***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: Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises , including breathing exercises , suryanamaskar , yogasana ( physical postures ) , pranayama ( breath slowing techniques ) , dhyana ( meditation ) , and a devotional session , and were told to practise these exercises for 65 minutes daily . They were then compared with a control group of 53 patients with asthma matched for age , sex , and type and severity of asthma , who continued to take their usual drugs . There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma , scores for drug treatment , and peak flow rate . This study shows the efficacy of yoga in the long term management of bronchial asthma , but the physiological basis for this beneficial effect needs to be examined in more detail Sixteen adult subjects with asthma in a clinical steady state were studied . On day 1 , after baseline spirometry , they underwent four histamine inhalation tests with functional recovery between each test . The provocative concentration causing a 20 % fall in FEV1 ( PC20 ) was obtained after each test . On days 2 , 3 , and 4 , after baseline spirometry , active and placebo ascorbic acid ( 2 gm ) was administered orally , double-blind , according to a 4.3.1 two-treatment crossover study design . One hour later , spirometry was performed , and PC20 was reassessed . We found no significant changes in FEV1 and FVC after ascorbic acid as compared with placebo administration . There was no difference between PC20 on days 2 , 3 , and 4 and by st and ardizing for the four PC20 results obtained on day 1 . We conclude that ascorbic acid has no acute bronchodilator effect and does not alter bronchial responsiveness to histamine in subjects with asthma A prospect i ve r and omised single-blind study of the effects of real and sham acupuncture on  exercise-induced asthma  was conducted in nineteen children .  Forced expiratory flow in 1st second ( FEV1 ) , forced vital capacity ( FVC ) , and peak expiratory flow rate ( PEFR ) were measured throughout acupuncture and after treadmill exercise . Neither real nor sham acupuncture affected the basal bronchomotor tone but both , when applied 20 min before exercise , attenuated exercise induced asthma : mean maximum percentage falls in FEV1 , FVC , and PEFR were 44.4 % , 33.3 % , and 49.5 % without acupuncture ; 23.8 % , 15.8 % , and 25.9 % after real acupuncture ; and 32.6 % , 26.1 % , and 34.3 % after sham acupuncture . Real acupuncture provided better protection against exercise-induced asthma than did sham acupuncture ( p less than 0.05 ) The acute effect of electric transcutaneous nerve stimulation ( TNS ) on bronchomotor tone was studied in 20 asthmatics . The stimulation was applied to four classical acupuncture points on the chest and back , and bronchomotor response was determined by measuring peak expiratory flow ( PEF ) . The experiments consisted of an adaptation period , placebo " stimulation " , TNS , and an isoprenaline inhalation test , in that order . In 11 patients PEF increased significantly ( greater than 15 % ) after placebo " stimulation " ; the mean change in all 20 patients after that period was + 12 % ( P less than 0.01 ) . TNS , however , did not change PEF significantly in any patient in spite of the fact that marked residual bronchoconstriction was shown in all patients demonstrated by an increase in PEF after inhalation of two isoprenaline puffs at the end of the experiment . The results suggest that the acute bronchodilatation obtainable with TNS is probably psychogenic ; no cutaneous-bronchial reflex could be demonstrated . The same kind of psychogenic reaction may also be involved in the bronchodilator response to needle acupuncture in asthma Abstract Objective : To test the hypothesis that homoeopathy is a placebo by examining its effect in patients with allergic rhinitis and so contest the evidence from three previous trials in this series . Design : R and omised , double blind , placebo controlled , parallel group , multicentre study . Setting : Four general practice s and a hospital ear , nose , and throat outpatient department . Participants : 51 patients with perennial allergic rhinitis . Intervention : R and om assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo . Main outcome measures : Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over third and fourth weeks after r and omisation . Results : Fifty patients completed the study . The homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo group ( mean difference 19.8 