***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: CONTEXT Irritable bowel syndrome ( IBS ) is a common functional bowel disorder for which there is no reliable medical treatment . OBJECTIVE To determine whether Chinese herbal medicine ( CHM ) is of any benefit in the treatment of IBS . DESIGN R and omized , double-blind , placebo-controlled trial conducted during 1996 through 1997 . SETTING Patients were recruited through 2 teaching hospitals and 5 private practice s of gastroenterologists , and received CHM in 3 Chinese herbal clinics . PATIENTS A total of 116 patients who fulfilled the Rome criteria , an established st and ard for diagnosis of IBS . INTERVENTION Patients were r and omly allocated to 1 of 3 treatment groups : individualized Chinese herbal formulations ( n = 38 ) , a st and ard Chinese herbal formulation ( n = 43 ) , or placebo ( n = 35 ) . Patients received 5 capsules 3 times daily for 16 weeks and were evaluated regularly by a traditional Chinese herbalist and by a gastroenterologist . Patients , gastroenterologists , and herbalists were all blinded to treatment group . MAIN OUTCOME MEASURES Change in total bowel symptom scale scores and global improvement assessed by patients and gastroenterologists and change in the degree of interference in life caused by IBS symptoms assessed by patients . RESULTS Compared with patients in the placebo group , patients in the active treatment groups ( st and ard and individualized CHM ) had significant improvement in bowel symptom scores as rated by patients ( P=.03 ) and by gastroenterologists ( P=.001 ) , and significant global improvement as rated by patients ( P=.007 ) and by gastroenterologists ( P=.002 ) . Patients reported that treatment significantly reduced the degree of interference with life caused by IBS symptoms ( P=.03 ) . Chinese herbal formulations individually tailored to the patient proved no more effective than st and ard CHM treatment . On follow-up 14 weeks after completion of treatment , only the individualized CHM treatment group maintained improvement . CONCLUSION Chinese herbal formulations appear to offer improvement in symptoms for some patients with IBS CONTEXT A prior national survey documented the high prevalence and costs of  alternative medicine use in the United States in 1990 . OBJECTIVE To document trends in alternative medicine use in the United States between 1990 and 1997 . DESIGN Nationally representative r and om household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997 , respectively . PARTICIPANTS A total of 1539 adults in 1991 and 2055 in 1997 . MAIN OUTCOMES MEASURES Prevalence , estimated costs , and disclosure of alternative therapies to physicians . RESULTS Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8 % in 1990 to 42.1 % in 1997 ( P < or = .001 ) . The therapies increasing the most included herbal medicine , massage , megavitamins , self-help groups , folk remedies , energy healing , and homeopathy . The probability of users visiting an alternative medicine practitioner increased from 36.3 % to 46.3 % ( P = .002 ) . In both surveys alternative therapies were used most frequently for chronic conditions , including back problems , anxiety , depression , and headaches . There was no significant change in disclosure rates between the 2 survey years ; 39.8 % of alternative therapies were disclosed to physicians in 1990 vs 38.5 % in 1997 . The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 ( 64.0 % ) and 1997 ( 58.3 % ) ( P=.36 ) . Extrapolations to the US population suggest a 47.3 % increase in total visits to alternative medicine practitioners , from 427 million in 1990 to 629 million in 1997 , thereby exceeding total visits to all US primary care physicians . An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and /or high-dose vitamins ( 18.4 % of all prescription users ) . Estimated expenditures for alternative medicine professional services increased 45.2 % between 1990 and 1997 and were conservatively estimated at $ 21.2 billion in 1997 , with at least $ 12.2 billion paid out-of-pocket . This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations . Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $ 27.0 billion , which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services . CONCLUSIONS  Alternative medicine use and expenditures increased substantially between 1990 and 1997 , attributable primarily to an increase in the proportion of the population seeking alternative therapies , rather than increased visits per patient OBJECTIVE To determine whether clinical trials originating in certain countries always have positive results . DATA SOURCES Abstract s of trials from Medline ( January 1966-June 1995 ) . STUDY SELECTION Two separate studies were conducted . The first included trials in which the clinical outcome of a group of subjects receiving acupuncture  was compared to that of a group receiving placebo , no treatment , or a nonacupuncture intervention . In the second study , r and omized or controlled trials of interventions other than  acupuncture  that were published in China , Japan , Russia/USSR , or Taiwan were compared to those published in Engl and . DATA EXTRACTION Blinded review ers determined inclusion and outcome and separately classified each trial by country of origin . DATA SYNTHESIS In the study of acupuncture  trials , 252 of 1085 abstract s met the inclusion criteria . Research conducted in certain countries was uniformly favorable to acupuncture ; all trials originating in China , Japan , Hong Kong , and Taiwan were positive , as were 10 out of 11 of those published in Russia/USSR . In studies that examined interventions other than acupuncture , 405 of 1100 abstract s met the inclusion criteria . Of trials published in Engl and , 75 % gave the test treatment as superior to control . The results for China , Japan , Russia/USSR , and Taiwan were 99 % , 89 % , 97 % , and 95 % , respectively . No trial published in China or Russia/USSR found a test treatment to be ineffective . CONCLUSIONS Some countries publish unusually high proportions of positive results . Publication bias is a possible explanation . Research ers undertaking systematic review s should consider carefully how to manage data from these countries The effects of prokinetic treatment with cisapride in patients with constipation-predominant irritable bowel syndrome ( IBS ) were evaluated in a r and omized , double-blind , placebo-controlled study . Sixty-nine IBS patients were assigned to a 12-week treatment with either 5 mg cisapride or placebo t.i.d . ; this dosage could be changed if necessary . The mean weekly number of days on which a stool was passed in the cisapride and placebo group increased to 5.3 and 4.4 ( p less than 0.05 ) during weeks 8 - 12 of treatment , and the number of days with stools of normal consistency increased to 3.5 and 1.9 ( p less than 0.05 ) , respectively . At week 12 , the reduction in severity and frequency scores for abdominal pain was significantly greater ( p less than or equal to 0.05 ) in the cisapride group ( 60 and 61 % ) than in the placebo group ( 40 and 32 % ) , as it was for abdominal distension ( p less than 0.05 ) . Cisapride tended to be better than placebo in diminishing flatulence . In 71 % versus 39 % of the patients the overall rating for the response to treatment was good or excellent at week 12 . Cisapride was well tolerated . These results suggest that the drug will be useful for the management of constipation-predominant IBS BACKGROUND Irritable bowel syndrome is a common cause of abdominal pain and discomfort and may be related to disordered gastrointestinal motility . Our aim was to assess the effects of long-term treatment with a prokinetic agent , cisapride , on postpr and ial jejunal motility and symptoms in the irritable bowel syndrome ( IBS ) . METHODS Thirty-eight patients with IBS ( constipation-predominant , n = 17 ; diarrhoea-predominant , n = 21 ) underwent 24-h ambulatory jejunal manometry before and after 12 week 's treatment [ cisapride , 5 mg three times daily ( n = 19 ) or placebo ( n = 19 ) ] . RESULTS In diarrhoea-predominant patients significant differences in contraction characteristics were observed between the cisapride and placebo groups . In cisapride-treated diarrhoea-predominant patients the mean contraction amplitude was higher ( 29.3 + /- 3.2 versus 24.9 + /- 2.6 mm Hg , cisapride versus placebo ( P < 0.001 ) ; pretreatment , 25.7 + /- 6.0 mm Hg ) , the mean contraction duration longer ( 3.4 + /- 0.2 versus 3.0 + /- 0.2 sec , cisapride versus placebo ( P < 0.001 ) ; pretreatment , 3.1 + /- 0.5 sec ) , and the mean contraction frequency lower ( 2.0 + /- 0.2 versus 2.5 + /- 0.4 cont./min , cisapride versus placebo ( P < 0.001 ) ; pretreatment , 2.5 + /- 1.1 cont./min ] than patients treated with placebo . No significant differences in jejunal motility were found in the constipation-predominant IBS group . Symptoms were assessed by using a visual analogue scale before and after treatment . Symptom scores relating to the severity of constipation were lower in cisapride-treated constipation-predominant IBS patients [ score , 54 + /- 5 versus 67 + /- 14 mm , cisapride versus placebo ( P < 0.05 ) ; pretreatment , 62 + /- 19 mm ] . Diarrhoea-predominant IBS patients had a higher pain score after cisapride therapy [ score , 55 + /- 15 versus 34 + /- 12 mm , cisapride versus placebo ( P < 0.05 ) ; pretreatment , 67 + /- 19 mm ] . CONCLUSION Cisapride affects jejunal contraction characteristics and some symptoms in IBS OBJECTIVE To observe the clinical efficacy of the combination of traditional Chinese medicine and western medicine in treating irritable bowel syndrome ( IBS ) and the result of intestinal flora regulation . METHODS Sixty IBS patients , 36 males and 24 females , were divided into two groups , with 30 patients in each group .  Herbal formula of TongxieYaofang and clostridium butyricum ( Cb ) were used in the first group for four weeks , while only Cb was used for four weeks in the second group . We observed the changes of coliform group , enterococcus , lactobacillus , bifidobacterium after treatment . RESULTS The effective rate of the Tongxie Yaofang and Cb treated group was significantly higher than that of the Cb treated group ( P < 0.05 ) . The numbers of bifidobacterium and lactobacillus increased , while the numbers of coliform group and enterococcus decreased after the treatment , and the changes of intestinal flora in the integrative medicine treated group were significantly greater than those in the Cb treated group . CONCLUSION After treatment with the combination of traditional Chinese medicine and western medicine , the intestinal flora can be regulated to equilibrium state Background and Aims : Padma Lax , a complex Tibetan herbal formula for constipation was evaluated for safety and effectiveness in treating constipation-predominant irritable bowel syndrome in a 3-month double-blind r and omised pilot study . Methods : Patients were recruited from Hadassah Hospital ’s Gastroenterology clinic , using the Rome I Criteria for irritable bowel syndrome , and the international consensus criteria for constipation . Symptom severity was evaluated monthly by patients and gastroenterologist , using categorical and numerical rating scales . A patient diary recorded daily stool habit and trial medication . Results : In 61 patients , ( 34 Padma Lax , 27 placebo )  , significant improvement was demonstrated after 3 months in the Padma Lax group compared to placebo in constipation , severity of abdominal pain , and its effect on daily activities , incomplete evacuation , abdominal distension and flatus/flatulence . A global assessment indicated that significantly more Padma Lax patients , compared to placebo , rated the current treatment superior to previous therapies tried for irritable bowel . Laboratory parameters displayed no clinical ly significant changes . Side effects , primarily loose stools in 7 Padma Lax patients responded well to lowering treatment dosage from 2 to 1 capsule/day . Conclusions : Padma Lax is a safe and effective treatment for  constipation-predominant irritable bowel syndrome  and may offer an alternative to the current multi drug approach Background : Herbal medications have been used in many countries for the treatment of patients with irritable bowel syndrome . 
    Output:
    
Compared with placebo , a St and ard Chinese herbal formula , individualised Chinese herbal medicine , STW 5 and STW 5-II , Tibetan herbal medicine Padma Lax , traditional Chinese formula Tongxie Yaofang , and Ayurvedic preparation showed significantly improvement of global symptoms .
Some herbal medicines may improve the symptoms of irritable bowel syndrome .