E-ISSN:2456-3110

Case Report

Diabetic Peripheral Neuropathy

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 3 MARCH
Publisherwww.maharshicharaka.in

Effect of Pramehantak Kashaya & Kapikachchu Churna in Diabetic Peripheral Neuropathy - A Case Study

Sahu ML1*, Ojha A2, Baghel PK3, Thakur S4, Dhruw D5
DOI:10.21760/jaims.10.3.66

1* Mannu Lal Sahu, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.

2 Aruna Ojha, Professor and HOD, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.

3 Pramod Kumar Baghel, Lecturer, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.

4 Shubham Thakur, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.

5 Dipika Dhruw, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.

Nowadays, diabetes mellitus is a prevalent medical condition. Physical inactivity and the hectic, stressful lifestyle of the modern world are major contributors to diabetes mellitus. Uncontrolled high blood sugar in diabetic individuals can harm nerves and impair their ability to communicate, which can result in diabetic neuropathy. The patient seen in the Kayachikitsa OPD at the Shri N.P.A. Government Ayurved Medical College and Hospital Raipur CG is the subject of this study. Patients complained of lower extremity discomfort, numbness, burning, and tingling that had gotten worse over the previous two years. A five-year history of diabetes mellitus is part of the past medical history. Diabetic peripheral neuropathy is the diagnosis made after a patient's complete medical history and physical examination. Based on the Doshas and Dushyas involved, this research explores the likely Ayurvedic correlation of this ailment. Pramehantak Kashaya and Kapikachhu Churna, two Ayurvedic medications, were used to treat this patient with success. According to the results, 50% of the burning sensation in the hands and feet, 67% of the tingling sensation, 100% of the numbness, and 50% of the pain in the lower limbs were relieved. Results for every symptom were really significant. Thus, it can be said that Pramehantak Kashaya and Kapikachhu Churna are quite beneficial for diabetic neuropathy sufferers.

Keywords: Pramehantak Kashaya, Kapikachhu Churna, Madhumeha, diabetic neuropathy

Corresponding Author How to Cite this Article To Browse
Mannu Lal Sahu, Post Graduate Scholar, Department of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chattisgarh, India.
Email: 		Sahu ML, Ojha A, Baghel PK, Thakur S, Dhruw D, Effect of Pramehantak Kashaya & Kapikachchu Churna in Diabetic Peripheral Neuropathy - A Case Study. J Ayu Int Med Sci. 2025;10(3):425-428.
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https://jaims.in/jaims/article/view/4509/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-02-11 2025-02-25 2025-03-05 2025-03-15 2025-03-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 12.64

© 2025 by Sahu ML, Ojha A, Baghel PK, Thakur S, Dhruw D and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(3)425
Download PDFBack To ArticleIntroductionMaterials and MethodsConclusionReferences
Mannu LS et al. Effect of Pramehantak Kashaya & Kapikachchu Churna

Introduction

One of the most prevalent types of peripheral neuropathy is diabetic neuropathy, which is characterized by a progressive pattern of nerve destruction. Somatic nerves, a significant contributor to morbidity and mortality, are also involved in this process. Causes of diabetic neuropathy. After ruling out alternative neuropathy causes, it is diagnosed based on symptoms and indicators. It affects 50-90% of patients with diabetes, and 15-30% of them will develop painful diabetic neuropathy (PDN), depending on the diagnostic criteria.[1] Along with Dhatu Kshaya and Oja Kshaya, the Samprapti of Madhumeha has Vata and Kapha Dosha Prakopa. Madhumeha symptoms include burning, numbness, tingling, Pipasadhikya, Kshudhadhikya, Aalasya (lassitude), and Mutra Madhurya (sweetness of urine).[2-4]
Numerous problems, including vascular, renal, ocular, and dermatological issues, arise in long-term diabetes mellitus patients. One of the most frequent side effects is neuropathy, which can cause tingling, numbness, and burning sensations in the hands and feet. Medicine Pramerhantak Kashyaya They are laxative, digestive, and anti-inflammatory because the majority of Katu Tikta Rasa and Ushna Virya ingredients. Pramehantaka Kashaya medicine ingredient Ushir, Giloy, Rakt Chandan, and Amalaki. This drug effectively prevents and treats diabetes mellitus by controlling the burning sensation in the palms and sole.

