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Triphala Ghrita 和 Goghrita Manda Tarpana 在治疗 Shushkakshipaka wsr 干眼症中的疗效：一项开放标记随机对照临床试验

2020 年 1 月
AYU（国际阿育吠陀研究季刊）41（1）：52

41(1):52

DOI： 10.4103/ayu.AYU_108_18

作者：

甘格达尔·蒂马普尔

SDM 阿育吠陀学院与医院

莎姆莎·菲亚兹

国家阿育吠陀研究院

背景：Shalakya Tantra 是阿育吠陀八个分支之一，其中还包括眼科。Shushkakshipaka（干眼症）是一种涉及眼睛所有部位（Sarvagata Netra Roga）的疾病，其特征是 Gharsha（沙砾感）、Toda（刺痛）、Kunita（畏光）、Avila Darshana（视力模糊）、Daha（灼热感）和 Raktaraji（眼充血）。所有这些症状都与干眼症的症状相似。目的和目标：本研究的目的是评估和比较 Triphala Ghrita 和 Goghrita Manda（牛酥油的上清液部分）Tarpana（对眼睛进行的治疗程序）在 Shushkakshipaka 治疗中的效果。材料和方法：从哈桑 Sri Dharmasthala Manjunatheshwara 阿育吠陀学院 Shalakya Tantra 的门诊部和住院部选取 30 名符合 Shushkakshipaka 纳入标准的患者。根据临床体征和症状的严重程度给予适当的评分，并根据治疗后这些症状的缓解情况进行评估。干眼症患者被交替分为两组接受 Tarpana 治疗，即 Triphala Ghrita Tarpana (TGT) 组和 Goghrita Manda Tarpana (GMT) 组，连续 7 天下午服用 Tarpana，15 天后进行随访，持续 2 个月。结果：两组中 73.3% 的患者出现中度缓解（缓解 50%-75%），两组中 26.7 名患者出现显著缓解（缓解 >75% 但 <100%）。 Gharsha (74%)、Avila Darshana (65%)、Upadeha (80%)、Daha (72%)、Kunita (78%)、Toda (59%) 和 Raktaraji (83%) 等症状得到缓解。结论：Goghrita Manda Tarpana (GMT) 对 Garsha、Toda 和 Daha 治疗后即刻的效果优于 Triphala Ghrita Tarpana (TGT)。

总体响应等级指数

…

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原文

介绍

Shushkakshipaka [1] 是Sarvagata Netra Roga [2]之一。

Sushruta 和 V 也提到过眼睛下方有 agbhata

疾病，由V引起艾塔和Pitta并具有

加尔沙（坚韧不拔感觉），电视奥达（刺类型的疼痛），

Upadeha （膜形成）克里赫onmeelan （困难

闪烁）五ishushkata （干燥），鲁克莎·达鲁纳

五阿特玛（眼睑粗糙）等。[1]这些症状可以是

与现代人干眼症状相关

药物是导致眼部不适的主要原因

影响数百万人。

干眼症[3]是一种疾病，范围从

轻度眼疲劳至异物感、疼痛、灼热和

视力威胁并发症。患者遭受相当大的

由此引起的不适会干扰日常活动。

干眼症的症状在以下情况下会加剧：

T的功效riphala Ghrita和Goghrita Manda T阿帕纳在

Shushkakshipaka w的管理.sr. 干眼症：

开放标记随机对照临床试验

Gangadhar M. Timmapur、Shamsa Fiaz1

BLDE 协会 AVS 阿育吠陀 Mahavidyalaya 医院和研究中心 Shalakya Tantra 系，维杰亚普尔, 卡纳塔克邦, 1 个部门沙拉基亚的时代

