Asthma, a pulmonary disorder, is characterized by airway inflammation and hyper responsiveness to stimuli that produce bronco-constriction. The stimuli include cold air, a wide variety of allergens and emotional stress. In Ayurvedic classics this disease was described under Tamaka swasa with a palliative treatment. In recent researches certain herbs from Ayurvedic Materia M edica have exhibited bronchodilator activity. Evidence based studies include -
In a pilot study, conducted at Central Research Institute (Siddha), Madras, on 38 patients suffering from bronchial asthma, the aqueous extract of the plant in a dosage of 30 to 60 ml was given twice or thrice daily. Good clinical response in 24 per cent cases, 60 per cent of the cases were relieved from wheezing within two week, while 90 per cent got relief from sever cough with expectoration. The raised eosinophil count was also normalized.
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Achyranthes aspera Linn.
A pilot study was carried out at Central Research Institute (Siddha), Madras, on 38 patients suffering from bronchial asthma. The oil obtained from the root soaked in cows urine was smeared on betel leaf and administered thrice a day to these patients. In most of the cases symptoms like wheezing, gasping, dyspnoea, sneezing and cough disappeared. A fall in the total WBC, eosinophil counts and ESR was observed.
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Acorus calamus Linn.
In a preliminary clinical trial on 15 patients with moderate to severe bronchial asthma, one to two gm of fresh root divided in three doses was administrated by chewing method for two-four weeks. The drug was found to have anti-asthmatic potential free from side effects.
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In another preliminary uncontrolled clinical trial, small pieces of the rhizome weighing one gm were administered to asthmatic patients four times a day for eight days by chewing method. Marked effect in relieving of bronchospasm was observed in some of the cases. No side effects were observed.
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Adhatoda zeylanica Medic. Syn. A. vasica Nees
A. zeylanica is one of the constituents of a herbo-mineral preparation "svasa kuthararasa" and an Ayurvedic preparation 'shireeshadi kashaya' (Albizia lebbeck, Solanum xanthocarpum, Glycyrrhiza glabra and A.zeylanica) which have been reported to be useful in patients suffering from bronchial asthma in the study at S. S. Hospital, Banaras Hindu University, Varanasi.
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Aegle marmelos Linn
In preliminary clinical trial, eight patients of asthma having marked wheezing and rhonch i in both lungs were given the plant (in the form of powder containing 100 mg aegelin, thrice daily for three d ays ). Of the eight cases, five had no improvement and lung signs were the same as before the treatment. One responded to a slight extent with diminished lung signs only for one and half to two hours after taking drug. The remaining two cases responded well to the drug.
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Albizia lebbeck (linn.) Benth.
In the series of 60 patients of bronchial asthma, a decoction of the plant in a dose of 25 ml (100 gm of the crude drug) four times a day for a period of three weeks showed varying degree of improvement in patients. The improvement was related to the chronicity of the disease. An increase in plasma cortisol with a fall of histamine and histaminase was observed.
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Tylophora indica (Burm.f.) Merrill
Clinical trial against asthma shows that Tylophora leaf chewed and swallowed daily in the early morning for six days reduces asthma symptoms (Shivpuri et al., 1969). An alcoholic extract of crude Tylophora leaves in one gram of glucose had comparable effects to that of chewing the crude leaf (Shivpuri et al., 1972). Another trial found similar success in reducing asthma symptoms (Thiruvengadam et al., 1978). However, the Tylophora was not as effective as a standard asthma drug combination. One double-blind trial failed to show any effect on asthma for Tylophora (Gupta et al., 1979).
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In the present study T. indica has been taken up to study its anti-asthmatic effect from
clinical pharmacological perspective.
About the Herbs :
Tylophora indica is a non classical drug and its use in traditional medical practice is well known. In 1844 this drug was officially included into the Bengal pharmacopeia as a substitute for ipecacuanha. It is also known by the name Khadakirasna or Anantamool. It is also referred by name Ajadweshi i.e. gouts hate it.
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Indian Ipecac is a small, slender, much branched, velvety, twining or climbing herb with yellowish sap. It is mostly found in the sub-Himalayan tract from Uttarakhand to Meghalaya and in the central and peninsular India. Rootstock is 2.5-5 cm thick. Leaves 6-11 cm long, 3.8-6 cm wide, are ovate-oblong to elliptic-oblong, with a narrow tip, heart-shaped at base, thick, velvety beneath when young, smooth above. Leaf stalks are up to 1.2 cm long. Flowers are small, 1-1.5 cm across, in 2 to 3-flowered fascicles in cymes in leaf axils. Sepal is divided nearly to the base, densely hairy outside. Sepals are lance-shaped. Flowers are greenish- yellow or greenish-purple, with oblong pointy petals. Fruit is a follicle, up to 7 x 1 cm, ovoid-lance shaped Flowering: August to December.
