Dyslipidemia & ayurveda

A VERY CORDIAL WELCOME TO
P.G. Deptt. of KAYACHIKITSA

CONTROLLED RANDOMIZED CLINICAL EVALUATION OF HERBAL
FORMULATION ‘CAP. CARDICAP’ & LEKHANA BASTI IN THE
MANAGEMENT OF DYSLIPIDEMIA W.S.R. CORONARY HEART
DISEASE (HRIDROGA)
Presented by :
Dr. Amit Kumar Sharma
BAMS, M.D. (Ay.)
Ph.D Scholar
PG Department of Kayachikitsa,
NIA , Jaipur.
Prof. R. K. Joshi
M.D. (Ay.), Ph.D (Ay.)
Prof. & Head
P.G.Deptt. of Kayachikitsa
DMS, NIA Hospitals
National Institute of Ayurveda
Jaipur
Supervisor

1. Indrayan A. Forecasting vascular disease cases and associated mortality in India. Reports of the National Commission on
Macroeconomics and Health. Ministry of Health and Family Welfare, India, 2005. Available from:
http://www.whoindia.org/EN/Section102/Section201_888.htm.
2. Lichtenstien AH, Appel J, branda M, et al. Diet and lifestyle recommendations revision 2006. A scientific statement from the American
Heart Association Nutrition Committee. Circulation 2006;114:82-96.
 Cardiovascular diseases : global burden
 by 2015 in India - 62 million patients will be with Coronary
Artery Disease (CAD)1
 Out of it - 23 million would be patients younger than 40 years of
age1
.
 Abnormal cholesterol levels are estimated to cause 18% of the
global CVDs and 56% of the global Ischaemic Heart
Diseases(IHD)2
 For every 1% reduction in lipid level, the risk of heart diseases
reduces by 2.5%2
 Dyslipidemia is an established risk factor for atherosclerotic
disease
PRESENT SCENARIO : NEED OF STUDY

1. Ayurveda and the battle against chronic disease: An opportunity for Ayurveda to go mainstream? Alen Hankey ; Yr : 2010 | Vol.1 | Issue : 1 | Pg :
9-12 Ayurveda and the battle against chronic disease: An opportunity for Ayurveda to go mainstream?

2. Lichtenstien AH, Appel J, branda M, et al. Diet and lifestyle recommendations revision 2006. A scientific statement from the American
Heart Association Nutrition Committee. Circulation 2006;114:82-96.
 Over 80% of the estimated 35 million annual deaths are in low
and middle-income countries and Over 25% are among people
below the age of 601
 The projected deaths from CAD by 2015 are 2.95 million :
 4% > 30 years of age,
 31% will be > 40 years and
 50% > 50 years.
 Evidence of recurrence of Atherosclerosis/blockade of vessels
after 5-7 yrs. Of Angioplasty/By Pass Surgery
 Safe, Non-invasive, Cost-effective, Alternate methods of
Treatment.
PRESENT SCENARIO : NEED OF STUDY

NEWER DEFINITIONS : NEW CHALLENGES
 Dreadful spread of Noncommunicable diseases (NCDs)
worldwide.
 Noncommunicable diseases (NCDs) kill more than 36 million
people each year.
 The four main types of noncommunicable diseases are
1. Cardiovascular Diseases (like heart attacks and stroke),
2. Cancers,
3. Chronic Respiratory Diseases (such as chronic
obstructed pulmonary disease and asthma) &
4. Diabetes
 Nearly 80% of NCD deaths - 29 million - occur in low- and
middle-income countries.

 More than 9 million of all deaths attributed to NCDs
occur before the age of 60; 90% of these "premature"
deaths occurred in low- and middle-income countries.
 Cardiovascular diseases account for most NCD deaths,
or 17.3 million people annually, followed by cancers (7.6
million), respiratory diseases (4.2 million), and diabetes
(1.3 million1
).
 These four groups of diseases account for around 80%
of all NCD deaths.
 They share four risk factors: tobacco use, physical
inactivity, the harmful use of alcohol and unhealthy diets.
NEWER DEFINITIONS : NEW CHALLENGES

WHAT IS DYSLIPIDEMIA : DEFINITION
Atherogenic dyslipidemia comprises a triad of
a. increased blood concentrations of small, dense
low-density lipoprotein (LDL) particles,
b. increased triglycerides, and
c. decreased high-density lipoprotein (HDL)
particles
Atherogenic Dyslipidemia, Cardiovascular Risk and Dietary Intervention , Kiran, Musunuru Lipids.
2010 October; 45(10): 907–914.

According to the guidelines of
NCEP ATP III : Dyslipidemia
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
>or = 60 High
Triglycerides
< 150 Desirable
150-199 Borderline high
200-499 High
>or = 500 Very high

Why would there be an insufficient
blood supply to the heart?
Coronary arteries are the only source of
fuel to the heart
The coronary arteries may become
partially/completely occluded:
 Atherosclerotic Plaques
C.A.D. - Hridroga

Blood Supply to the heart
 Left Main Coronary Artery:
Circumflex Artery (CX) Left
Atrium and Side and Back of
LeftVentricle
Left Anterior Descending
Artery (LADA) Front and
bottom of LeftVentricle
C.A.D. - Hridroga
Right Coronary Artery 
Right Atrium and Right
Ventricle
Posterior Descending
Artery  infero-posterior
aspect of Left Ventricle

ATHEROSCLEROSIS
C.A.D. - Hridroga
 Progressive inflammatory disorder of the arterial wall
 Characterised by Focal Lipid-rich Deposits of Atheroma
that may remain clinically silent.
 When become large enough to impair arterial perfusion
or
 Ulceration or disruption of the lesion
Thrombotic
occlusion Embolisation

ATHEROSCLEROSIS FURTHER LEADS TO
C.A.D. - Hridroga
Dyslipidemia
HTN
Blood
Supply to
Heart

CARDIOVASCULAR RISK FACTORS
1. Age (the major determinant of risk)
2. Male sex
3. Cigarette smoking
4. Diabetes mellitus
5. Cholesterol (as assessed by TC, LDL-C or apoB)
6. HDL-C
7. Blood pressure
8. Family history of premature CAD (younger than 60
years of age)
9. Inflammatory biomarkers (especially hs-CRP) &
10. Overweight and obesity.

AYURVEDIC PRINCIPLES : MEDO ROGA
NIDANA
 vO;k;kefnokLoIu'ys"eykgkjlsfou% A
e/kqjks·Uujl% izk;% LusgkUesn % izo/kZ;sr~ AA (Ma.Ni.-
34/1)
 rnfrLFkkSY;efrlEiwj.kkn~xq:e/kqj'khrfLuX/kksi;ksxknO;
k;keknO;kok
;kn~fnokLoIukn~g"kZfuR;RoknfpUruk}htLoHkkokPpksi
tk;rsA (Ch. Su. – 21/04)
 esnL;rho lao`)s lglSokfuykn;% A
fodkjku~ nk:.kku~ d`Rok uk'k;UR;k'kq thfore~ AA
(Ma.Ni.- 34/8)

vO;k;ke - Lack of physical activity or exercise
fnokLoIu – Day Dreaming or lathargyness
'ys"eykgkjlsfou% & e/kqjks·Uujl%
izk;% LusgkUesn % izo/kZ;sr –
Indulgence in food item rich in calories, fats
g"kZfuR;Ro , vfpUru – No mental work,
No involvement in owns surroundings

CLINICAL MANIFESTATIONS OF MEDO-DHATU DUSTI
 ¥çÌSÍêÜSØ ÌæßÎæØéáæðãýUæâæð
ÁßæðÂÚUæðŠæÑ ·ë¤‘ÀþUÃØßæØÌæ ÎæñÕüËØ´
Îæñ»ü‹ŠØ´ SßðÎæÕæŠæÑ ÿæéÎçÌ×æ˜æ´
çÂÂæâæçÌØæð»à¿ðçÌ Öß‹ˆØCUæñ ÎæðáæÑÐ (Ch. Su.
21/4)
 'kSfFkY;kr~ lkSdqek;kZn~ xq:RokPp esnlks toksijks/k
%A (Ch. Su. – 24/04)
AYURVEDIC PRINCIPLES : MEDO ROGA

