Vol.01, Issue-05, November 2024
Author: Dr. Manasa B., MD Ayurveda
Abstract
Ayurveda is the most ancient and traditional system of medicine in India. Nowadays, many people of all age groups are suffering from Kasa Roga. In modern science, it is called a cough, which is a voluntary and involuntary act that clears the throat and breathing passage. Talisadi Churna is one of the widely used effective formulations frequently prescribed in cough. It has Talisapatra, Shunti, Pippali, Maricha, Vamshalochana, Ela, Twak, and Sharkara as ingredients. In Talisadi Churna, the proportion of Sharkara is twice that of the rest of the ingredients. In recent times, the incidence of type 2 diabetes mellitus has resulted in increased attention. Therefore, the present study is intended to evaluate the action of Talisadi Churna prepared by replacing Sharkara with Stevia rebaudiana in the management of Kasa and to study the effect of Talisadi Churna on blood glucose levels in diabetic patients.
Introduction
Kasa is one of the most common symptoms of respiratory diseases. The to-and-fro movement of air through Pranavaha Srotas is the vital sign of life, the normalcy of which suggests good health. The human respiratory system is mostly exposed to the environment, and due to pollution, it leads to various respiratory tract diseases; Kasa is the most common among them.
Kasa is a disease which characteristically produces a typical sound of a broken bronze vessel[^1]. In the pathogenesis of the disease, there is obstruction of Prana and Udana Vayu due to various reasons. In Ayurveda, Kasa is divided into five types: Vataja, Pittaja, Kaphaja, Kshayaja, and Kshataja. Acharya Charaka has explained the lakshanas of Kasa, which can correlate with cough in modern science.
Amongst all treatment forms available in Ayurvedic literature, oral drug administration, i.e., the Shamana line of management, is quite important, most preferable, and effective. By looking at the individual herbal constituents of Talisadi Churna, it appears that this combination might be effective in combating the signs and symptoms associated with Kasa. In Talisadi Churna, the proportion of Sharkara is twice that of the rest of the ingredients[^2].
In recent times, the incidence of type 2 diabetes mellitus has resulted in increased attention. Globally, type 2 diabetes mellitus is considered a common disease. Dietary habits are a major factor for the rising incidence and risk factors associated with diabetes mellitus[^3]. Among them, sugar consumption is important. There are many different types of sugar, and it is used in almost everything we consume. Artificial sugars are on the rise, but these contain chemicals that may not be good for us. Ayurveda has a holistic approach towards medicine. Even though usage of refined sugar, which has high caloric content, is common in prescribed formulations, it is difficult to prescribe among type 2 diabetes mellitus patients.
Sugar can contribute to our health in a good way; however, if abused, it can cause serious health issues such as diabetes, obesity, unhealthy skin, arthritis, and hyperactivity in children. These sugars, along with contributing calories, remain as risk factors for chronic diseases such as hypertension and cardiovascular disease[^4]. Today, we are searching for better alternatives to chemical-based artificial sweeteners such as Stevia. In the end, our society needs to lower our intake of sugar in order to better our health.
Stevia rebaudiana is a natural alternative to sugar. Studies suggest that it does not raise blood sugar levels, making it safe for people with diabetes[^5]. Traditionally, stevia plant leaves were used to sweeten beverages and medicine for more than 1500 years by the Guarani people of South America[^6]. Stevia leaf contains natural sweet compounds called steviol glycosides with relative sweetness of 30 times that of refined sugar[^7]. The Food Safety and Standards Authority of India (FSSAI) has issued approval for stevia as a sweetener[^8]. Pure stevia is considered as Generally Recognized As Safe (GRAS) by the US FDA[^9].
Therefore, the present study is intended to evaluate the action of Talisadi Churna prepared by replacing Sharkara with Stevia rebaudiana in the management of Kasa and to study the effect of Talisadi Churna on blood glucose levels in diabetic patients.
Objectives
- To compare both samples of Talisadi Churna clinically in patients of Kasa.
- To study the effect on blood glucose levels by both the samples of Talisadi Churna in diabetic patients.
Materials and Methods
Sample Size and Grouping
Sample Size: A total of 40 patients who fulfilled the diagnostic and inclusion criteria of either sex were selected for the comparative clinical study.
Grouping: The 40 patients were assigned into four groups: A1, A2, B1, and B2.
- Group A1: 10 non-diabetic patients with lakshanas of Kasa were assigned to this group.
- Group A2: 10 patients of type 2 diabetes mellitus with lakshanas of Kasa were assigned to this group.
- Group B1: 10 non-diabetic patients with lakshanas of Kasa were assigned to this group.
- Group B2: 10 patients of type 2 diabetes mellitus with lakshanas of Kasa were assigned to this group.
Intervention:
- Group A1 and A2: Given Compound A (Talisadi Churna prepared by classical method with Sharkara).
- Group B1 and B2: Given Compound B (Talisadi Churna prepared by replacing Sharkara with Stevia rebaudiana).
Diagnostic Criteria
- Symptoms explained in classical Ayurvedic texts and modern medical literature.
Inclusion Criteria
- Patients presenting with lakshanas of Kasa.
- Patients of Kasa with chronicity less than 15 days duration.
