Efficacy of Guggulu and Shallaki based Ksharasutra with Triphala Guggulu orally in the management of Bhagandara w.s.r. to fistula-in-ano: A open labelled randomized comparative clinical study.
{"title":"Efficacy of <i>Guggulu</i> and <i>Shallaki</i> based <i>Ksharasutra</i> with <i>Triphala Guggulu</i> orally in the management of <i>Bhagandara</i> w.s.r. to fistula-in-ano: A open labelled randomized comparative clinical study.","authors":"Aditya Nema, Sanjay Kumar Gupta, Tukaram Dudhamal, Vyasdeva Mahanta","doi":"10.4103/ayu.AYU_156_16","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>Bhagandara</i> is a disease of ano-rectal region and can be correlated with fistula-in-ano. <i>Ksharasutra</i> (application of medicated thread) is being practiced for ano-rectal disorders, particularly in <i>Bhagandara</i>. <i>Guggulu</i>-based <i>Ksharasutra</i> has shown good results in previous studies. Literatures and experiments of <i>Shallaki</i> showed anti-inflammatory, antifungal, analgesic, wound healing properties and <i>Shallaki</i> <i>Niryasa</i> (resin of <i>Boswellia serrate</i> Roxb.) is also having binding effect. Here, <i>Shallaki</i>-based <i>Ksharasutra</i> is used in comparison of <i>Guggulu</i>-based <i>Ksharasutra</i> with <i>Triphala</i> <i>Guggulu</i> orally for better outcome in the management of <i>Bhagandara</i>.</p><p><strong>Aim: </strong>The aim of this study was to evaluate and compare the efficacy of <i>Guggulu</i> and <i>Shallaki</i> based <i>Ksharasutra</i> with <i>Triphala</i> <i>Guggulu</i> orally in the management of <i>Bhagandara</i>.</p><p><strong>Materials and methods: </strong>Total 46 patients were registered and randomly allocated by computer generated chart by into three groups. In group A (<i>n</i> = 15), <i>Guggulu</i>-based <i>Ksharasutra</i> was applied in fistula-in-ano without any oral medication; in group B (<i>n</i> = 16), <i>Guggulu</i>-based <i>Ksharasutra</i> was applied with <i>Triphala</i> <i>Guggulu</i> orally; and in group C (<i>n</i> = 15), <i>Shallaki</i>-based <i>Ksharasutra</i> was applied with <i>Triphala</i> <i>Guggulu</i> orally. Patients were assessed for pain, discharge, itching and swelling in the affected region and unit cutting time (UCT) of fistulous tract. <i>Ksharasutra</i> was changed by railroad technique on weekly based follow-up till complete healing of the tract occurred.</p><p><strong>Results: </strong>In group A, relief in pain, discharge, and swelling was found and was statistically highly significant while insignificant result was found in itching after cut through of the fistulous tract and the same results were found in group B (<i>n</i> = 14) and group C (<i>n</i> = 15). The mean UCT was higher in group A (8.94 days/cm) than in group C (8.43 days/cm) and in group B (8.59 days/cm).</p><p><strong>Conclusion: </strong><i>Shallaki</i> based <i>Ksharasutra</i> is more effective in cutting of fistula track while <i>Guggulu</i> based <i>Ksharasutra</i> is more effective in pain relief in the treatment of <i>Bhagandara</i>, along with oral <i>Triphala</i> <i>Guggulu</i> as compared to <i>Guggulu</i> based <i>Ksharasutra</i> with and without <i>Triphala</i> <i>Guggulu</i> orally.</p>","PeriodicalId":8720,"journal":{"name":"Ayu","volume":"41 4","pages":"211-217"},"PeriodicalIF":0.0000,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/44/AYU-41-211.PMC9261991.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ayu","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ayu.AYU_156_16","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/6/3 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: Bhagandara is a disease of ano-rectal region and can be correlated with fistula-in-ano. Ksharasutra (application of medicated thread) is being practiced for ano-rectal disorders, particularly in Bhagandara. Guggulu-based Ksharasutra has shown good results in previous studies. Literatures and experiments of Shallaki showed anti-inflammatory, antifungal, analgesic, wound healing properties and ShallakiNiryasa (resin of Boswellia serrate Roxb.) is also having binding effect. Here, Shallaki-based Ksharasutra is used in comparison of Guggulu-based Ksharasutra with TriphalaGuggulu orally for better outcome in the management of Bhagandara.
Aim: The aim of this study was to evaluate and compare the efficacy of Guggulu and Shallaki based Ksharasutra with TriphalaGuggulu orally in the management of Bhagandara.
Materials and methods: Total 46 patients were registered and randomly allocated by computer generated chart by into three groups. In group A (n = 15), Guggulu-based Ksharasutra was applied in fistula-in-ano without any oral medication; in group B (n = 16), Guggulu-based Ksharasutra was applied with TriphalaGuggulu orally; and in group C (n = 15), Shallaki-based Ksharasutra was applied with TriphalaGuggulu orally. Patients were assessed for pain, discharge, itching and swelling in the affected region and unit cutting time (UCT) of fistulous tract. Ksharasutra was changed by railroad technique on weekly based follow-up till complete healing of the tract occurred.
Results: In group A, relief in pain, discharge, and swelling was found and was statistically highly significant while insignificant result was found in itching after cut through of the fistulous tract and the same results were found in group B (n = 14) and group C (n = 15). The mean UCT was higher in group A (8.94 days/cm) than in group C (8.43 days/cm) and in group B (8.59 days/cm).
Conclusion: Shallaki based Ksharasutra is more effective in cutting of fistula track while Guggulu based Ksharasutra is more effective in pain relief in the treatment of Bhagandara, along with oral TriphalaGuggulu as compared to Guggulu based Ksharasutra with and without TriphalaGuggulu orally.
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