Nidana Sevena
Kapha Bhuistha Dosha Vridhi
Jatharagnimandya
Ama formation
Samarasa formation
Medodhatwagnimandyata
Poshaka Sama Medo Dhatu
Poshya Sama Medo Datu
Circulates in
the Body
Uttaradhatu Poshanabhava
Ahara : Excessive intake of
Kapha – Medovardhaka Ahara
e.g. ? Saturated fat intake,
TFAs etc.
Beeja Swabhava
(Genetic factor)
Vihara : Sedentary life style
e.g. Avyayama. Diwashayana
etc.
Ama mixing with Dosha
Dushya, Mala
Madhuratarasya
Rasavridhi
Continuation of Ama production
and sama condition
Continuous
Nidana Sevana
Circulates in the body
Medoroga
Deposits in
Various Srotasa
Upadravapadravas
Vikriti Mulaka
Medovridhi
Due to constant incoming
of Medo Poshakamsa
Medo Dhatu
Dusti

Dosha Tridosha Kapha - Kledaka
Pitta - Pachaka
Vata - Samana , Vyana
Agni Jatharagni
Parthiva, Apya Bhutagni
Rasa and Meda Dhatvagni
Dushya Rasa, Meda Dhatu
Utthana Amashaya
Srotas Medovaha Srotas
Roga Marga Bahya
Kha-vaigunya
Sthala
Rasavaha and Pranavaha Srotas
Dosha-Dushya
Sammurchana
Prakriti Sama Samaveta or Vikriti Vishama Samaveta
Sroto Dushti Sanga
Margavarodha (Ch.Su. 21/3-4)
Vyadhibala Daruna
Svabhava Chirakari
Prabhava Krichchra Sadhya, in chronic cases Asadhya
Adhisthana Whole Body, particularly Vapavahana and Medodhara Kala
MEDOROGA : SAMPRAPTI GHATAKA

Following modern terms can be probably correlated with their
parallel terms in Ayurvedic literature, which take active part in
the development of various type of C.A.D in Table
• Familial predisposition for
coronary artery diseases
Kulaja Vikriti or Beejaswabhava
• Dietary factors of hyperlipidaemia Ati Snigdha,Madhura, Guru
Bhojana
• Failure of mechanisms to maintain
normal blood levels of lipids,
glucose,lipoproteins
Agni Dusti
• Hyperlipidaemia,high levels of LDL
& VLDL & low levels of HDL
Medo Dusti
• Initial structural disintegrity of
intima of coronary arteries
Khavaigunya
• Stage of appearance of fatty
streaks in the intima of coronary
arteries
Sthana- Sansryavastha
• Coronary atherosclerosis
• (Pre-clinical stage)
Hrit- Dhamanipratichaya
• Narrowing of coronary arteries due
to atherosclerotic plaque
Sroto Sanga

AYURVEDIC PRINCIPLES : MEDO ROGA :
CHIKITSA SIDHHANT
 Hyperlipidaemia can be managed effectively on following Ayurvedic
principles of treatment.
1. Nidana Privarjana
2. Langhana, Upavasa
3. Shodhana therapy
4. ShamanaTherapy
la{ksir% fØ;k;ksxks funku ifjotZue~ A (Su
prq"izdkjk
(Su. Utt. – 1/25)

AYURVEDIC PRINCIPLES : MEDO ROGA :
CHIKITSA SIDHHANT
 Hyperlipidaemia can be managed effectively on following
Ayurvedic principles of treatment.
1. Administration of Dipana, Pachana and Lekhana drugs.
2. Kapha Meda Nashaka Chikitsa - Use of Katu andTikta
Rasa Dravya
3. Vyayam & Pranayama

HRIDROGA IN AYURVEDA
nw"kf;Rok jla nks"kk foxq.kk% ân;a xrk% A
dqoZfUr ân;s ck/kka ânzksx ra izp{krs AA
(Su.Su. 43/4)
 Any type of Badhaa (obstruction) felt in doing day-to-day
work, may be due to Hridroga. This ‘any type of Badhaa’ may
be correlated with breathlessness due to exertion,
palpitation, discomfort or pain in chest on walking etc.
C.A.D. - Hridroga

HRIDROGA IN AYURVEDA
 Five types of Hridrogas have been described : (Ch.Su.17,
Ma.Ni. 29)
1. Vataja 2. Pittaja 3. Kaphaja
4. Sannipataja 5. Krimija
C.A.D. - Hridroga

oSo.;ZewPNkZTojdklfgDdk'oklkL;oSjL;r`"k
kizeksgk% A
NfnZ% dQksRDys'k#tks∙#fp'p ânzksxtk%
L;qfoZfo/kkLrFkk∙U;sA
(Ch.Chi. 26/78)
vvvvvvvvvvvvvvvvvvv
vv vvv
vvv
vvvvv
vcccc
ccccc
c
vvvvv
v
HRIDROGA IN AYURVEDA :
CLINICAL MANIFESTATIONS

Mitya-Ahara-Vihara Sevana,
Swaprakopaka Nidana
Agni-Mandya
Sama Rasa Utpatti
Srotorodha,
Dhamani Pratichaya
Uro-Ruja
Hridroga
KULAJA
MITHYA AHARA-VIHARA
• Excess of Guru, Madhura,
Snigdha food.
• Smoking etc.
SNEHA-VYAPATA
(Dyslipidaemia)
DHAMANI PRATICHAYA
(Cor. Atherosclerosis)
HRIDROGA
(C.A.D.)
HRIDROGA : SAMPRAPTI (pathogenesis)
C.A.D. - Hridroga

Dosha Tridoshas specially Avalambaka Kapha, Sadhaka Pitta, Vyana and
Prana Vayu,
Agni Agni Mandya, Dhatvagni-Rasagni and Medagni Mandya
Dushya Rasa Dhatu, Ojas, Meda Dhatu
Utthana Amashaya, Pakwashya
Srotas Rasavaha Srotas
Roga Marga Madhyama Roga Marga
Kha-vaigunya
Sthala
Rasavaha and Pranavaha Srotas
Dosha-Dushya
Sammurchana
Prakriti Sama Samaveta or Vikriti Vishama Samaveta
Sroto Dushti Sanga, Atipravriti and Siragranthi, later stages Vimargagamana
Vyadhibala Daruna
Svabhava Chirakari
Prabhava Krichchra Sadhya, in chronic cases Asadhya
Adhisthana Hridaya
HRIDROGA : SAMPRAPTI GHATAKA
C.A.D. - Hridroga

GOALS OFTREATMENT
C.A.D. - Hridroga
AYURVEDIC PRINCIPLES : HRIDROGA :
CHIKITSA SIDHHANT
rUegr~ rk egkewykLrPpkSt% ifjj{krk A
ifjgk;kZ fo'ks"ks.ks eulks nq%[kgsro%
AA
â|a ;r~ L;k|nkStL;a lzksrlka ;r~
izlknue~A
rÙkr lsO;a iz;Rusu iz'keks Kkueso
pAA
(Ch.Su. 30/13-14)
1. To Prolong life span
2. Improve Quality of Life
3. Prevent Myocardial Infarction
4. Improve Effort Tolerance

 Chikitsa Siddhanta:
 Nidana Parivarjana (e.g. Smoking AlcoholTobacco)
 Doshanusara Chikitsa
 Hrid-Balakaraka Aushadha
 Complete Rest (Physically & Mentally)
 Diet & Lifestyle Modifications
NOTE : Vatasamaka and Kapha Samaka medicines should
be administered as Vata is the causative Dosa and
Heart is situated in the region of Kapha.
CHIKITSA SIDHHANT

For achieving these objectives, following measures
are to be adopted :
1. Explanation of the nature of illness and
reassurance to the patient.
2. Modifications of Risk Factors .
3. Treatment of coexisting condition viz. Anaemia,
Hypertension and hypo or Hyperthyroidism.
4. Modification of Activities – Physical activities
should be modified to maintain the balance
between the myocardial oxygen supply and
demand. Physical efforts which precipitate
angina should be avoided.
CHIKITSA SIDHHANT

5. Treatment of Vatika Hridroga should be followed in
Angina Pectoris
6. In case of strong patient mild Vamana Karma and
mild Basti Therapy is recommended.
CHIKITSA SIDHHANT