l/min , 95 % confidence interval 10.4 to 29.1 , P=0.0001 ) . Both groups reported improvement in symptoms , with patients taking homoeopathy reporting more improvement in all but one of the centres , which had more patients with aggravations . On average no significant difference between the groups was seen on visual analogue scale scores . Initial aggravations of rhinitis symptoms were more common with homoeopathy than placebo ( 7 ( 30 % ) v 2 ( 7 % ) , P=0.04 ) . Addition of these results to those of three previous trials ( n=253 ) showed a mean symptom reduction on visual analogue scores of 28 % ( 10.9 mm ) for homoeopathy compared with 3 % ( 1.1 mm ) for placebo ( 95 % confidence interval 4.2 to 15.4 , P=0.0007 ) . Conclusion : The objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo In 25 patients with moderate to severe asthma , we compared the therapeutic effectiveness of classic Chinese acupuncture with that of " placebo " acupuncture administered in a r and omly ordered , subject- and evaluator-blind , crossover fashion twice weekly for 4 weeks . Real and placebo acupuncture periods were each preceded and followed by 3- to 4-week periods during which no acupuncture was administered . Outcome variables consisted of the following : daily symptoms and medication use self-scored on patient diaries , spirometry and whole body plethysmography performed once weekly during the entire course of the study and repeated serially during 3 hours after real and placebo acupuncture treatment , patients ' self- assessment of acute efficacy of acupuncture therapy , and physician 's physical findings before and after  acupuncture treatment . Two-way analysis of variance failed to reveal a significant effect of either form of acupuncture  on symptoms , medication use , or lung function measurements . Similarly , no significant acute effect of  acupuncture on lung function , self-ratings of efficacy , or physician 's physical findings was found by covariance analysis or the Wilcoxon signed-rank test . When data during the entire course of the study were examined on an individual basis by analysis of variance with repeated measures , only two subjects demonstrated significantly favorable responses to real versus placebo acupuncture , but one subject demonstrated the reverse , suggesting that these responses were not specifically related to acupuncture therapy . Thus , our findings failed to demonstrate any short- or long-term benefit of acupuncture therapy in the management of moderate to severe asthma A double-blind crossover study of the effects of real and placebo acupuncture on bronchial reactivity to histamine was carried out on 16 patients with moderately severe asthma . Treatment with real or placebo acupuncture  failed to modulate the bronchial hyperreactivity to histamine . These results suggest that a single treatment with acupuncture is unlikely to provide improvement in the management of acute bronchial asthma The hypothesis that homoeopathic potencies are placebos was tested in a r and omised , double-blind , placebo-controlled trial . The study model chosen compared the effects of a homoeopathic preparation of mixed grass pollens with placebo in 144 patients with active hayfever . The homoeopathically treated patients showed a significant reduction in patient and doctor assessed symptom scores . The significance of this response was increased when results were corrected for pollen count and the response was associated with a halving of the need for antihistamines . An initial aggravation of symptoms was noted more often in patients receiving the potency and was followed by an improvement in that group . No evidence emerged to support the idea that placebo action fully explains the clinical responses to homoeopathic drugs OBJECTIVE To evaluate the effect of Buteyko breathing techniques ( BBT ) in the management of asthma . DESIGN Prospect i ve , blinded , r and omised study comparing the effect of BBT with control classes in 39 subjects with asthma . The study was conducted from January 1995 to April 1995 . PARTICIPANTS AND SETTING Subjects recruited from the community , aged 12 to 70 years , with asthma and substantial medication use . MAIN OUTCOME MEASURES Medication use ; morning peak expiratory flow ( PEF ) ; forced expiratory volume in one second ( FEV1 ) ; end-tidal ( ET ) CO2 ; resting minute volume ( MV ) ; and quality of life ( QOL ) score , measured at three months . RESULTS No change in daily PEF or FEV1 was noted in either group . At three months , the BBT group had a median reduction in