Insights & Discussion
Acupuncture appeared to significantly reduce fatigue severity measured by Chalder's Fatigue Scale and the Fatigue Severity Scale compared with other types of control.
Sixteen studies with 1346 subjects were included. Most studies had low methodological quality. Meta-analyses showed a favourable effect of acupuncture on overall response rate compared with sham acupuncture and Chinese herbal medicine. Acupuncture also appeared to significantly reduce fatigue severity measured by Chalder’s Fatigue Scale and the Fatigue Severity Scale compared with other types of control.
Our review indicated that acupuncture was more effective than sham acupuncture and other interventions (Chinese herbal medicine, mainly), but no firm conclusion could be reached owing to limited data, poor quality and potentially exaggerated effect size evaluation. Further large, rigorously designed and reported RCTs are required.
Discover Related Insights
Acupuncture on treating chronic fatigue syndrome has the advantage for efficacy and safety compared to conventional treatments such as drugs, counselling psychology and physical therapy.
2020 Chinese Journal of Integrative Medicine Acupuncture for Chronic Fatigue Syndrome: An Overview of Systematic Reviews Yin ZH, Wang LJ, Cheng Y, Chen J, Hong XJ, Zhao L, et al.
Systematic Review Chronic Fatigue Syndrome
We found that acupuncture on treating Chronic Fatigue Syndrome has the advantage for efficacy and safety compared to conventional treatments such as drugs, counseling psychology and physical therapy. Acupuncture has shown to have less side effects and drug resistance. A combined therapy of Western medicine and Chinese medicine has proven to be most effective for patients.
Treatments according to traditional Chinese medicine syndrome differentiation can provide patients with individualized treatments for chronic fatigue syndrome.
2020 Evidence-Based Complementary and Alternative Medicine Advances in Clinical Research on Traditional Chinese Medicine Treatment of Chronic Fatigue Syndrome Zhang X, Wang M, Zhou S
Chronic Fatigue Syndrome Syndrome Differentiation
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.
Xiao Yao San and its modifications were effective for the improvement of general symptoms and fatigue severity in chronic fatigue syndrome post-treatment.
2020 Journal of Physiology & Pathology in Korean Medicine Effectiveness of Soyo-san (Xiaoyao-san) and its Modifications on Chronic Fatigue Syndrome: a Systematic Review and Meta-analysis Kim J, Song J, Nam D
Systematic Review Chronic Fatigue Syndrome Xiao Yao San
We performed selection/exclusion process from the found studies to conform with prespecified criteria, and assessed the final included trials according to the Cochrane risk of bias tool. The included studies were classified based on the interventions in experimental and control group.
Eight randomized controlled trials and one controlled clinical trial (total 921 participants) were eligible and their results were synthesized in the meta analysis. The synthesis showed a considerable effect of Soyo-san and its modifications on improvement of general symptoms and fatigue severity in CFS patients, while effect on depression and anxiety were inconclusive.
Acupuncture on back-shu points of five zang, significantly improves both the physical and mental fatigue in chronic fatigue syndrome patients, along with enhancing their psychological status.
2018 World Journal of Acupuncture-Moxibustion Acupuncture on back-shu points of five zang for chronic fatigue syndrome: A randomized control trial CHEN S, LIU R, WU B, CHEN S, GUO F, XUE X, et al.
Randomised Controlled Trial Back-Shu Points Chronic Fatigue Syndrome
In this study, sixty patients divided into a treatment group and a control group. The treatment group received acupuncture on the back-shu points of five zang organs. Techniques used included perpendicular and oblique needling, lifting-thrusting, and twisting-twirling, each acupoint being attended for 10 seconds. In contrast, the control group received the treatment outward of these points without seeking deqi, a sensation linked to effective needling, and with no manipulation. Both groups received treatments twice a week, each lasting twenty minutes, and to a total of eight treatments.
The study's results showed that there was a higher effective treatment rate seen in the group who received acupuncture on back-shu points than the control group. Physical and mental fatigue scores, assessed using Fatigue Scale-14, were significantly reduced post-treatment in the treatment group. Moreover, the Symptom Check-List 90, used to measure the patient's psychological status, showed notable improvement in the treatment group, demonstrating that the acupuncture approach used in the treatment group improved not just physical and mental fatigue but also the patients' psychological state. While the treatment rendered a positive impact on the control group too, the outcome was more pronounced in the treatment group.
Acupuncture and moxibustion were found to be more effective than Chinese herbal medicine, western medicine and placebo treatment (sham-acupuncture) in relieving symptoms of chronic fatigue syndrome.
2017 BMC Complementary Medicine and Therapies Acupuncture and moxibustion for chronic fatigue syndrome in traditional Chinese medicine: a systematic review and meta-analysis Wang T, Xu C, Pan K, Xiong H.
Systematic Review Chronic Fatigue Syndrome
A total of 31 randomized controlled trials (RCTs) were enrolled in analyses. In traditional direct meta-analysis, we found that in comparison to Chinese herbal medicine, CbAM (combined acupuncture and moxibustion, which meant two or more types of acupuncture and moxibustion were adopted) had a higher total effective rate. Compared with Chinese herbal medicine, western medicine and sham-acupuncture, SAM (single acupuncture or single moxibustion) had a higher total effective rate. In addition, compared with SAM, CbAM had a higher total effective rate. In network meta-analyses, similar results were recorded. Subsequently, we ranked all treatments from high to low effective rate and the order was CbAM, SAM, Chinese herbal medicine, western medicine and sham-acupuncture.
In the treatment of CFS, CbAM and SAM may have better effect than other treatments. However, the included trials have relatively poor quality, hence high quality studies are needed to confirm our finding.
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