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Introduction

Ayurveda is the science of life which is focused on maintenance of positive health in the healthy and eradication of ailments in the diseased through its holistic approach, lifestyle practices, dietary habits and safer medications. Today medoroga is a major concern to deal with. Excessive accumulated fat may cause significant health and social difficulties. Prevalence of obesity and thereby dyslipidemia has significantly increased during the last few decades. National Health and Medical Research Council, Australia, fetched the attention of healthcare professionals for the treatment of obesity in adults, adolescents and children hence every age group is being affected by obesity and dyslipidemia significantly [1].  W.H.O. predicted that approximately 2.3 million adults are overweight (BMI between 25 to 29.9 kg/m2) and more than 700 million are obese. Medoroga (obesity) is directly linked to several different physical conditions like dyslipidemia, cardiovascular risk, stroke, etc3. Asanadi Ghana is introduced by Vagbhatta in Ashtang Hriday Samhita in chapter 15 of Sutrasthan in which he classified number of drugs having same actions in one group. Asanadi Ghana has 20 drugs having same functions like Medo dosh nashak, shwitra nashak, premeh hara, pandu and kruni nashan[2].The combination of such drugs may show the same properties. Hence synergetic effects of all these drugs could be seen when they are used in the management of dyslipidemia to treat this condition.

Need of Study:

A best cost-effective combination which can help to normalize the lipid levels to avoid further deteriorations. Asanadi Gana can be beneficial in many ways i.e. to treat dyslipidemia and to avoid complications of allopathic drugs like statins, fibrates, etc. also these drugs have certain limitations too. Hence, there must be an ayurvedic classical preparation to treat dyslipidemia which would be safer[4].

Aim :To evaluate the efficiency of Asanadi Gana Kwath Ghanavati in the management of dyslipidemia.

Objective :To evaluate the efficiency of Asanadi Gana Kwath Ghanavati in the management of dyslipidemia through conceptual study.

Need of Study:

A best cost-effective combination which can help to normalize the lipid levels to avoid further deteriorations. Asanadi Gana can be beneficial in many ways i.e. to treat dyslipidemia and to avoid complications of allopathic drugs like statins, fibrates, etc. also these drugs have certain limitations too. Hence, there must be an ayurvedic classical preparation to treat dyslipidemia which would be safer[4].

Aim :To evaluate the efficiency of Asanadi Gana Kwath Ghanavati in the management of dyslipidemia.

Objective :To evaluate the efficiency of Asanadi Gana Kwath Ghanavati in the management of dyslipidemia through conceptual study.

Disease review:

The disease medoroga has been described in detail in the classical texts like Bruhatraiyi and Laghutrayi.

Definition:  Ati-Sthulat-Bruhanam vridhhi Durgadas – meaning excessive meda (fat) in the body.

Survey of literature

Charak Samhita [5] – Charak has explained this disease in Ashtoninditadhya – sutrasthan – 21. Also in sharirsthan – 3/12 Khuddika Garbhavakruti sharir. He told that the medo dhatu is matruj bhav. He also explained the management of medovruddhi in sutrasthan chapter 21.

Sushruta Samhita [6] – In sharirsthan adhayay 15, named dosh dhatumalakshay vruddhividnyaniy he emphasized the pathogenesis and management of the disease with some useful dravyas. He also explained medodhatu with its physiology in the sutrasthan 15/5.

Ashtang Sangrah [7]– chapter 23 – Dwividhopakramaniya adhyay – according to Vagbhat over eating of snigdh dravyas and sedentary lifestyle can cause medodhatu vriddhi in the body.

Ashtang Hriday8 – Sutrasthan – 14. He explained the shodhan, deepan and pachan ruksham treatment for medovruddhi.

In shodhanadi Gan Sangrah Vagbhat told the unique combination to treate medoroga (dyslipidemia) i.e. Asanadi Gana.

Madhav Nidan [9] – Medorog nidan 3, chapter34

Bhavprakash [10] – He explained the signs and symptoms in Rogi pariksha prakaran 65 – 66

Sharangdhar Samhita [11] – Kaladi prakaran – 21. According to him medodhatu is oily, guru and gives strength to the body.