谭崔，国家 A 研究所yurveda，斋浦尔，拉贾斯坦邦，印度

背景：Shalakya T antra是 A 的八个分支之一yurveda，其中还包括眼科。Shushkakshipaka （干

眼睛综合症是其中之一疾病，包括全部眼睛的部分（Sarvagata Netra Roga）特征作者： Gharsha （坚韧不拔感觉），

电视oda （刺痛）、 Kunita （畏光）、Avila Darshana （视力模糊）、Daha （烧灼感）和Raktaraji （充血）

在眼睛里）。所有这些症状都类似于干眼症的症状。目的和目标：本研究的目的是

目的是评估和比较Triphala Ghrita和Goghrita Manda（牛酥油的上清液部分）的效果。阿帕纳（治疗

程序完毕 Shushkakshipaka治疗中的眼部损伤。材料和方法：符合纳入标准的 30 名患者

Shushkakshipaka的标准是从Shalakya T的门诊部和住院部中选出的达摩斯塔拉

曼朱那瑟瓦拉学院yurveda，Hassan。根据临床症状和体征的严重程度给予适当的评分，并且

评估基于治疗后这些症状的缓解情况。干眼症患者被交替分配到两个

T组arpana , 即Triphala Ghrita T阿帕纳（TGT）集团和Goghrita Manda Tarpana (GMT) 集团以及电视阿帕纳

7 颗星连续的天下午与跟随向上15 后天2 人份个月。结果：中等宽慰（缓解 50%–75%）曾是出现在

73.3% 的患者两组均有明显缓解 (>75%但缓解程度<100%）在 26.7两组患者均有改善。缓解

症状包括Gharsha (74%)、 Avila Darshana (65%)、 Upadeha (80%)、 Daha (72%)、 Kunita (78%)、 T奥达(59%) 和拉克塔拉吉(83%)

结论：效果戈格里塔·曼达·塔尔帕纳(GMT)在加莎，Toda和Daha 的情况在之后立即好转

比Triphala Ghrita T治疗效果更佳阿帕纳（TGT）。

关键词： A yurveda、干眼症、 Goghrita Manda 、 Sushkakshipaka 、 Triphala Ghrita

通讯地址： Dr. Gangadhar M. Timmapur ，

BLDE 沙拉基亚坦陀罗系副教授兼系主任

协会的 AVS 阿育吠陀 Mahavidyalaya 医院和研究中心

Centre, Vidya Nagar, Bagalkot R oad, Vijayapur ‑ 586 109, 卡纳塔克邦, 印度。

电子邮件：drgmtimmapur@gmail.com

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抽象的

如何引用本文：Timmapur GM, Fiaz S. Ecacy的T里帕拉·格里塔

高格里塔·曼达·T arpanazàiSushkakshipaka wsrdeguǎnlǐzhōng 。

干眼症：一项开放标记随机对照临床试验

审判。于2021；41：52-7。

提交日期：2018 年 5 月 31 日修订日期：2018 年 7 月 31 日

接受日期：2020 年 5 月 3 日发布日期：2021 年 7 月 30 日

[2021 年 7 月 31 日星期六从 http://www.ayujournal.org 免费下载，IP：178.34.160.224]

