ROLE OF AMRUTADHYA GUGGULU AND LEKHAN BASTI IN MEDODUSHTI WITH SPECIAL REFERENCE TO DYSLIPIDAEMIA

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ROLE OF AMRUTADHYA GUGGULU AND LEKHAN BASTI IN
MEDODUSHTI WITH SPECIAL REFERENCE TO DYSLIPIDAEMIA
Fulzele Ashwini Ingle Nilesh1 Saroj Udai Raj Mishra D. S.
Department of Kayachikitsa, 1Department of Kaumarabrithya,
National Institute of Ayurveda, Jaipur, Rajasthan, India
INTRODUCTION
During last centuries, life style
alteration has been characterised by
increased calories, fat intake and reduction
in physical activities along with a dramatic
increase in metabolic syndrome related
disorder such as Diabetes, Dyslipidaemia,
HTN, obesity, and so on. Cardiovascular
diseases (CVD) are the major cause of
morbidity and mortality in our society with
Dyslipidaemia contributing significantly to
atherosclerosis. Dyslipidaemia alone
currently affects approximately 10% of
global population. The term Dyslipidaemia
is used to describe disordered lipid
metabolism. All component of
Dyslipidaemia get the most attention
because of the link between cholesterol and
CVD as it is major risk factor for fatal
diseases such as Coronary Artery Disease.
According to WHO survey done in
2002 almost 1/5th (80%) of global stroke
events and about 56% of global heart
disease are attributed to Dyslipidaemia.
This is responsible for about 4.4 million
death (7.9% of the total) and 2.8% of
global disease burden. According to
National Commission on Macroeconomics
and Health (NCMH), government of India
undertaking, there would be around 62
million patients with Coronary Artery
Disease (CAD) by 2015 in India and of this
23 million would be patients younger than
40 years of Age.
Research Article International Ayurvedic Medical Journal ISSN:2320 5091
ABSTRACT
Cardiovascular diseases (CVD) are the major cause of morbidity and mortality in
our society with Dyslipidaemia contributing significantly to atherosclerosis. All components
of Dyslipidaemia get the most attention because of the link between plasma lipids and CVD,
as it is major risk factor for fatal diseases such as Coronary Artery Disease (CAD). As de-
scribed in Ayurveda, Medodushtijanya Sign and Symptoms shows strikingly resemblance
with Dyslipidaemia explained in modern text. Thus while treating the Medodushti, selection
of Dravya should have criteria that help to Lekhana of excessive Meda-Kapha without
Vayu-prakopa and normalising the Agni both at the level of Jatharagni and Dhatwagni.
Thus to assess the efficacy of Lekhana Basti and Amrutadhya Guggulu, present study was
planned and carried out on 30 clinically diagnosed and investigated individuals of
Dyslipidaemia. Patients were selected from OPD and IPD of Arogyashala, NIA, Jaipur.
Patients were administered Amrutadhya Guggulu in dose of 3g/day with 15 Lekhana Basti.
The results were highly significant in both Subjective as well as Objective parameters. Thus,
this study gave very effective, safe, and easily manageable management of Dyslipidaemia in
cheaper rate.
Keywords: Medodushti, Dyslipidaemia, Amrutadhya Guggulu, Lekhana Basti

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AIMS AND OBJECTIVES
To evaluate clinically the combined effect
of Amrutadhya Guggulu and Lekhan Basti
in management of Dyslipidaemia using
various scientific parameters.
MATERIALS AND METHODS
A) Selection of Patients:
The study was conducted on 30
clinically diagnosed patients of
Medodushti and Dyslipidaemia on the
basis of subjective and objective
parameters. Patients were randomly
selected from OPD and IPD of
Aarogyashala, P.G. Department of
Kaychikitsa NIA, Jaipur. A regular record
of assessment of all patients was
maintained according to proforma
prepared for the purpose.
B) Inclusion criteria:
a) Diagnosed and Confirmed cases of
Dyslipidaemia and Medodushti on the
basis of investigations
b) Patients of either sex between the age
group of 20 to 60 years
c) Patients willing to sign the consent
form
d) Patients willing to undergo the process
of Basti therapy
Diagnostic Criteria: Table 1:
Lipid profile used as diagnostic criteria
Serum Lipoproteins
Fasting values (mg/dl)
Interpretation
Total cholesterol
< 200
Desirable
200 -239
Borderline High
> or = 240
High
LDL cholesterol
< 100
Optimal
100-129
Near optimal
130-159
Borderline high
160-189
High
> or = 190
Very High
HDL cholesterol
< 40
Low
>40
High
Triglycerides
< 150
Desirable
150-199
Borderline high
200-499
High
>or =500
Very high
C) Exclusion criteria:
i. Patients below 20 and above 60 years
ii. Patients suffering from diseases like
Nephrotic syndrome, Hypothyroidism,
IDDM, Jaundice, Hepatitis, Chronic
infections and other serious diseases.
iii. Patients contraindicated for Basti as
mentioned in Samhitas.
iv. Patients not willing for consent and
Basti
D) Grouping and Administration of
Drug:
30 clinically diagnosed patients were
administered Amrutadhya Guggul (3g/day)
in three divided doses for 30 days with
lukewarm water and 15 Lekhan Basti.
Anuvasan Basti with Dashmool Taila was
given on 1st day and on every 4th day of
Lekhan Basti i.e. 1 Anuvasan at starting
day and then after 3 consecutive Lekhan

