Vishaghna Mahakashaya Ghanavaṭi versus Haridrakhaṇḍa for Urticaria: A Randomized Comparative Clinical Trial of an Ayurvedic Antitoxic Treatment Approach

Background: Śītapitta (urticaria-like skin hypersensitivity) is described in Ayurvedic literature and is clinically comparable to urticaria. The Ayurvedic antitoxic treatment principle advocates management of disorders arising from allergic or toxic provocation. Viṣaghna Mahākaṣāya, a ten-herb Ayurvedic formulation, was prepared as a solid extract tablet and evaluated against Haridrākhaṇḍa. Objective: To evaluate and compare the efficacy of Viṣaghna Mahākaṣāya Ghanavaṭī and Haridrākhaṇḍa in urticaria using symptom scores, Urticaria Activity Score over 7 days (UAS7), Urticaria Control Test (UCT), and haematological parameters. Methods: A prospective, open-label, randomized comparative clinical trial was conducted at the National Institute of Ayurveda, Jaipur. Fifty patients were randomized into two groups of 25 each. Group A received Haridrākhaṇḍa 6 g twice daily and Group B received Viṣaghna Mahākaṣāya Ghanavaṭī 4 g twice daily for 30 days. Outcomes included classical symptoms, attack frequency, UAS7, UCT, serum IgE, erythrocyte sedimentation rate (ESR), and differential leucocyte count (DLC). Results: Both groups produced statistically highly significant intra-group improvements across most subjective parameters (p < 0.0001). Group A showed greater percentage relief in wheals, itching, burning sensation, fever, and UAS7 band. Intergroup comparison revealed significant superiority of Group A for wheals (p = 0.0172) and burning sensation (p = 0.0091). Objective parameters showed non-significant changes, with a clinically notable 47.17% reduction in serum IgE in Group A. Conclusion: Both Haridrākhaṇḍa and Viṣaghna Mahākaṣāya Ghanavaṭī were effective in urticaria. Haridrākhaṇḍa showed superior efficacy for wheals and burning sensation, while Viṣaghna Mahākaṣāya Ghanavaṭī remains a viable sugar-free Ayurvedic antitoxic alternative.