- Patients irrespective of sex, aged above 15 years and below 70 years.
- Patients known to have type 2 diabetes mellitus presenting with lakshanas of Kasa.
- Diabetic patients on unchanged hypoglycemic treatment at least 3 months prior to inclusion.
Exclusion Criteria
The following conditions were excluded from the study:
- Kshataja Kasa
- Kshayaja Kasa
- Kasa with sub-acute condition and more than 15 days of chronicity history.
- Kasa as Anubandha Lakshana in other systemic diseases except type 2 diabetes mellitus.
- Type 2 diabetes patients with associated complications.
Parameters
Subjective and objective parameters of baseline data and after-treatment data were statistically analyzed.
Subjective Parameters
- Kasa: Cough
- Kanthe Kandu: Itching in throat
- Stevana: Expulsion of sputum
Objective Parameters
- Frequency of bouts of cough
- Duration of bouts of cough
- Blood glucose levels (in diabetic patients)
Observations and Results
Clinical Results
Comparative Results of Both Groups
- Comparative analysis of the overall effect of the treatments in both the groups was done statistically using the unpaired t-test.
- The test shows that the treatment is more significant in Group A when compared to Group B.
- Group A overall result is 72.28% improvement.
- Group B overall result is 68.48% improvement.
- In both groups, blood glucose patterns showed no significant changes after the treatment.
Discussion
Overall Effect of the Therapy
- The comparison showed that the Talisadi Churna prepared by replacing Sharkara with Stevia rebaudiana is almost equal to Talisadi Churna in alleviating the main symptom of Kasa.
- The Talisadi Churna group (with Sharkara) is better in comparison to the variant prepared with Stevia rebaudiana in managing Stevana (expulsion of sputum) and in reducing nighttime symptoms of Kasa.
- Talisadi Churna possesses Katu Rasa (pungent taste), Ushna Virya (hot potency), Katu Vipaka, and Kapha-Vataghna properties predominantly, along with Vata Pittahara, Sheeta Virya (cold potency), and Madhura Vipaka (sweet post-digestive taste), which naturally antagonize Shwasa Roga, a Kapha-Vata predominant disease.
- Stevia has anti-inflammatory and immunomodulatory actions[^10], which may enhance the action of Talisadi Churna and mask the pungent taste of other drugs.
Conclusion
- Comparative analysis of the overall effect of the treatments in both the groups was done statistically. Both groups exhibited statistically significant results in reducing the intensity and frequency of cough.
- Blood glucose patterns showed no significant changes after the treatment in both groups. From these results, it can be concluded that Talisadi Churna does not significantly affect blood sugar levels in diabetic patients.
- Future studies with larger sample sizes and advanced parameters may further evaluate the present findings.
References
- Charaka Samhita, Chikitsa Sthana 18/08, by Vaidya Jadavaji Trikamji Acharya, edited by Agnivesh, revised by Charaka and Dridhabala with the Ayurveda Deepika Commentary of Chakrapani Datta, Chaukhambha Sanskrita Samsthan, Page no. 540.
- Śārṅgadhara, Srikantamurthy KR. Śārṅgadhara Saṃhitā: A Treatise on Āyurveda. Reprint 2009. Varanasi: Chaukhambha Orientalia; 2016. (Jaikrishnadas Ayurveda Series No.58). Madhyama Khanda, Chapter No.6, Shloka No.130-3, Page No.98.
- Caraka and Drdhabala, Sri Cakrapanidatta’s Ayurveda Dipika Commentary. Caraka Samhita of Agnivesa. Reprint Edition 2011. Yadavji Trikamji V, editor. Varanasi: Chaukhamba Surabharati Prakashan; (Chaukhamba Ayurvijnana Granthamala 34). Chikitsasthana, Chapter No.6, Shloka No.4, Page No.445.
- Harvard Health Publishing. The sweet danger of sugar [Internet]. Harvard Health Blog. Harvard Health Publishing; [cited 2019 Feb 28]. Available from: https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar
- Research [Internet]. Stevia.com. [cited 2019 Feb 27]. Available from: https://www.stevia.com/research/
- Stevia | Description, Plant, & Sweetener | Britannica.com [Internet]. [cited 2019 Feb 25]. Available from: https://www.britannica.com/plant/stevia-plant
- Singh PK, Singh D, Nainwal RC. Stevia (Stevia rebaudiana) a bio-sweetener. Anusandhaan – Vigyaan Shodh Patrika. 2018;6(1).
- Chibber. Indian scientific panel recommends stevia approval for food products [Internet]. Foodnavigator.com. William Reed Business Media Ltd.; 2011 [cited 2019 Feb 26]. Available from: https://www.foodnavigator.com/Article/2011/10/04/Indian-scientific-panel-recommends-stevia-approval-for-food-products
- FDA regulatory approach to steviol glycosides [Internet]. NeuroImage. Academic Press; 2018 [cited 2019 Feb 26]. Available from: https://www.sciencedirect.com/science/article/pii/S0278691518307063
- Boonkaewwan C, Ao M, Toskulkao C, Rao MC. Specific immunomodulatory and secretory activities of stevioside and steviol in intestinal cells. Journal of Agricultural and Food Chemistry. 2008;56(10):3777–3784.