CLINICAL STUDIESCLINICAL STUDIES

1. Conceptual and clinical studies on Medoroga vis-a-vis
Dyslipidemia w.s.r. to Coronary Artery Disease
(Hridroga) on various scientific parameters.
2. Clinical evaluation of the role of proposed
formulations Cap. Cardicap & Lekhana Basti) treatment
in the management of Dyslipidemia (Medoroga).
3. To put forward a hypothesis in the form of effective
strategies as Ayurvedic approaches for prevention of
Dyslipidemia (Medoroga) w.s.r to Coronary Artery
Disease (Hridroga).
AIMS & OBJECTIVES

 The current research project is a randomized, comparative,
open ended, pre and post design, clinical trial.
 Selection Of Patients:
 The present study was done on 60 clinically diagnosed and
confirmed patients of Medoroga Roga and Dyslipidaemia,
randomly selected from the OPD/IPD unit of P.G.
department of Kaya Chikitsa & Arogyashala, National Institute
of Ayurveda, Jaipur and Cardiology Unit of S.M.S. Bangar
Memorial Hospital, Jaipur.
MATERIALS AND METHODS

 Exclusion Criteria adopted for the current clinical
trial :
1. Patients suffering from obesity due to hereditary
indisposition.
2. Patients suffering from drug induced obesity.
3. Dyslipidaemia due to injudicious use of drugs such as
diuretics, corticosteroids, etc.
4. Increased abdominal girth due to other diseases e.g.Ascites.
5. Having hormonal disorder e.g. Hypothyroidism, IDDM.
6. Congestive Heart Failure

 Exclusion Criteria adopted for the current clinical
trial :
7. Acute Myocardial Infarction
8. Congenital Anomalies
9. Valvular Diseases
10.Hypertrophied Cardio Myopathies
11.Diabetic Complications
12.Severe Hypertension
13.Severe Anaemia

RANDOMIZATION ANDTREATMENT
SCHEDULE :
 Out of 80 cases registered, 60 Clinically diagnosed & confirmed
patients of Dyslipidemia matching our criterias of selection were
selected and randomly divided into following three groups-
 Group I- (Control Group) 20 registered patients of
Dyslipidemia were administered standard allopathic drug Tab.
Atorvastatin 10 mg H.S. with water for 30 days .
 Group II- 20 registered patients of Dyslipidemia were
administered Ayurvedic Herbral formulation “Cap. Cardicap
(Hingwadi Churna)” with Barley Water (Yavambhasa – Yava Sadhita
Jala) for 30 days .
 Group III- 20 registered patients of Dyslipidemia were
administered Ayurvedic Herbral formulation “Cap. Cardicap
(Hingwadi Churna)” for 30 days with Lekhana Basti (15 days)
treatment simultaneously.

CRITERIA FOR ASSESSMENT
Subjective Parameters
 Subjective improvement : in terms of Improvement in general feeling
of well being after the course of the therapy.
 Clinical evaluation in terms of Blood Pressure (Systolic and Diastolic
in mm of Hg), Body Weight (in Kgs.), BMI recorded before, during
and follow up visits.
Objective Parameters : it included
 Hematological Examinations – Hb (gm%), ESR (in mm 1st
Hr).
 Biochemical evaluation in the form of Lipid Profile (mg/dL) i.e. Sr.
Cholesterol, Sr.Triglyceride,V.L.D.L, L.D.L and H.D.L.
 Bld. Urea and Sr. Creatinine (mg/dL) for the safety profiles.
 Blood Sugar Fasting (mg/dL)
 E.C.G. changes.
Blood Pressure Classification – JNC 7, [JNC 7 Express. JAMA. 2003 Sep 10; 290(10):1314]

SYMPTOM RATING SCALE
 It was developed by Prof.A.K. Sharma et. al. for the assessment
of clinical improvement, the incidence of presenting features and
severity of the symptoms of Hridroga (C.A.D.)
S. No. GRADE PERCENTAGE NUMBER ACCORDING
TO GRADE
1. Nil 0% 0 0
2. Mild 25% 1 +
3. Moderate 50% 2 ++
4. Severe 75% 3 +++
5. Agonizing 100% 4 ++++
C.A.D. - Hridroga

CANADIAN CARDIOVASCULAR SOCIETY
 GRADE I - Ordinary physical activity, such as walking, and climbing
stairs, does not cause Angina. Angina occurs with sternous, rapid or
prolonged exertion of work or during recreation.
 GRADE II - There are slight limitations of ordinary activity, walking
more than two blocks on the level and climbing more than one flight
of ordinary stairs at a normal place and in normal conditions.
 GRADE III - Marked limitation of ordinary physical activity, walking
one to two blocks on the level or climbing one flight of stairs in
normal conditions and on normal place will produce Angina.
 GRADE IV - There is an inability to carry on any physical activity
without discomfort.Anginal Syndrome may be present at rest.

ATORVASTATIN
 Class: Lipid-Lowering Agents, Statins HMG-CoA Reductase
Inhibitor
 works by inhibiting HMG-CoA reductase, an enzyme found in liver
tissue that plays a key role in production of cholesterol in the
body.
 DOSE : 10 mg H.S. with water for 30 days .
 Indications:
1. Dyslipidemia
 Indicated as an adjunct to diet for treatment of elevated total-C,
Apo B, andTG levels and to increase HDL-C
2. Cardiovascular disease
 Reduce risk of stroke & heart attack in type 2 diabetes patients
without evidence of heart disease but with other risk CV factors
(eg, smoking, HTN, low HDL-C, family history of early CHD)

ATORVASTATIN
 Contraindications: In active liver diseases like cholestasis,
hepatic encephalopathy, hepatitis, and jaundice, unexplained
elevations in AST or ALT levels, pregnancy and breastfeeding.
 Adverse effects
 Headache is the most common side effect, occurring in more than
10% of patients. Other Side effects that include:
1. Weakness
2. Insomnia and dizziness
3. Chest pain and peripheral edema
4. Rash
5. Abdominal pain, constipation, diarrhea, dyspepsia, flatulence,
nausea
6. Urinary tract infection

ATORVASTATIN
7. Arthralgia, myalgia, back pain, arthritis
8. Sinusitis, pharyngitis, bronchitis, rhinitis
9. Infection, flu-like syndrome, allergic reaction
10. Memory loss/dementia.
11. Elevation of Alanine transaminase (ALT) and Aspartate
transaminase (AST) in few cases.
12. High-dose also been associated with worsening glycemic
control.
13. Myopathy with elevation of creatinine kinase (CK) and
rhabdomyolysis are the most serious side effects, although rare
at <1%.

TRIAL DRUG : CAP. CARDICAP AND ITS INGREDIENTS
Herbal Formulation Cap. Cardicap (Hingwadi Churna)
Textual Reference Bhaishajya Ratnawali 33/21
S.No. Constituents Latin Name Part Used Qty. in Per 500
mg Capsule
1. Shuddha Hingu Ferula narthrax Gum-Resin 45 mg
2. Vacha Acorus calamus Rhizome 45 mg
3. Vida Lavana Ammonium Salt - 45 mg
4. Sauntha Zingiber officinalis Rhizome 45 mg
5. Pippali Piper longum Fruit 45 mg
6. Kutha Sassura lapa Root 45 mg
7. Haritaki Terminalia chebula Fruit Pulp 45 mg
8. Chitraka Plumbago zylenicum Root 45 mg
9. Yavakshara Potassium Salt - 45 mg
10. Sauvarchala Lavana Black Salt - 45 mg
11. Pushkaramula Inula racemosa Root 45 mg
fg³~xwxzxa/kk
foM~fo'od`".kkdq"BkHk;kfp=d;ko'jde~A
ficsRllksopZyiq"djk<aÓ ;okEHklk
'kwyânke;gue~AA ¼ânzksx fpfd- (33/21½½
Dose: 1 gm B.D. i.e. 2 Capsules (500 mg each) B.D. for 30 days
Anupana – Barley Water (Yavambhasa – Yava Sadhita Jala)

