Clinical Trial Report of STRESS GUARD In Stress Disorder
INTRODUCTION
:
Most people find it difficult to define stress, yet they can experience
it often. In general term, stress can be defined as an excessive demand on physical and mental
energy, often leading to anxiety anger, distress, fear,
irritability and, frustration. This causes in increase in the
secretions of pituitary, adrenal and thyroid hormones
angiotension secretion from kidneys. All these lead to rise in
the cholesterol levels. as well as rise in blood pressure.
A stressful life styles, resulting from day to day problems of
finance, education, family and inter personal relationships, as
also the demand of work, travel, insecurity job and business,
and an urge to exceed and accomplish more than what we already
possess-all lead to a degree of stress that results in
slow but progressive damage to our different system.
So reducing the stress level can not only protect from the,
disease but also enhance our quality of life enormously.
According to latest health report,' stress is said to be one of
the largest Killer of man today'. It is now becoming, more
accepted as being crucial related to our total health physical, mental and emotional.
Two powerful body systems cope with stress. The nervous system
control the rapid body changed, while the endocrine system
regulates by releasing hormones into the blood. The adrenal
activates the sympathetic nervous system, reducing the
normalizing effects of body function. This increases the
metabolic rate. Heart-rate, circulation and blood pressure.
AIMS AND OBJECTS:
To evaluation the therapeutic value of "STRESS GUARD"
Capsule in the patients of stress disorders, the present
clinical trial was undertaken. 'Total 45 cases have included in
this study. Who were studies in different groups, viz., trial
group and control group. Trial group included 30 patients to
whom STRESS GUARD, trial drug was administered. Control group
included 15 patients, to whom placebo was administered in the
similar way.
MATERIAL AND METHOD :
45 patients of stress disorder 'were 'registered during the
course of trial. The study consisted clinical patterns in stress
disorder and the management of the particular conditions with
"STRESS GUARD" Capsule.
Out of 30 patients of the trial group, 26 cases had completed
the full treatment. Schedule (i.e., 60 days) till now and
remaining, 4 cases had discontinued the course of treatment.
The control group included 15 patients, out of which, 10
patients, followed the full term treatment (i.e. 60 days) and
rest 5 patient had discontinued the course of
treatment.
The clinical pattern were studied in all 45 cases for incidence
of age, sex (male & female), religion, occupation, economic
status, educational status, social status and symptoms of stress
disorders following the incidence of blood cortisol, which will
be presented in the final reports.
Selection of Cases :
All patients selected for study were interrogated and the
details history was recorded in the prescribed case history
sheet. All patients were thoroughly examined and findings were,
also recorded. To establish the final diagnosis, the blood
Cortisol was done and routine examination of Blood, Stool and
Urine etc. were also done. In addition to the observation
of subjective features.
Criteria of Final Diagnosis :
All
the patients included in clinical study were carefully examined
and records were maintained with detail clinical history. The
individual who have symptoms of stress disorders with or without
raised Blood Cortisol levels were Subjected to clinical trial.
Method of Drug Administration :
The drug "STRESS GUARD" was administered orally
to the patients of the trial group in the form of capsules
prepared and supplied by "HERBS INDIA", 1,Gupta Lane,
Kolkata-700006". The patients of stress disorders
taken for the study, were administered 2 capsules (Each
500 mg) twice daily morning and evening with water for a period
60 days.
'Placebo'
Capsule was administered orally to the patients of control
group. in the similar way which was also prepared and supplied
by the 'HERBS INDIA, 1, Gupta Lane, Kolkata-700006'.
Diet :
Any specific diet schedule was not prescribed to the patients.
Follow Up :
Follow up study was conducted in a cases at interval of 15 days
for 2 months (60 days), Blood Cortisol was done in each cases
before treatment and after 2 months (60 days) of treatment.
Cortisol was done in each cases before treatment and after 60
days of treatment.
