Yang/Qi invigoration: an herbal therapy for chronic fatigue syndrome with yang deficiency?

Abstract:

According to traditional Chinese medicine (TCM) theory, Yang and Qi are driving forces of biological activities in the human body. Based on the crucial role of the mitochondrion in energy metabolism, we propose an extended view of Yang and Qi in the context of mitochondrion-driven cellular and body function.

It is of interest that the clinical manifestations of Yang/Qi deficiencies in TCM resemble those of chronic fatigue syndrome in Western medicine, which is pathologically associated with mitochondrial dysfunction. By virtue of their ability to enhance mitochondrial function and its regulation, Yang- and Qi-invigorating tonic herbs, such as Cistanches Herba and Schisandrae Fructus, may therefore prove to be beneficial in the treatment of chronic fatigue syndrome with Yang deficiency.

 

Source: Leong PK, Wong HS, Chen J, Ko KM. Yang/Qi invigoration: an herbal therapy for chronic fatigue syndrome with yang deficiency? Evid Based Complement Alternat Med. 2015;2015:945901. doi: 10.1155/2015/945901. Epub 2015 Feb 11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339790/ (Full article)

 

Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials

Abstract:

BACKGROUND: There is no curative treatment for chronic fatigue syndrome (CFS). Traditional Chinese medicine (TCM) is widely used in the treatment of CFS in China.

OBJECTIVE: To evaluate the effectiveness and safety of TCM for CFS.

METHODS: The protocol of this review is registered at PROSPERO. We searched six main databases for randomized clinical trials (RCTs) on TCM for CFS from their inception to September 2013. The Cochrane risk of bias tool was used to assess the methodological quality. We used RevMan 5.1 to synthesize the results.

RESULTS: 23 RCTs involving 1776 participants were identified. The risk of bias of the included studies was high. The types of TCM interventions varied, including Chinese herbal medicine, acupuncture, qigong, moxibustion, and acupoint application. The results of meta-analyses and several individual studies showed that TCM alone or in combination with other interventions significantly alleviated fatigue symptoms as measured by Chalder’s fatigue scale, fatigue severity scale, fatigue assessment instrument by Joseph E. Schwartz, Bell’s fatigue scale, and guiding principle of clinical research on new drugs of TCM for fatigue symptom. There was no enough evidence that TCM could improve the quality of life for CFS patients. The included studies did not report serious adverse events.

CONCLUSIONS: TCM appears to be effective to alleviate the fatigue symptom for people with CFS. However, due to the high risk of bias of the included studies, larger, well-designed studies are needed to confirm the potential benefit in the future.

Copyright © 2014 Elsevier Ltd. All rights reserved.

 

Source: Wang YY, Li XX, Liu JP, Luo H, Ma LX, Alraek T. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014 Aug;22(4):826-33. doi: 10.1016/j.ctim.2014.06.004. Epub 2014 Jun 30. https://www.ncbi.nlm.nih.gov/pubmed/25146086

 

Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back

Abstract:

OBJECTIVE: To compare the differences of therapeutic effect of chronic fatigue syndrome treated with the combined therapy of coiling dragon needling and cupping on back and the western medicine therapy with Prednisone.

METHODS: Seventy-two cases were randomly divided into an acupuncture and cupping group (37 cases) and a Prednisone group (35 cases). In acupuncture and cupping group, Jiaji (EX-B 2) points of T1–L5 were applied with coiling dragon needling (once a day), combined with moving cupping on back (once every two days); in Prednisone group, Prednisone tablets were orally taken for 10 mg at 8:00 am. Seven days made one course, and 2 courses were carried on totally. FS-14 scale and BELL’s chronic fatigue syndrome integral table were applied to evaluate the fatigue degree of patients before and after treatment, and the therapeutic effects of both groups were compared.

RESULTS: After one course of treatment, the BELL’s scores of both groups were obviously improved (both P < 0.01), but there was no significant difference between groups (P > 0.05); after two courses of treatment, the BELL’s score in acupuncture and cupping group improved more obviously than that in Prednisone group, and the total effective rate of 91.9% (34/37) in acupuncture and cupping group was superior to that of 71.4% (25/35) in Prednisone group (P < 0.05).

CONCLUSION: The therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back is positive, superior to that of Prednisone with oral administration.

 

Source: Xu W, Zhou RH, Li L, Jiang MW. Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back. Zhongguo Zhen Jiu. 2012 Mar;32(3):205-8. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22471128

 

Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients

Abstract:

OBJECTIVE: To observe the therapeutic effect and safety of acupuncture of Back-shu points [Xinshu (BL 15), Pishu (BL 20), etc.] in the treatment of chronic fatigue syndrome (CFS).