Contents Of Cap. Cardicap
Hingu Vacha
Pippali
Shunthi
YAVA
Kootha
PushkarmoolaChitrakamoola
Cap. CARDICAP
Vida Lavana

PHARMACODYNAMICS OF CAP. CARDICAP
(HINGWADI CHURNA)
S.
NO.
Compo
-nent
Drugs
Rasa Guna Virya Vipaka Karma
1. Hingu Katu Laghu,
snigdha,
tikshna
Ushna Katu Anulomana,Hrdya, Deepana,
Pachana, Shulahara,
Krimighna, Balya, Bhedaniya.
2. Vacha Tikta,
Katu
Teekshna,
Sara,
Laghu
Ushna Katu K-V hara, Lekhana
Agnivriddhikar Deepana,
Anulomana.
3. Vida
Lavana
Lavana Laghu,
Tikshna,
Ruksha,
Vyavai
Ushna Madhura K-V hara, Deepana,
Vistambhasulahara,
Hridgauravahara, Aruchi,
Ruchya
4. Shunthi Katu Laghu,
Snigdha
Ushna Madhura K-V hara, Deepana,
Amapachana Vatanulomana,
Hridya, Vedanasthapana
5. Yava
Kshara
Lavana
, Katu
Laghu,
Snigdha,
Teekshna,
Sukshma
Ushna Katu K-V hara, Amapachana,
Deepana, Lekhana, Balya

S.
NO.
Compo-
nent
Drugs
Rasa Guna Virya Vipaka Karma
6. Pippali Katu Laghu,
Snigdha,
Teekshna
Anushna
Sheeta
Madhura K-V hara, , Deepana,
7. Kootha Tikta,
Katu
Laghu,
Ruksha
Deepana, Pachana,
Rasayana
8. Haritaki Kshaya,
Tikta,
Madhura,
Katu,
Amla
Laghu,
Ruksha
Ushna Madhura Tridoshashamaka
9. Chitraka Katu Laghu,
Tikshna,
Ruksha,
Ushna Katu K-V hara Shamaka,
Lekhana, Dipana,
Pachana, Kaphaghana,
Rasayana
10. Pushkar
a Moola
Katu
Tikta,
Laghu,
Tikshna
Ushna Katu Hritashoolahara,
Medohara, Deepana,
Pachana, Anulomana
11. Yava Madhura,
Kashaya
Ruksha
Mridu
Sheeta Katu Lekhana, Kaphahara,
Medohara, Sthairyakara,
Balya, Vrishya
PHARMACODYNAMICS OF CAP. CARDICAP
(HINGWADI CHURNA) […contd]

PHARMOCODYNAMICS OF CAP. CARDICAP
(HINGWADI CHURNA)
S. No. Action of Drug No.of Drugs Percentage
1. Deepana 9 90%
2. Kapha Vatahara 7 70%
3. Lekhana 5 50%
4. Pachana 4 40%
5. Hridya 4 40%
6. Srotoshodhaka 3 30%
7. Vrishya 2 20%
8. Rasayana 2 20%
9. Balya 3 30%
10. Anulomana 2 20%
11. Amapachana 2 20%

LEKHANA BASTI
Triphala Kwatha - 250 ml.
Gomutra - 150 ml.
Madhu - 40 gm.
Saindhava - 10 gm.
Yavakshara - 10 gm.
Vacha + Mulaithi Kalka - 20 + 20 gm.
Sarshapa taila - 50 ml.
 Method of Preparation of Basti
ßf=Qyk DokFk xksew= {kkSnz {kkj
lekfUork%A
Å"dkfnizrhokik oLr;ks ys[kuk% Le`rk
%AAÞ [Su. Chi. 38/81]
C.A.D. - Hridroga
ßekf{kda yo.ka Lusga dYda DokFkfefr Øekr~AÞ
vkokisr~ fu:gk.kka ãso la;kstus fof/k%AA [A.H.
Su. 19/45]

CONTENTS OF LEKHANA BASTI
Madhu Sarshapa Taila Saindhava
Amalaki Vibhitaki Haritaki
(Emblica officinalis) (Terminalia belerica) (Terminalia chebula)

CONTENTS OF LEKHANA BASTI
Gomutra Yavakshara
C.A.D. - Hridroga
Vacha
Mulaithi
Lekhana Basti

S.
NO.
Drug Rasa Guna Virya Vipaka Karma
1. Triphala Kshaya,
Tikta, Katu,
Madhura
Amla
Laghu, Ruksha Ushna Madhura Tridoshahara,
Lekhana,
Deepana,
2. Gomutra Katu, Lavana Laghu,
Ruksha,
Teekshana
Ushna Katu K-V hara, Deepana,
Pachana,
Chhedana,
Lekhana
3. Madhu Kshaya,
Madhura
Guru, Ruksha Ushna Katu K-V hara,
Shodhaka,
Lekhana,
Chhedana,
Medohara
4. Saindhava Lavana Laghu,
Snigdha
Anushna Madhura Tridoshahara,
Deepana, Pachana,
Balya, Vrishya
5. Yavakshara Lavana, Katu Laghu,
Snigdha,
Teekshna,
Sukshma
Ushna Katu K-V hara,
Amapachana,
Deepana,
Lekhana, Balya
6. Vacha Tikta, Katu Teekshna,
Laghu
Ushna Katu K-V hara,
Lekhana,
Deepana, Vrishya
7. Mulaithi Madhur Guru, Snigdha Sheeta Madhura V-P hara,
Asthapanopaga,
Balya, Chhedana
8. Sarshapa Taila Tikta, Katu Teekshana,
Snigdha
PHARMACODYNAMICS OF CONTENTS OF LEKHANA BASTI

ACTION OF DRUGS OF LEKHANA BASTI
S. No. Action of Drug No.of Drugs Percentage
1. Lekhana 6 75%
2. Medohara 6 75%
3. Kapha Vatahara 5 62.5%
4. Deepana 5 62.5%
5. Pachana 3 37.5%
6. Balya 3 37.5%
7. Vrishya 3 37.5%
8. Srotoshodhaka 3 37.5%
9. Tridoshahara 2 25%
C.A.D. - Hridroga
Matra - 450-500 ml.
(according to the
tolerance of patient)
Retention Time - Max. 10 to 12 min.

OBSERVATIONSOBSERVATIONS
&&
RESULTSRESULTS

PATTERN OF CLINICAL RECOVERY OF SYMPTOMS OF
CORONARY ARTERY DISEASE (HRIDROGA) IN 20 PATIENTS
TREATED WITHTAB.ATORVASTATIN (GROUP I)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean
%
S.D.± S.E.± p Result
Breathlessness 2.4 2.2 0.2 8.33 0.41 0.091 0.125 NS
Chest Pain 1.3 0.7 0.6 46.15 0.51 0.16 0.0313 S
Palpitation 2.1 1.0 1.1 52.38 0.74 0.23 0.0156 S
Fatigue 1.9 0.6 1.3 68.4 0.50 0.112 0.007 H.S.
Others 1.8 1 0.8 44.4 0.63 0.2 0.0313 S

CORONARY ARTERY DISEASE (HRIDROGA) IN 20
PATIENTSTREATED WITH CAP. CARDICAP (GROUP II)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean
%
Breathlessness 2.2 0.6 1.6 72.72 0.96 0.30 0.0078 H.S.
Chest Pain 2.0 0.5 1.5 75 0.91 0.29 0.0078 H.S.
Palpitation 1.1 0.4 0.7 63.63 0.67 0.21 0.0313 S
Fatigue 1.8 1 0.8 44.44 0.63 0.2 0.0313 S
Others 2.3 1.6 0.7 30.43 0.48 0.15 0.0156 S

CORONARY ARTERY DISEASE (HRIDROGA) IN 10 PATIENTS
TREATEDWITH CAP. CARDICAP AND LEKHANA BASTI
TREATMENT (GROUP III)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean
%
Breathlessness 2.5 0.9 1.6 64 0.96 0.30 0.0039 H.S.
Chest Pain 2.2 0.9 1.3 59.09 0.67 0.21 0.0039 H.S.
Palpitation 2.2 0.6 1.6 72.72 0.96 0.30 0.0078 H.S.
Fatigue 1.8 0.5 1.3 72.22 0.94 0.3 0.0313 S
Others 2.2 0.8 1.4 63.63 0.84 0.2 0.0039 H.S.

