A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF PARIBHADRA PRATISARANIYA KSHARA AND NIMBA PRATISARANIYA KSHARA IN THE MANAGEMENT OF ABHYANTARA ARSHA (INTERNAL HAEMORRHOIDS)
Dr. Pushpendra Singh Pal*, Dr. Nadakuduru Tejo Lakshman
ABSTRACT
Background: Abhyantara Arsha (internal haemorrhoids) is a common anorectal disorder described in Ayurveda and is classified among the Ashta Mahagada because of its chronicity, recurrence, and impact on patients' quality of life. Among the various treatment modalities described by Acharya Sushruta, Kshara Karma is considered an effective minimally invasive para-surgical procedure. Although different herbal Pratisaraniya Ksharas have been used in clinical practice, comparative evidence on the efficacy of Paribhadra and Nimba Pratisaraniya Kshara is limited. Objective: To evaluate and compare the clinical efficacy of Paribhadra Pratisaraniya Kshara and Nimba Pratisaraniya Kshara in the management of Abhyantara Arsha. Materials and Methods: A prospective, randomized, comparative clinical study was conducted on 60 patients with first-, second-, and third-degree internal haemorrhoids. Patients were randomly allocated into two groups of 30 each. Group A received Paribhadra Pratisaraniya Kshara, while Group B received Nimba Pratisaraniya Kshara following the standard Kshara Karma procedure. Clinical assessment was performed using subjective parameters (bleeding per rectum and pain), objective parameters (size and colour of pile mass and sphincter tone), and secondary outcome measures including patient satisfaction, recovery time, time to return to work, and duration of hospital stay. Statistical analysis was performed using appropriate tests, with P<0.05 considered statistically significant. Results: Both groups demonstrated statistically significant improvement in all assessed clinical parameters. However, Group A showed greater reductions in bleeding (88.32% vs. 71.25%), pain (88.94% vs. 75.11%), and pile mass size (77.15% vs. 64.70%) compared with Group B. Patients treated with Paribhadra Pratisaraniya Kshara also experienced faster recovery, earlier return to routine activities, and higher satisfaction scores. No major postoperative complications or serious adverse events were observed in either group. Conclusion: Both Paribhadra and Nimba Pratisaraniya Kshara are safe and effective para-surgical interventions for Abhyantara Arsha. However, Paribhadra Pratisaraniya Kshara demonstrated comparatively superior therapeutic efficacy and may be considered a preferable treatment option for first-, second-, and selected third-degree internal haemorrhoids.
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