Therapeutic Benefit of Panchashirisha Agad Ghan Vati with Phalatrikadi Kwath Ghan Vati in Alcoholic Fatty Liver Disease (Garavisha Janya Yakrut Vikara): A Randomized Comparative Clinical Study

Background: Alcoholic fatty liver disease (AFLD), the earliest reversible stage of alcohol-associated liver disease (ALD), is characterized by ≥5% triglyceride accumulation within hepatocytes due to chronic alcohol consumption.In Ayurveda, the cumulative toxic effects of alcohol can be correlated with Garavisha, which gradually vitiates Dosha, Dhatu, and Srotas, leading to Yakrut Vikara.Aim: To evaluate the additional therapeutic benefit of Panchashirisha Agad Ghan Vati along with Phalatrikadi Kwath Ghan Vati in Garavisha Janya Yakrut Vikara with special reference (w.s.r.) to AFLD.Materials and methods: A randomized comparative clinical study was conducted on 30 patients with grade I and grade II AFLD.Participants were randomly allocated into two groups using a computer-generated randomization sequence.Group A received Phalatrikadi Kwath Ghan Vati with Madhu, while group B received Phalatrikadi Kwath Ghan Vati plus Panchashirisha Agad Ghan Vati with cow Ghruta for 45 days.Allocation concealment was ensured using the sequentially numbered opaque sealed envelope (SNOSE) technique.Participants were advised to abstain from alcohol throughout the study period, and compliance was assessed during follow-up visits by self-report.Assessment included clinical symptoms, liver function tests, and ultrasonography (USG).The study received Institutional Ethics Committee approval (IEC No. IEC/ ACA/2024/02/04) and CTRI registration (CTRI/2025/04/084778).Results: Both groups showed significant improvement.Group B demonstrated greater improvement in Aruchi, Daurbalya, Koshtha Shoola, and liver enzymes [serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT)].Mean subjective improvement was 80.63% in group B vs 52.92% in group A, while mean objective improvement was 48.48% and 30.83%, respectively.No participant discontinued treatment due to adverse events, and both interventions were well tolerated throughout the study period.Intergroup analysis demonstrated comparatively greater improvement in group B than group A for both subjective and objective outcome measures. Conclusion:The addition of Panchashirisha Agad Ghan Vati was associated with comparatively greater clinical and biochemical improvement than Phalatrikadi Kwath Ghan Vati alone.However, these findings should be interpreted cautiously considering the exploratory design, small sample size, and open-label nature of the study.Larger, adequately powered randomized controlled studies are required to confirm these findings.