CLINICAL PATTERN:
The present study consists of total 45 cases who have symptoms
of stress disorders and completed the full course of treatment
schedule (i.e. 60 days). Though we had registered 45
cases for the present study, out of which 10 cases (5 patient
trial group and 5 patient control group) had not completed the
full course of treatment. So the clinical pattern will be
discussed on 45 cases. But the result will be analyzed
observation of the findings of 36 cases (i.e. 26 patient in
trial group and 10 patients in control group).
Age Incidents :
Patient of the present study were from 20 to 60 years of
age. Patients of different age group are given in Table no. 1.
Table No. 1 showing the incidence of different Age Group
|
Sl.
No.
|
Age
Groups (years)
|
No.
of Patients
|
Percentage
|
|
1
|
21-35
|
15
|
33.33
|
|
2
|
36-50
|
20
|
44.45
|
|
3
|
51&
Above
|
10
|
22.22
|
|
Total
|
45
|
100.00
|
Sex Incidence :
Patients of both sexes were registered for the present
study. The sex groups are given in Table No. 2.
Table No. 2 showing the incidence of Sex
|
Sl.
No.
|
Sex
|
No.
of Patients
|
Percentage
|
|
1
|
Male
|
37
|
82.22
|
|
2
|
Female
|
08
|
17.78
|
|
Total
|
45
|
100.00
|
Religion
Incidents :
Patients of various religions were included in this study.
Patients belonging to different religion are shown in Table No.
3.
Table No. 3 showing the incidence of Religion
|
Sl.
No.
|
Religion
|
No.
of Patients
|
Percentage
|
|
1
|
Muslim
|
04
|
08.89
|
|
2
|
Hindu
|
38
|
84.44
|
|
3
|
Christian
|
03
|
06.67
|
|
Total
|
55
|
100.00
|
Occupation
Incidents :
In this study patients belonging to various occupations were
included and shown in Table No. 4.
Table No. 4
showing the incidence of Occupation
|
Sl.
No.
|
Religion
|
No.
of Patients
|
Percentage
|
|
1
|
Service
|
09
|
20.00
|
|
2
|
House-Wives
|
06
|
13.33
|
|
3
|
Labour
|
03
|
06.67
|
|
4
|
Cultivator
|
06
|
13.33
|
|
5
|
Student
|
09
|
20.00
|
|
6
|
Businessman
|
08
|
17.78
|
|
7
|
Retired
|
04
|
8,89
|
|
Total
|
30
|
100.00
|
Economic
Status :
In this study patients of different income groups were recorded
and shown in Table No. 5.
Table NO. 5 : Showing the incidence of Income Status
|
Sl.
No.
|
Income
Status
|
No.
of Patients
|
Percentage
|
|
1
|
L. 1. G.
|
30
|
66.67
|
|
2
|
M. 1. G.
|
15
|
33.33
|
|
Total
|
45
|
100.00
|
Educational
Status :
When educational status was enquired, patients of both
literate and illiterate were found in this series. The
educational status as found are given in Table No. 6
Table No. 6 showing the incidence of Educational Status
|
Sl.
No.
|
Religion
|
No.
of Patients
|
Percentage
|
|
1
|
Illiterate
|
3
|
06.67
|
|
2
|
Primary
|
16
|
35.56
|
|
3
|
Madhyamik
|
7
|
15.56
|
|
4
|
Higher Secondary
|
6
|
13.33
|
|
5
|
Graduate
|
11
|
24.44
|
|
6
|
Post
Graduate
|
02
|
04.45
|
|
Total
|
55
|
100.00
|
Rural
and urban Incidents :
This study included patients from urban and rural areas
shown in Table no. 7.
Table No. 7 showing the incidence of Rural and Urban
|
Sl.
No.
|
Rural
& Urban
|
No.
of Patients
|
Percentage
|
|
1
|
Rural
|
17
|
37.78
|
|
2
|
Urban
|
28
|
62.22
|
|
Total
|
45
|
100.00
|
Incidence
of Diet Habits:
Patients included in the present study were found to have both
types of diet habits (Vegetarian & Non-Vegetarian),
which are presented in Table No. 8.