DYSLIPIDEMIA (MEDOROGA) IN 20 PATIENTSTREATED
WITHTAB.ATORVASTATIN (GROUP I)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean% SD
±
SE
±
p Result
Sarva Karya Asamarthata
(Difficulty in Routine
activities)
2.3 1.6 0.7 30.43 0.48 0.15 0.0156 S
Khsudra Shwasa
(Dyspnea)
2.4 2.2 0.2 8.33 0.41 0.091 0.125 NS
Swedadhikya (Increased
Perspiration)
1.3 0.7 0.6 46.15 0.51 0.16 0.0156 S
Daurbalya (Weakness) 1.8 1.1 0.7 38.88 0.67 0.21 0.0313 S

WITH CAP. CARDICAP (GROUP II)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean
%
SD
±
SE
±
p Result
activities)
2.3 1.6 0.7 30.43 0.48 0.15 0.0156 S
Khsudra Shwasa
(Dyspnea)
2.2 0.6 1.6 72.72 0.96 0.30 0.0078 H.S.
Perspiration)
1.8 1.1 0.7 38.88 0.67 0.21 0.0313 S
Daurbalya (Weakness) 1.6 0.9 0.7 43.75 0.48 0.15 0.0156 S

PATTERN OF CLINICAL RECOVERY OF SYMPTOMS OFPATTERN OF CLINICAL RECOVERY OF SYMPTOMS OF
DYSLIPIDEMIA (DYSLIPIDEMIA (MEDOROGAMEDOROGA) IN 20 PATIENTSTREATED) IN 20 PATIENTSTREATED
WITH CAP. CARDICAP & LEKHANA BASTI (GROUPIII)WITH CAP. CARDICAP & LEKHANA BASTI (GROUPIII)
Symptoms Mean
BT
Mean
AT
Mean
Diff.
Mean
%
SD
±
SE
±
p Result
activities)
2.6 1.5 1.1 42.30 0.73 0.23 0.0156 S
Khsudra Shwasa
(Dyspnea)
2.5 0.9 1.6 64 0.96 0.30 0.0039 H.S.
Perspiration)
2.9 1.2 1.7 58.62 0.94 0.3 0.0039 H.S.
Daurbalya (Weakness) 2.5 0.7 1.8 72 0.91 0.29 0.0039 H.S.

PATTERN OF PHYSIOLOGICAL CHANGES INPATTERN OF PHYSIOLOGICAL CHANGES IN
DYSLIPIDEMIA (DYSLIPIDEMIA (MEDOROGAMEDOROGA) IN 20 PATIENTSTREATED) IN 20 PATIENTSTREATED
WITHTAB.ATORVASTATIN (GROUP I )WITHTAB.ATORVASTATIN (GROUP I )
Group I Mean BT Mean AT Mean
Diff.
Mean
%
S.D.± S.E.± t p Result
Body wt. in Kgs. 70.73 69.34 1.39 1.96 1.24 0.39 2.52 <0.01 S
BMI 31.00 29.34 1.65 5.32 1.18 0.39 4.18 <0.01 S
Systolic BP in
mm. of Hg.
144.30 137.50 6.80 4.72 3.43 1.08 5.00 <0.001 HS
Diastolic BP in
mm. of Hg.
87.84 83.04 4.80 5.46 2.86 0.90 5.26 <0.001 HS

PATTERN OF PHYSIOLOGICAL CHANGES IN
WITH CAP. CARDICAP (GROUP II )
Group II Mean BT Mean
AT
Mean
Diff.
Mean
%
S.D.± S.E.± t p Result
Body wt. in Kgs. 70.93 69.1 1.83 2.5 1.77 0.56 3.26 <0.01 S
BMI 29.23 28.36 0.86 2.94 0.91 0.20 4.24 <0.01 S
Systolic BP in
mm. of Hg.
128.70 125.90 2.80 2.17 3.16 1.00 3.75 <0.01 S
Diastolic BP in
mm. of Hg.
84.50 83.10 1.40 1.65 2.32 0.73 2.74 <0.01 S

Pattern of Physiological Changes in Dyslipidemia (Medoroga)
in 20 Patients treated with Cap. Cardicap and Lekhana Basti
Treatment (Group III)
Group III Mean
BT
Mean
AT
Mean
Diff.
Mean
%
S.D.± S.E.± t P Result
Body wt. in
Kgs.
66.150 62.650 3.5 5.29 1.10 0.24 14.22 <0.001 H.S
BMI 28.086 26.817 1.269 4.48 1.11 0.24 5.09 <0.001 H.S
Systolic BP in
mm. of Hg.
138.70 134.70 4.00 2.88 2.67 0.84 4.74 <0.001 HS
Diastolic BP in
mm. of Hg.
86.59 82.79 3.80 4.38 3.71 1.17 3.24 <0.01 S

PATTERN OF HEMATOLOGICAL & BIO-CHEMICAL CHANGES
IN 20 PATIENTS OF DYSLIPIDEMIA (MEDOROGA)TREATED
WITHTAB.ATORVASTATIN (GROUP I )
Observations Mean BT Mean
AT
Mean
Diff
Mean
%
S.D.
±
S.E.
±
t p Result
Hb gm.% 13.08 12.91 0.17 1.29 0.44 0.13 1.21 >0.05 NS
ESR in
mm./Ist hr.
27.01 15.0 12.01 44.69 24.60 7.78 1.54 >0.05 NS
Blood sugar- (F)
mg/dl
129.30 128.55 .750 0.5 3.07 0.68 1.090 >0.05 NS
Blood urea
mg/dl
26.8 26.5 0.3 1.11 26.41 8.35 0.99 >0.05 NS
S.creatinine
mg/dl
0.97 0.79 0.18 18.55 0.63 0.25 2.67 >0.05 NS

PATTERN OF HEMATOLOGICAL & BIO-CHEMICAL
CHANGES IN 20 PATIENTS OF DYSLIPIDEMIA (MEDOROGA)
TREATEDWITH CAP. CARDICAP (GROUP II)
Observations Mean BT Mean AT Mean
Diff
Mean
%
S.D.
(±)
S.E.
±
t p Result
Hb gm.% 13.52 13.13 0.39 2.88 0.58 0.18 2.11 >0.05 NS
ESR in mm./Ist
hr
27.5 10.2 17.3 62.90 16.74 5.29 3.26 <0.01 S
Blood sugar-(F)
mg/dl
119.30 117.90 1.4 1.1 6.41 1.43 0.341 >0.05 NS
Blood urea
mg/dl
31.9 26.9 5.0 15.67 3.53 1.11 4.70 >0.05 NS
S.creatinine
mg/dl
1.02 0.87 0.15 14.70 0.65 0.20 2.65 >0.05 NS

PATTERN OF HEMATOLOGICAL & BIO-CHEMICAL
CHANGES IN 20 PATIENTS OF DYSLIPIDEMIA (MEDOROGA)
TREATED WITH CAP. CARDICAP & LEKHANA BASTI (GP. III)
Observations Mean BT Mean
AT
Mean
Diff
Mean % S.D. () S.E.± t p Result
Hb gm.% 13.44 13.26 0.18 1.33 0.22 0.06 2.5 >0.05 NS
ESR in mm./Ist
hr
38.5 16.2 22.6 58.24 58.24 11.59 3.66 <0.01 S
Blood sugar-(F)
mg/dl
119.90 120.1 0.20 0.02 3.2 0.72 0.27 >0.05 NS
Blood urea
mg/dl
24.0 22.30 1.7 7.08 2.85 0.90 2.29 >0.05 NS
S.creatinine
mg/dl
1.2 0.91 0.29 24.16 0.51 1.61 3.37 >0.05 NS