Timmapur 和 Fiaz： Triphala Ghrita和Goghrita Manda T的角色干眼症中的阿帕纳

AYU ¦体积41¦问题1¦ 一月至三月2020 53

受到污染和潮湿的环境，例如空调和

室内加热器。[4]不幸的是，尽管进行了许多研究

正在对干眼症进行研究，永久治愈

干眼症仍然无法治愈，而且似乎也没有更近的症状。

电视arpana [5]是重要的眼部

治疗（Kriyakalpa）滋养眼睛并治愈

的Vata Pitta疾病。[6,7]它可能有助于管理

Shushkakshipaka的它的油化（Snehana）和瓦塔

以及Pitta平息行动。

Netra中显示了Triphala Ghrita和Goghrita Manda

羅加（眼睛疾病）它是查克舒什亚（改善

想象）， Snehana （油）和拉萨亚纳（恢复活力）

属性。[8] Triphala Ghrita含有T riphala具有

据报道具有免疫调节剂、抗菌剂和

抗炎活性[9] ，因此可能有助于检查

预防干眼症的进展-细胞来自

释放细胞因子（主要是白细胞介素 6）会刺激

干眼症的炎症成分。

研究目的

•评估并比较Triphala Ghrita的功效

电视arpana （TGT）和Goghrita Manda 塔尔帕纳（格林威治标准时间）

Shushkakshipaka 的管理。

数据来源

我。具有典型症状和体征的患者

Shushkaakshipaka像Gharsha 、 Toda和Daha在

根据纳入和排除来选择眼睛

门诊和住院标准

沙拉基亚 T 研究生院的胃窦

SDM 学院哈桑的尤尔韦达和医院

二、试验药物：Triphala Ghrita是从 SDM 采购的

药房、Udupi 和Goghrita Manda被采购

从克里亚卡尔帕单位的SDM 学院阿育吠陀

和哈桑医院。

材料和方法

设计了一项前瞻性的临床比较研究，

诊断依据为

古典文献中提到的病史和症状。批准

从机构道德委员会曾是已采取前

开始试验。患者信息表已提供

30 名患者，并征得所有患者的知情同意

患者。诊断已确认经过 Schirmer 氏病测试

泪条湿润程度和泪液破裂时间的值

泪膜上出现干燥斑点。[表1]

统计 T埃斯特斯

人口统计数据以百分比表示。

评估标准得分进行了统计分析

条款意思是值的BT（之前治疗后）、AT（

治疗）， SD（标准）偏差）和东南（标准

错误）。两种疗法该团体是评估

通过应用学生的配对' t '之前进行对比测试

治疗期间及治疗后评分的评定标准。

所获得的结果被认为具有高度显著性

对于P <0.001，意义重大对于P <0.05和微不足道为了

P > 0.05。

纳入标准

• 5 岁以上的患者以及60 岁以下

性别

•具有以下典型体征和症状的患者

Shushkakshipaka 就像Gharsha （坚韧不拔的感觉），

电视奥达（刺类型疼痛），乌帕德哈（膜

形成), 克里赫伦米兰（困难在闪烁）

维舒什卡塔（干燥），鲁克莎·达鲁纳·瓦特玛（粗糙的

眼睑

•符合条件的案件阿帕纳

排除标准

• ‍Shushkakshipaka （干眼部综合症联系

患有其他特定眼部疾病，例如Savrana

Shukla （角膜溃疡）、 Arma （翼状胬肉）。

• ‍‍那些不适合服用T的人阿帕纳–Netra Ragata （红色

眼病）、Jwara（发烧）和Pratishaya（鼻炎）。

治疗组

30 名Shushkakshipaka （干眼症）患者

选择者随机的采样技术（便捷方法）

样本和患者被交替分配到

以下两组各有15名患者。

• 团体温度计 – 15 名患者受到对于 T里帕拉

格利塔阿帕纳

•组GMT–15患者是受到为了戈格里塔

曼达阿帕那。

用法用量

塔尔帕纳

为了T的目的阿帕纳程序，黑扁豆四和

将水混合在一起形成面团。这个面团

然后用来在眼睛周围形成一个圆形的墙。然后，

病人被要求闭上眼睛， Ghrita已填满在

圆形边界内的空间。倒完Ghrita后，

要求患者逐渐睁开和闭上眼睛。

电视表 1：客观参数的分级

客观的

参数

观察

0 级 1 年级 2 年级 3 年级

席尔默氏病

测试

泪液润湿程度

1 分钟内剥离 15 毫米以上

撕条润湿程度

1 分钟内超过 10 毫米 ‑ 15 毫米

撕条润湿程度

1 分钟内超过 5 毫米 - 10 毫米

撕条润湿程度

1 分钟内 1 毫米 ‑ 5 毫米

泪液破裂

时间

干燥的外观

15 秒后出现斑点

出现干燥斑点

10 至 15 秒之间

出现干燥斑点

5 至 10 秒之间

出现干燥斑点

5秒内

[2021 年 7 月 31 日星期六从 http://www.ayujournal.org 免费下载，IP：178.34.160.224]

Timmapur 和 Fiaz： Triphala Ghrita和Goghrita Manda T的角色干眼症中的阿帕纳

AYU ¦体积41¦问题1¦ 一月至三月2020

大约 10–15毫升的 Triphala Ghrita或Gogritha

Manda用于Tarpana每天下午

连续 7 天可享 1000 Matra Kala /30 分钟[1,7]

建议患者不要歪头，也不要眨眼

间歇性地。患者没有服用任何对抗疗法药物或

治疗过程中使用任何其他内服药物。

后续行动

这后续行动曾是完毕在一个间隔的每一个15天向上

到 60 天和再次出现这症状在

随访期过后视为疾病复发。

治疗评估

治疗评估基于以下因素

完成前后的体征和症状状况

根据自我制定的评分来评估治疗效果

尺度。评分是根据客观参数进行的，

按照T1. Gharsha （坚韧不拔的感觉在眼睛）维拉

达沙那（模糊想象）， Upadeha （过度粘稠状

有粘液/粘稠感在眼睛）达哈（燃烧感觉

在眼睛）国田（畏光），戸田（刺型的

疼痛在眼睛）和拉克塔拉吉（拥塞在眼睛

被纳入主观参数[表2]。这

总体评估基于以下参数

在T中提到能够 3.

