***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The clinical effects of mucolytics in patients with chronic obstructive pulmonary disease ( COPD ) are discussed controversially . Cineole is the main constituent of eucalyptus oil and mainly used in inflammatory airway diseases as a mucolytic agent . We hypothesised that its known mucolytic , bronchodilating and anti-inflammatory effects as concomitant therapy would reduce the exacerbation rate and show benefits on pulmonary function tests as well as quality of life in patients with COPD . Methods In this double-blind , placebo-controlled multi-center- study we r and omly assigned 242 patients with stable COPD to receive 200 mg of cineole or placebo 3 times daily as concomitant therapy for 6 months during winter-time . The frequency , duration and severity of exacerbations were combined as primary outcome measures for testing as multiple criteria . Secondary outcome measures included changes of lung function , respiratory symptoms and quality of life as well as the single parameters of the exacerbations . Results Baseline demographics , lung function and st and ard medication of both groups were comparable . During the treatment period of 6 months the multiple criteria frequency , severity and duration of exacerbations were significantly lower in the group treated with cineole in comparison to placebo . Secondary outcome measures vali date d these findings . Improvement of lung function , dyspnea and quality of life as multiple criteria were statistically significant relative to placebo . Adverse events were comparable in both groups . Conclusion Concomitant therapy with cineole reduces exacerbations as well as dyspnea and improves lung function and health status . This study further suggests cineole as an active controller of airway inflammation in COPD by intervening in the pathophysiology of airway inflammation of the mucus membrane . Trial registration IS RCT BACKGROUND A r and omized double-blind placebo controlled clinical study was undertaken to investigate the safety and efficacy of a plant-based formulation ( DCBT1234-Lung KR ) , which earlier through 2 trials was found to improve FEV1 and the quality of life of COPD patients . OBJECTIVE The efficacy of DCBT1234-Lung KR was assessed using pulmonary function tests , arterial blood gas ( ABG ) analyses and the clinical symptoms of COPD in a 6-month study period against a matching placebo and a biomedical drug combination ( salbutamol+theophylline+bromhexine ) . METHODS One hundred and five subjects aged between 35 and 85 years with a smoking history of more than 20 pack years , showing little or no improvement in FEV1 upon a bronchial challenge of 200 microg of inhaled salbutamol and exhibiting ABG percentage of less than 85 % of oxygen saturation were taken up for the study . The study had 3 arms viz . , the plant-based formulation ( DCBT1234-Lung KR ) , placebo and salbutamol ( 12 mg/day ) plus theophylline ( 300 mg/day ) plus bromhexine ( 24 mg/day ) . The end point of the study was determined as an improvement of FEV1 by 200 mL and /or increased ABG values ( > 90 % PaO2 ) and clinical symptoms like dyspnoea , wheezing , cough , expectoration , disability , and sleep disturbances . RESULTS DCBT1234-Lung KR patients showed statistically significant ( 95 % level ) improvement in FEV1 and PaO2 in comparison with salbutamol+theophylline+bromhexine and placebo patients . Twenty-three per cent of DCBT1234-Lung KR patients , 19 % of salbutamol+theophylline+bromhexine group and 12 % of placebo group patients showed the desired 200 mL improvement in FEV1 values in comparison with the other 2 arms . Improved PaO2 was observed in 15.4 % of the DCBT1234-Lung KR patients while no improvement was seen with patients in any other arms . Symptoms like dyspnoea , wheezing , cough , expectoration , disability and sleep disturbances also significantly reduced in DCBT1234-Lung KR and the biomedical group patients , but not in the placebo arm . CONCLUSIONS DCBT1234-Lung KR was equivalent , if not better than the present day treatment with salbutamol , theophylline and bromhexine combination in COPD patients and this was ascertained using FEV1 and ABG values The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . Background Traditional Chinese medicine ( TCM ) has been used to treat chronic obstructive pulmonary disease ( COPD ) for many years . This study aim ed to evaluate the efficacy and safety of the comprehensive therapy based on the three common TCM patterns in stable COPD patients . Methods A four-center , open-label r and omized controlled method was conducted . A total of 352 patients were divided into the trial group ( n = 176 , treated with conventional Western medicine and Bu-Fei Jian-Pi granules , Bu-Fei Yi-Shen granules , and Yi-Qi Zi-Shen granules based on the TCM patterns respectively ) and the control group ( n = 176 , treated with conventional Western medicine ) . The frequency and duration of acute exacerbation , lung function , clinical symptoms , 6-minute walking distance ( 6MWD ) , dyspnea scale and quality of life were observed during a 6-month treatment period and at a further 12-month follow-up . Results A total of 306 patients completed the study fully . The full analysis set ( FAS ) population was 350 and the per- protocol analysis set ( PPS ) population was 306 . After the 6-month treatment and 12-month follow-up , there were significant differences between the trial and control group in the following : frequency of acute exacerbation ( FAS : P = 0.000 ; PPS : P = 0.000 ) ; duration of acute exacerbation ( FAS : P = 0.000 ; PPS : P = 0.001 ) ; FEV1 ( FAS : P = 0.007 ; PPS : P = 0.008 ) ; symptoms ( FAS : P = 0.001 ; PPS : P = 0.001 ) ; 6MWD ( FAS : P = 0.045 ; PPS : P = 0.042 ) ; dyspnea scale ( FAS : P = 0.002 ; PPS : P = 0.004 ) ; and physical domain ( FAS : P = 0.000 ; PPS : P = 0.000 ) , psychological domain ( FAS : P = 0.008 ; PPS : P = 0.011 ) , social domain ( FAS : P = 0.001 ; PPS : P = 0.000 ) and environment domain ( FAS : P = 0.015 ; PPS : P = 0.009 ) of the WHOQOL-BREF question naire . There were no differences between the trial and control group in FVC , FEV1 % and adverse events . Conclusions Based on the TCM patterns , Bu-Fei Jian-Pi granules , Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on measured outcomes in stable COPD patients over the 6-month treatment and 12-month follow-up , with no relevant between-group differences in adverse events . Trial Registration This trial was registered at Chinese Clinical Trial Register Center , ChiCTR-TRC-11001406 ETHNOPHARMACOLOGICAL RELEVANCE Bu-Fei Yi-Shen granule combined with acupoint sticking therapy has been used in the patients with stable chronic obstructive pulmonary disease ( COPD ) as major traditional interventions for the treatment of the disease . AIM OF THE STUDY The objective of this study was to evaluate the efficacy and safety of traditional Chinese herbal medicine , the Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable COPD . METHODS A 4-center , double-blinded , double-dummy and r and omized controlled method was conducted . 244 patients who were divided into the trial group ( n=122 , treated with Bu-Fei Yi-Shen granule combined with Shu-Fei Tie acupoint sticking therapy and oral placebo sustained-release theophylline ) and the control group ( n=122 , treated with oral sustained-release theophylline and placebo Bu-Fei Yi-Shen granule combined with placebo Shu-Fei Tie acupoint sticking therapy ) . The frequency and duration of acute exacerbation , lung function , clinical symptoms , six-minute walking distance , dyspnea grade and quality of life were observed during the 4-month treatment period , and for a further 6 months follow-up . RESULTS Two hundred and twenty one patients fully completed the study , intent-to-treat ( ITT ) population was 234 and per- protocol ( PP ) population was 221 . After treatment for 4 months and follow-up for 6 months , there were differences between the experimental and control group in frequency of acute exacerbation ( ITT : P=0.007 , P=0.013 ; PP : P=0.045 , P=0.046 ) ; duration of acute exacerbation ( ITT : P=0.030 , P=0.005 ; PP : P=0.048 , P=0.006 ) ; scores of symptoms ( ITT : P=0.000 , P=0.000 ; PP : P=0.000 , P=0.000 ) ; six-minute walking distance ( ITT : P=0.002 , P=0.001 ; PP : P=0.002 , P=0.001 ) ; dyspnea grade ( ITT : P=0.014 , P=0.009 ; PP : P=0.018 , P=0.012 ) ; physiological aspects ( ITT : P=0.003 , P=0.000 ; PP : P=0.001 , P=0.000 ) ; psychological aspects ( ITT : P=0.007 , P=0.001 ; PP : P=0.001 , P=0.000 ) and environment aspects ( ITT : P=0.003 , P=0.000 ; PP : P=0.001 , P=0.000 ) of the WHOQOL-BREF question naire . There were no differences between the experimental and control group in FVC , FEV1 and FEV1 % and adverse events . CONCLUSIONS Bu-Fei Yi-Shen granule combined with acupoint sticking therapy showed beneficial effects for patients with stable COPD in the measured parameters over the 4-month treatment period and 6 months follow-up , with no relevant between-group differences in adverse events Ginseng is a root that has been used to treat patients with various illnesses for the last 2000 years . The purpose of this study was to evaluate the effects of Ginseng extract ( G115 ) on Pulmonary Function Tests ( PFTs ) , Maximum Voluntary Ventilation ( MVV ) , Maximum Inspiratory Pressure ( MIP ) and Maximal Oxygen Consumption ( VO2max ) in patients with moderately-severe Chronic Obstructive Pulmonary Disease ( COPD ) . Ninety-two adults were r and omly divided into the experimental ( n = 49 , G115 100 mg bid for three months ) and placebo-control ( n = 43 ) groups . PFTs , MVV and MIP were studied before treatment and every two weeks for the 3-month- study period .  Exercise test and VO2max measurements were performed before the beginning and after six weeks and three months . P lower than 0.05 was considered significant . Baseline demographics and pulmonary parameters were similar between the groups . In the experimental , but not in the control group , all parameters significantly increased above baseline and compared with the placebo group . Maximum increase , compared with baseline was FVC-32.5 % , FEV1.0 - 27.0 % , PEF-27.5 % , FEF50 - 45.4 % , FEF75 - 56.9 % , MVV-40.4 % , MIP-47.0 % and VO2max-37.5 % . No side effects were observed . G115 100 mg bid for three months , but not placebo , improved PFTs , MVV , MIP and VO2 max in patients with moderately-severe COPD with no side effects Objective To evaluate the efficacy of Bufei Yishen Granule ( 补肺益肾颗粒 , BFYSG ) combined with Shufei Tie ( 舒肺贴 ) acupoint sticking therapy on quality of life of patients with stable chronic obstructive pulmonary disease ( COPD ) . Methods A multi-center , double-blinded , double-dummy and r and omized controlled method was adopted in this trial . A total of 244 patients were r and omly assigned to a trial group and a control group according to the r and om number , each with 122 patients ; treatment allocation occurred when the participants met the inclusion criteria and signed the informed consent form . In the trial group , patients were treated with BFYSG combined with “ Shufei Tie ” ac 
    Output:
    
A meta- analysis conducted from 15 high quality studies ( 18 publications ) showed that HM as an adjunct therapy had no significant improvement in pulmonary function ( FEV1 , FEV% , FVC , and FEV1/FVC ) compared to conventional medicine .
The efficacy of the adjunct HM on improving the arterial blood gas ( PaCO2 and PaO2 ) for AE COPD and S COPD remains inconclusive due to the heterogeneity among the studies .
However , HM as an adjunct therapy improved clinical symptoms and quality of life ( total score , activity score , and impact score of St. George 's Respiratory Question naire ) .