Research Article International Ayurvedic Medical Journal ISSN:2320 5091

CLINICAL EVALUATION OF SHATAVARYADI CHURNA IN THE MANANGE- MENT OF KSHEENA SHUKRA W.S.R. TO OLIGOSPERMA 1Trivedi Atal Bihari 2 Gupta Twinkle 3 Sharma Pankaj 4 Chaudhary Robin 1Associate Prof. P.G., 2Associate, 3P.G.Scholar, 4P.G.Scholar, Prof. P.G. Deptt. Of Kayachikitsa, J.I.A.R, Jammu, India

ABSTRACT Male infertility has received less attention, even though it is widely reported. According to a population study, incidence of contribution of male factor alone is 40-50%. Management of infertility in modern medical science has its own limitations and adverse effects. Further it can assure only 30 to 40% results. It is every expensive and a common man cannot afford. In Ayur- vedic classics, herbal and herbo-mineral fertility agents are explained in details. Shatavaryadi Churna given in Yoga Ratnakar act as Veerya Vardhak. To prove the action of a drug, a clinical trial on human being is very necessary. Now, in this scientific era, any drug cannot be accepted without a scientific clinical trial. So, clinical trial is very important part of a study. Here the present study is entitled as “Clinical Evaluation of Shatavaryadi Churna in the Management of Ksheena Shukra w.s.r. to Oligospermia”. In this study trial is being done on 30 patients to ob- serve & conclude the effects of Shatavaryadi Churna. Keywords: Ksheen Shukra, oligospermia, infertility, ayurveda, veerya

INTRODUCTION Owing to the changed life styles, equilibrium with nature. Each and every sci- mankind is facing many serious health prob- ence has its own fundamental principles. lems. Often it is taught and preached that Among the medical systems Ayurveda has “Health is Wealth”, but nobody thinks over it also been built up with its own unbreakable these days. In the blind urge to gather wealth, fundamental principles. The ancient scrip- we have invited tensions and stress to be parts tures of Ayurveda were provided with a crys- of our lives. Due to increasing pollution and tal clear vision about the past, present and the adulteration these days nothing available in coming future (Trikala Gyana) by the proper pure form. In this era of fast food, we are tak- eradication of Raja and Tamo Gunas from ing food which is adulterated by preserva- mind. They are known as Gunas Doshas, tives and many other chemicals. These adul- Dhatus and Malas are considered to be the terated dietary habits pose a hazard to health. very basic constituents of a living body. A Ayurveda the science of life, prevention & disease resulted due to the imbalances of longevity, is the oldest & most holistic & these constituents. The Panchabhautic and comprehensive medical system available. It Tridoshik theories are generally applied uses the inherent principles of nature to help while dealing with a patient. Simply the re- maintain health in a person by keeping the in- moval of increased constituents, supply or dividual’s body, mind & spirit in perfect

Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma creation of decreased constituents and keep- for curing oligospermia. Hundreds of formu- ing the normal constituents in their own state lations, herbs & recipes, variety of Pan- can be considered as Chikista. chakarma & rejuvenation therapies are advo- Ayurvedic classics have mentioned that the cated to achieve the above said qualities of reproduction is the work of Shukra Dhatu1. semen. But if there is any type of Dushti in Shukra Ayurveda has advocated a separate branch Dhatu the process of reproduction impaired. which deals with the management of defec- A person having Shukra duhsti is unable to tive semen & spermatogenesis along with fulfill his Chaturvidha Purusharth. There are sexual potency, is called as Vajikarana Tan- eight type of Shukra Dushti. Ksheena Shukra tra (aphrodisiacs medicine). Vajikarana ther- has been described under Shukra dushti. apy is recommended in Ayurveda for men Here, Vata Dosha along with Pitta undergoes who are above 16 & below 70 to maintain op- vitiation and the normal qualities and quan- timum sexual activity & healthy semen. tity of the Shukra Dhatu is deranged. As a re- The treatment of oligospermia comprises of sult of vitiation of Vata and Pitta Doshas the administration of Rasayanas & Vajikara channels which carry Shukra (Shukravaha Dravyas or medicines (virilifactory or aphro- Srotas) under goes Dushti, which in capaci- disiacs) internally, Panchakarma & Vajikar- tates one normal individual from conceiving nana therapies for rejuvenation and lifestyles his life partner, ending in infertility2. modifications will not only help in better con- In modern medicines the conditions associ- ception but also in producing healthy off- ated with Ksheena Shukra in Ayurveda can spring. be well matched with oligospermia. In this AIMS AND OBJECTIVES- condition the sperm count comes below 20 The present research work has been under- mill/ml3. The corresponding decrease in like- taken with following two main objectives lihood of conception is associated with de- are- crease of sperm count. 1. To study the etiopathogenesis of Ksheena As per Ayurveda, oligospermia can be corre- Shukra w.s.r. to Oligospermia. late with ‘Shukra Kshaya’. Even though none 2. Conceptual and Clinical study on of the standard Ayurvedic texts have men- Ksheena Shukra w.s.r. to Oligospermia tioned about the count of sperm or motility of 3. To evaluate the effect of SHATAVAR- sperm but clearly mentions the quality of se- YADI CHURNA in the patients of men in the form of ‘Shuddha Shukra Laksh- Ksheena Shukra w.s.r. to Oligospermia nas’. on scientific parameters. In Ayurveda, healthy semen which is more MATERIALS AND METHODS- fertile is described as, the semen which is 1. Literary source:-A complete review of white, heavy, sticky, and sweet in taste, more all available literatures including classi- in quantity and which may look like the col- cal texts, articles and reputed journals4 our of ghee or honey or oil is always fertile. was done concerned with the disease At Charka, we provide a very effective, ho- Ksheena Shukra (Oligospermia) and the listic & wide range of treatment modalities trial drug Shatavaryadi Churna.