观察

年龄分布患者显示最高 46%

的患者在年龄组21 –三十五年，随后

27%患者谁是在年龄组的5 ‑20年，17%

年龄在 51-75 岁之间，10%之间

这年龄组为 36-50 岁。的30例，发生率

Shushkakshipaka是观察到60% 的女性和 40%在男性

患者。患者的社会经济地位分布

显示最大的 73% 属于到中间班级

关注经过23%患者WHO属于到上班级和

04%属于下层阶级。 Prakriti明智的分布表明

63% 属于V阿塔-皮塔贾, 27% 是的V ata-Kaphaja和

10%属于Pitta-Kaphaja Prakriti 。严重程度分布

结果显示，80%为中度，20%为重度

年级。患者的病因分布显示，最大

67% 的人暴露于风、灰尘、空调、暴露于

阳光、温度变化，53%的患者遵循

谁正在使用Amla （酸）、Ushna-Tikshna （热和辛辣的）

食品类文章，30%的患者有长时间阅读的习惯，

27%有头痛病史，10%有类风湿病史

关节炎，07% 的人有头皮屑、关节疼痛和

chronic rhinitis, 03% each had history of myopia, multiple

sclerosis, acne and chalazion.

Among 30 patients of Shushkakshipaka, 30 (100%) of patients

had Garsha, Avila Darshana, Daha, Kunita, Toda/Pakavata

Shoola, 29 (97%) of patients had Upadeha and 24 (80%) of

patients had Raktaraji.

Result

Dry eye includes a spectrum of disorders ranging from mild eye

strain to foreign-body sensation, pain, burning sensation with sight

threatening complications. Patients face considerable discomfort

with this affliction which interferes with the daily routine

functioning. In this study, 30 patients of Shushka-Akshipaka (dry

eye) were treated in two groups, each comprising 15 patients.

Efficacy of Triphala Ghrita Tarpana (TGT): 15 patients

in this group were given Tarpana with Triphala Ghrita of

approximately 10–15 ml in afternoon for consecutive 7 days

for 30 minutes. In this group, signicant relief was found in

Gharsha (74%), Avila Darshana (65%), Upadeha (80%),

Daha (72%), Kunita (78%), Toda (59%), Raktaraji (83%),

Schirmer’s test of right eye (70%), Schrimer’s test of left

Table 2: Grading’s of Subjective parameters

Symptom Status of the symptom

Grade 0 Grade 1 Grade 2 Grade 3

Gharsha (gritty feeling) Absent Occasionally present Frequently present with

lacrimation

Continuously present with

lacrimation and congestion.

Avila Darshana (blurring of

vision)

Absent Occasionally present Intermittently present Frequently present

Upadeha (excessive stringy

mucus/lmy feeling in the

eyes)

Absent Occasionally present and the

patient is able to open the

eyes easily

Frequently present and

patient is able to open the

eyes easily

Frequently present and

patient is able to open the

eyes with much diculty

Daha (burning sensation in

the eye)

No burning

sensation in eyes

Occasional burning sensation

in eyes

Regular burning sensation

in eyes

-------

Kunita (photophobia) Absent Sensitivity to bright light and

other bright stimulus

Sensitivity to mild sunlight

but comfortable in dim lights

Sensitivity to even dim light

with an inability to open eyes

Toda (pricking type of pain

in the eyes)

Absence of

pricking pain

Mild - tolerable and

negligible pricking pain

Moderate - constant and

tolerable pricking pain

Severe - intolerable and

constant pricking pain

Raktaraji (congestion) Absent Discrete, thin vessels vascular

network limited to palpebral

conjunctiva and fornix

Prominent vascular network

involving peripheral part of

bulbar conjunctiva

Fiery red involving whole

bulbar conjunctiva and

circumcorneal zone

Daruna and Ruksha Vartma Absent Occasionally present Intermittently present Frequently present