METHODS: A total of 120 CFS patients were equally randomized Into acupuncture and control groups. Acupuncture needles were inserted into bilateral Xinshu (BL 15), Pishu (BL 20), and Gaohuang (BL 43) points, once daily for 4 weeks except weekends. For patients of the control group, acupuncture needles were inserted into the shallow layer of the non-acupoints (two mid-points of the horizon lines passing through the crossing-points of the 1st and 2nd branches of the Gallbladder Meridian and the crests of 4th, 5th and 11th thoracic vertebrae). General health scale (SF-20) and Chalder fatigue scale were used to measure the CFS patients’ degree of general health. A follow-up survey was carried out 3 months after the last treatment.

RESULTS: In comparison with pre-treatment, the scores of Chalder fatigue scale were decreased significantly in both treatment and control groups (P < 0.01), while the scores of physiological function (PF) and general health (GH) of SF-20 in both acupuncture groups and those of the role function (RF), social function (SF), mental health (MH) and pain sensation (PS) in the treatment group were increased apparently after the treatment (P < 0.05, P < 0.01). The scores of Chalder Scale and PF, RF, SF, GH, MH, PS and the CFS patients’ satisfication degrees 4 weeks (64.4% and 36.7%) and 3 months (62.3% and 32%) after the treatment in the treatment group were significantly superior to those of the control group (P < 0.05).

CONCLUSION: Acupuncture at Back-shu point has a good therapeutic effect (including immediate and midterm effect) in the treatment of chronic fatigue syndrome patients.

 

Source: Zhang W, Liu ZS, Xu HR, Liu YS. Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients. Zhen Ci Yan Jiu. 2011 Dec;36(6):437-41, 448. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22379791

 

A study of median frequencies of skeletal muscle undergoing Tuina intervention in patients with chronic fatigue syndrome

Abstract:

OBJECTIVE: To study the changes in median frequency (MF) from a surface electromyogram of skeletal muscles and functional assessment of chronic illness therapy (FACIT) figure scale scores for patients with chronic fatigue syndrome (CFS) before and after Tuina treatment.

METHODS: A controlled clinical trial was adopted. Thirty-two patients suffering from CFS were enrolled according to the inclusion criteria from outpatient department of Shanghai Yueyang Hospital of Integrated Chinese and Western Medicine in China; thirty normal people whose gender, age, height and body mass were concordant with the CFS patients were selected as the normal group. Surface electromyography was used to detect the median frequency (MF) of biceps, quadriceps, and waist and back muscle before and after a 20-day course of treatment. CFS patients also were asked to fill out the figure scale of FACIT to evaluate the degree of fatigue.

RESULTS: There was no significant difference in surface electromyography MF of myoelectric signal of biceps and quadriceps between CFS and normal person; however, the waist and back muscle MF of the normal person was significantly lower than that of the CFS patients. Before and after treatment, there were no obvious changes in the MF of myoelectric signals of all muscles. Tuina significantly decreased the scale score of FACIT.

CONCLUSION: Tuina can improve the symptom of patients with CFS.

 

Source: Liu KP, Fang M, Dai DC, Jiang SY, Zuo YZ. A study of median frequencies of skeletal muscle undergoing Tuina intervention in patients with chronic fatigue syndrome. Zhong Xi Yi Jie He Xue Bao. 2011 Oct;9(10):1083-7. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/22015189

 

Effects of a Chinese traditional formula Kai Xin San (KXS) on chronic fatigue syndrome mice induced by forced wheel running

Abstract:

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional medicine, Kai Xin San (KXS), composed of ginseng (Panax ginseng), hoelen (Wolfiporia cocos), polygala (Polygala tenuifolia) and Acorus gramineus, is famous for the treatment of emotion-thought disease, such as settling fright, quieting the spirit and nourishing the heart.

AIM OF THE STUDY: The present study investigated the effect of KXS on chronic fatigue syndrome (CFS) mice induced by forced wheel running.

MATERIALS AND METHODS: Seventy two healthy adult male Kunming mice were randomly divided into six groups: home cage control group, CFS group, CFS group with Modafinil treatment at 13 mg/kg/d doge, KXS treatment at 175 mg/kg/d, 350 mg/kg/d and 700 mg/kg/d doge. CFS mice were induced by forced wheel running with higher speed for 4 weeks and then taken an exhausted exercise. The biochemical parameters including serum lactate dehydrogenase (LDH), serum urea nitrogen (SUN), serum testosterone (T), liver glycogen (LG), muscle glycogen (MG) and muscle lactic acid (MLA) were determined by using commercially available kits. The splenocytes proliferation from mice was examined by MTT method. The levels of interleukin-2 (IL-2) and interleukin-4 (IL-4) secreted by splenocytes were determined by ELISA.

