A randomized controlled clinical study to evaluate the efficacy of Yastimadhu Hydrogel in Parikartika vis-a-vis Fissure-in-Ano

Abstract

Parikartika, commonly known as Fissure-in-Ano, ranks among the prevalent anorectal disorders and represents a painful affliction affecting the anal region. Its clinical presentation bears a striking resemblance to the description of Parikartika in Ayurvedic texts. Contemporary therapeutic approaches involve the application of local soothing agents, oral analgesics, and stool softeners during the initial stages. Surgical interventions, including Lord’s dilation, fissurectomy, and sphincterotomy, are considered in more advanced cases. Ayurveda, on the other hand, advocates the use of various drugs with distinct properties for treating this condition, with Yashtimadhu being recognized for its Vrana Ropan, Mrudukara, Tvak Prasadana, and Pitta-Anila Hara properties. Recognizing the regenerative potential of hydrogels on the skin, our study sought to evaluate and compare the local effects of Yashtimadhu hydrogel and Yashtimadhu Ghrita in the management of Parikartika. A randomized comparative study was conducted involving 60 patients with Fissure-in-Ano, divided into two groups. The trial group (n=30) received Yashtimadhu hydrogel through local application for a period of 3 weeks, while the control group (n=30) underwent treatment with Yashtimadhu Ghrita during the same duration. Assessment of symptoms such as Pain, Bleeding, Constipation, Itching, Discharge, and the size of anal fissure, along with observations on the anal fissure floor and granulation tissue, revealed promising results. Statistical analysis indicated the effectiveness of both Yashtimadhu hydrogel and Yashtimadhu Ghrita in the conservative management of Parikartika. Notably, Yashtimadhu Ghrita emerged as a more potent remedy in the management of anal fissure when compared to Yashtimadhu hydrogel.