Mostly diabetics patients trouble constipation Pramehantak Kashaya ingredient Triphala is very effectively laxative and antidiabetic drug. Haridra and Daruharidra anti-oxidant and anti-inflammatory properties support the body's immune system and aid in the battle against illness, and Gokshura, Lodhra and Satavari very effectively in urinary system. Diabetic patients trouble frequent micturition and burning micturition.[5] Kappikacchhu was chosen for the Balya and neuroprotective therapy of diabetic neuropathy because of its neuroprotective, antioxidant, anti-stress, and adaptogenic qualities. It helps diabetic neuropaths feel better and reduce their body aches. Kashaya possesses strong antidiabetic, antioxidant, and antiglycation properties. These medications were chosen for the treatment of diabetic neuropathy because of their neuroprotective, antioxidant, anti-stress & adaptogenic qualities.[6,7]

Materials and Methods

History of the presenting illness

On 2/5/2024, a 52-year-old female patient with a history of diabetes mellitus arrived at the Kayachikitsa department's OPD no. 20240009758 with a 2-year history of lower limb discomfort, tingling, calf soreness, burning sensations in her hands and feet, and numbness in her hands and feet.

The patient was using oral hypoglycemic medications (glimipride 1g, metformin 500 mg) for diabetes mellitus. He had a sudden, severe paralysis in his right lower limb during the course of his sickness. He gradually had a burning feeling in his lower limbs, along with related sensory impairment that included tingling in the same leg and numbness in the proximal portion of the lower limb.

When she was admitted, her HbA1c was 8.1%. She was receiving care at an allopathic facility for her diabetes. She is a homemaker who works. No noteworthy prior history of trauma or other chronic illnesses was found. There was a history of diabetes in both the mother and the father.

Family History: DM in both mother and father was present.

Personal History: No H/o any drug allergy, No history of any type of addiction like smoking, alcohol.

Systemic Examination

Respiratory system: No any deformity, with B/L lungs sound clear

CVS system: S1S2 is audible sound, No murmur

Digestive System: NAD with normal bowel sounds. P/A Soft

Uro-genital System: Burning micturition, frequent micturition

Investigations

  • CBC - No any significant finding.
  • Hb -14.6gm%
  • HbA1c - 8.1 %
  • RBS - 136 mg/dl with medicine
  • HIV, HBsAg, VDRL - Negative.

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Mannu LS et al. Effect of Pramehantak Kashaya & Kapikachchu Churna

Criteria for diagnosis[8]

1. Karpadadaha (burning sensation of hand and feet)
2. Karpadasuptata (numbness in hand and feet feet)
3. Piplika Sanchar (tingling sensation both hand and feet
4. Suchivat Vedna (pricking sensation)
5. Pain in Lower Limb

Scoring and Gradation Patterns[8]

Table 1

Burning sensationScore
No burning sensation0
Occasional burning sensation of palm and sole1
Intermittent burning sensation throughout body2
Continuous burning sensation throughout body3

Table 2

Tingling sensationScore
No burning sensation0
Intermittent Tingling sensation in upper and lower extremities1
Continuous Tingling sensation in upper and lower extremities2
Continuous Tingling sensation in whole body3

Table 3

NumbnessScore
No numbness0
Numbness occasionally1
Mild periodic numbness2
Continuous numbness3

Table 4

PainScore
No numbness0
Pain in only feet1
Pain in Leg2
Pain in leg and hand3

Table 5: Showing scoring before and after treatment.

SNSymptomsBTATRelief %
1.Burning sensation2150
2.Tingling sensation3167
3.Numbness30100
4.Pain in Lower Limb2150

Chikitsa (Line of treatment)

Name of drug Dose Frequency Duration

Name of the drugDoseFrequencyDuration
Pramehantak Kashaya40 mlEmpty stomach Twice a day for3 months
Kapikachhu churna3 gramsTwice a day
After meal with warm milk		3 months

Table 6: Pathya-Apathya

  • Avoid excessive exercise and day sleep. Don’t walk for long time.
  • Madhumeha is Kapha Pradhan Roga, so patient should avoid Kapha Dosha Prakopak Ahara-Viharae., sweet (Madhura), Amla (sour), Lavana (Salty) food.
  • Avoid fats (butter, oil, malai) and fat rich foods.
  • Vihara (lifestyle modification) - Aasanas (Dhanurasana, Paschimottanasana, Bhujangasana etc.)
  • Diet recommended to the patient Cereals - Old rice, Barley (Hordeum vulgare), Godhuma (wheat).
  • Pulses - Adhaki (red gram - Cajanus cajan), Kulattha (horse gram), Mudga (green gram).
  • Vegetables - Tanduleyaka (Amaranthus spinosus), Methica (Methi - Fenugreek leaves), Patola, Karavellaka (Bitter gourd).
  • Fruits - Orange, Naspati, Ananass, Apple, Jambu (Syzigium cumini), Kapitha (Feronia limonia)
  • Oils - Atasi (Linu usitatisimum), Sarsapa (Mustard).

