Preprint / Version 1

Management of chronic pain with Jalaprakshalana (water-wash) Shodhita (processed) Bhanga (Cannabis sativa L.) in cancer patients with deprived quality of life: An open-label single arm clinical trial

Authors

  • Swagata Tavhare Department of Dravyaguna, GJ Patel Institute of Ayurvedic Studies and Research, New Vallabhvidyanagar, Anand, Jamnagar, Gujarat, India
  • Rabinarayan Acharya Department of Dravyaguna, Institute for Post Graduate Teaching and Research in Ayurved, Gujarat Ayurved University, Jamnagar, Gujarat, India
  • R Reddy Regional Ayurveda Research Institute for Mother and Child Health, CCRAS, Nagpur, Maharashtra, India
  • Kartar Dhiman Central Council for Research in Ayurvedic Sciences, Ministry of AYUSH, Government of India, New Delhi, India

Keywords:

Anxiety, Bhanga, Cannabis sativa, cancer pain, depression, quality of life, Shodhana

Abstract

Introduction: Pain is a common and complex symptom of cancer having physical, social, spiritual and psychological aspects. Approximately 70%–80% of cancer patients experiences pain, as reported in India. Ayurveda recommends use of Shodhita (Processed) Bhanga (Cannabis) for the management of pain but no research yet carried out on its clinical effectiveness. Objective: To assess the analgesic potential of Jala-Prakshalana (Water-wash) processed Cannabis sativa L. leaves powder in cancer patients with deprived quality of life (QOL) through openlabel single arm clinical trial. Materials and Methods: Waterwash processed Cannabis leaves powder filled in capsule, was administered in 24 cancer patients with deprived QOL presenting complaints of pain, anxiety or depression; for a period of 4 weeks; in a dose of 250 mg thrice a day; along with 50 ml of cow’s milk and 4 g of crystal sugar. Primary outcome i.e. pain was measured by Wong-Bakers FACES Pain Scale (FACES), Objective Pain Assessment (OPA) scale and Neuropathic Pain Scale (NPS). Secondary outcome namely anxiety was quantified by Hospital Anxiety and Depression Scale (HADS), QOL by FACT-G scale, performance score by Eastern Cooperative Oncology Group (ECOG) and Karnofsky score. Results: Significant reduction in pain was found on FACES Pain Scale (P < 0.05), OPA (P < 0.05), NPS (P < 0.001), HADS (P < 0.001), FACT-G scale (P < 0.001), performance status score like ECOG (P < 0.05) and Karnofsky score (P < 0.01). Conclusion: Jalaprakshalana Shodhita Bhanga powder in a dose of 250 mg thrice per day; relieves cancerinduced pain, anxiety and depression significantly and does not cause any major adverse effect and withdrawal symptoms during trial period. Keywords: Anxiety, Bhanga, Cannabis sativa, cancer pain, depression, quality of life, Shodhana

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