daily beta 2-agonist dose of 904 micrograms ( range , 29 micrograms to 3129 micrograms ) , whereas the control group had a median reduction of 57 micrograms ( range , -2343 micrograms to 1143 micrograms ) ( P = 0.002 ) . Daily inhaled steroid dose fell 49 % ( range , -100 % to 150 % ) for the BBT group and 0 ( range , -82 % to + 100 % ) for the control group ( P = 0.06 ) . A trend towards greater improvement in QOL score was noted for BBT subjects ( P = 0.09 ) . Initial MV was high and similar in both groups ; by three months , MV was lower in the BBT group than in the control group ( P = 0.004 ) . ET CO2 was low in both groups and did not change with treatment . CONCLUSION Those practising BBT reduced hyperventilation and their use of beta 2-agonists . A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre Adult asthmatics , ranging from 19 to 52 years from an asthma and allergy clinic in a university setting volunteered to participate in the study . The 17 students were r and omly divided into yoga ( 9 subjects ) and nonyoga control ( 8 subjects ) groups . The yoga group was taught a set of breathing and relaxation techniques including breath slowing exercises ( pranayama ) , physical postures ( yogasanas ) , and meditation . Yoga techniques were taught at the university health center , three times a week for 16 weeks . All the subjects in both groups maintained daily symptom and medication diaries , collected A.M. and P.M. peak flow readings , and completed weekly question naires . Spirometry was performed on each subject every week . Analysis of the data showed that the subjects in the yoga group reported a significant degree of relaxation , positive attitude , and better yoga exercise tolerance . There was also a tendency toward lesser usage of beta adrenergic inhalers . The pulmonary functions did not vary significantly between yoga and control groups . Yoga techniques seem beneficial as an adjunct to the medical management of asthma Abstract Objective : To evaluate the efficacy of homoeopathic immunotherapy on lung function and respiratory symptoms in asthmatic people allergic to house dust mite . Design : Double blind r and omised controlled trial . Setting : 38 general practice s in Hampshire and Dorset . Participants : 242 people with asthma and positive results to skin prick test for house dust mite ; 202 completed clinic based assessment s , and 186 completed diary based assessment s. Intervention : After a four week baseline assessment , participants were r and omised to receive oral homoeopathic immunotherapy or placebo and then assessed over 16 weeks with three clinic visits and diary assessment s every other week . Outcome measure : Clinic based assessment s : forced expiratory volume in one second ( FEV1 ) , quality of life , and mood . Diary based assessment s : morning and evening peak expiratory flow , visual analogue scale of severity of asthma , quality of life , and daily mood . Results : There was no difference in most outcomes between placebo and homoeopathic immunotherapy . There was a different pattern of change over the trial for three of the diary assessment s : morning peak expiratory flow ( P=0.025 ) , visual analogue scale ( P=0.017 ) , and mood ( P=0.035 ) . At week three there was significant deterioration for visual analogue scale ( P=0.047 ) and mood ( P=0.013 ) in the homoeopathic immunotherapy group compared with the placebo group . Any improvement in participants ' asthma was independent of belief in complementary medicine . Conclusion : Homoeopathic immunotherapy is not effective in the treatment of patients with asthma . The different patterns of change between homoeopathic immunotherapy and placebo over the course of the study are unexplained We assessed the clinical and biochemical effects in asthmatic children of fish oil supplementation and a diet that increases omega-3 and reduces omega-6 fatty acids . Thirty nine asthmatic children aged 8 - 12 yrs participated in a double- 
    Output:
    
Breathing techniques , e.g. improved control of breathing by yoga , may contribute to the control of asthma symptoms , but due to the small number of controlled trials and due to the small number of patients it is not possible to make firm judgments .
Herbal remedies can not be recommended based on the available evidence .
Recommendations for a diet high in vitamin C and marine fatty acids are not harmful , but evidence for clinical ly meaningful effects are scant .
Up to now evidence is lacking that alternative forms of medicine are more effective than placebo in asthma .