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Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma 2. Selection of cases- The study was con- 1. Subjective parameters. ducted in single group clinically and 2. Objective parameters. pathologically diagnosed selected from Ø Subjective Parameters: the I.P.D of JIAR. • Improvement in the signs and symptoms CRITERIA FOR SELECTION OF of Ksheena Shukra- Daurbalya, Mukh CASES- sosha, Panduta, Sadanam, Shrama, Infertile male patients having Lakshanas of Klaibya, Shukravisrga/ Alpa shukra Ksheena Shukra were selected and sent for visarga semen analysis. If the laboratory report con- • Sexual health parameters5- firms Oligospermia, then those patients were Loss of libido included in present study. Erectile dysfunction Ø Inclusion criteria:- Premature ejaculation 1. Male patients of age ranging from 20 to Decrease in sperm count and other relevant 45 years. symptoms. 2. Diagnosed cases of Oligospermia by se- Ø Objective parameters: men analysis. • Semen analysis i.e. Total sperm count, 3. Patients with psychological disorders. Liquefaction Time, Volume, Viscosity, Ø Exclusion criteria pH, Sperm Count, Sperm Motility rate6. 1. Age below 20 and above 45 years. Subjective & objective parameters will be as- 2. Total Sperm count > 40 million. sessed before, during and after treatment. The 3. Patients with Cardiovascular diseases. data obtained will be subjected to statistical 4. Patients with Tuberculosis and mumps. analysis. 5. Patients with hypertension. POORVA KARMA: - Before starting the INVESTIGATIONS: Semen Analysis- Se- treatment all the patients were given men Analysis i.e. Liquefaction Time, Vol- Haritkyadi Churna in the dose of 5gm at bed ume, Viscosity, pH, Sperm Count, Sperm time for Kosth Shuddhi for 5 days. Motility are done. DRUG DESIGN:- CLINICAL ASSESSMENT: - Clinical as- sessment and the response to the treatment is studied under following two headings Sample size 30 Patients Drug Shatavaryadi Churna Dose 3-5 gms BD, before meal Anupana Cow Milk Duration 60 Days Follow up 1 Month

REGIME: - All the patients will be strictly Pitta Dosha. Patients are also advised to keep advised to avoid the Aharas and Viharas Brahmcharya during the course of treatment. which causes vitiation of Vata Dosha and SAMPLE COLLECTION

