Comparative study of a Siddha formulation for

the management of Azhal Keelvayu (Osteo Arthritis)

ABSTRACT

Anti arthritic activity of Santha Sandhirodaya Mathirai (S.S.Pills, a Siddha formulation) was taken up for assessment on Azhal keelvayu (Osteo arthritis) patients. 120 patients were selected and divided into 3 groups. I group received S.S.Pills 3 pills with Thunai marunthu (Adjuvant) 1 gm of Thirikadugu choornam three times a day with honey, II group received Thirikadugu choornam 1 gm three times daily with honey. III group received S.S. Pill 3 tds with honey. Treatment period was 21 days without any interval. The anti arthritic effect of Santha sandirodaya mathirai alone and with adjuvant were assessed and compared with the clinical parameters such as pain, tenderness, swelling by joint circumference. The I group and III group showed more or less equal effect on Azhal keelvayu both clinically and statistically.

Azhal Keelvayu in Siddha system of medicine:

This is the first system to emphasize health as the perfect state of physical, psychological, social and spiritual components of a human being. The fundamental principle of this medicine is successfully eliminates the evil side effects without losing the beneficial medicinal properties. In India it is estimated that approximately four out of 100 people are affected by Azhal keelvayu (Osteo arthritis). According to Siddha system of medicine diseases are said to be the result of derangement of one or two or all the three humours (Vali, Azhal , Iyam ). Accumulation of vali kutram in poruthu (Joints) is said to be keelvayu. One of the leading causes of illness among aged people is Azhalkeel vayu.. The signs and symptoms of Osteo arthrits is simulate the symptoms described in Azhal keelvayu in Siddha.The goal of Azhal keelvayu therapy is to decrease pain and maintain or improve joint function.. In Siddha large number of medicines is available for the management of Azhal keelvayu. One such medicine is Santha santhirodaya mathirai (Veeramamunivar vagada thirattu)

Preparation of the drug ((Veramamunivar vagada thirattu)

• Venkaram (Borax) – 10gm.

• Rasa Karpooram – (Mercuric sub chloride) – 20 gm.

• Manjal (Curcuma longa) – 60gm.

• Elumichai Charu (Lemon Juice) – 110 gm.

Method

Purified Rasa Karpooram, Purified Venkaram and manjal were ground with lime juice for 12 hrs, then brought into fine consistency, rolled into 100mg pills and dried in shade.

Dosage                              3 pills thrice daily

Thunaimarunthu-                1 gm Thirikadugu chooranam

Anupanam (Vehicle)             Honey

Therapeutic uses

• Rasa karpooram (Mercuric subchloride) is useful for vatha thodam, pitta thodam, juram, kamalai,etc. Mercury is widely used in Siddha medicine. Siddhars used Mercury not only to cure innumerable diseases, but also to rejuvenate the body and promote longevity.

• Manjal (Curcuma longa) is useful for many diseases. It has potent anti inflammatory and hepatoprotective property also.

• Vengaram (Borax) is effective in peptic ulcer, skin diseases etc.

Atomic absorption spectrometry analysis

• The concentration of Mercury in two marketed samples was analyzed by using atomic absorption spectrometry.

• Sample I 6.204mg/l

• Sample II 13.61mg/l

• Sample I is selected for further studies.

X-Ray Fluoresecence Spectrometric study

XRF study of Santha Santhirodaya mathirai shows that `the presence of Aluminium, Carbon, Calcium, Chlorine, Copper, Iron, Mercury, Potassium, Magnesium, Manganese, Sodium, Phosphorus, Sulphur, Silicon, Titanium, Oxygen, Palladium, Rhenium, And Strontium.

RESULTS AND DISCUSSION:

The concentration of mercury present in the sample used is 6.204mg/dl. XRF analysis shows the presence of Calcium ,Phosphate,Copper in the drug which is essential for bones. Deficiency of these minerals produces demineralization of bones. The presence of these minerals in the drug may be useful in Azhal keelvayu.

Clinical evaluation

120 patients of both sexes and age group above 50 years were selected randomly with the clinical features such as pain, swelling, and tenderness. Azhal keelvayu can detected either through physical examination for joint changes or X-ray of joints in the affected areas. The circumference of the joint, X- ray knee joint were taken before treatment. The patients were divided into 3 groups according to the administration of the test drug and anupanum. The drug was administered for a period of 21 days for all the three groups.

• Group I  - 40 patients received S.S.Pills (3pills) and Thirikadugu Chooranam (1 gm)

• Group II  - 40 patients received Thirikadugu Chooranam(1gm)

• Group III - 40 patients received S.S.Pills.(3 pills)

 The improvement in signs and symptoms were clinically and statistically observed and compared.

Table 1

The table shows that the improvements in Pain, tenderness, swelling were statistically significant in all the three groups (Paired chi square).

B.T – Before Treatment,  A.T – After Treatment.

Table II and III shows that the reduction in joint circumference in all three groups were statistically significant (Paired‘t’ test).

The mean joint circumference reduced by group I was compared with group II. The reduction was about 0.5 cm more in group I than the group II that was statistically significant. Hence we consider that group I was more effective than group II.

The reduction in joint circumference was 0.2 cm more in (group I) than S.S.Pill (group III). That was statistically not significant it means both the groups are having more or less equal efficacy.

Summary and Conclusion

It can be concluded that the Santha santhirodaya pill has got the curative potential to reduce the aggravated vatha which can be evidenced from the pronounced clinical trials. No side effects were observed which suggests that the drug is safe to use therapeutically. This kind of finding can be exploited in the successful treatment of Azhal keelvayu with Santha santhirodaya mathirai.