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Evaluation of the biochemical changes in bile under the influence of compound indigenous drug in biliary stone diseases


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Abstract

Background
Biliary stone disease is an old aged anguish of mankind. Many chemical agents and
traditional medicines have been tried to dissolve biliary stones but all have come with
limited success. “Phaltrikadi” has also been used to treat jaundice since ages as an
“Ayurvedic Polyherbal Formulation” with acceptable good results. Since “Phaltrikadi” is
clinically very effective, the main objective of the study were –
(a) To know its effects on various inorganic and organic contents of bile especially when
the bile is proven lithogenic i.e. in patients of Cholelithiasis and Choledocholithiasis.
(b) To evaluate the prophylactic effect of the compound drug on biliary stone diseases
as well as changes in bile juice composition that is responsible for the recurrence of
stones after successful cholecystectomy.
Methods
Total 64 patients of Cholelithiasis and Choledocholithiasis after cholecystectomy with
choledochotomy and T-tube drainage were allocated in two groups for the studyGroup A (Treated Group) - 34 cases; drug was given in the form of freshly prepared decoction
from 4th post operative day to 10th post operative day. Group B (Control Group) - 31 cases;
no drug will be given to the patients of in this period. Screening of biochemical changes
of Bile juice was done by various biochemical procedures in Intraoperative bile juice
(Lithogenic bile), Third postoperative day (Pre-therapy sample) and Tenth postoperative
day (Post therapy sample). All data was evaluated and presented accordingly with the help
of Student “t” test and Paired “t” test.
Results
No adverse event was noted in any patient. All patients responded well with the decoction.
Progressive decrease in sodium ion concentration in bile is highly significant in Group
A as compared to Group B. Similar trends were also observed in biliary Potassium (K+
),
Calcium (Ca++), Magnesium (Mg++) and Chloride (Cl-
) levels. All of these were significantly
decreased in Group A than Group B. In the present study, total protein level was significantly
decreased. Likewise, total cholesterol concentration showed progressive decline after initial
rise on third day. Bile concentration of triglyceride and phospholipid showed progressive
rise during therapy whereas no statistical significance was encountered in phospholipid
concentration.
Bilirubin concentration was progressively decreased during treatment in Group A and this
decline was also significant after therapy when compared to Group B.
Conclusions
It is concluded that the trial drug “PHALTRIKADI KWATH” has got potential in relieving
the biliary stone disease by maintaining the bile chemistry in equilibrium as may be helpful
in avoiding the recurrence of stones after successful cholecystectomy. The trial drug has
significant effects on various inorganic and organic ingredients which are responsible for
biliary stone formation. Thus it can be used in biliary sludge cases to avoid frank gallstones
formation.Background
Biliary stone disease is an old aged anguish of mankind. Many chemical agents and
traditional medicines have been tried to dissolve biliary stones but all have come with
limited success. “Phaltrikadi” has also been used to treat jaundice since ages as an
“Ayurvedic Polyherbal Formulation” with acceptable good results. Since “Phaltrikadi” is
clinically very effective, the main objective of the study were –
(a) To know its effects on various inorganic and organic contents of bile especially when
the bile is proven lithogenic i.e. in patients of Cholelithiasis and Choledocholithiasis.
(b) To evaluate the prophylactic effect of the compound drug on biliary stone diseases
as well as changes in bile juice composition that is responsible for the recurrence of
stones after successful cholecystectomy.
Methods
Total 64 patients of Cholelithiasis and Choledocholithiasis after cholecystectomy with
choledochotomy and T-tube drainage were allocated in two groups for the studyGroup A (Treated Group) - 34 cases; drug was given in the form of freshly prepared decoction
from 4th post operative day to 10th post operative day. Group B (Control Group) - 31 cases;
no drug will be given to the patients of in this period. Screening of biochemical changes
of Bile juice was done by various biochemical procedures in Intraoperative bile juice
(Lithogenic bile), Third postoperative day (Pre-therapy sample) and Tenth postoperative
day (Post therapy sample). All data was evaluated and presented accordingly with the help
of Student “t” test and Paired “t” test.
Results
No adverse event was noted in any patient. All patients responded well with the decoction.
Progressive decrease in sodium ion concentration in bile is highly significant in Group
A as compared to Group B. Similar trends were also observed in biliary Potassium (K+
),
Calcium (Ca++), Magnesium (Mg++) and Chloride (Cl-
) levels. All of these were significantly
decreased in Group A than Group B. In the present study, total protein level was significantly
decreased. Likewise, total cholesterol concentration showed progressive decline after initial
rise on third day. Bile concentration of triglyceride and phospholipid showed progressive
rise during therapy whereas no statistical significance was encountered in phospholipid
concentration.
Bilirubin concentration was progressively decreased during treatment in Group A and this
decline was also significant after therapy when compared to Group B.
Conclusions
It is concluded that the trial drug “PHALTRIKADI KWATH” has got potential in relieving
the biliary stone disease by maintaining the bile chemistry in equilibrium as may be helpful
in avoiding the recurrence of stones after successful cholecystectomy. The trial drug has
significant effects on various inorganic and organic ingredients which are responsible for
biliary stone formation. Thus it can be used in biliary sludge cases to avoid frank gallstones
formation.

Keywords

gallstone, phaltrikadi kwath, decoction, cholecystectomy, cholelithiasis, multifactorial disease, dietary habit

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