost all the complaints which
was well appreciated during the follow up period.
 The study revealed that results are statistically
significant in the management of both vatika and
vatakaphaja types of grudhrasi