RESULTS: CFS mice with KXS administration exhibited less electric shock time when compared with CFS group without drug treatment. The effect of KXS has after demonstrated reduction in SUN, LDH and MLA levels and an increase in T, LG and MG levels. CFS mice with KXS could improve the proliferation of splenocytes compared with CFS group without drug treatment. The cultured splenocytes from CFS mice without KXS supplementation produced more interleukin-2 (IL-2) but less interleukin-4 (IL-4) when compared with home cage control mice. The cultured splenocytes of CFS mice with KXS supplementation produced more interleukin-2 (IL-2) but less interleukin-4 (IL-4) when compared with CFS group without drug treatment.

CONCLUSIONS: The results of this preliminary study provide evidence that KXS could ameliorate CFS by affecting the physiological markers for fatigue. This study also supported the use of KXS against CFS by improving the proliferation of splenocytes from CFS mice and modulating the disturbance of cytokines induced by CFS.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

 

Source: Cao Y, Hu Y, Liu P, Zhao HX, Zhou XJ, Wei YM. Effects of a Chinese traditional formula Kai Xin San (KXS) on chronic fatigue syndrome mice induced by forced wheel running. J Ethnopharmacol. 2012 Jan 6;139(1):19-25. doi: 10.1016/j.jep.2011.08.030. Epub 2011 Aug 22. https://www.ncbi.nlm.nih.gov/pubmed/21884774

 

A meta analysis on randomized controlled trials of acupuncture treatment of chronic fatigue syndrome

Abstract:

OBJECTIVE: To assess the effectiveness of acupuncture treatment of chronic fatigue syndrome (CFS).

METHODS: According to the requirement of evidence-based medicine, CFS, fatigue syndrome, acupuncture and moxibustion, acupuncture, electroacupuncture, auricular acupuncture, auricular pellet pressure, plum-blossom needle, intradermal needle, moxibustion, three edged needle, cupping, cup-moving, acupoint injection, etc. were selected as the subject words for retrieving the related papers form domestic and foreign medical databases. The RCT was used as the enrolled criteria, and the clinical cure rate, markedly effective rate, total effective rate, and the scores of the Fatigue Assessment Instrument Questionnaire (FAI) and fatigue scale (FS) were used as the assessment indexes. The statistical package (RevMan 4.2) was used to review management and analysis of 13 papers.

RESULTS: A total of 28 papers were enrolled. Logistic regression analysis showed that the total odds ratio (OR) was 4.56, with 95% confidence interval (CI) [2.84, 7.33] for the total effective rate in 10 studies, the total OR was 2.07 with 95% CI [1.49, 2.88] for the markedly effective rate in 8 studies, and the total OR was 2.51 with 95% CI [1.64, 3.85] for the clinical cure rate in 8 studies. The weighted mean difference (WMD) was -29.52 with 95% CI [-36.17, -22.88] for the FAI score in 3 studies, and the WMD -1.22 with 95% CI [-1.77, -0.67] for the FS score in 4 studies. The therapeutic effect in the treatment group of CFS was superior to that in the control group (P<0.01).

CONCLUSION: Acupuncture therapy is effective for CFS, but still needs being confirmed by more high-quality studies.

 

Source: Wang JJ, Song YJ, Wu ZC, Chu XO, Wang XH, Wang XJ, Wei LN, Wang QM. A meta analysis on randomized controlled trials of acupuncture treatment of chronic fatigue syndrome. Zhen Ci Yan Jiu. 2009 Dec;34(6):421-8. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/20209981

 

Polysaccharide of radix pseudostellariae improves chronic fatigue syndrome induced by poly I:C in mice

Abstract:

Radix Pseudostellariae is used as a tonic drug in traditional Chinese medicine with immunomodulating and anti-fatigue activities, and the polysaccharide is considered as the main active component. The purpose of this study is to examine the effect of the polysaccharide isolated from Radix Pseudostellariae (PRP) on mouse chronic fatigue syndrome (CFS) induced by intraperitoneal injection of polyriboinosinic:polyribocytidylic acid (poly I:C), a double-stranded synthetic RNA.

It has shown that the fatigue symptom of mice lasted at least 1 week as evaluated by forced swimming time. PRP (100, 200, 400 mg kg(-1)), orally administered 3 days before poly I:C injection, showed dose-dependent anti-fatigue effects.

In addition, poly I:C led to evident alterations in neuroendocrine and immune systems of mice, such as reduced spontaneous activity and learning ability, declined serum level of corticosterone, increased weight indexes and T lymphocyte numbers in thymuses and spleens, and increased CD4(+)/CD8(+) ratio but decreased proliferation ability of T lymphocytes in spleens. PRP alleviated the abnormalities caused by poly I:C, and restored the function of hosts to normal conditions.

The findings suggest that PRP is beneficial to CFS, and the underlying mechanisms of action involve neuroendocrine and immune systems.