Yogratnakar [12] – Medoroga chikitsa – He has explained the treatement in detail.

Bhel Samhita [13] – sutatrthan 11/10 samashayana parighniy adhaya

Chakradatta [14] – Chapter 36

Table no.1 Nidan of Medoroga

Samprapti: [14]

The above etiological factors vitiate the agni and formation of aama takes place. This aama covers the internal lining of different body channels and srotorodha takes place. According to Gangadhar, the movement  of vata dosh is specially confined to Koshtha resulting stimulation of agni and the patient becomes voracious eater and only the medodhatu is accumulated in the body. The vitiated medodhatu emits bad and unpleasant odour due to sweating.

Modern review of dyslipidemia [15]

Dyslipidemia may be 1. Primary (genetic) 2. Secondary – caused due to lifestyle and other factors. Primary causes are single or multiple gene mutations that result in either over production or defective clearance of triglycerides and LDL. Secondary dyslipidemia may be due to sedentary lifestyle with excessive dietary intake of total calories, saturated fat, cholesterol and Trans fats.

Types of lipids:

•    Sr. Cholesterol

•     Triglycerides

•        LDL

•        HDL

•       VLDL

Cholesterol is the circulating fatty substance most implicated in the atherogenic process. Its origin is twofold: 300 to 700 mg per day is of exogenous origin i.e. coming from excessive dietary fat intake. Particularly, elevated LDL, is one of the most prevalent risk factors contributing to the evolution of atherosclerosis and consequent vascular disease. Most of the lipids are in the form of triglycerides. They can cause severe complications as stroke, ASCVD and vascular changes. VLDL are also circulating lipid bodies which can easily deposit in the vessels. HDL is good cholesterol as it carries the LDL and VLDL back to liver where the effect of LDL and VLDL can be nullified.

