Clinical Evaluation of Multiple Versus Single Putaka Gandharvahastadi Ruksha Vasti in Katigraha

Vasti Karma is regarded as foremost among Panchakarma therapies because of its diverse therapeutic actions. Among various Vasti techniques, Churnavasti, described by Chakrapani in his commentary on the Charaka Saṃhita, is predominantly Rukshana in action and is known as Ruksha Vasti. Conventionally administered as a single Putaka, attainment of Samyak Niruha Lakshana may be inadequate. Ashtanga Hrdaya recommends repeated administration when Vasti is expelled spontaneously until Samyak Niruha Lakshana is achieved. Based on this principle, the present study compared multiple Putaka with conventional single Putaka administration of Gandharvahastadi Ruksha Vasti in Kattgraha. Methods: A pragmatic randomized controlled trial was conducted among 42 participants with Kattgraha, randomly allocated into two groups. The trial group received Gandharvahastadi Ruksha Vasti through multiple Putaka for a maximum of 3 days, while the control group received single Putaka administration for up to 7 days. Outcomes included Samyak Niruha Lakshana, Samyak Ruksha Lakshana, Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI). Data were analyzed using Wilcoxon Signed Rank and Mann–Whitney U tests. Results: The trial group showed statistically significant attainment of Samyak Niruha Lakshana, including Antikt, Prasṛshta, Aśaya Laghava, Laghuta, Gatra Mardava, and Agni–Ruci. Although the control group demonstrated greater cumulative attainment of Samyak Ruksha Lakshana, these features appeared earlier in the trial group. Both groups showed significant improvement in VAS and ODI scores, without significant intergroup differences. Conclusion: Multiple Putaka administration was superior to single Putaka in achieving Samyak Niruha Lakshana, while both approaches were comparable in Samyak Ruksha Lakshana, pain, and disability outcomes.