Comparative Efficacy of Classical Formulations

Abstract

Classical Ayurvedic formulations - Kashayas, Ghritas and Tailas, Asavas and Arishtas, Churnas, and Rasashastra preparations - have been in continuous clinical use for centuries, but cross-formulation comparative-efficacy evidence in modern biomedical terms has accumulated slowly and unevenly. Individual formulations have well-characterised evidence bases (Triphala, Arjunarishta, Chyavanprash, Jatyadi taila), but comparing across the broad categories has been hampered by heterogeneous trial design and by the different regulatory treatment of herbal-only versus herbal-mineral preparations. We consolidated 88 peer-reviewed clinical studies published between 2012 and 2024 that compared classical Ayurvedic formulations against either each other or against conventional comparators. Studies were grouped into five formulation frames: F1 (Kashayas / decoctions), F2 (Ghritas and Tailas / medicated ghee and oils), F3 (Asavas and Arishtas / fermented preparations), F4 (Churnas / powdered formulations including Triphala and Trikatu), and F5 (Rasashastra / mineral-herbal preparations including Bhasmas). Each frame was scored on the Classical Formulation Efficacy Index (CFEI), a weighted composite across clinical effect size, reproducibility across preparations, classical-to-modern concordance, safety profile, and standardisation feasibility. Churnas (F4) and Asavas/Arishtas (F3) scored highest at CFEI 0.862 and 0.824, carried by strong clinical evidence bases and standardisable preparation protocols. Our reading is that a well-prioritised subset of classical formulations is now ready for formal guideline-level integration