PATTERN OF CHANGES IN LIPID PROFILE 20 CASES OF
DYSLIPIDEMIA (MEDOROGA)TREATED WITHTAB.
ATORVASTATIN (GROUP I )
Lipid Profile Mean
BT
Mean AT Mean
Diff.
Mean % SD
±
SE
±
t p Result
S.Cholesterol 305.50 254 51.50 16.8 15.31 3.42 15.04 < 0.001 HS
S.Triglyceride 233 173.50 59.5 25.5 19.05 4.26 13.96 < 0.001 HS
V.L.D.L. 46.60 33.95 12.65 27.1 3.57 0.79 15.83 < 0.001 HS
H.D.L 51.50 50.75 0.75 1.4 1.86 0.41 1.80 >0.05 NS
L.D.L. 207.40 145.55 61.85 29.82 22.06 4.93 12.53 < 0.001 HS

PATTERN OF CHANGES IN LIPID PROFILE IN 20 CASES
OF DYSLIPIDEMIA (MEDOROGA)TREATED WITH CAP.
CARDICAP (GROUP II )
Lipid Profile Mean BT Mean AT Mean
Diff.
Mean
%
SD
±
SE
±
t p Result
S.Cholesterol 242.27 225.35 16.90 6.9 10.94 2.44 6.903 < 0.01 S
S.Triglyceride 208.48 169.55 38.92 18.6 59.54 13.31 2.923 < 0.001 HS
V.L.D.L. 49.39 45.90 3.49 7.06 3.58 0.80 4.356 <0.001 HS
H.D.L 55.15 56.10 -0.95 1.72 4.045 0.90 1.050 >0.05 NS
L.D.L. 137.66 125.15 12.51 9.08 16.93 3.78 3.304 <0.001 HS

PATTERN OF CHANGES IN LIPID PROFILE IN 20 CASES
OF DYSLIPIDEMIA (MEDOROGA)TREATED WITH CAP.
CARDICAP AND LEKHANA BASTI ( GROUP III)
Lipid Profile Mean
BT
Mean
AT
Mean
Diff.
Mean % S.D.± S.E.± t p Result
S.Cholesterol 274 171.75 103.10 37.6 18.669 4.174 24.698 <0.001 H.S.
S.Triglyceride 225.75 173.30 52.45 23.23 19.712 4.408 11.899 <0.001 H.S.
V.L.D.L. 32.70 30.60 2.10 6.4 1.80 0.57 3.70 <0.001 H.S.
H.D.L 58.35 56.85 1.5 2.5 5.32 1.91 1.259 >0.05 N.S.
L.D.L. 171.95 81.56 90.39 52.56 19.106 4.272 21.157 <0.001 H.S.

PATTERN OF E.C.G. CHANGES IN 20 CASES OF
DYSLIPIDEMIA (MEDOROGA)TREATED WITHTAB.
ATORVASTATIN (GROUP I )
Leads Mean
BT
Mean
AT
Mean
Diff.
Bipolar
Limb
Leads
1.57 0.28 1.29 81.81 1.11 0.42 3.05 <0.01 S
Augmente
d Leads
1.28 0.42 0.86 66.67 0.89 0.34 2.52 <0.01 S
Precordial
Leads
3.00 0.60 2.40 80 2.07 0.92 2.58 <0.01 S

PATTERN OF E.C.G. CHANGES IN 20 CASES OF
DYSLIPIDEMIA (MEDOROGA) TREATED WITH CAP.
CARDICAP ( GROUP II )
Leads Mean
BT
Mean
AT
Mean
Diff.
Bipolar Limb
Leads
1.28 0.42 0.86 66.67 1.069 0.40 2.12 <0.01 S
Augmented
Leads
1.83 1.33 0.50 27.27 0..54 0.22 2.23 <0.01 S
Precordial
Leads
2.85 0.50 2.40 85.00 2.37 0.89 2.71 <0.01 S

OF E.C.G. CHANGES IN IN 20 CASES OF DYSLIPIDEMIA
(MEDOROGA) TREATEDWITH CAP. CARDICAP AND
LEKHANA BASTI (GROUP III )
Leads Mean
BT
Mean
AT
Mean
Diff.
Mean
%
SD
±
SE
±
t p Result
Bipolar Limb
Leads
1.33 0.17 1.16 87.50 0.75 0.30 3.79 <0.01 S
Augmented
Leads
1.25 0.37 0.87 70.00 0.99 0.35 2.49 <0.01 S
Precordial
Leads
3.28 1.00 2.28 69.56 1.25 0.47 4.82 <0.001 H.S.

DISCUSSIONS
 Medoroga (Dyslipidemia) is Santarpanajanya Roga.
 Nidana of Kaphavridhi, Medovridhii, Prameha and Sthaulya are
almost similar and they could be considered as Nidana of
Dyslipidemia as well.
 Atisthaulya (obesity) is considered as one of the eight
despicable conditions as described by Acharya Charaka.
 Atherosclerosis is the most common cause of C.A.D.
(Hridroga).

IMPORTANCE OF HRIDAYA
CHETANA, PRANAYATANA, MARMA
C.A.D. - Hridroga

PROBABLE MODE OF ACTION OF CAP. CARDICAP
Cap. Cardicap
MEDA
KAPHA
KLEDA
RASA
Kashaya Rasa Sharira Kledopshoshana property (Ch.Su.26)
(9) Rukhsa (Depletion), Lekhana (Scrapping off)
Sangrahi, Stambhaka
Tikta Rasa Kleda-Meda-Kapha-Shoshana , Lekhana,
(4) Pachana
Katu Rasa Sroto-Shodhaka, Mansa Vilekhana, helps in
(2) Pachana
Abaddha
Meda
Baddha
Meda
Lekhana
Pachana
PRABHAVA
C.A.D. - Hridroga
SROTAS

Katu Vipaka (7)
Laghu(10),
Teekshna(7),
Rukhsa(3) Gunas
Jatharagni,
Rasadhatvagni &
Medodhatvagni.
Sheeta Veerya
(4)
Cap. Cardicap
Cap. Cardicap
Ashukari
Prabhava
Pitta
Prashmaka
enrichment of
Rasa Dhatu
Tend to increase
HOLISTIC MANNER
C.A.D. - Hridroga
Madhura
Vipaka
(4)
Madhura Rasa
(2)
PROBABLE MODE OF ACTION OF CAP. CARDICAP

PROBABLE MODE OF ACTION :
LEKHANA BASTI
 Basti Chikitsa has been referred to as Ardha-Chikitsa.
 Lekhana(6), Kaphavatahara (5), Srotoshodhaka (3), Deepana (5),
Pachana (3) and hypolipidaemic properties.
 When introduced through rectum reach upto the level of
Nabhi, Kati, Parshva and Udara Pradesha and produce cleansing
effects. (Ch.Si.1/40), (Su.Chi.35/24)
 It escapes the complex phenomenon of digestion.
 The parasympathetic stimulation by the administration of
Basti increases the overall activity of the G.I.T. and allows
rapid propulsion of contents along the tract.This propulsive
effect is associated with simultaneous increase in secretions
of gastro-intestinal glands.
C.A.D. - Hridroga

 Veerya of Basti Dravyas is spread throughout the body with
the help of Apana, Udana and VyanaVayu.
 Vitiated Doshas are propelled out of the Koshtha forcefully
removing the Avarana of Vayu.
 Sarshapa Taila is basically Snigdha, Ushna and Teekshna Guna
Pradhana which can control vitiated Kapha and Vata Dosha
and can dissolve the Meda Dhatu by its Teekshna Guna.
 By the Ushna Veerya and Lekhana properties of these Basti
dravyas it spreads throughout the body and expel out the
vitiated Dhatu and Dosha by Lekhana (Scraping) action.
LEKHANA BASTI

 Due to the presence of properties like
Lekhana (hypolipidemic),
Karshana,
Srotoshodhaka,
Pachana,
Medohara,
Ashukari and
Kapha-Vatahara
Cap. Cardicap and Lekhana Basti have worked out to be
Cardio-tonic & Cardio-protective in nature.
LEKHANA BASTI

PROBABALETHERAPEUTIC EFFECTS PRODUCED
BY CAP. CARDICAP & LEKHANA BASTI
 Lekhana, Karshana, Srotoshodhana, Pachana,
Medohara, Ashukari, Kaphahara & Hypolipidemic
properties of Cap. Cardicap & Lekhana Basti may
breakdown the pathogenesis of atheromatous plaques
and check the formation of thrombus or embolism in
blood vessels.
 Transient improvement in Coronary Blood Suppy i.e.
Coronary Vasodilator activities.

