Abstract

Cirrhosis is a chronic liver disease in which there is necrosis of liver cells followed by fibrosis and nodule formation causing gross derangement of the liver architecture. It is a leading cause of death due to complications associated with it like variceal bleeding, encephalopathy and ascites. The major causes of cirrhosis of liver includes chronic viral infections with hepatitis B or C virus, Chronic alcoholic liver disease, non-alcoholic fatty liver disease. It was associated with 2.4% of the global deaths in 2019 [1]. In Ayurveda syndrome of Cirrhosis of liver can be correlated to the disease Kumbhakamala. As per Acharya Charaka, the disease Kumbhakamala is a complication of diseases Kamala (hepatocellular jaundice) [3]. The disease Kamala on chronicity or if left untreated advances to the complicated stage called Kumbhakamala characterized by hematemesis, malena, ascites, edema, anorexia, anemia, jaundice, drowsiness and coma. While, preparing the diagnostic criteria, the features mentioned in both Ayurvedic as well as modern science were considered. Drugs like Guduchi, Daruharidra, Bhumyamalki, Ashwagandha Punarnawa, Katuki, and Arjuna have hepatoprotective activities. Katuki act as cholagogue. Guduchi, Daruharidra and Bhumyamalki, acts as antiviral. Ashwagandha and Arjuna acts as hepatoprotective. Punanava acts as diuretic and anti-inflammatory. Considering their pharmacological profile, they were selected for making the unified herbo-mineral compound Sidoliv. Patients having history of prolonged intake of alcohol or chronic infection with HBV or HCV having features of Cirrhosis of liver supported with pathological and sonological findings were selected for the study from OPD and IPD sections of Pakwasa Samnvaya Rugnalaya and all India Ayurveda Research Institute, Hanuman-nagar Nagpur. Two capsules were given with plain water twice a day for 45 days. The capsules were provided by Shree Baidynath Bhavan, Nagpur. Three follow ups were taken at the interval of 15 days. Investigations were done before and after the trial. Non parametric tests like Npar test and Wilcoxon Signed Rank tests were applied to assess the result in clinical features where severity of these features was graded in the score between 0 to 3 and where such severity gradation was not possible, McNemar test was applied for assessment of the response to the drug therapy. It is observed and concluded that the present randomized clinical trial does not show any significant improvement with regard to clinical features or pathological parameters. Keywords: Kumbhakamala, Cirrhosis