A systematic review of acupuncture and moxibustion treatment for chronic fatigue syndrome in China

Abstract:

Studies on the treatment of chronic fatigue syndrome (CFS) with acupuncture and moxibustion in China were reviewed. All studies concluded the treatments were effective, with response rates ranging from 78.95% to 100%. However, the qualities of the studies were generally poor, and none of them used a RCT design. The common acupoints/sites used in the treatment of CFS, which may reflect the collective experience of acupuncturists in China based on Traditional Chinese Medicine theories can be used to evaluate the effectiveness of acupuncture for the treatment of CFS in future studies using more scientifically rigorous study designs.

 

Source: Wang T, Zhang Q, Xue X, Yeung A. A systematic review of acupuncture and moxibustion treatment for chronic fatigue syndrome in China. Am J Chin Med. 2008;36(1):1-24. https://www.ncbi.nlm.nih.gov/pubmed/18306446

 

Effectiveness of distant healing for patients with chronic fatigue syndrome: a randomised controlled partially blinded trial (EUHEALS)

Abstract:

BACKGROUND: Distant healing, a form of spiritual healing, is widely used for many conditions but little is known about its effectiveness.

METHODS: In order to evaluate distant healing in patients with a stable chronic condition, we randomised 409 patients with chronic fatigue syndrome (CFS) from 14 private practices for environmental medicine in Germany and Austria in a two by two factorial design to immediate versus deferred (waiting for 6 months) distant healing. Half the patients were blinded and half knew their treatment allocation. Patients were treated for 6 months and allocated to groups of 3 healers from a pool of 462 healers in 21 European countries with different healing traditions. Change in Mental Health Component Summary (MHCS) score (SF-36) was the primary outcome and Physical Health Component Summary score (PHCS) the secondary outcome.

RESULTS: This trial population had very low quality of life and symptom scores at entry. There were no differences over 6 months in post-treatment MHCS scores between the treated and untreated groups. There was a non-significant outcome (p = 0.11) for healing with PHCS (1.11; 95% CI -0.255 to 2.473 at 6 months) and a significant effect (p = 0.027) for blinding; patients who were unblinded became worse during the trial (-1.544; 95% CI -2.913 to -0.176). We found no relevant interaction for blinding among treated patients in MHCS and PHCS. Expectation of treatment and duration of CFS added significantly to the model.

CONCLUSIONS: In patients with CFS, distant healing appears to have no statistically significant effect on mental and physical health but the expectation of improvement did improve outcome.

Copyright (c) 2008 S. Karger AG, Basel.

 

Source: Walach H, Bosch H, Lewith G, Naumann J, Schwarzer B, Falk S, Kohls N, Haraldsson E, Wiesendanger H, Nordmann A, Tomasson H, Prescott P, Bucher HC. Effectiveness of distant healing for patients with chronic fatigue syndrome: a randomised controlled partially blinded trial (EUHEALS). Psychother Psychosom. 2008;77(3):158-66. doi: 10.1159/000116609. Epub 2008 Feb 14. https://www.ncbi.nlm.nih.gov/pubmed/18277062

 

Observation on therapeutic effect of point pressure combined with massage on chronic fatigue syndrome

Abstract:

OBJECTIVE: To search for an effective therapy for chronic fatigue syndrome (CFS).

METHODS: Eighty-five cases of CFS were treated with massage and pressing of Back-shu points, combined with pressing acupoints on the head. The therapeutic effect was observed.

RESULTS: After treatment of 3 courses, 26 cases were markedly effective, 52 cases were effective, and 7 cases were ineffective, with a total effective rate of 91.8% and a markedly effective rate of 30.6%.

CONCLUSION: Pressing acupoints and massage can effectively improve clinical symptoms of the patient with chronic fatigue syndrome.

 

Source: Yao F, Ji Q, Zhao Y, Feng JL. Observation on therapeutic effect of point pressure combined with massage on chronic fatigue syndrome. Zhongguo Zhen Jiu. 2007 Nov;27(11):819-20. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/18085145

 

Normalization of the increased translocation of endotoxin from gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome

Abstract:

There is now evidence that chronic fatigue syndrome (CFS) is accompanied by an increased translocation of endotoxins from gram-negative enterobacteria through the gut wall, as demonstrated by increased prevalences and median values for serum IgM and IgA against the endotoxins of gram-negative enterobacteria. This condition can also be described as increased gut permeability or leaky gut and indicates intestinal mucosal dysfunction (IMD).

