Pharmacotherapeutic Evaluation of Paribhadra Patra (Erythrina variegata LINN.) and Amalaki Phala (Emblica officinalis GAERTN.) Kwatha in the Management of Amlapitta (Hyperacidity)

Abstract

Background: Amlapitta is a commonly encountered gastrointestinal disorder described in Ayurveda in association with disturbed Agni, Vidagdha Ahara and Pitta predominance. Its clinical manifestations overlap with symptoms commonly described in hyperacidity and related upper gastrointestinal complaints. The present study evaluated Paribhadra Patra and Amalaki Phala Kwatha as a combined Ayurvedic intervention. Aim: To evaluate the efficacy and safety of Paribhadra Patra (Erythrina variegata Linn.) and Amalaki Phala (Emblica officinalis Gaertn.) Kwatha in the management of Amlapitta. Materials and Methods: A single-arm, open-label, prospective exploratory clinical study was conducted in clinically diagnosed patients of Amlapitta. Thirty-two patients were registered and 30 completed the study. The formulation was administered as 50 mL twice daily after meals for 30 days, with clinical assessment at baseline, day 15 and day 30 and follow-up. Pharmacognostical, physicochemical, preliminary phytochemical and TLC studies were also performed. Subjective outcomes were analyzed using the Wilcoxon signed-rank test and objective parametric variables by paired t-test. Results: All six assessed subjective parameters showed statistically highly significant improvement (p < 0.001). Improvement was 74.09% in Tiktamlaudgara, 67.00% in Utklesha, 53.14% in Avipaka, 50.92% in Guruta, 40.71% in Klama and 32.37% in Aruchi. The overall mean symptom score decreased from 11.07 ± 3.42 to 5.03 ± 1.90, giving 54.58% overall improvement (p < 0.001). Fourteen patients showed significant improvement and 16 showed moderate improvement. No significant adverse effects were reported. Conclusion: Paribhadra Patra–Amalaki Phala Kwatha demonstrated significant improvement in the clinical manifestations of Amlapitta and was well tolerated during the study period. Its probable action can be interpreted through Deepana, Pachana, Pittashamana, Kaphahara, Amapachana and Rasayana effects, together with reported antioxidant, anti-inflammatory and gastroprotective activities. Larger controlled studies are required for confirmation.

Introduction

This study evaluates the clinical efficacy and quality characteristics of a combination of Paribhadra (Erythrina variegata) and Amalaki (Emblica officinalis) Kwatha in the management of Amlapitta, an Ayurvedic condition associated with impaired digestion, aggravated Pitta, and symptoms resembling hyperacidity, dyspepsia, gastritis, and reflux.

Rationale

Ayurveda considers Agni (digestive/metabolic function) central to health. Disturbed Agni can lead to improper digestion, Ama formation, and Dosha imbalance. The study identifies dietary, behavioural, and psychological factors associated with Amlapitta. The most frequently reported dietary factors were:

• Viruddha Ahara: 36.6%
• Vidahi Ahara: 30%
• Ruksha Ahara: 20%
• Ajirnashana: 13.3%

Other contributing factors included daytime sleeping, suppression of natural urges, night waking, excessive sun exposure, stress, anxiety, anger, and fear.

Paribhadra was selected for its traditional Deepana-Pachana and Kapha-related actions, while Amalaki was selected for its Pittashamana and Rasayana properties.

Aim and Objectives

The main aim was to evaluate the clinical effectiveness of Paribhadra Patra and Amalaki Phala Kwatha in Amlapitta. Additional objectives were to:

• Authenticate the two herbal drugs pharmacognostically.
• Evaluate their physicochemical properties.
• Identify preliminary phytochemical constituents.
• Assess their effect on major Amlapitta symptoms.
• Evaluate safety and tolerability.

Methodology

The study was a single-arm, open-label, prospective clinical study conducted at the Postgraduate Institute of Ayurveda, Jodhpur.

• 32 patients were registered.
• 30 patients completed the study.
• Completion rate: 93.75%.
• Treatment: 50 mL Kwatha twice daily after meals for 30 days.
• Assessments were conducted at baseline, day 15, and day 30.
• Statistical analysis used the Wilcoxon signed-rank test, with p < 0.05 considered significant.

The principal symptoms assessed were Avipaka, Klama, Utklesha, Tiktamlaudgara, Guruta, and Aruchi.

Pharmacognostical and Phytochemical Findings

Both Erythrina variegata and Emblica officinalis were subjected to macroscopic, microscopic, powder-microscopic, physicochemical, phytochemical, and TLC evaluation.

The drugs showed characteristic microscopic features such as vascular bundles, sclerenchyma, stone cells, calcium oxalate crystals, parenchyma, and other diagnostic structures.

Preliminary phytochemical screening indicated the presence of several constituents, including:

• Alkaloids
• Tannins
• Saponins
• Glycosides
• Proteins
• Carbohydrates
• Amino acids
• Reducing sugars

Amalaki also showed the presence of ascorbic acid. TLC fingerprinting of Paribhadra produced five identifiable spots with Rf values of 0.18, 0.35, 0.56, 0.74, and 0.87.

Clinical Findings

The participants were predominantly female (70%) and most were aged 31–40 years (43.3%).

All six major symptoms showed statistically significant improvement after treatment:

The greatest improvement was observed in Tiktamlaudgara (74.09%), followed by Utklesha (67.0%) and Avipaka (53.14%). Aruchi showed the lowest improvement (32.37%), although the change remained statistically significant.

Conclusion

The present exploratory clinical study suggests that Paribhadra Patra–Amalaki Phala Kwatha is a promising Ayurvedic intervention for the management of Amlapitta. The formulation produced statistically highly significant improvement in all six assessed subjective parameters, with an overall improvement of 54.58%. The greatest response was observed in Tiktamlaudgara (74.09%), followed by Utklesha (67.00%), Avipaka (53.14%), Guruta (50.92%), Klama (40.71%) and Aruchi (32.37%). From the Ayurvedic perspective, the response can be understood through Deepana, Pachana, Amapachana, Pitta-Kapha Shamana and Rasayana actions. From a contemporary perspective, the documented phytochemical composition provides a plausible basis for antioxidant, anti-inflammatory and gastroprotective activity. These interpretations are supportive rather than definitive mechanistic proof. The findings are encouraging, but the absence of a control group and the relatively small sample size restrict firm conclusions about comparative efficacy. Larger randomized, controlled and preferably multicentric studies with standardized pharmaceutical preparation and longer follow-up are recommended.

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Copyright

Copyright © 2026 Dr. Kalpana Poonia, Dr. Chandan Singh, Dr. Manoj Kumar Adlakha, Dr. Rajendra Prasad Purvia, Dr. Nikita Panwar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.