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Timmapur 和 Fiaz： Triphala Ghrita和Goghrita Manda T的角色干眼症中的阿帕纳

AYU ¦ Volume 41 ¦ Issue 1 ¦ January-March 2020 55

eye (68%), tear break‑up time of right eye (70%) and tear

break‑up time of left eye (69%). In 15 patients of group

where Triphala Ghrita Tarpana was done, complete remission

was not observed in any patient, marked relief in 26.7% and

moderate relief in 73.3% of patients. In 15 patients of this group

after all follow‑ups, 13 patients sustained the eect of therapy,

while 2 patients got recurrence in the symptoms [Table 4 and

Figure 2].

Ecacy of Gogritha Manda Tarpana (GMT): 15 patients

in this group were given Tarpana with Goghrita Manda of

approximately 10–15 ml in the afternoon for consecutive

7 days for 30 minutes. In this group, the signicant relief

was found in Gharsha (68%), Avila Darshana (69%)

[Figure 1] (73%), Upadeha (68%), Daha (53%), Kunita (68%),

Toda (60%), Raktaraji (100%), Schirmer’s test of right

eye (69%), Schrimer’s test of left eye (72%), tear break‑up time

of right eye (70%) and tear break‑up time of left eye (70%)

[Figure 1]. In 15 patients of this group, complete remission

was not observed in any patient, marked relief in 26.7%, and

moderate relief in 73.3% of patients [Figure 2]. In 15 patients of

group GMT after all follow‑ups, 11 patients sustained the eect

of therapy, while 4 patients got recurrence in the symptoms. In

nutshell, the present clinical study has established that Tarpana

with Goghrita Manda yields good result in follow-up than that

of Triphala Ghrita Tarpana [Tables 5 and 6, Figure 3].

Discussion

Dry eyes are one of the most common causes of chronic

low-grade burning, irritation, and discomfort of the eyes. It

is caused due to disturbance in the tear lm function owing

to change in lipid, water, or mucin component of the tears.

It is now recognized that dry eye syndrome results from an

underlying cytokine and receptor‑mediated inammatory

process aecting the lacrimal glands. Inammation, in turn,

can either decrease tear production or alter the contents of

the tear lm and disrupt homeostasis at the ocular surface,

leading to dry eye syndrome. These ndings have redirected

treatment eorts toward more targeted therapies aimed at

resolving the underlying inammation. Anti‑inammatory/

immunomodulatory treatments are now becoming standard

therapy for moderate to severe dry eye syndrome.

Contemporary tear substitutes stimulate the cell surface

glycoproteins that maintain ocular hydration and mucoadhesive

property due to lipid content in it. It slows the evaporation

of the tear lm, thus resolves the condition which leads to

dry eye.

74 65

80 72 78

70 6868 73 68

68 60

100

69 72

100

Garsha Avila Darshana

Assigned groups & symptoms

symptoms ill in mean % in AT in both groups

Upadeha Daha Kunita Toda RaktarajiSchirmer’s

Test-RE

Schirmer’s

Test-LE

% Percentage

Gr.TGT Gr.GMT

Figure 1: Comparison of improvement in the symptoms between the groups – TGT: [TGT: Triphala Ghrita Tarpana, GMT: Goghrita Manda Tarpana, AT:

After treatment, RE: Right Eye, LE: Left Eye]

Overall improvement among 30 Pt.'s

26.7

73.3 73.3

Complete

remission

Marked relief Moderate relief Mi ld relief No relief

Assigned groups & Re sult

Percentage

Gr .TGT Gr.GMT

Figure 2: Overall percentage of improvement in the patients. TGT: Triphala

Ghrita Tarpana, GMT: Goghrita Manda Tarpana group

Overall Response to the Therapy during Follow up Period

100

Sustained Effect Relapsed

Assigne d groups & Re sult

Percentage

Gr.TGT Gr.GMT

Figure 3: Overall response to the therapy during follow‑up period in the

patients. [TGT: Triphala Ghrita Tarpana, GMT: Goghrita Manda Tarpana]