Here we report a case of a 13 year old girl with CFS who showed very high values for serum IgM against the LPS of some enterobacteria and signs of oxidative and nitrosative stress, activation of the inflammatory response system, and IgG3 subclass deficiency. Upon treatment with specific antioxidants and a “leaky gut diet”, which both aim to treat increased gut permeability, and immunoglobins intravenously, the increased translocation of the LPS of gram negative enterobacteria normalized and this normalization was accompanied by a complete remission of the CFS symptoms.

 

Source: Maes M, Coucke F, Leunis JC. Normalization of the increased translocation of endotoxin from gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome. Neuro Endocrinol Lett. 2007 Dec;28(6):739-44. https://www.ncbi.nlm.nih.gov/pubmed/18063928

 

A clinical trial of acupuncture for treating chronic fatigue syndrome in Hong Kong

Abstract:

OBJECTIVE: To evaluate the efficacy of acupuncture in treating chronic fatigue syndrome (CFS) in Hong Kong.

METHODS: A single-blinded, randomized controlled trial design was adopted. Participants meeting inclusion criteria were randomly assigned to a treatment and a control group according to 1:1 ratio, resulting in an effective sample size of 99, with 50 and 49 patients in treatment and control group respectively. The same set of acupuncture points, which were selected according to traditional Chinese medicine theories, was applied in both groups, while conventional needle acupuncture was applied in treatment group and sham acupuncture (without skin penetration) was applied in control group. Schedule of treatment was the same in both groups, i.e. twice a week for 4 weeks. Key outcome measures were Chalder’s Fatigue Scale, diagnostic criteria for CFS of the US’s Centre for Disease Control and SF-12 health-related quality of life (HQOL) questionnaire. Adverse events, if any, were recorded.

RESULTS: Improvements in physical and mental fatigue and HQOL in both groups were observed, but the improvements in treatment group were significantly bigger than in control group (P<0.01 or P<0.05). No adverse events occurred.

CONCLUSION: Acupuncture is a safe, effective treatment for CFS.

 

Source: Yiu YM, Ng SM, Tsui YL, Chan YL. A clinical trial of acupuncture for treating chronic fatigue syndrome in Hong Kong. Zhong Xi Yi Jie He Xue Bao. 2007 Nov;5(6):630-3. [Article in Chinese] http://www.jcimjournal.com/jim/showAbstrPage.aspx?articleid=167219772007060630 (Full article)

 

Possible use of repeated cold stress for reducing fatigue in chronic fatigue syndrome: a hypothesis

Abstract:

BACKGROUND: Physiological fatigue can be defined as a reduction in the force output and/or energy-generating capacity of skeletal muscle after exertion, which may manifest itself as an inability to continue exercise or usual activities at the same intensity. A typical example of a fatigue-related disorder is chronic fatigue syndrome (CFS), a disabling condition of unknown etiology and with uncertain therapeutic options. Recent advances in elucidating pathophysiology of this disorder revealed hypofunction of the hypothalamic-pituitary-adrenal axis and that fatigue in CFS patients appears to be associated with reduced motor neurotransmission in the central nervous system (CNS) and to a smaller extent with increased fatigability of skeletal muscle. There is also some limited evidence that CFS patients may have excessive serotonergic activity in the brain and low opioid tone.

PRESENTATION OF THE HYPOTHESIS: This work hypothesizes that repeated cold stress may reduce fatigue in CFS because brief exposure to cold may transiently reverse some physiological changes associated with this illness. For example, exposure to cold can activate components of the reticular activating system such as raphe nuclei and locus ceruleus, which can result in activation of behavior and increased capacity of the CNS to recruit motoneurons. Cold stress has also been shown to reduce the level of serotonin in most regions of the brain (except brainstem), which would be consistent with reduced fatigue according to animal models of exercise-related fatigue. Finally, exposure to cold increases metabolic rate and transiently activates the hypothalamic-pituitary-adrenal axis as evidenced by a temporary increase in the plasma levels of adrenocorticotropic hormone, beta-endorphin and a modest increase in cortisol. The increased opioid tone and high metabolic rate could diminish fatigue by reducing muscle pain and accelerating recovery of fatigued muscle, respectively.