Chemical Components :
The major constituent in this plant is alkaloid Tylophorine. The other alkaloids include Tylophorinidine, Septicine and Isotylocrebrine.
Materials and Methods :
Seven male patients between the age group of 30-50 years with history of bronchial asthma of 10-15 years duration were included in the present study. The symptoms and signs include breathlessness, cough and wheeze. Symptoms aggravate more during night time (nocturnal) and episodes are more during winter season. Indigestion and anxiety were the aggravating factor. Patients suffering from chronic obstructive pulmonary disorder (COPD) were excluded in the present study.
Type of the trial - open, uncontrolled trial.
Method of administration :
The matured leaves of tylophora indica (three leaves) were pounded and administered during the spells of disease.
The total study was conducted through OPD of Department of Dravya Guna, at Dr. A. L. Government Ayurvedic Hospital, Vijayawada.
Observation :
- Relief was appreciated after 15 minutes and complete relief was noticed after 25 minutes.
- Out of seven cases only two cases have complained of two to three vomiting and the rest of the patients had feeling of nausea.
- All the patients complained of abdominal distress which should be considered as undesirable side effects . It could be due to the irritation of gastric mucosa caused by the drug.
- Relief from breathlessness and wheeze was persistent up to four to five hours and the symptoms reappeared after five hours.
- No appreciable effect was noticed in terms of the repetition of dosage of the drug.
- The response appears to be palliative.
- Sleep was not disturbed due to drug therapy.
In present study T. indica was studied for its activity in bronchial asthma from
clinical pharmacological perspective. The drug (three leaves) was administered to seven patients suffering from breathlessness, cough and wheeze. Time taken for initiation of activity was 15 minutes and complete relief was noted after 25 minutes. Response is temporary as the symptoms reappeared after five hours. Abdominal distress and nausea were complained by all the patients. The drug has not exhibited any other adverse drug reactions. This recipe can be utilized in acute cases for short term relief of broncho-constriction. Tylophora indica may be relieving bronchospasm through reflex action, as it is rightly quoted "Emetics in sub emetic doses act as bronchodilators."
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References :
- Raman, K. G., Bhardwaj, T. P. R. and Purushothaman, K. K. 1979. A pilot study of Kuppaimeni (Acalypha indica ) in Swasakasam (bronchial asthma). J Res Indian Med Yoga Homoeop 14 (3-4), 81-86.
- Suresh, A., Anandan, T. Sivanandam, G. and veluchamy, G. 1985. A pilot study of Naayuruvi Kuzhi Thailam in Eraippunoi (bronchial asthma). J Res Ayur Siddha 6, 171-176.
- Rajasekharan, S. and srivastava, T. N. 1977. Ethnobotanical study on Vacha and a preliminary clinical trial on bronchial asthma. J Res Indian Med Yoga Homoeop 12, 92-96.
- Chandra prakash 1980. A note on the preliminary study on Acorus calamus L. in the treatment of bronchial asthma. J Res Ayur Siddha 1, 329-330.
- Mahesh Chandra, Upadhyay, B. N. and Mishra, J. K. 1996. Effect of Svasa kuthararasa and Sirishadi Kashaya on patients of Tamaka svasa . Ancient sci Life 15, 213-218.
- Rai Chaundhuri, M.N., Roy, N.and Dasgupta, B. 1958. Aegelin in bronchial spasm. Bull Calcutta Sch Trop Mad 6, 70
- Tripathi, S. N., Shukla, P., Misra, A. K. and Udupa, K. N. 1978. Experimental and clinical studies on adrenal function in bronchial asthma with special reference to the treatment with Albizzia lebbeck. Quart J Surg Sci 14, 169-176
- Gupta, Double-blind trial of Tylophora in Asthma, Indianjournals, 1979
- Bapalal G. vaidya, Nighantu Adarsha Vol. 1, Chaukhambha Bharti Academy, Varanasi, India 2002. R. S. Satoskar, S. D. Bhandarkar, S. S. Ainapure, Pharmacology and Pharmacotherapeutics, Popular Prakasan, Mumbai, 1
* Professor & H. O. D.
Institute of Post Graduate Teaching & Research in Ayurveda
Gujarat Ayurved University, Jamnagar, Gujrat, India
