Exploring Chronic Fatigue Syndrome: A Holistic Perspective


Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complex and debilitating condition characterized by extreme, persistent fatigue that is not alleviated by rest and is often worsened by physical or mental activity. The condition can significantly impact an individual’s quality of life, making effective treatment approaches essential.  

Traditional Chinese Medicine (TCM), particularly acupuncture and herbal medicine, offers a complementary approach to managing CFS by addressing both the symptoms and underlying imbalances in the body. Emerging research supports the potential benefits of these therapies in improving fatigue and overall well-being.  


Research and Evidence  

Acupuncture Combined with Usual Care: A multicenter, non-blinded randomized controlled trial (RCT) by Kim et al. (2015) involving 150 participants found that acupuncture, when combined with usual care, may significantly improve fatigue in individuals with CFS and idiopathic chronic fatigue.  

Acupuncture and Fatigue Severity: A systematic review and meta-analysis by Zhang (2019) analyzed 16 studies involving 1,346 participants. The findings demonstrated a favorable effect of acupuncture on overall response rates compared to sham acupuncture and Chinese herbal medicine. The treatment was also associated with a significant reduction in fatigue severity.  

These results suggest that acupuncture may be a valuable adjunctive therapy for CFS, offering relief from fatigue and enhancing the overall response to care in affected individuals.

The following patterns may represent the underlying contributing factors for the development of depression:

  • Blood stagnation, Heart yin deficiency, Kidney yin deficiency, Liver fire, Liver qi stagnation and Spleen qi deficiency.
  • The commonly used acupuncture points include Tongli HT5, Yinbai SP1, Sanyinjiao SP6, Fenglong ST40
  • The commonly used herbs include Chaihu Jia Longgu Muli Wan, Ganmai Dazao Tang, Gui Pi Wan and Xiao Yao Wan.

Research

Acupuncture plus SSRIs superior to SSRIs alone, with an early onset of action and was safe and well- tolerated; Electric Acupuncture had greater effect than manual acupuncture (Chan 2015 – SR of 13 RCTs: 1 high quality trial, 5 moderate, 7 low) (1)

Effective and safe for major depressive disorder, especially in improving sleep, mood and QoL by modulating and normalizing the limbic–paralimbic–neocortical network (LPNN), including the default mode network (DMN); ‘promising evidence’ (Bosch 2015 – Review of SRs & MAs)(2)

Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative cost of delivering these interventions (Spackman 2014 –cost-effectiveness in one RCT)(3)


References

1. Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis. J Affect Disord. 2015 May 1;176:106-17.

2. Bosch P, van den Noort M, Staudte H, Lim S. Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture. Explore (NY). 2015 Jul-Aug;11(4):281-91.

3. Spackman E, Richmond S, Sculpher M, Bland M, Brealey S, Gabe R, et al. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial. PLOS ONE. 2014;9(11):e113726.