Advances in clinical research on traditional Chinese medicine treatment of Chronic Fatigue Syndrome, by in Evidence-Based Complementary and Alternative Medicine Vol 2020, #4715679 [doi.org/10.1155/2020/4715679]
Review abstract:
Chronic fatigue syndrome (CFS) is one of the most common chronic diseases in modern society and affects patients’ quality of life to a certain extent. To date, the etiology and pathogenesis of CFS are still not completely clear. Various therapies have been developed, but there is still a lack of specific drugs or treatments.
As a kind of adjuvant therapy, traditional Chinese medicine (TCM) has aroused widespread concern about the improvement of CFS. Although a large number of clinical randomized controlled trials have confirmed the therapeutic effect of TCM on CFS, the exact efficacy is still controversial.
This article summarizes the clinical research methods and efficacy of TCM in the treatment of CFS over the past five years from the perspectives of syndrome differentiation, external treatment, and combination therapy.
7. Summary
Currently, there are many methods for treating CFS with TCM, showing its advantages. On one hand, treatments according to syndrome differentiation are diverse and involve herbal decoctions and proprietary Chinese medicines. External treatments include moxibustion, acupuncture, tuina, cupping, and other treatments. Combination therapies include two or more external treatments combined and internal and external treatments combined, which are often better than monotherapies and can remedy deficiencies. However, the clinical manifestations of CFS are different. Although fatigue is the main manifestation, there are individual differences in the appearance of insomnia or muscle pain in some patients. Treatments according to syndrome differentiation can provide patients with individualized treatments. On the other hand, TCM often has the advantages of simplicity, effectiveness, convenience, and a lower cost.
However, there are still many problems in the treatment of CFS with TCM. For example, diagnostic criteria of syndrome differentiation, treatment methods, and efficacy evaluations have not yet reached a consensus. Some therapies are quite cumbersome or rare, but the efficacy is almost the same. Sometimes, combination therapy is taken, but the focus on primary and secondary treatments is not clear. Therefore, it is difficult to compare which therapy is better, which reduces the credibility of the studies.
Among the databases that we examined, RCT experiments accounted for a large proportion, and the total effective rates of observation groups were often over 90% and were even as high as 100%. However, there was a lack of repeated experiments. The level of evidence is not good enough, and high-quality clinical trials are still needed, which remains the main contradiction in the treatment of CFS with TCM.
In the process of searching the papers, we also found some folk-specific therapies, such as a classic medicated diet porridge using herbs (composition: Yam 10 g, Semen euryales 10 g, Leek seed 10 g, and Japonica rice 50 g), which can improve symptoms such as fatigue by taking 500 ml once every other day [74]. Another one, which involves head scraping combined with music therapy for 15 min qd 5 times a week, may achieve similar results [75]. Spinal conditioning (a tuina technique) combined with tea therapy (a teabag made from Tangerine peel 20 g, Mint 15 g, Wild Jujube seed 20 g, and Bupleurum 20 g) can activate the brain [76]. Baduanjin exercise combined with acupuncture may strengthen immunity to treat CFS [77]. All these therapies might have effects on CFS to some extent, but related studies are rare, research data are relatively scarce, and safety cannot be guaranteed.
Therefore, the recommendations are as follows.
(1) To standardize the consensus of TCM diagnosis and treatment of CFS, unified and standardized syndrome differentiation and efficacy evaluation system should be established.
(2) Multicenter, large-sample RCT experiments on CFS should be conducted to provide proof of evidence-based medicine using TCM.
(3) CFS model research and animal experiments should be carried out to provide scientific theories for verifying the efficacy of TCM therapies.
(4) Clinical studies of folk-specific therapies should be conducted, emphasizing the safety and reliability of clinical trials to enrich the TCM studies on CFS.
