Evaluation Of Virechana Efficacy Using Nimbaamritadi Erand Tailam And Gandharvahastadi Erand Tailam In Vatarakta: A Pilot Clinical Trial

Abstract

Background: Gout, a chronic inflammatory arthritis marked by acute joint pain, redness, and swelling, results from the accumulation of monosodium urate crystals due to hyperuricemia. In Ayurveda, it correlates with Vatarakta, a condition arising from the vitiation of Vata dosha and Rakta dhatu. Though modern treatments offer symptomatic relief, they are often accompanied by side effects. Ayurveda advocates Virechana Karma (therapeutic purgation) for Vatarakta, with formulations like Nimbaamritadi Erand Tailam and Gandharvahastadi Erand Tailam being traditionally used. However, clinical evidence comparing their efficacy is limited.

Materials and Methods: A pilot, open-label, comparative clinical trial was conducted on 20 patients diagnosed with Vatarakta, divided into two groups (n=10 each). Group A received Nimbaamritadi Erand Tailam, and Group B received Gandharvahastadi Erand Tailam as Virechana drugs. Patients were assessed on subjective parameters (pain, burning sensation, tenderness, swelling, walking ability) and objective parameters (ESR, serum uric acid) at baseline and on the 1st, 15th, and 30th days post-treatment. Ethical approval was obtained, and informed consent was taken.

Results: Both groups showed symptomatic and biochemical improvements. Group A showed greater relief in pain (39.28%), burning sensation (42.85%), swelling (41.66%), and walking ability (44%) compared to Group B. Group B showed slightly better relief in tenderness (42.30% vs. 38.46%). ESR and serum uric acid levels declined more in Group A (19.13% and 7.31%) than in Group B (13.07% and 3.74%), with the reduction in serum uric acid being statistically significant in both groups (p < 0.05).

Conclusion: Both formulations were effective for Vatarakta, but Nimbaamritadi Erand Tailam provided superior clinical and biochemical outcomes. It can be recommended as a potent Ayurvedic intervention for gouty arthritis. Further large-scale, long-term studies are warranted to substantiate these preliminary findings.