A Study On The Effect Of Chincha Kshar Along With Varunadi Kwath In The Management Of Mutrashmari

Abstract

Background: Mutrashmari (urolithiasis or urinary calculi) is among the most common urinary disorders and is notorious for severe pain and high recurrence rates. Modern treatment relies on surgical removal or lithotripsy, which address existing stones but do not prevent recurrence. Ayurvedic classics describe Mutrashmari in detail and advocate conservative management using herbal formulations and Kshara (alkaline ash preparations) before resorting to surgery. Chincha Kshar (alkali from Tamarindus indica) combined with Varunadi Kwath (a polyherbal decoction described in Ayurvedic texts) is a promising oral therapy mentioned in classical literature but has not been extensively studied clinically.

Objectives: To evaluate the clinical efficacy of Chincha Kshar along with Varunadi Kwath in the management of Mutrashmari (renal stones), particularly in relieving symptoms (renal colic, dysuria) and facilitating stone disintegration or expulsion.

Materials and Methods: An open-label single-arm clinical trial was conducted with patients of Mutrashmari. Patients aged ≥15 years with radiologically confirmed renal or ureteric calculi (up to ~12 mm in size) and classical symptoms were enrolled. Patients received Chincha Kshar 500 mg orally, along with Varunadi Kwath 40 mL, twice daily after meals for 15 days. Outcomes were assessed by subjective symptom scores (renal colic pain on Visual Analogue Scale; grading of burning micturition) and objective measures (stone size on ultrasonography, presence of hematuria) recorded before treatment, after 15 days of therapy, and at one-month follow-up. Safety was monitored through blood chemistry and reports of adverse effects. Descriptive statistics and paired t-test were used to analyze pre- and post-treatment changes (with p<0.05 as significant).

Results: All patients reported substantial symptomatic relief following treatment. Mean renal colic pain score (VAS) reduced from ___/10 at baseline to ___/10 post-treatment, a statistically significant improvement (p<0.001). Burning micturition, present in __% of patients at baseline, was completely relieved in ___% of those by day 15. Associated symptoms like dysuria and urinary urgency also improved. Ultrasonography revealed a reduction in calculus size in the majority of patients: the mean stone size decreased from ___ mm to ___ mm (p<0.001). Complete stone clearance (no calculus on follow-up imaging) was achieved in __% of patients (particularly those with stones ≤8 mm), while another __% showed partial fragmentation or downward migration of calculi. Hematuria, which was initially detected in __ patients, resolved entirely in all affected cases. No significant adverse effects were observed; renal function tests remained in normal range and no patient developed obstructive complications during the trial.

Conclusion: The combination of Chincha Kshar and Varunadi Kwath demonstrated notable efficacy in managing Mutrashmari. It significantly alleviated renal colic and dysuric symptoms and aided in disintegrating or expelling urinary stones up to moderate sizes. This therapy, rooted in Ayurvedic principles, offers a cost-effective and safe conservative management option for renal calculi, potentially reducing the need for surgical intervention in eligible patients. Further controlled studies with larger sample sizes are recommended to compare this combined regimen against standard treatments and to confirm long-term benefits in stone clearance and recurrence prevention.