MANAGEMENT OF PSORIASIS: A COMPARATIVE CLINICAL STUDY OF STANDARD AYURVEDA & ALLOPATHIC PROTOCOLS

How to cite this article (APA): Dr. Sameer Shinde, Dr.Puneet Bhargava, and Dr. Daya Shanker Mishra. (2021). Management Of Psoriasis: A Comparative Clinical Study Of Standard Ayurveda & Allopathic Protocols. International Journal of Research GRANTHAALAYAH, 9(8), 290-301. doi: 10.29121/granthaalayah.v9.i8.2021.4190 290 MANAGEMENT OF PSORIASIS: A COMPARATIVE CLINICAL STUDY OF STANDARD AYURVEDA & ALLOPATHIC PROTOCOLS


INTRODUCTION
Psoriasis is a papulosquamatous disorder of skin characterized by sharply defined erythamatous lesions. It is notoriously chronic & is well known for its course of remission & exacerbation. In India approx 80 lakhs (0.8%) Population is affected by this dreadful disease. The exact cause is still unknown. The intensity of disease is such high that to increase awareness among people, patients & doctors 29 October is officially declared as "World Psoriasis Day". Modern medicine offers treatment with PUVA, Corticosteroids & Antimitotic Drugs. But therapy gives serious side effects like Bone Marrow depletion, Liver & kidney Failure. Classical Ayurveda treats this disease as a one of a type of Kustha. Besides all treatments while treating the Kustha all Acharyas specially focused on Panchakarma (Shodhana Therapy) to control & to prevent the remission. As Kustha is also described as one of a Raktapradoshaj vyadhi so Laghumanjisthadi Ghan having Raktashodhak, Raktaprasadak, kushthaghna kandughna properties was selected for trial & a clinical comparative study was done.

Need of Study
A lot of research work has been done on treatment of Psoriasis in both modern & Ayurveda Sciences & lot of is still going on. Each science has its own claims over the management & success rate. But still a promising cure for Psoriasis is not found. According to the survey of the US National Psoriasis Foundation on 40,350 patients shows that 78% of severe psoriatic Patients were still frustrated by the lack of efficacy of treatment. Archives of Dermatology (2001) So now a day it became essential to find out a safe, economic, effective treatment for psoriasis.  Texts.

Method of study (protocol of Study) Consent
Written informed consent was taken on prescribed Performa before the inclusion of patient in trial. They are briefed about merits and demerits of research plan before taking consent.

Effect on Total PASI Score
In Group A the mean PASI Score of before treatment was 21.82. It lowered down to 6.99 with SD±8.30 giving a relief of 67.13 % which was statistically highly significant.
In Group B the mean PASI Score of before treatment was 19.32. It lowered down to 5.97 with SD± 7.29 giving a relief of 69.09 % which was statistically highly significant.

Effect of Drug on Kandu (Itching Index)
In Group A Mean Itching index before treatment was 2.66 which was reduced to 1 showing 62.5 % relief which is statistically highly significant.
In Group B mean Itching index before treatment was 2.46 which was reduced to 1.33 showing 54.05 % relief which is statistically highly significant.
Effect of Drug on Daha (Burning Index) In Group A mean burning index before treatment was 1.4 which was reduced to 0.6 showing 57.14 % relief which is statistically highly Significant.
In Group B mean burning index before treatment was 1.13 which was reduced to 0.53 showing 52.9 % relief which is statistically.

Intergroup Comparison
To access the efficacy of two therapies intergroup comparison was done. As the variables are nonparametric, we used Mann-Whitney Test for stastically analysis. The results are as follows

Effect of Drug on Laboratory Parameters • Hematological Investigations
Patients were advised to go for lab investigation before & after Treatment. Data collected was analyzed & students Paired 't' Test was applied. The results found are as follows...

Effect on Liver Function Test:
Changes in Liver function tests before & after treatment are as follows...

Changes in Hematological Parameters
Graph 3: showing changes in LFT.

Overall effect of Therapy
In Group A: Complete improvement was observed in 20% patients; marked improvement was observed in 66.66% patients, moderate improvement was observed in 13.33% patients.
In Group B: Complete improvement was observed in 20% patients; marked improvement was observed in 40% patients, moderate improvement was observed in 33.33% patients & 6.66% Shows Mild improvement.  Lin et al. (2010). This helps in reducing the rapid shading of epithelium in psoriasis. 3) Mollugin one of active principle of Manjistha showed inhibition of passive cutaneous anaphylaxis (PCA) and protection of mast cell degranulation in rats. Gupta et al. (1999)

CONCLUSION
• Both the groups show considerable efficacy which is highly significant clinically as well as statistically (P<0.001) however intergroup comparison shows that there is no major difference in efficacy of Ayurvedic trial drug & control Allopathic drug. It suggests that Ayurvedic formulation is as much potent as Methotrexate in controlling the disease. • The above data reveals that both drugs show highly significant results in reducing the PASI Score. Better resonse was seen in Kandu & Daha in patients treated with Ayurvedic formulation. • In liver function test significant increase in SGOT & SGPT levels were observed in patients treated by Allopathic drug. Though the increased SGOT &SGPT were in normal ranges it suggests that prolonged administration of drug may detoriate Liver functions. While in patients with Ayurvedic formulation no significant changes were observed. Thus, Ayurvedic formulation has distinct advantage in safety profile over Allopathic counterpart. • Significant reduction in ESR which is supposed to be an inflammatory marker proves potent Anti-inflammatory action of Ayurvedic Trial drug. • Relapse is major problem in treatment of Psoriasis. Ayurvedic trial drug shows 26% relapse rate as compare to Methotrexate showing 46.33% relapse. It shows that Ayurvedic drug is more potent in preventing the relapse of disease than Allopathic counterpart. Thus, it can be concluded that Ayurvedic trial Formulation has potent action in controlling disease as well as it is much better in preventing the recurrent relapse than standard allopathic regime. In safety profile Ayurvedic formulation has distinct advantage over allopathic counterpart.