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Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma • Sample is collected preferably between DISTRIBUTION OF PATIENTS ACC. TO 9am -11 am. PSYCHOLOGICAL CONDITION • Before sample collection patient is asked The graph here by shows the psychological to remain abstinence for 3-5 days. condition of the patients, out 30 patients • The sample is collected in a dried, sani- 5(16.66%) patients were stressed, tized, wide mouthed plastic bottle. 17(56.66%) were normal, 6(20%) were in the • The patient is asked to deliver the sample condition of anxiety and rest 2(6.66%) were to the lab within 20 minutes. depressed. OBSERVATIONS AND RESULTS DISTRIBUTION OF THE PATIENTS AC- DISTRIBUTION OF PATIENTS ACC. TO CORDING TO PRAKRITI AGE- The tables shows that out of 30 patients The above given table notifies that the sample 46.66% of the patients were having Vata- was split into five classes of five years age Pitta, 30% of the patients were having Vata- group interval. The maximum no. of the pa- Kapha and rest 23.33% of the patients were tients recorded in the age group of 26-30 was having Pitta-Kapha Prakriti. 46.66%, in the age group of 31-35 was DISTRIBUTION OF THE PATIENTS 26.66% and in the age group 36-40 was ACC. TO THEIR MASTURBATION IN- 6.66% was 20%, in the age group of 41-45 DULGENCE was 6.66%. The table shows the masturbation indulgence DISTRIBUTION OF THE PATIENT AC- of all the patients, out of all the patients 3.33 CORDING TO MARITAL STATUS %(1) were regular since adolescence,30%(9) The table hereby reveals the marital status of indulged only in adolescence, 26.66%(8) the 30 patients. The maximum no. of the pa- were occasionally and rest 40% were having tients was married and their percentage is no history. found to 93.33% i.e. total 28 patients were DISTRIBUTION OF THE PATIENTS AC- married. Rest of the 2 patients with percent- CORDING TO THEIR UNDERGAR- age of 6.66 was unmarried. MENTS DISTRIBUTION OF THE PATIENTS AC- The data in the table shows that 66.66% of CORDING TO THEIR AGNI the patients worn synthetic and 33.33% of the Out of the 30 patients 8(26.66%) and patients worn cotton under gar- 11(36.66%) patients were having Samgni and ments.26.66%(8) of the patients worn loose Vishama Agni respectively. Rest 7(23.33%) undergarments and rest 73.33%(22) of the and 4(13.33%) patients were having Tik- patients worn tight undergarments. shana and Madhyama Agni respectively. DISTRIBUTION OF THE PATIENTS AC- DISTRIBUTION OF THE PATIENTS AC- CORDING TO THEIR KSHEENA CORDING TO THEIR BOWEL SHUKRA LAKSHANA The table depicts that out of the total no. of The Ksheena Shukra Lakshana like Dour- patients 60% of the patients were having reg- balya were present in 17 patients(56.66%), ular bowel habit and rest 40% of the patients Mukha Shosha were present in 11 pa- were having irregular bowel type. tients(36.66%), Sadan present in 13 pa-

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Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma tients(43.33%), Shrama present in 16 pa- CLINICAL RESULTS tients(53.33%), Pandu present in 9 pa- Table no.1 Effect Of Shatavaryadi Churna tients(30%), Klaibya present in 7 pa- On Ksheena Shukra Lakshana tients(23.33%) and Alpa Shukra Visarga pre- sent in 10 patients(33.33%). Mean PARAMETERS BT AT MEAN %age DIFF Daurbalya 17 03 82.35 Mukha shosha 11 02 81.82 Panduta 09 03 66.66 Sadanam 13 10 76.92 Shrama 16 10 75 Klaibyam 07 05 28.57 Alpa shukra visarg 10 08 80 Table no. 2 EFFECT OF SHATAVARYADI CHURNA ON TOTAL SPERM COUNT Mean d % S.D. S.E t P Df BT AT 19.20 56.96 37.77 19.67 21.88 3.99 9.45 <0.001 29 Table no. 3 EFFECT OF SHATAVARYADI CHURNA ON VOLUME Mean d % S.D. S.E T P Df BT AT 1.90 2.883 0.983 51.73 0.499 0.09 10.77 <0.001 29 Table no. 4 EFFECT OF SHATAVARYADI CHURNA ON MOTILITY Mean d % S.D. S.E t P Df BT AT 28.67 53.40 24.73 86.25 14.63 2.67 9.25 <0.001 29 Table no. 5 EFFECT OF SHATAVARYADI CHURNA ON LIQUEFACTION Mean d % S.D. S.E T p Df BT AT 17.87 25.17 7.3 40.85 3.19 0.58 12.50 <0.001 29

DISCUSSION Dhatu as well as the semen is Garbhot- Here the topic “Clinical Evaluation of padana. Because of the similarities in the Shatavaryadi Churna in the management of qualities as well as the functions of both Ksheena Shukra w.s.r to. Oligospermia” has Shukra and the semen, the Shukra mentioned been taken to assess the effects of Shamana in Ayurveda can be compared easily to that drug. Ksheena Shukra is a condition where of semen of modern medicine. Although, in in Shukra Dhatu gets vitiated either quantita- Ayurveda many effective remedies for tively or qualitatively due to the vitiated Vata Ksheena Shukra are mentioned without any and Pitta Dosha that are provoked due to said known side effects but a major drawback at- Nidana. Shukra is the Param Sara of Ahara tributed to these remedies are that they in- Rasa. The function attributed to Shukra volve laborious treatment procedures such as 299 www.iamj.in IAMJ: Volume 4; Issue 03; March - 2016

Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma Shodhana procedures, where the patient has The final conclusion can be drawn on the ba- to be hospitalized and moreover, they have to sis of all the clinical observations and the re- follow strict diet and regimen during these sults obtained during the study:- procedures and these procedures are more 1. Dominance of Vata and Pitta Dosha in the time consuming also. Moreover, there are disease Ksheena Shukra can be interpreted some patients who are physically unfit for by clinical data which shows that majority these Shodhana procedures and Shamana of patients (46.66%) were having Vata- treatment has been advised for such kind of Pitta Prakarti, rest of the patients were patients in our Ayurvedic classics. Pitta and Vatta Pradhan prakarti. Major- Oligospermia can be somewhat compare with ity of the patients were from Madhym Ksheena Shukra according to modern sci- Vaya which is again period of Pitta Pra- ence. But, if we consider the characteristics dhanta. feature of Ksheena Shukra, we cannot co-re- 2. Shatavaryadi Churna found highly effec- late Ksheena Shukra with Oligospermia di- tive for the treatment of Ksheena Shukra rectly. The criteria for diagnosis is based and its associated symptoms. strictly on quantity But according to Ayur- 3. Shatavaryadi Churna contains drugs veda the excellent tissue element status is which have Shukral, Vajikaran, Vrishya, hampered. Fertilizing capacity of Shukra Brimhana, Balya, Rasyana, and Ka- Dhatu is depends upon its excellent status ra- moudipak properties. The mode of action ther than the no. of sperm count. drugs which is based on Samanya Vishesh Also, in the present era, due to the change in Nyaya, according to which drugs with sim- life style, hectic activities, and busy life ilar qualities leads to enhance their similar schedules and lack of time also, many a qualities in the subject. time’s patients though fit are not ready to un- 4. Drug also showed promising results in the dergo Shodhana procedures. Keeping this in ejaculatory control and the viscosity of se- mind, an attempt was made to treat the men. Ksheena Shukra (Oligospermia) and study 5. No side effects were observed by the pa- was made to assess the efficacy of Shatavar- tients during the trial period of the drug. yadii Churna on seminal parameters without 6. Being presence of potent drugs in the se- any classical Shodhana procedures. As the lected formulation, it can be tried in the drug under trial are having Balya, Vrishaya, other diseases associated with Shukravaha Shukrala, Vajikarana and Rasayana proper- Srotodusti. Further research can provide ties and are used with ksheera as Sahapana more fruitful results. which is mentioned as Sadhya Shukra 7. The modality of treatment was economi- karaka. Hence the trial of the drug cal, non-invasive, and very easy and can “Shatavaryadi Churna” is done on the 30 pa- be done at OPD level. tients from the OPD of J.I.A.R. and assess- 8. All parameters except Klaibyam show im- ment of the patients on the selected criteria is provement with Shatavaryadi Churna. continuously analyzed. 9. Proper sex education, counseling and die- CONCLUSION tary corrections were found to be most ef- fective in treatement of Ksheena Shukra. 300 www.iamj.in IAMJ: Volume 4; Issue 03; March - 2016

Chaudhary Robinet al: Clinical Evaluation Of Shatavaryadi Churna In The Manangement Of Ksheena Shukra W.S.R. To Oligo- sperma 10. Since the present Yogas contain potent 4. Baghel M.S., Researches in Ayurveda, drugs, they can be tried in other diseases Mridu Ayurvedic Publications, Jamnagar, associated with Shukravaha Srotodushti. 2005. 11. Due to unavoidable circumstances, we re- 5. Jeffery S. Flier, Harrison’s Principles of stricted duration of treatment only for 60 Internal Medicine, 15th Edition, Volume- days. We can expect better result if medi- 1, Mc Graw Hill, Newyork, 2001. cation is extended up to more. 6. Tortora & Grabowski, Principles of Anat- REFERENCES omy and Physiology, 7th edition, Harper 1. Acharya Shukla Vidyadhar and Tripathi Collins College Publishers, New York, Ravi Dutt, Caraka Samhia of Agnivesa, 1993. 2006 Edition, published by Chaukhamba Sanskrit Pratisthan, Delhi. CORRESPONDING AUTHOR 2. Kaviraja Shastri Ambikadutta, Sushruta Dr. Chaudhary Robin Samhita of Maharsi Susruta, Edition 2010, P.G.Scholar, Chaukhambha Sanskrit Publisher, New Dep’t. Of Kayachikitsa J.I.A.R, Jammu, In- Delhi. dia Email: [email protected] 3. CCRW Edwards, Davidson’s principles and Practice of Medicine, 19thedition, Churchill living Stone, New York, Source of support: Nil 2002. Conflict of interest: None Declared

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