Management

Intervention - Asanadi Gana Ghanavati

  Dose – 1000 mg BID

Anupan – lukewarm water, before meal

Discussion

Asanadi Gana contains 20 herbs having special characteristics to overcome excessive fats in the body as well as excessive lipids. Asana is Kashaya rasa Pradhan dravya. It is Laghu and Ruksha in Guna and its Vipaka is Katu. Hence it gives strength to intestines with its astringent property also it helps to interfere the excessive absorption of fats from dietary food items. Hence, hypothetically it helps to control the level of tryglycerides. Bhurja Vriksha is Kashaya rasa Pradhan dravya. Its virya is Ushna and Vipaka is Katu. It is best used for its Tridosha shamaka property. By using this herb all tridoshas can be brought to equilibrium hence it corrects the digestive system and helps to regulate the production of chylomicrons, triglycerides, VLDL and LDL. Arjuna is best known for its properties to correct the dyslipidemia. It is Kashaya rasa Pradhan dravya having Shita virya and Katu Vipaka. Its prabhava is Hrudya. It is used as cardiotonic all over the world. Hence, it also controls the dyslipidemia in human body. It maintains the health of internal lining of the blood vessels and coronary arteries. Karanja is Tikta, Katu and Kashaya rasa Pradhan in properties. Its virya is Ushna and Vipaka is Katu. All these drugs which are Katu Vipaki, Ushna Virya and Katu, Tikta and Kashaya in Rasa are best to treat unctus nature of body tissues. The excessive accumulation of body fats in the form of lipids can be removed from body tissues with these special properties. Hence all these drugs are best effective for the management of dyslipidemia. Khadir is Tikta and Kashaya rasa Pradhan dravya. Its Virya is Shita and Vipaka is Katu. With its Lghu and Ruksha Guna it is best used as Kapha-Pitta Shamaka. Hence, it is very useful to regulate the metabolism at the level of liver, intestines and Blood. Its area of action is usually adipose tissues and Skin. It also works as blood purifier hence, obesity, Adiposity and Dyslipidemia can be treated as well. Shirisha is Madhura, Tikta and Kashaya rasa Pradhan dravya. Its virya is Ushna and Vipaka is Katu. It is well known for its Vishaghna property. dislipidemia is also a kind of unwanted proportions of lipids. They act as a Visha dravya (Toxins/Aama) for human body. When Shirish is used to treat this condition, it starts creating equilibrium in the body by detoxification of body tissues by its tridosha shamaka property and nullifies the effects of dyslipidemia. Shinshapa is Kashaya, Katu and Tikta rasa Pradhan dravya. Its Vipaka is Katu and it is Guru and Ruksha gunapradhana dravya. By its Tridosha shamaka properties it is best to treat excessive fats in the human body. Meshashrungi is very effective to treat Rasagata Sneha and Raktagata Sneha as it is Kashaya rasa Pradhan. It’s Virya is Ushna and Vipaka is Katu so, it is Kapha-Vataghna in property.it is also used to purify blood and blood vessels. Shweta Chandan is Tikta and Madhura in rasa. It is Virya is Shita and Vipaka is Katu. It is also known for pittashamaka and Kapha shamaka in property. Rakta Chandan is Guru and Ruksha in Guna having Katu Vipaka and Shita Virya. So, it can control dyslipidimia. Daruharidra is unique to control dyslipidemia in the blood and also it is very useful to maintain the all-physiological processes at the level of intestines and liver. Taad is Madhura in Rasa and Vipaka and it is Shita in Virya. It is known for its Vata-Pitta shamaka property. Palash is Katu, Tikta and Kashaya rasa Pradhan dravya. It is Virya is Ushna and Vipaka is Katu. Palash is very effective herb to restore health of blood and known to maintain adequate HDL in body. Aguru is Katu and Tikta rasa Pradhan dravya having Ushna virya and Katu Vipaka. It is known for its Kapha-Vata shamaka properties hence Aguru is being used to treat excessive fat content in the body. Saag is Katu, Tikta and Kashaya in guna. It is best to treat diseases of Rakta dhatu. Hence used to treat dyslipidemia. Shaal is Kashaya and Tikta in properties it is Virya is Ushna and Vipaka is Madhura. It is Tridosha shamaka so it can treat dyslipidemia and obesity. Puga is Kashaya and Madhura rasa Pradhan. It’s Kashaya rasa is very beneficial to control dyslipidemia. In India it is used daily after having food in many households. Hence it is used for it’s special properties to control Raktagata Sneha. Dhavada is Pitta shamaka as it is Kashaya and Madhura. It also has Shita Virya and Katu vipaka. Indrayava is best herb to control dyslipidemia because it is the best liver tonic. It corrects the almost all pathologies of liver. It is the best drug to correct the metabolism at the level of intestines, liver and different body tissues. Hence it is very useful drug to control dyslipidemia. The synergistic effect of all these drugs in Asanadi Gana could be the best remedy to treat dyslipidemia. Most of the herbs in this combination are Kashaya, Katu and Tikta Rasa Pradhan, having Katu Vipaka and also having Tridosha Shamaka properties18. Hence this combination seems to be appropriate to overcome dyslipidemia and its serious complications on human body. It is known that, dyslipidemia can cause a major risk factor for ASCVD (Atherosclerotic cardiovascular disease), Stroke and peripheral vascular disorders. The raised LDL-C with decreased HDL-C in blood can start formation of plaques in blood vessels. The persistent raised values of cholesterol, triglycerides and LDL in blood are the basic key factors for the formation of atherosclerosis. When the treatment started with Asanadi Kwath Ghana Vati in the patients of dyslipidemia, at the end of three months the values of cholesterol, triglycerides, LDL, VLDL, LDL/HDL ratio and Cholesterol/HDL ratio went significantly down as P<0.01, hence this classical combination of Asanadi kwath Ghana vati is also effective to lower the risk of ASCVD, Stroke and peripheral Vascular disorder.

Conclusion

It is concluded that the Asanadi Gan is having some important herbs which have some special properties to treat dyslipidemia. The herbs act with Rasa and Mahabhut properties. The combination of Katu, Tikta and Kashay rasatmak herbs have best effect on medovruddhi especially the raktgat med and dhatugat med i.e., dyslipidemia can be controlled as well. This classical, herbal preparation can be a good alternative in the management of dyslipidemia.