A COMPARATIVE CLINICAL STUDY BETWEEN POLYHERBAL COMBINATION (GUDUCHI, GUGGULU, MANJISTHA) AND XANTHINE OXIDASE INHIBITOR IN THE MANAGEMENT OF VATARAKTA W.S.R TO HYPERURICEMIA

Background: Vatarakta is a disease described in Ayurvedic literature involving the pathological interaction of Vata Dosha and Rakta Dhatu. Its manifestations, including joint pain, swelling, redness, tenderness, burning sensation, and stiffness, show clinical similarities to gout. Hyperuricemia is an important biochemical factor in the pathogenesis of gout. A polyherbal combination of Guduchi, Guggulu, and Manjistha has been described in Ayurvedic therapeutic practice for disorders associated with Vatarakta. Aim: To evaluate and compare the therapeutic effects of Guduchi–Guggulu–Manjistha Vati and febuxostat in patients with Vatarakta with special reference to hyperuricemia. Materials and Methods: The comparative clinical study was conducted at Ayurvedic teaching hospitals in Kolkata. Seventy-two patients were registered, of whom 60 completed the trial. Patients were allocated to two groups of 30 each. Group A received Guduchi–Guggulu–Manjistha Vati, 500 mg twice daily after meals with lukewarm water. Group B received febuxostat 40 mg. Both groups underwent treatment for 45 days with follow-up at 15-day intervals. Seven subjective parameters and serum uric acid concentrations were evaluated. Paired statistical comparisons and nonparametric analyses were reported. Results: Both groups demonstrated statistically significant improvement in several subjective parameters. Group A showed 32.47% relief in Ruka, 36.17% in Sopha, 41.20% in Raga, and 38.86% in Daha. Group B showed 33.33% relief in Toda and 29.16% in Stabdhata. Mean serum uric acid decreased from 7.227 to 7.133 mg/dL in Group A (1.30%; p=0.161) and from 7.177 to 6.620 mg/dL in Group B (7.82%; p<0.001). The thesis reported a significant between-group difference in serum uric acid change (p=0.001). Overall, 49 patients (81.67%) showed mild improvement, one (1.67%) showed moderate improvement, and 10 (16.67%) showed insignificant improvement. Conclusion: Guduchi–Guggulu–Manjistha Vati was associated with improvement in several subjective manifestations of Vatarakta but did not demonstrate a statistically significant reduction in serum uric acid. Febuxostat produced a greater biochemical urate-lowering effect. Larger controlled trials are needed to confirm the clinical effects and safety of the polyherbal formulation.