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Basti, one Anuvasan Basti was adminis-
tered. Thus, total 15 Lekhana Basti and 6
Anuwasana Basti were administered.
Study design: Randomized, Control, Open
Clinical study
Criteria for assessment:
Both subjective and objective
parameters were employed for assessment
of the impact of the treatment.
a) Subjective Criteria:
1) Kshudhadhikya
2) Pipasadhikya
3) Kshudrashwasa
4) Sweadadhikya
5) Atinidra
6) Daurbalya
7) Gaurava
8) Daurgandhya
All these symptoms assessment was done by using Symptom Rating Scale as following:
Table 2: Gradation of Subjective parameters
Gradation of Subjective parameters
Absence of symptoms
0
Mild degree of symptoms
1
Moderate degree of symptoms
2
Severe degree of symptoms
3
Very severe degree of Symptoms
4
The details of score adopted for the main signs and symptoms.
b) Objective Criteria:
1) Anthropometric Assessment:
Weight of the Patient (in Kg)
B.M.I.( 24-34kg/m2)
Chest Circumference
Hip Circumference
Waist Circumference
Waist - Hip Ratio
2) Biochemical parameters:
Routine Blood Investigation i.e.
Hb%, TLC, DLC, ESR
Total Lipid profile
Fasting Blood sugar
OBSERVATIONS AND RESULTS
Study shows overall 88.33%
patients belonged to 3rd to 6th decade of
life. Max. 43.33% Patients were Vata-
Kaphaj Prakriti. 55% were found to have
Madhuara Rasa dominant. 51.66%
patients were dominantly having
Adhyashana in their Dietary Habits,
followed by 45% patients with
Vishmashana. Higher incidence of various
Nidanas like 28% patients with Gurvati
Seven,47% patients with Madhurati seven,
50% had history of Snigdhati seven, 50%
patients with Kshiraati seven, 43% with
Adhyashana, 50% Shaiyya sukha, 37%
Swapnasukha, 63% with Avyayama, 47%
with Diwaswapa and 50% with Achinta
etc are found to be etiological factors in
Medoroga. About 58.33%.patients, in the
study showed associated history of
Diabetes mellitus, 35% were having
history of CAD and Osteoarthritis each,
45% patients having the history of
Hypertension associated with
Dyslipidaemia.

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Table 3: showing effect of therapy in Subjective Parameters
(Wilcoxon matched paired single ranked test)
Variable
Mean
Mean
Diff
%
Relief
SD±
SE±
p
S
BT
AT
Kshudhadhikya
0.40
0.06
0.33
83.33%
0.54
0.09
<0.001
HS
Pipasadhikya
0.73
0.26
0.46
63.63%
0.77
0.14
<0.001
HS
Daurbalya
2
0.43
1.56
78.33%
1.10
0.20
<0.001
HS
Swedadhikya
0.56
0.26
0.30
52.94%
0.53
0.09
<0.001
HS
Atinidra
0.63
0.23
0.40
63.15%
0.62
0.11
<0.001
HS
Kshudrashwasa
1.86
0.60
1.26
67.85%
0.69
0.12
<0.001
HS
Gaurav
1.86
0.63
1.23
66.07%
0.72
0.13
<0.001
HS
Krucchvyavayata
1.66
0.10
0.06
40%
0.25
0.04
>0.05
NS
Daurgandhya
0.4
0.26
0.13
33.33%
0.34
0.06
>0.05
NS
(HS: Highly Significant S: Significant NS: Non Significant)
Table 4: showing effect of therapy in Anthropometric Parameters
Parameters
Mean
Diff.
%
Relief
SD±
SE±
T
P
S
BT
AT
Body Weight (kg)
75.01
71.4
3.61
4.82
0.99
0.18
18.6
<0.001
HS
B.M.I. ( kg/m2)
31.36
29.78
1.57
5.02
0.53
0.09
16.1
<0.001
HS
Chest Circumference (cm)
100.9
99.28
1.7
1.68
0.94
0.17
9.87
<0.001
HS
Waist Circumference (cm)
110. 110.2
106.1
4.15
3.76
2.89
0.52
7.85
<0.001
HS
Hip Circumference (cm)
116.1
107.6
8.43
7.26
7.54
1.37
6.12
<0.001
HS
Waist :Hip Ratio
0.91
0.90
0.0011
1.23
0.01
0.003
3.19
<0.001
HS
(HS: Highly Significant S: Significant NS: Non Significant)
Table 5: showing effect of therapy on Lipid Profile
Variable
Mean
Mean
Diff.
% Relief
SD±
SE±
T
p
S
BT
AT
Sr.TC (mg/dl)
229.2
202.7
26.52
11.56
13.5
2.47
10.6
<0.001
HS
Sr.TG (mg/dl)
212.6
191.7
20.86
9.81
11.7
2.14
9.70
<0.001
HS
Sr.LDL (mg/dl)
113.5
104.8
8.64
7.617
7.01
1.28
6.75
<0.001
HS
Sr.VLDL ( % )
47.80
45.15
2.65
5.55
5.07
0.92
2.86
<0.01
HS
Sr.HDL (mg/dl)
66.86
67.5
0.63
0.94
1.84
0.33
1.87
>0.05
NS
FBS (mg%)
92.13
91.66
0.46
0.50
10.2
1.86
0.25
>0.05
NS
(Sr. TC-Serum Total Cholesterol; Sr.TG-Serum Triglycerides; Sr.LDL-Serum Low Density
Lipoproteins; Sr.VLDL- Serum Very Low Density Lipoproteins; Sr.HDL-Serum High Den-
sity Lipoproteins FBS-Fasting Blood Sugar)