Table No. 8 Showing the incidence of Diet Habits
|
Sl.
No.
|
Diet
Habits
|
No.
of Patients
|
Percentage
|
|
1
|
Non
Vegetarian
|
34
|
75.56
|
|
2
|
Vegetarian
|
11
|
24.44
|
|
Total
|
45
|
100.00
|
Incidence
of Nature of Work :
In this trial study nature of work were studied which are
presented in Table No. 9.
Table No. 9 Showing the incidence of Nature of Work
|
Sl.
No.
|
Nature
of Work
|
No.
of Patients
|
Percentage
|
|
1
|
Sedentary
|
25
|
55.55
|
|
2
|
Moderate
|
12
|
26.67
|
|
3
|
Hard worker
|
08
|
17.78
|
|
Total
|
45
|
100.00
|
Incidence
of Marital Status :
In this study married and unmarried both patients are included
which are presented in Table No. 10.
Table No.10 Showing the incidence of Marital Status
|
Sl.
No.
|
Marital
Status
|
No.
of Patients
|
Percentage
|
|
1
|
Unmarried
|
10
|
22.22
|
|
2
|
Married
|
35
|
77.78
|
|
3
|
Hard worker
|
08
|
17.78
|
|
Total
|
45
|
100.00
|
RESULT
AND OBSERVATION :
Response of Treatment in Group A (Trial Group) :
Group-A or Trial group consisted of 30 patients, out of which
four patients had discontinued and 26 cases had completed the
treatment schedule of 60 days. Patients were observed in terms
of subjective criteria's before treatment, during treatment and
after treatment. The response of treatment on subjective criteria's
as observed before treatment and after treatment are
presented below in Table No. 11.
|
Sl.
No.
|
Symptoms
|
No.
of Pt. before treatment
|
No.
of Pt. after
treatment
|
Percentage
of relief
|
|
1
|
Anorexia
|
2-
5
|
16
|
64.00
|
|
2
|
Apprehension
|
24
|
17
|
70.83
|
|
3
|
Breathlessness
|
24
|
16
|
66.67
|
|
4
|
Constipation
|
20
|
16
|
80.00
|
|
5
|
Diarrhea
|
26
|
17
|
65.39
|
|
6
|
Disinterest
of life
|
24
|
18
|
75.00
|
|
7
|
Dizziness
|
20
|
14
|
70.00
|
|
8
|
Fatigue
|
24
|
19
|
79.16
|
|
9
|
Frequency
of micturation
|
20
|
12
|
60.00
|
|
10
|
Headache
|
22
|
12
|
54.55
|
|
11
|
Hopelessness/Helplessness
|
20
|
14
|
70.00
|
|
12
|
Inability
to work
|
25
|
16
|
64.00
|
|
13
|
Insomnia
|
20
|
12
|
60.00
|
|
14
|
Lack of
concentration
|
20
|
13
|
65.00
|
|
15.
|
Lack of
self confidence
|
21
|
13
|
61.10
|
|
16.
|
Loss of
libido
|
20
|
8
|
40.00
|
|
17.
|
Loss of
weight
|
20
|
09
|
45.00
|
|
18.
|
Pain-chest/Abdomen
|
18
|
10
|
55.56
|
|
19.
|
Recurrent
thought for death /suicide
|
18
|
12
|
66.67
|
|
20.
|
Slowing
of thinking
|
20
|
09
|
45.00
|
|
21.
|
Slowing
of speed
|
21
|
11
|
52.39
|
|
22.
|
Skin
rashes /ulcer
|
11
|
5
|
45.46
|
|
23.
|
Sweating
|
22
|
14
|
63.64
|
|
24.
|
Tremor
|
15
|
09
|
60.00
|
It
is revealed from the above table that more than 70% of relief
was observed in symptoms like apprehension, disinterest of life,
fatigue, hopelessness, dizziness and constipation than 50% of
relief was observed in symptoms like recurrent thought for
death, diarrhea, inability to work, anorexia, sweating, lack of
concentration, lack of self confidence, frequency of micturition,
insomnia, tremor, pain in chest or abdomen, headache etc. In
other symptoms, the relief found was less than 50%.