 

Source: Sheng R, Xu X, Tang Q, Bian D, Li Y, Qian C, He X, Gao X, Pan R, Wang C, Luo Y, Xia Y, Dai Y. Polysaccharide of radix pseudostellariae improves chronic fatigue syndrome induced by poly I:C in mice. Evid Based Complement Alternat Med. 2011;2011:840516. doi: 10.1093/ecam/nep208. Epub 2011 Jun 23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137695/ (Full article)

 

Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome

Abstract:

BACKGROUND: Chronic fatigue is increasingly common. Conventional medical care is limited in treating chronic fatigue, leading some patients to use traditional Chinese medicine therapies, including herbal medicine.

OBJECTIVES: To assess the effectiveness of traditional Chinese medicine herbal products in treating idiopathic chronic fatigue and chronic fatigue syndrome.

SEARCH STRATEGY: The following databases were searched for terms related to traditional Chinese medicine, chronic fatigue, and clinical trials: CCDAN Controlled Trials Register (July 2009), MEDLINE (1966-2008), EMBASE (1980-2008), AMED (1985-2008), CINAHL (1982-2008), PSYCHINFO (1985-2008), CENTRAL (Issue 2 2008), the Chalmers Research Group PedCAM Database (2004), VIP Information (1989-2008), CNKI (1976-2008), OCLC Proceedings First (1992-2008), Conference Papers Index (1982-2008), and Dissertation Abstracts (1980-2008). Reference lists of included studies and review articles were examined and experts in the field were contacted for knowledge of additional studies.

SELECTION CRITERIA: Selection criteria included published or unpublished randomized controlled trials (RCTs) of participants diagnosed with idiopathic chronic fatigue or chronic fatigue syndrome comparing traditional Chinese medicinal herbs with placebo, conventional standard of care (SOC), or no treatment/wait lists. The outcome of interest was fatigue.

DATA COLLECTION AND ANALYSIS: 13 databases were searched for RCTs investigating TCM herbal products for the treatment of chronic fatigue. Over 2400 references were located. Studies were screened and assessed for inclusion criteria by two authors.

MAIN RESULTS: No studies that met all inclusion criteria were identified.

AUTHORS’ CONCLUSIONS: Although studies examining the use of TCM herbal products for chronic fatigue were located, methodologic limitations resulted in the exclusion of all studies. Of note, many of the studies labelled as RCTs and conducted in China did not utilize rigorous randomization procedures. Improvements in methodology in future studies is required for meaningful synthesis of data.

 

Source:Adams D, Wu T, Yang X, Tai S, Vohra S. Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006348. doi: 10.1002/14651858.CD006348.pub2. https://www.ncbi.nlm.nih.gov/pubmed/19821361 

 

Randomized controlled clinical trials of acupuncture treatment of chronic fatigue syndrome

Abstract:

OBJECTIVE: To observe the effect of acupuncture on the fatigue degree in patients with chronic fatigue syndrome (CFS).

METHODS: Seventy CFS patients were equally randomized into control and treatment groups according to randomized block design. Acupuncture was applied to Baihui (GV 20), Danzhong (CV 17), Zhongwan (CV 12), etc., for patients in treatment group, and to non-acupoints (2 cm respectively to the abovementioned acupoints) for those in control group. The treatment was given once every other day, 14 times altogether. The fatigue degree and the therapeutic effect were assessed by Chalder’s fatigue scale (FS).

RESULTS: A total of 64 cases (32/group) were finished in this study. After the treatment, the physical FS (5.0 +/- 2.4 vs 6.8 +/- 1.5), mental FS (1.8 +/-1.8 vs 3.1 +/- 1.5) and the total FS (6.8 +/- 3.8 vs 9.9 +/- 2.5) in treatment group, physical FS (5.0 +/- 2.5 vs 6.4 +/- 1.5) and the total FS (7.5 +/- 3.4 vs 9.6 +/- 2.8) in control group decreased significantly compared with pre-treatment (P < 0.01, P < 0.05). There was no marked change in mental FS (2.5 +/- 11.6 vs 3.2 +/- 11.6) in control group after the treatment (P > 0.05). Comparison between two groups showed no significant differences in the 3 indexes (P > 0.05).

CONCLUSION: Acupuncture can relieve CFS patients’ physical and mental fatigue and the therapeutic effect of acupuncture of acupoints is relatively better than that of non-acupoints in reducing mental fatigue.

 

Source: Wang JJ, Song YJ, Wu ZC, Chu XO, Wang QM, Wang XJ, Wei LN, Meng H, Wang XH. Randomized controlled clinical trials of acupuncture treatment of chronic fatigue syndrome. Zhen Ci Yan Jiu. 2009 Apr;34(2):120-4. [Article in Chinese] https://www.ncbi.nlm.nih.gov/pubmed/19685727