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DISCUSSION
Probable mode of action of amrutadhya
guggulu:
Contents of the Amrutadhya
Guggulu are Guduchi (Tinospora
cordifolia), Ela (Elettaria cardamomum),
Vidanga (Embellica ribes), Kutaja
(Halorrhena antidysentrica), Vibhitaki
(Terminalia belerica), Haritaki
(Terminalia chebula), Aamlaki (Embelica
officinalis), Guggulu (Commiphora mukul)
in the proportion of 1:2:3:4:5:6:7:8 i.e.
having highest concentration of Guggulu
in the combination. Guggulu which is
having Pravabha of Medo-Vatahara. Out
of 8 Dravyas, there are 5 Dravyas having
dominant Tikta Rasa, 6 Dravyas having
dominanacy of Kashaya and Katu Rasa.
Katu, Tikta and Kashaya Rasa are having
potential to pacify the Kapha Dosha.
Among these three, Katu Rasa has poten-
tial to enlighten the potential of Agni and
to scrap out the excess Mansa and Meda,
Tikta Rasa is also having properties of
Deepana (enlighten the Agni), Paachana
(enhances digestive power), Kleda-Meda
Shoshaka (scrap out excessive Meda and
Kapha), Srotovishodhaka (open the micro
channels) and potent in Lekhana property,
Kashaya Rasa also has property of Sharir-
Kleda Shoshana. So, by all these
properties it also helps in scrapping of ex-
cessive Meda and Kapha. All these domi-
nant Rasa in this formulation thus helps in
breakage of pathogenesis of Disease. Be-
sides this, there is dominanacy of Laghu,
Ruksha and Tikshna Gunas in the Amru-
tadhya Guggulu which also helps in Kap-
hamedashamaka property and Kleda-
medashoshana. With all these properties,
along with Sukshma property of Guggulu,
helps in Bhedana of Avarana of Samana
Vayu and Vatanulomana-Vataharanam
property of Some Dravyas help to nor-
malise the Apana vayu thus, controlling
the Apana vata other Vata Doshas also can
be normalised in their functions by virtue
of all properties of various Dravyas in the
Formulation. Many of them have been
proved to be Hypolipidemic.
Probable mode of action of lekhana
basti:
Basti is very important therapy to
manage Vata Dosha, and is called as
Ardhachikitsa (half) or Purnachikitsa
(whole treatment plan) in any sort of
diseases, as mentioned in Charak
Siddhisthaan 1/35. Also, Lekhan Basti has
all its contents with Ruksha, Tikshna,
Laghu Gunas dominanat, Ushna Virya,
Katu Vipaka dominant and Kapha-Vatahar
properties. With the Samyaka introduction
of Basti, there is Srotovishodhana along
with Deepana and Pachana i.e.
normalisation of Agni at the level of
Jatharagni and Dhatwagni. Thus it helps
in breakage of Pathogenesis of Disease.
All the properties of contents of Lekhan
Basti administered in this trial, helps in
Kapha-Medaharan, Karshana of excess
Medas from the body and Vatanulomana,
normalising the Apana Vayu fuctions, thus
controlling the functioning of rest Vata
Doshas , so helps to break pathogenesis of
Medoroga.
CONCLUSION
Dyslipidaemia is very prevalent in
today’s society and the risk factor for
cardiovascular disorders mostly seen
associated with diabetes mellitus and
Hypertension.
In this clinical study, effects are highly
significant in both subjective as well as
objective parameters, this shows that

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Medoroga which is considered as Krich-
chasadhya by Acharyas should be treated
with the help of Shodhana therapy.
Thus, it can be concluded that from the
present clinical trial both the Amrutadhya
Guggulu and Lekhana Basti are highly
effective in management of the
Dyslipidaemia.
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CORRESPONDING AUTHOR
Dr. Ashwini Fulzele
PG Scholar, Department of Kayachikitsa
National Institute of Ayurveda,
Jaipur – 302002
Rajasthan, India
Email: dr.ashwinifulzele@gmail.com
Source of support: Nil
Conflicts of interest: None Declared