PROBABLE THERAPEUTIC EFFECTS PRODUCED
BY CAP. CARDICAP & LEKHANA BASTI
 Antianginal (Prevents or alleviates Angina).
 Coronary Vasodilator (Results in dilation of coronary
blood flow)
 Thrombolytic & Antiplatelet agent (Prevents thrombus
formation).
 Vasoprotective (Protective effects on blood vessels).
 Hypotensive (Controls & regulates raised Blood
pressure).
 Hypolipidaemic (Reduces blood lipids concentrations).
 Antioxidant (Reduces oxidative stress).
 Antiinflammatory (Counteracts inflammation).
 Immunomodulator (Immune status enhancer).
 Cardioprotective/Anabolic agent.
C.A.D. - Hridroga

 The serum lipid profile of few patients investigated just after
Lekhana Basti showed an increase in serum triglyceride levels,
which returned to normal within 15 days. This effect may be
produced as a result of rapid weight loss, due to the release of
triglycerides into blood after breakdown of the adipose tissues.
 Three patients with earlier complaints of external
piles/fissure/fistulas were dropped out from the study due to
the difficulty in the administration of the Basti.
 Few cases reported feeling of burning sensation in abdomen
after administration of Lekhana Basti. It would had been due to
Teekshnata of Gomutra, which was taken care of by adjusting the
quantity of Gomutra in the mixture of Lekhana Basti.
C.A.D. - Hridroga
Some of salient observations made during current
research project

Hingu
1. Chemical Composition and Antioxidant Properties of
Ferula-assa-foetida Leaves Essential Oil; Hassan Ahmadvand,
et. al., Page 1Published online: July 8, 2013, IJPT | July 2013 |
vol. 12 | no. 2
2. Antihypertensive role of polyphenols., Advances in Clinical
Chemistry, Rodrigo R, et. al. , 2012;58:225-54.
3. Anti-diabetic[12], Anti-bacterial [13], Immune Stimulating [14],
Anti-allergic [15], Anti-hypertensive [16], Anti-ischemic,
antiarrythmic[17], anti-thrombotic[18], Hypocholesteromic,
Hepatoprotective [19], and Anti-inflammatory [20],
Anticarcinogenic [21,22].
RESEARCHES DONE GLOBALLY

 Vacha :
1. Parab RS et al., Hypolipidaemic activity of Acorus calamus L in rats.,
Fitoterapia 2002; 73(6):451.
2. Acuna UM et al., Antioxidant capacities of ten edible North
American Plants, Phytother Res. 2002; 16(1): 63-5.
3. Danilevskii NF et al., Antimicrobial activity of a tincture of Japanese
Pagoda tree (Sophora Japonica)., Microbial Zn. 1982; 44(5)/80-2.
4. Menon MK et al., The mechanism of the tranquillizing action of
arasone from Acorus calamus Linn., J. Pharm. Pharmacol 1967;
19(3):170-5.
5. Maj J et al., Pharmacological properties of the native calamus
(Acorus calamus L) & spasmolytic effect of etheric oil. Acta Pal
Pharm. 1966; 23(5):477-82.

 Shunthi
1. Comparative evaluation of the efficacy of ginger and orlistat on
obesity management, pancreatic lipase and liver peroxisomal catalase
enzyme in male albino rats; Mahmoud RH, Elnour WA., European
Review for Medicinal & Pharmaceutical Sciences, 2013 Jan;17(1): Page
No. 75-83.
2. Anti-inflammatory effects of zingiber officinale in type 2 diabetic
patients., Mahluji S, Ostadrahimi A, Mobasseri M, Ebrahimzade Attari
V,Payahoo L ,Advanced pharmaceutical bulletin; 2013; Edition 3(Vol. 2):
Page No.273 to 276.
3. Antihyperlipidemic effects of ginger extracts in alloxan-induced
diabetes and propylthiouracil-induced hypothyroidism in (rats); Al-
Noory AS, Amreen AN, Hymoor S.; Pharmacognosy research, 2013
July ;5(3): Page No.157-61

Shunthi (…contd)
4. The prevalence of alternative herbal medicine and nutritional
complementary product intake in patients admitted to out-
patient cardiology departments, [Article in Turkish] ; Gücük
pek E, Güray Y, Demirkan B, Güray U, Kafes H, Başyi it F.;İ ğ
Turk Kardiyol Dern Ars. 2013 Apr;41(3):218-24.
Pippali
1. Effect of piperine in the regulation of obesity induced
dyslipiemia in high fat diet rats, Shreya S. Shah et. al ; Indian
Journal of Pharmacology, 2011 May-Jun; 43(3): 296–299.
2. Hypolipidemic effects of a new piperine derivative GB-N
from Piper longum in high-fat diet-fed rats; Bao L, Bai
S, Borijihan G., Pharmaceutical Biology, 2012 Aug;50(8):962-7

Pippali (…contd)
3. Antidiabetic and antihyperlipidemic activity of Piper longum
root aqueous extract in STZ induced diabetic rats, Nabi et al.
BMC Complementary and Alternative Medicine 2013, 13:37.
4. Antiobesity effect of a Polyherbal formulation, Ob-200g in
female Rats fed on cafeteria and atherogenic diets, Gurpreet
Kaur, S.K. Kulkarni, Indian Journal of Pharmacology, 2000 ; 32:
294-299Effect of piperine in the regulation of obesity-induced
dyslipidemia in high-fat diet rats.
Kootha
1. Cardiotonic activity of methanolic extract of Saussurea lappa Linn
roots.Akhtar MS et al.; Pakistan Journal of Pharmaceutical Sciences ;
2013 Nov;26(6):197-201.

Kootha (…contd)
2. Role of Inula racemosa and Saussurea lappa in Management of
Angina Pectoris, S. Dwivedi, P. N. Somani and K. N. Udupa,
Pharmaceutical Research, 1989,Vol. 27, No. 4 , Pages 217-222.
3. Anti-hepatotoxic activity of Saussurea lappa extract on D-
galactosamine and lipopolysaccharide-induced hepatitis in mice,
Yaeesh S, Jamal Q, Shah AJ, Gilani AH., Phytotherapy Research :
PTR ; 2010 Jun;24 Suppl 2:S229-32.
4. Mohamed saleem et al. A review on phytochemical and
pharmacological aspects of Saussurea lappa. Int.J.Rev Life
Sci.2012;2:24-31.
Haritaki
1. The hypolipidemic activity of ethyl acetate soluble fraction of
the alcoholic extract of T.chebula in normal and Trition-treated
rats is reported (Khanna et al, 1993 and amrithveni et al, 2001).

Haritaki (…contd)
2. Bala Haritaki is found to be effective in reducing the levels of
total lipids, serum TG, S. Cholesterol, LDL and VLDL
significantly, also increasing the HDL levels significantly (Sood
and Sharma, 2000).
3. Hypolipidemic activity of Terminalia chebula in rats, Khanna,
A.K., R. Chander, N.K. Kapoor, C. Singh and A.K. Srivastava,
Fitoterapia 64, 4, 351--356
4. Hypolipidemic activity of Haritaki (Terminalia chebula) in
atherogenic diet induced hyperlipidemic rats (V Maruthappan, K
Sakthi Shree, 2010); Journal of Advanced Pharmaceutical
Technology & Research (JAPTR) Year : 2010 | Volume : 1
| Issue : 2 | Page : 229-235

Chitraka
1. Santhakumari G, Rathinam P.G. Shesadri C, (1978) Anticoagulant
activity of plumbagin. Indian J. Exp. Boil.Vol. 16 (4) PP: 485-487.
2. Shanker R et.al. (1987) Antilipid, perioxidative efficacy of
plumbagin and menadion, Curr. Sci,Vol. 56 (17) PP: 890-892.
3. Sharma I,Varma M & Dixit V.P. (1990) Hypolipidaemic effect of
Panchole an Ayurvedic remedy in rabbit. Int. J. of Gude drug Res,
Vol 28 (1) PP: 33-38.
4. SharmaI et.al (1991) Hypolipidaemic and antiatherosclerotic
effects of plumbagin in rabbits. Ind. J. Phy. & Pharm.Vol- 35, PP: 10-
14
5. Itoigawa M et al. (1991) Cardiotonic action of plumbagin on
guinea-pig papillary muscle, planta medicaVol. 57 (4) PP: 317-319

 Pushkarmoola
1. Singh R., Upadhyaya B.N., et.al., Evaluation of anti-ischaemic potential of
Pushkar Guggulu in the treatment of IHD. 2nd World Congress on Bio-
technol. Dept. of Herb. Med. (NBRI), Lucknow, U.P., P. 163, Feb. 20-22,
2003, C.R.I., Lucknow, U.P.
2. Seth S.D. et.al., Role of Inula in protection against isoproterenol induced
Myocardial necrosis in rats : I.J. Physiol. Pharmacol. 1998; 42(1): 101-6.
3. Petkov V. Inula hypotensive, antiatheromatous and coronary vasodilating
action, Am. J. Clin. Med. 1979; 7:197-236.
4. Vakawa, Cytomegalo Virus is inhibited by Terminalia Chebula etc. Altum
Med.Rev. 1996
5. Tripathi,Y.B. et.al.,Assessment of the adrenergic beta blocking activity of
Inula racemosa, J.ethano Pharmaco., 1998; 23(1): 3-9.