TESTING THE HYPOTHESIS: To test the hypothesis, a treatment is proposed that consists of adapted cold showers (20 degrees Celsius, 3 minutes, preceded by a 5-minute gradual adaptation to make the procedure more comfortable) used twice daily.

IMPLICATIONS OF THE HYPOTHESIS: If testing supports the proposed hypothesis, this could advance our understanding of the mechanisms of fatigue in CFS.

 

Source: Shevchuk NA. Possible use of repeated cold stress for reducing fatigue in chronic fatigue syndrome: a hypothesis. Behav Brain Funct. 2007 Oct 24;3:55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2164952/ (Full article)

 

The thoughts and methods for clinical research on acupuncture treatment of chronic fatigue syndrome

Abstract:

The general situation of chronic fatigue syndrome (CFS) and the criteria for its diagnosis are discussed, and it is put forward that making qi and blood of the zang-fu organs balanced is the key to acupuncture treatment of the disease. Such aspects as case selection, point selection and therapeutic assessment are also discussed in the present paper.

 

Source: Yao R. The thoughts and methods for clinical research on acupuncture treatment of chronic fatigue syndrome. J Tradit Chin Med. 2007 Sep;27(3):163-5 http://www.journaltcm.com/modules/Journal/contents/stories/073/1.pdf (Full article)

 

Chronic fatigue syndrome treated by acupuncture and moxibustion in combination with psychological approaches in 310 cases

Abstract:

OBJECTIVE: To observe clinical therapeutic effect of acupuncture and moxibustion combined with a psychological approach on chronic fatigue syndrome (CFS).

METHODS: The treatment was given by acupuncture plus moxibustion combined with a psychological approach based on differentiation of symptoms and signs in 310 cases.

RESULTS: Of 310 cases observed, 275 cases (88.7%) were clinically cured, 28 cases (9%) improved, and 7 cases (2.3%) failed.

CONCLUSION: Acupuncture plus moxibustion combined with a psychological approach is an effective therapy for CFS.

 

Source: Guo J.Chronic fatigue syndrome treated by acupuncture and moxibustion in combination with psychological approaches in 310 cases. J Tradit Chin Med. 2007 Jun;27(2):92-5. http://www.journaltcm.com/modules/Journal/contents/stories/072/3.pdf (Full article)

 

Lymphatic drainage of the neuraxis in chronic fatigue syndrome: a hypothetical model for the cranial rhythmic impulse

Abstract:

The cranial rhythmic impulse is a palpable, rhythmic fluctuation believed to be synchronous with the primary respiratory mechanism. The precise physiologic mechanism of the cranial rhythmic impulse is not fully understood. Based on traditional and current views of the cranial rhythmic impulse, animal studies, and clinical findings in patients with chronic fatigue syndrome, the author argues that the cranial rhythmic impulse is the rhythm produced by a combination of cerebrospinal fluid drainage from the neuraxis (brain and spinal cord) and pulsations of central lymphatic drainage induced by the sympathetic nervous system. In addition, evidence is provided to demonstrate that a disturbed, palpable, and visible neurolymphatic process leads to chronic fatigue syndrome. This process may also explain the pathophysiologic mechanisms leading to other disease states. Finally, the author’s proposed manual treatment protocol for patients with chronic fatigue syndrome is described.

 

Source: Perrin RN. Lymphatic drainage of the neuraxis in chronic fatigue syndrome: a hypothetical model for the cranial rhythmic impulse. J Am Osteopath Assoc. 2007 Jun;107(6):218-24. https://www.ncbi.nlm.nih.gov/pubmed/17635902

 

A new treatment: thermal therapy for chronic fatigue syndrome

Abstract:

Thermal therapy using far-infrared ray dry sauna was performed for patients with chronic fatigue syndrome (CFS). Symptoms such as fatigue, pain, and low-grade fever were dramatically improved on two patients. And prednisolone administration was discontinued and became socially rehabilitated 6 months after discharge. On other 11 patients with CFS, physical symptoms such as fatigue and pain improved, too. Furthermore, we reported that repeated thermal therapy had relaxation effect and diminishes appetite loss and subjective complaints in mildly depressed patients. These results suggest that repeated thermal therapy may be a promising method for the treatment of CFS.

 

Source: Masuda A, Munemoto T, Tei C. A new treatment: thermal therapy for chronic fatigue syndrome. Nihon Rinsho. 2007 Jun;65(6):1093-8. [Article in Japanese] https://www.ncbi.nlm.nih.gov/pubmed/17561703