Hypoglycemic activity of Kaidarya Patra Choorna (Murraya koenigii linn.) in Diabetes mellitus type 2 with OHA’s

Globally and nationally the Diabetes mellitus with its complications become the most important contemporary and challenging health problem. It should be treated with diet and exercise, typically in conjunction with oral hypoglycemic drugs (OHD) and the complications are so critical and hazardous, and oral hypoglycemic agents and insulin which is used for the treatment of diabetes mellitus by the allopathic system of medicine have numerous side effects. In spite of available treatment number of patients is on rise. It is convincing that the herbal or mineral remedies stated in ayurveda used singly or in combination have potency in the treatment of madhumeha. However, our country is indeed rich in its vast variety of flora, throught variegated physical feature of the land, extending from mountains to the oceans. The practitioners of Indian system of medicine have been using the plant materials and are claiming success in treatment of madhumeha even today. Therefore, taking a lead it will be worthwhile to reappraise the commonly used plant remedies in the treatment of madhumeha, with an unbiased scientific spirit. In Ayurveda kaidarya is mentioned as parvata nimba. Nimba is the best drug used in Prameha. Edible variety of Nimba i.e curry leaves can be useful. Kaidarya is having katu, tikta, and kashaya rasa and sheeta veerya. It pacifies vitiated kapha and pitta. Kaidarya has been used traditionally since few years for treatment of prameha. Placebo control may not be ethical in the disease hence single arm study along with modern medicine is preffered. AYURLOG National Journal of Research in Ayurved Science (A peer-reviewed open access Indexed e-journal of Ayurved Since 2013) http://www.ayurlog.com Nov2020 | Volume 08th | Issue: 6th ISSN: 2320-7329

Globally and nationally the Diabetes mellitus with its complications become the most important contemporary and challenging health problem. It should be treated with diet and exercise, typically in conjunction with oral hypoglycemic drugs (OHD) and the complications are so critical and hazardous, and oral hypoglycemic agents and insulin which is used for the treatment of diabetes mellitus by the allopathic system of medicine have numerous side effects. In spite of available treatment number of patients is on rise. It is convincing that the herbal or mineral remedies stated in ayurveda used singly or in combination have potency in the treatment of madhumeha. However, our country is indeed rich in its vast variety of flora, throught variegated physical feature of the land, extending from mountains to the oceans. The practitioners of Indian system of medicine have been using the plant materials and are claiming success in treatment of madhumeha even today. Therefore, taking a lead it will be worthwhile to reappraise the commonly used plant remedies in the treatment of madhumeha, with an unbiased scientific spirit. In Ayurveda kaidarya is mentioned as parvata nimba. Nimba is the best drug used in Prameha. Edible variety of Nimba i.e curry leaves can be useful. Kaidarya is having katu, tikta, and kashaya rasa and sheeta veerya. It pacifies vitiated kapha and pitta. Kaidarya has been used traditionally since few years for treatment of prameha. Placebo control may not be ethical in the disease hence single arm study along with modern medicine is preffered. Fenugreek and Emblica officinalis showed the most consistency in lowering fasting blood sugar (FBS) or glycated hemoglobin (HbA1c) levels in diabetic patients. The hypoglycaemic effects of cinnamon and Momordica charantia were seen the best. However, green tea exhibited inadequate benefits in reducing FBS. In another report, the consumption of cinnamon is connected with a statistically significant decrease in levels of fasting plasma glucose. Murraya koenigii (Family: Rutacea) is a small tree. Curry leaf is found almost throughout India up to an altitude of 1500 meters. It is much cultivated for its aromatic leaves. Kaidarya plant (experimental plant) extracts (methanolic and aqueous) have been evaluated for its hypoglycaemic activity in Streptozotocin induced diabetic rat model, so it was highly essential to compare the data of hypoglycaemic activity of Kaidarya (Murraya koenigii linn.) leaves powder with previous results.
Hence, the main goal of the present study to find out the better source to manage the hyper glycaemia. We have evaluated leaves powder of the experimental plant (Murraya koenigii) collected from Pune, Maharashtra region in the month of October for its hypoglycaemic action.

Objective:
 To study ayurvedic perspective of prameha.  Ellaborative study of Diabetes mellitus  Detailed study of kaidarya.  To assess the hypoglycemic activitiy of kaidarya patra choorna in treatment of Diabetes mellitus type 2.

1) Patients:
32 patients were selected from indoor and outdoor patients department of the hospital.
The drugs mentioned in the churna yoga are cleaned and dried. They are powered by pounding with mortar and pestle and sieved through a thin layer of cloth (Vastragalita). In a prescription where there are a number of ingredients, the best method is to powder the drugs separately, weight the required quantities of the drugs and mix them all together.

5) Pathya and Apathya:
Trial group and control group were adviced to take standard diabetic diet according to ayurvedic texts and modern medical science.

Discussion on Results:
The parameters of Madhumeha were statistically analyzed. Significance of difference between before and after treatment was assessed by applying student's 't ' test for unpaired data of objective parameters like HbA1c. The Wilcoxon test was applied to compare the effect of both treatments. In case of all the parameters, the statistical evaluation revealed that there was significant reduction in sign and symptoms, hence both the treatment were significantly effective in case of Madhumeha. When Wilcoxon test was applied to compare the effect of both treatment, it showed that in case of prabhoot mutrata, aavilmutrata, naktamutrata the treatment of trial group was significantly superior than that of control group. When unpaired 't' test was applied to compare the effect of both the treatment, it showed that in case of BSL the treatment of trial group was significantly superior to control group. Effect on prabhoot mutrata, aavilmutrata, naktamutrata was due to kledaghna, kaphaghna, laghu, ruksha property and Kashaya, Tikta rasa Pradhan. In this study it was observed that the patients having mild to moderate signs and symptoms were get cured and those having moderate to severe symptoms were improved.

Trial group:
Improvement i.e. controlled diseased condition was found in trial group was 93.75% marked improvement was observed, and 6.25% moderate improvement was observed.

Control group:
Improvement i.e. controlled diseased condition was found in control group was 81.25% moderate improvement was observed, and 18.75% mild improvement was observed.

Conclusion:
 After analyzing the all data and observations, it was concluded that Kaidarya patra choorna used in trial group along with the oral hypoglycemic agents ( Metformin + Sulphonyl Urea group) shown significant results as compared to only oral hypoglycemic agents ( Metformin + Sulphonyl Urea group) used in control group.  Statistically significant effect of Kaidarya patra choorna on prabhoot mutrata, aavilmutrata and on BSL as compared to control group was may be due to- Correction of dushya kleda-utpatti which is responsible for above said lakshana's in samprapti  The drug also may act at mulasthana of mutravaha strotas which are meda/vapavahan.  Further it has been concluded that combined therapy is superior and also has organ protective (hepato protective) effect. So for long term use combined therapy is recommended, since kaidarya is swasthavrittakar dravya is safe to take for longer duration in prescribed dose.