A COMPARATIVE EVALUATION OF THE EFFECT OF PANCHMULABALADI IN THE MANAGEMENT OF

(Osteo-arthritis) divided into three Groups A, B and C in terms of the nature of given treatment. Group A patients were prescribed Shamana therapy with Rasnadi guggulu , group B patient were administered Panchamulabaladi ksheer basti in kalabasti schedule of 16 days, group C patients were given Rasnadi guggulu after completion of Panchmulabaladi ksheer basti as per the schedule in group B. Subjective parameters and objective parameters were made out to assess the Clinical response. All group shows statistically highly significant relief in the subjective and objective parameters.


Group -B
In this group, Panchmulabaladi Ksheer Basti in Kala basti schedule of 16 days was administered. Patients were advised Panchkola churna 3gm bid after meal for 3-5 days for Amapachana. Abhyanga with Bala tail and mridu nadi swedana was done prior to basti treatment as purvakarma. In this group 15 patients were registered, out of which 10 patients completed their course.

Group -C
Patients of this group were given Rasndi guggulu after completion of Panchmulabaladi Ksheer Basti as per the schedule of group A and B.
In this group 15 patents were registered out of them 11 patients completed the course.

Assessment Of Clinical Response
Subjective parameters and objective parameters were made out to assess the clinical response in all the groups.

Stiffness scale items:
How severe is your knee joint stiffness after first wakening in the morning and later in the day.   Other 0 0%          Maximum number of patients were having chronicity of 1-2 years (33.33%) , followed by chronicity of more than 5 years (22.22%) and 2-5 years of Chronicity (17.77%).The disease Sandhigatavata is encountered as a Yapya or Kastasadhya variety of disease under the Vatavyadhi and all the Yapyavikaras are chronic in nature. As per observations, the chronicity of the Sandhigatavata is reflected. The chronicity is inversely proportional to the prognosis of disease i.e. if chronicity is less, prognosis is good. In this series, 80% patients gave history of Gradual onset while20% patients gave history of Insidious onset of the disease. Gradual slow progression of the disease Osteoarthritis is common. Data of the present study shows the same thing.
Therapeutic response of the clinical trial : Statistically highly significant relief was obtained in all the groups in the complain of prasaran-akunchanyohvedana ( Pain ) as p < .001 in all the groups but percentage relief in pain was more in Group C than group B, and group B more than Group A. Statistically significant result was obtained in between the group comparison after the treatment as p < .05.
Statistically not significant relief was obtained in Group A in complain of Stambha (Stiffness) as p > .05. In Group B and C highly significant result was obtained (p< 0.001). Degree of improvement was more in group C than group B. Highly significant result was obtained on between the groups comparison as p < .05.
All the groups have highly significant relief in complain of Sparshakshamatwa (tenderness) as p < .001 in all the groups. Between the groups comparison result was insignificant, percentage relief was highest in group C, and B have more percentage relief than group A.
Similarly all the groups have highly significant improvement in Shotha (swelling), Sandhigati-asamarthya (restriction of movement), Atopa (crepitus) and Walking time as p < .001 in all the groups in all the symptoms. Between the Groups comparison was not significant. Degree of improvement by seeing the percentage relief, effect was highest in group C than Group B, group B more effective than group A.
WOMAC Score was significantly reduced in all the groups after trial therapy as p is < .001 in all the groups. The mean difference was 12.21 ± 5.31 in Group A. While it was 21.70 ± 5.12 in Group B and 22.82 ± 4.19 in group C. On intergroup comparison statistical significance was obtained in WOMAC score between Group A and B and Group A and C.
In Group A, B and C, 35.7%, 40% and 63.6% patient respectively had the good response, 50%, 50% and 27.3% have moderate response respectively and14.3%, 10% and 9.1% respectively shows poor response. Any group didn't have No response in any patient.
Shamana therapy as Rasnadi Guggulu provided also better result in all signs and symptoms but low in percentage in comparison to Basti (shodhana) and Basti (Shodhana) followed by administration of Rasnadi Guggulu (shaman).
In this study the Basti therapy has shown beneficial effects on subjective and objective criteria of the patients of Sandhigatavata.

Probable Mode Of Action Rasnadi Guggulu
The Rasnadi Guggulu can reduce the symptoms as well as the degenerative process due to various actions of individual drugs in it. The contents of this composition are all Vata Shamaka. The drugs like Rasna, Eranda, Devadaru are not only capable of pacifying Vata but also is very good in promoting the health by normalising the Doshas. This composition can also help to control the progressive degeneration, desquamation and necrosis of perichondreal tissues and chondrocytes of the articular cartilage. Rasna is a known anti-inflammatory drug as well as disease modifying agents. Amrita, Shunthi, Devadaru have immunomodulatory action from which can regulate the