In all patients who had completed the treatment schedule of 60
days, were also observed in terms of improvements on objective
features (Estimation of Blood Cortisol Level AM). The level of
cortisol was estimated before treatment and after treatment. The
observations are presented statistically in table no. 12.
|
Sl.
No.
|
Schedule
of
Examination
|
Mean
|
SD±
|
SE±
|
t
|
p
|
|
1
|
Before
Treatment
|
289.81
|
92.20
|
18.08
|
16.03
|
<
0.001
|
|
2
|
Vegetarian
|
254.92
|
71.81
|
14.08
|
18.11
|
It is clear from the above table
that in trial group (Group A) the mean level of cortisol before
treatment was 289.81 ng/dI and reduced to 254.92 ng/dI (mean
level) after treatment. The P-value is highly significant.
Response
of treatment in Group '13' (Control Group)
Group
B or Control Group consisted of 15 patients out of which 5
patients had discontinued the treatment and 10 patients had
completed the treatment schedule of 60 days. Patients were
observed in terms of subjective features (as in trial group A)
before treatment, during treatment and after treatment. The
response of the treatment on subjective criteria's as observed
before the treatment and after the treatment are presented below
in table no. 13.
Table No.13 Showing the response
of treatment on subjective features of stress disorder in
control group 'Group 13'
|
Sl.
No.
|
Symptoms
|
No.
of Pt. before treatment
|
No.
of Pt. after treatment
|
Percentage
of relief
|
|
1
|
Anorexia
|
8
|
8
|
00.00
|
|
2
|
Apprehension
|
6
|
7
|
-16.67
|
|
3
|
Breathlessness
|
6
|
6
|
00.00
|
|
4
|
Constipation
|
8
|
8
|
00.00
|
|
5
|
Diarrhea
|
8
|
9
|
-12.50
|
|
6
|
Disinterest
of life
|
5
|
7
|
-40.00
|
|
7
|
Dizziness
|
20
|
6
|
-50.00
|
|
8
|
Fatigue
|
4
|
5
|
-25.00
|
|
9
|
Frequency
of micturation
|
7
|
7
|
00.00
|
|
10
|
Headache
|
9
|
11
|
-22.22
|
|
11
|
Hopelessness/Helplessness
|
4
|
6
|
-50.00
|
|
12
|
Inability
to work
|
5
|
6
|
-20.00
|
|
13
|
Insomnia
|
10
|
8
|
-25.00
|
|
14
|
Lack of
concentration
|
7
|
8
|
-14.29
|
|
15.
|
Lack of
self confidence
|
9
|
9
|
00.00
|
|
16.
|
Loss of
libido
|
3
|
3
|
-00.00
|
|
17.
|
Loss of
weight
|
6
|
7
|
-16.67
|
|
18.
|
Pain-chest/Abdomen
|
4
|
4
|
00.00
|
|
19.
|
Recurrent
thought for death /suicide
|
7
|
7
|
00.00
|
|
20.
|
Slowing
of thinking
|
5
|
5
|
00.00
|
|
21.
|
Slowing
of speed
|
21
|
4
|
00.00
|
|
22.
|
Skin
rashes /ulcer
|
2
|
2
|
00.00
|
|
23.
|
Sweating
|
6
|
7
|
-16.67
|
|
24.
|
Tremor
|
3
|
3
|
-00.00
|
The responses
of treatment on subjective features in patients of Group B
(control group) as revealed from the above table, it is found
that there was no relief in subjective features. Moreover,
negative relief was observed in some of the subjective features
like dizziness, helplessness, insomnia, fatigue, disinterest of
life, headache.
In
the patients of group B (control group) who had completed the
treatment schedule of 60 days, were also observed in terms of
improvements on objective features (estimation of Blood Cortisol
level-AM). The level of cortisol was estimated before
treatment and after treatment. The observations are presented
statistically in table no.14.