The patient claimed significant improvement during the course of the three-month Pramehantak Kashya and Kapikachhu Churna course. The patient reported a remarkable improvement at the end of three months, prior to therapy his blood sugar level was 8.1%, and following treatment sugar level 6.5%

One of the most prevalent side effects of diabetes mellitus is neuropathy (Madhumeha). Vata and Pitta Doshas are implicated in Diabetic perpheral neuropathy, According to Ayurvedic principles. It results in burning and numbness in the hands and feet. Kapikachhu Churna's neuroprotective properties make it useful for reducing symptoms like tingling and burning. One type of Vataj Prameha is Madhumeha.

During the treatment, patient was kept only on oral medication for a period of two months. Thus, after the two months of treatment, patient had got significant improvement in burning sensation of hands and feet showed 50% relief, 67% relief in tingling sensation, 100% relief in numbness and 50% relief in Pain in lower limbs.


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Mannu LS et al. Effect of Pramehantak Kashaya & Kapikachchu Churna

Now patient is gradually improving and there is no recurrence of symptoms after the 3 months of follow up.

Conclusion

There will be an increase in patients with neuropathy as population of diabetics in India and around world rises. Therefore, it is imperative that we adapt our treatment strategies and assist in resolving complex issues like diabetic neuropathy. Type II Diabetes, lifestyle and dietary habits are considered as cause of disease. The causative factor of Prameha reduces digestive power and promotes formation of Aama (undigested substances) which is very sticky in its property and coats organs and tissues of body. This Aama is responsible for vitiation of all Doshas and Dhatus. The Pramehantak Kashaya has property to digest Aam by its Aampachana property and remove it from body by its purgative action. The Kashaya have ingredients which have laxative, digestive, and anti-inflammatory properties because majority of Katu Tikta Rasa and Ushna Virya. This drug effectively prevents and treats diabetes mellitus by controlling burning sensation in palm and sole. Many of drugs have anti-oxidant and anti-inflammatory properties support body's immune system and aid in battle against illness, very effectively in urinary system. Kappikacchhu was chosen for Balya and neuroprotective therapy of diabetic neuropathy because of its neuroprotective, antioxidant, anti-stress, and adaptogenic qualities. It helps diabetic neuropaths feel better and reduce their body aches. During treatment and follow-up period, no unintended side effects of therapy were noted. Therefore, it can be said that these herbs are very beneficial in managing diabetic neuropathy; nevertheless, more research with a larger sample size and a longer duration is needed to confirm this effect. Based on findings, it can be concluded that Ayurvedic medications utilized in this study are useful in restoring reduced perception of heat, cold, and vibration. Additionally, these medications are safe bec. they haven't caused any negative effect.

References

1. Walker BR, editor. Davidson’s Principles and Practice of Medicine. 22nd ed. Edinburgh: Elsevier; 2006. p. 831 [Crossref][PubMed][Google Scholar]

2. Vagbhata. Astāngahrdayam with the commentaries Sarvangasundara of Arunadatta and Ayurvedarasayana of Hemadri, collated and edited by Parādakara Hariśāstrī. Sutra 12/49. Varanasi: Chaukhamba Orientalia. [Crossref][PubMed][Google Scholar]

3. Sushruta. Sushruta Samhita with Nibandha Sangrah Hindi Commentary of Dalhanacharya and Nyayachandrika Panjika of Gayadasacharya on Nidanasthana, edited by Yadavji Trikamji Acharya. Nidan Vatvyadhi, Chap. 1. Varanasi: Chaukhamba Sanskrit Sansthan; [year]. p. 201, 261, 263 [Crossref][PubMed][Google Scholar]

4. Agnivesha. Charaka Samhita, revised by Chakradatta and Dridhabala with Vidyotani Hindi Commentary by Satya Narayan Sastri, edited by Kashinath Sastri. Part 2, Chikitsa Sthana, Vatvyadhi, Chap. 28. Varanasi: Chaukhamba Bharati Academy [Crossref][PubMed][Google Scholar]

5. Rastantrasar and Siddha Prayog Sangrah. Part 2. Prameha Rogahikar. Varanasi: Chaukhamba Sanskrit Sansthan; [year]. p. 183 [Crossref][PubMed][Google Scholar]

6. Database on Medicinal Plants Used in Ayurveda. Vol. 3. CCRAS, Dept. of ISM&H, Ministry of Health & Family Welfare, Govt. of India, New Delhi; p. 200-203 [Crossref][PubMed][Google Scholar]

7. A Comprehensive Review on Ethnopharmacology, Phytochemistry, and Pharmacological Activity of Amazing Velvet Bean: Mucuna Pruriens (L. ). World J Pharm Pharm Sci. 2023;14(5):540-554. [Crossref][PubMed][Google Scholar]

8. Baghel MS. Developing Guidelines for Clinical Research Methodology in Ayurveda. Jamnagar: Gujarat Ayurved University; 2005. . [Crossref][PubMed][Google Scholar]

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