Table 3: Gradation index for overall response

Response Result % (Criteria of response)

improvement

<25% relief in signs, symptoms and clinical tests

Mild relief 25%‑50% relief in the signs, symptoms and clinical tests

Moderate relief 50%‑75% relief in the signs, symptoms and clinical tests

Marked relief >75% but <100% relief in the signs symptoms and

clinical tests

Complete relief 100% relief in the signs, symptoms and clinical tests

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Timmapur and Fiaz: Role of Triphala Ghrita and Goghrita Manda Tarpana in dry eye syndrome

AYU ¦ Volume 41 ¦ Issue 1 ¦ January-March 2020

Table 4: Effect of Triphala Ghrita Tarpana

Symptoms Mean score % of reduction

in mean score

S.D of

mean (±)

S.E of

mean (±)

t P

BT AT

Gharsha 2.06 0.53 74.19 0.516 0.13 11.49 <0.001

Avila Darshana 1.93 0.66 65.51 0.593 0.153 8.26 <0.001

Upadeha 1.66 0.33 80 0.617 0.159 8.36 <0.001

Daha 2.13 0.6 71.8 0.51 0.13 11.49 <0.001

Kunita 1.8 0.4 77.77 0.50 0.13 10.68 <0.001

Toda/Pakavat Shoola 2.26 0.93 58.82 0.67 0.17 7.63 <0.001

Raktaraji 0.8 0.13 83.33 0.73 0.19 3.50 <0.001

Schirmer’s Test of Right Eye 20.6 70 0.77 0.20 6.99 <0.001

Schirmer’s Test of Left Eye 2.26 0.73 67.64 0.83 0.21 7.12 <0.001

Tear Break up Time of Right Eye 20.6 70 0.81 0.21 6.63 <0.001

Tear Break up Time of Left Eye 1.93 0.6 68.96 0.79 0.20 6.46 <0.001

BT: Before treatment, AT: After treatment, SD: Standard deviation, SE: Standard error

Table 6: Symptom wise effect in follow‑up in the patients

Symptom wise effect in 15 days follow‑up (n=30) Group TGT % of patients Group GMT % of patients

Sustained Relapsed Sustained Relapsed

Gharsha (gritty feeling) 80 20 73.3 26.6

Avila Darshana (blurring of vision) 93.33 6.66 100 0

Upadeha (excessive stringy mucs/lmy feeling in the eyes) 93.33 6.66 100 0

Daha (burning sensation in the eyes) 60 40 86.66 13.33

Kunitna (photophobia) 93.33 6.66 73.3 26.6

Toda (pricking pain in the eyes) 86.66 13.33 93.33 6.66

Raktaraji (congestion in the eyes) 93.33 6.66 93.33 6.66

Schirmer’s test RE 80 20 86.66 13.33

Schirmer’s test LE 73.33 26.66 100 0

Tear break‑up time ‑ RE 66.66 33.33 86.66 13.33

Tear break‑up time ‑ LE 86.66 13.33 86.66 13.33

TGT: Triphala Ghrita Tarpana, GMT: Goghrita Manda Tarpana, RE: Right Eye, LE: Left Eye

Table 5: Effect of Goghrita Manda Tarpana

Symptoms Mean score % of reduction

in mean score

S.D of

mean (±)

S.E of

mean (±)

t P

BT AT

Gharsha 2.06 0.6 67.74 0.50 0.13 10.68 <0.001

Avila Darshana 1.73 0.46 73.07 0.45 0.11 10.71 <0.001

Upadeha 1.46 0.46 68.18 0.53 0.13 7.24 <0.001

Daha 2.13 1 53.12 0.35 0.09 12.47 <0.001

Kunita 1.86 0.6 67.85 0.59 0.15 8.26 <0.001

Toda/Pakavat Shoola 2.33 0.93 60 0.63 0.16 8.57 <0.001

Raktaraji 1.06 0 100 0.45 0.11 9.02 <0.01

Schirmer’s Test of Right Eye 2.4 0.73 69.44 0.74 0.19 8.68 <0.001

Schirmer’s Test of Left Eye 2.13 0.6 71.87 0.63 0.16 9.27 <0.001

Tear Break up Time of Right Eye 2.46 0.73 70.27 0.61 0.15 10.87 <0.001

Tear Break up Time of Left Eye 2.2 0.66 69.69 0.63 0.16 9.38 <0.001

BT: Before treatment, AT: After treatment, SD: Standard deviation, SE: Standard error

Tarpana forms an occlusive lm over the surface of the eyeball

and improves the composition of tear lm by enhancing the

mucin and aqueous layers. It prevents frictional damage

to the ocular surfaces secondary to lid movement or extra

ocular movements. It helps by retaining uid and maintaining

hydration of the ocular surface. It is eective in reducing

evaporation rate and blinking rate in patients with dry eye

syndrome.[8] It prevents desiccation from corneal tear lm and

reduces burning sensation in patients with dry eye syndrome.