Pushkarmoola (…contd)
6. Tripathi, S.N. et.al., Beneficial effect of Inula racemosa in Angina pectoris:
I.J. Physio Pharmaco, 1984; 28(1): 73-5.
7. Singh R.P., et.al., Use of Pushkar Guggulu, an indigenous anti-ischaemic
drug in the management of I.H.D. Int. J. Pharmaco., 1993; 31:1470-160.
8. Patel V. et.al., Effect of indigenous drug Pushkarmoola on experimentally
induced M.I. in rats,Act. Nerv. Super. (Praha) 1982; Suppl. 3(Pt.2): 387-94.
9. Whan. Han., J.,Gon Lec B., et.al., Ergolide, Sesquiterpena, lactone from
Inula brittania inhibits inducible nitric oxide synthase, Br. J. Pharmaco
2001:133(4):503-12
10. Miller A.L., Antibacterial effect of Pushkarmoola, T. Chebulla Altum Med.
Rev., 1998; 3(6): 422-31.

Amalaki :
1. Emblica officinalis reduces Serum, Aortic and Hepatic Cholesterol in Rabbits;
Thakur, CP ; Experientia 1985. 41:423-4.
2. Effect of the Indian gooseberry (Amla) on Serum Cholesterol levels in men
aged 35-55 years. Jacob, A. et al. European Journal of Clinical Nutrition 1988.
42:939-44.
3. The Ayurvedic medicines Haritaki, Amla and Bahira reduce cholesterol -induced
atherosclerosis in Rabbits; Thakur, CP. et al; International Journal of
Cardiology 1988. 21:167-75.
4. Euchol is a proprietary blend of herbs known to be effective in maintaining a
healthy body fat and cholesterol, based on traditional Indian medicine
Ayurveda. http://www.ayurvedix.com/eucholinfo.html.

Amalaki : (…contd)
5. Influence of Amla (Emblica officinalis Gaertn.) on hypercholesterolemia and
lipid peroxidation in cholesterol-fed rats ; Kim HJ, Yokozawa T, Kim HY, Tohda
C, Rao TP, Juneja LR. Journal of Nutritional Science and Vitaminology, Tokyo
2005 Dec;51(6):413-8.
6. Amla (Emblica officinalis Gaertn.) prevents dyslipidaemia and oxidative stress
in the ageing process.Yokozawa T, Kim HY, Kim HJ, Okubo T, Chu DC, Juneja
LR ; British Journal Of Nutrition ; 2007 Jun;97(6):1187-95.
Vibhitaki :
1. Preventive actions of Terminalia belerica in experimentally induced
atherosclerosis; Shaila HP, Udupa AL, Udupa SL; International Journal of
Cardiology,Volume 49, Issue 2,April 1995, Pages 101-106.

Vibhitaki : (…contd)
2. Hypolipidemic activity of three indigenous drugs in experimentally
induced atherosclerosis. Shaila HP, Udupa AL, Udupa SL;; International
Journal of Cardiology,Volume 67, Issue 2, December 1998, Pages 119-
124.
3. Hypolipidemic effect of Triphala in experimentally induced
hypercholesteremic rats; Saravanan S, Srikumar R, Manikandan S, Jeya
Parthasarathy N, Sheela Devi R.; Journal of the Pharmaceutical Society
of JapanVolume 127, Issue 2, February 2007, Pages 385-388.
Mulaithi :
1. Antiobesity and lipid lowering effects of Glycyrrhiza chalcones:
Experimental and computational studies. R.B. Birari, S. Gupta, C.G.
Mohan, K.K. Bhutani; Phytomedicine - International Journal of
Phytotherapy and PhytopharmacologyVol.9, Feb. , 2009.C.A.D. - Hridroga

CONCLUSIONS
1. Dyslipidemia : abnormal amount of lipids in the blood due to
impaired lipid metabolism and a major risk factor for many life
threatening diseases like Coronary artery disease, Diabetes mellitus
etc.
2. Description of Medoroga in Ayurvedic classics : limited & scattered. On
the basis of their clinical manifestations it could be proposed that
Vata-Kaphaja type of Hridroga can be co-related with the disease
entity Coronary Artery Disease.
3. Dyslipidemia on the basis of sign and symptoms could be probably
correlated with abnormal Medo Dhatu (Medo Dosha Dushti).
OBJECTIVE 1

4. Cap. Cardicap & Lekhana Basti when used separately and / or
together act not only on a single modifiable risk factor but on a
variety of these factors. By significantly reducing Total
Cholesterol, Serum Triglyceride, Serum L.D.L., Serum V.L.D.L.
these preparations control & correct dyslipidemias (Medoroga)
leading to arrest of the pathogenesis of formation of
atheromatous plaque and ultimately delaying the pathogenesis
of C.A.D. (Hridroga).
5. Cap. Cardicap & Lekhana Basti when used separately or
together show trends of clinical improvement in Symptoms
when assesed on various parameters and By improving
ischaemic changes in E.C.G. provides potent antianginal and
coronary vasodilating effects.
CONCLUSIONS (…contd)
OBJECTIVE 2

6. Cap. Cardicap & Lekhana Basti have very limited role to play in
acute episodes of C.A.D. but these can be used effectively
separately or in combination together as an adjuvant therapy
along with modern coronary vasodilators or independently to
prevent or slow down or reverse the pathogenesis of
Atherosclerosis, which is an essential precursor of C.A.D.
6. Trial Drugs Cap. Cardicap and Lekhana Basti are safe herbo-
mineral formulations which have shown encouraging results in
the prevention / management of Dyslipidemia (Medoroga) on
various scientific parameters.
7. They were well tolerated by almost all the patients and no side /
toxic effects were observed during the course of the therapy
and during the follow up visits. Thereby confirming safe use of
these drugs even for prolonged durations.

9. A new hypothesis can be put forward,“The administration of
Cap. Cardicap and / or Lekhana Basti separately or in
combination together may prove to be an effective strategy as
Ayurvedic approach for the prevention of Dyslipidemia
(Medoroga) w.s.r. to C.A.D. (Hridroga).”
10. Dietary and Lifestyle modifications, besides proposed
Ayurvedic strategies are essential factors to be strictly adhered
to by the patient for effective control / prevention of
Dyslipidemia (Medoroga) w.s.r. to C.A.D. (Hridroga).
OBJECTIVE 3

Therefore, it can be concluded that Cap. Cardicap
and Lekhana Basti can be used separately or in
combination together effectively in the
management of C.A.D. to prevent / delay /
reverse the progress of Atherosclerosis leading to
Dyslipidemia (Medoroga) w.s.r. Coronary Artery
Disease (Hridroga).

C.A.D. - Hridroga
la{ksir%
fØ;k;ksxks
funku ifjotZue
PREVENTIVE
CARDIOLOGY
PREVENTION IS BETTER THAN CURE

Dyslipidemia & ayurveda

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Dyslipidemia & ayurveda

Similar to Dyslipidemia & ayurveda (20)

Recently uploaded

Recently uploaded (20)

Dyslipidemia & ayurveda

Editor's Notes