Table No. 14 Showing
response of treatment on cortisol level (AM ng/dl) of blood in patients of stress disorders in control group B (N=10).
|
Sl. No.
|
Schedule of Examination
|
Mean
|
SD±
|
SE±
|
t
|
p
|
|
1
|
Before Treatment
|
266.30
|
88.54
|
27.10
|
16.03
|
10.93
|
|
2
|
Vegetarian
|
311.40
|
86.55
|
8.66
|
18.11
|
35.96
|
The response of
treatment on cortisol level in group B (control group) shows
that the mean cortisol level which was 266.30 ng/dI before
treatment had increased upto 311.40 ng /dI after treatment. This
indicates that there was no improvement in control group.
DISCUSSION:
In
the Present clinical study, 45 patients suffering from
stress-disorders were included. The total cases were a
randomly divided into two groups viz. (1) Group A (Trial group)
consisted of 30 patients to whom "STRESS GUARD", the
trial drug was given for a period of 60 days; (2) Group B
(Control Group) consisted of 15 cases to whom placebo was given
for 60 days. Out of these cases 4 cases could not be followed in
Group A (Trial Group) and 5 cases in Group B (Control Group). 26
cases in Group A (Trial Group) and 10 cases in group B (Control
Group) could be followed up properly.
In
trial group to all the patients "STRESS GUARD" Capsules
(each 500 mg) was given in the dose of 2 capsules twice daily
morning and evening with water for a period of 60 days.
Similarly in Control Group to all the cases 'PLACEBO' capsule
(each 500 mg) was given in the dose of 2 caps twice daily
morning and evening with water.
The
effect of treatment on both the group of patients were assessed
at the end of the treatment. The response of the treatment was
observed mainly on subjective improvements. At the end of the
treatment, the result was assessed in terms of excellent
improvement, good improvement and poor improvement.
The patients were included under good response
group when they showed more than 70% relief of subjective
features. The patients were included under good response group
when they showed between 51 to 70% relief of subjective feature
and patients showing relief of subjective features below 51%
were leveled under poor response group. In consideration to the
effects of the drug in Trial Group 19.23% cases were included
under excellent response group, 69.23% under good response
groups and 11.54% in poor response group.
In
the trial group in most of the cases of the cortisol level was
found to be reduced. The effects of the treatment on cortisol
levels in patient of group A (Trial Group) have been
statistically analyzed and found highly significant (P <
0.001).
Any improvement in patients of Control Group (Group B) was not
found when the effect of the treatment on subjective criteria's were
analyzed. When the effect on cortisol level was
observed, it was seen that the mean cortisol value which was
266.30 ng/dI before treatment had increased up to 311.40 ng/dl
after treatment.
When the response of treatment in both the groups were analysed
and compared, it is revealed that, there is definite improvement
in the patients of Group A or Trial Group, treated
with "STRESS GUARD".
During the clinical study of the 'STRESS GUARD' Capsules, none of
the patients had shown any side effects.

CONCLUSION:
The drug "STRESS GUARD" Capsule has been found to be an
effective drug on stress disorders. The result in the trial
group has shown encouraging results. After 60 days of treatment along with the
improvements of the subjective criterias significant response
was also noticed on objective criteria, particularly on serum
cortisol level in trial group. Hence 'STRESS GUARD' can safely be
prescribed in cases of stress.
ACKNOWLEDGEMENT
We sincerely acknowledge Dr. P.K. Mukherjee, Project Officer and
Assistant Director (Ayurveda) for sanctioning permission to
conduct the trial at Institute of Post Graduate Ayurvedic
Education & Research at Shayamadas Vaidyasastrapith
Hospital, Kolkata - 700009. We further acknowledge M/s. HERBS
INDIA, 1, Gupta Lane, Kolkata -700006, for their
financial support for this trial.
Research
Scholar
Dr. Mofizuddin Ahmed |
Co-investigator
Dr. P.C. Tripathi
|
Principal
Investigator
Dr. B. P. Shaw
|
|