It also reduces reex tearing and the need for articial tears

and warm compressors. It is well tolerated by the patients

and provides a totally new therapeutic approach providing

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Timmapur and Fiaz: Role of Triphala Ghrita and Goghrita Manda Tarpana in dry eye syndrome

AYU ¦ Volume 41 ¦ Issue 1 ¦ January-March 2020 57

steady levels of medication to the ocular surface which oers

additional benets in the management of dry eye syndrome.

Triphala Ghrita as being the best immune-modulator, it

confers anti‑inammatory activity and in dry eye syndrome

thereby prevents T‑cells from releasing cytokines (primarily

interleukin‑6) that incite the inammatory component of dry

eye. As Triphala Ghrita is best for its antibiotic activity, it

reduces the inammation and improves lipid production in

dry eye syndrome.[9]

Goghrita Manda is a Sneha Dravya (oily material) belonging

to Jangama Varga (animal origin). It is considered best in all

Sneha Dravyas. Ayurveda recommends Goghrita as best and

if not specied, the epithet Ghrita always applies to Goghrita.

Goghrita is lipophilic in nature which facilitates absorption

through corneal epithelium.

Moreover, compared to the articial tear products, as Triphala

Ghrita or Goghrita is rich in lipid content which reects

mucoadhesive properties, the degree of contact time with the

ocular surface is greater. Hence, the eect of Tarpana is better

as it has got contact time of more than 15 min. Tarpana also

stimulates the lacrimal glands to produce tears. Mucin layer

which is present in tear lm allows the Ghrita to spread over

the ocular surface. This approach provides long lasting relief

to the patients with moderate-to-severe dry eye symptoms.

Conclusion

The explanation of clinical features of Shushkakshipaka in

all classical texts collectively gives complete picture that

resembles with dry eye syndrome. The eect of Triphala

Ghrita Tarpana is better in the subsequent follow-up than

immediately after effect of the treatment with minimal

recurrence, in the cases of dry eye syndrome. The eect of

Goghrita Manda Tarpana is better in immediately after eect

of the treatment but found to have a greater rate of recurrence.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conicts of interest.

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Dry eye syndrome (DES) is a chronic ocular condition characterized by reduced tear production or increased tear evaporation, leading to discomfort, visual disturbances, and potential damage to the ocular surface. Conventional treatments like artificial tears provide temporary relief without addressing the underlying causes. This article explores the potential of Ayurvedic interventions in managing DES by drawing parallels with "Shushkashipaka," an Ayurvedic ocular surface disease with similar manifestations. Ayurveda offers various Kriyakalpa procedures such as Tarpana, Putpaka, Parisheka, Ashchyotana, Nasya, and Anjana, which can help address the multifactorial nature of DES. These personalized and comprehensive approaches provide alternative and complementary therapeutic options for managing DES. Further research and clinical studies are needed to validate the efficacy and safety of Ayurvedic interventions in managing DES. However, the principles and therapeutic procedures described in Ayurvedic texts hold promise in addressing this prevalent eye condition.

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Two – Arm, Randomized, Open Labeled, Comparative, Prospective Clinical Study to Assess the Efficacy of Amalaki Ghrita Aashchyotana versus Hydroxypropyl Methylcellulose Eye Ointment in Dry Eye Syndrome with special reference to Shushkaakshipaka

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Phytochemical and pharmacological actions of Triphala; Ayurvedic formulation – A review

Jan 2012
16-5

DV Gowda
G Muruli
PR Rangesh
RD Deshapande

Gowda DV, Muruli G, Rangesh PR, Deshapande RD. Phytochemical and pharmacological actions of Triphala; Ayurvedic formulation -A review. Int J Pharm Sci Rev Res 2012;15:16-5.