• acupuncture
• chinese drugs
• complementary therapies
• coronavirus disease-19
• fatigue
• long COVID

• Humans
• Retrospective Studies
• Female
• Male
• COVID-19/complications
• COVID-19/therapy
• Medicine, Chinese Traditional/methods
• Middle Aged
• Adult
• Aged
• SARS-CoV-2
• Acupuncture Therapy/methods
• Post-Acute COVID-19 Syndrome
• Germany
• Treatment Outcome
• Surveys and Questionnaires
• Austria

• Association for Classical Acupuncture and Traditional Chinese Medicine (AGTCM), Vienna School of Traditional Chinese Medicine (WSTCM)

• acupuncture
• acupuncture point combinations
• autonomic nervous system (ANS)
• chronic fatigue syndrome (CFS)
• heart rate variability (HRV)

• Xiaoyao San
• chronic fatigue syndrome
• meta-analysis
• standard biomedical treatments
• systematic review
• traditional Chinese medicine

• Angelica gigas nakai
• Anti-fatigue
• Astragalus membranaceus bunge
• Cervus elaphus Linnaeus
• Exercise performance

• Chronic fatigue syndrome
• Integrated traditional chinese and western medicine
• Review

• Fatigue Syndrome, Chronic/therapy
• Fatigue Syndrome, Chronic/physiopathology
• Humans
• Medicine, Chinese Traditional/methods

• anxiety
• depression
• insomnia
• network analysis
• quality of life

• Humans
• Sleep Initiation and Maintenance Disorders/epidemiology
• Cross-Sectional Studies
• Quality of Life
• Male
• China/epidemiology
• Depression/epidemiology
• COVID-19/epidemiology
• COVID-19/psychology
• Anxiety/epidemiology
• Female
• Adult
• Young Adult
• Firefighters/psychology
• Firefighters/statistics & numerical data
• Surveys and Questionnaires
• Prevalence

• Chronic fatigue syndrome
• Classical chinese herbal formula
• Efficacy
• Randomized controlled trial
• Sijunzi decoction

• Humans
• Fatigue Syndrome, Chronic/drug therapy
• Drugs, Chinese Herbal/pharmacology
• Drugs, Chinese Herbal/therapeutic use
• Gastrointestinal Microbiome/drug effects
• Female
• Double-Blind Method
• Male
• Adult
• Middle Aged
• Quality of Life
• Fatigue/drug therapy
• Treatment Outcome
• Surveys and Questionnaires

• Chinese herbal medicine
• hip fracture surgery.
• postoperative fatigue syndrome
• total joint arthroplasty

• Humans
• Arthroplasty, Replacement, Hip
• Drugs, Chinese Herbal/therapeutic use
• Hip Fractures/surgery
• Hip Fractures/drug therapy
• Postoperative Complications/drug therapy
• Randomized Controlled Trials as Topic

• YN2020MS16,YN2019ML08,YN2022GK05 Science and Technology Planning Project of Guangdong Province

• CONSORT-CHM
• chronic fatigue syndrome
• randomized clinical trial
• risk of bias
• traditional and complementary medicine

• Universidade de Macau

• Depressive disorder
• Escitalopram oxalate tablets
• Jiajian Guipi decoction
• Sleep quality
• Traditional Chinese medicine syndromes

• herbal medicines
• multitarget therapy
• network pharmacology
• phytomedicine and ethnopharmacology
• pleiotropic and selective action
• reproducibility quality and efficacy
• synergy and antagonism

• AKT1
• EGFR
• Mannose 6-phosphate
• VEGFA
• ginsenoside Rg1
• metabolomics
• network pharmacology
• taurine

• Beijing Municipal Natural Science Foundation
• National Natural Science Foundation of China

• Adult
• Humans
• Acupuncture Therapy/methods
• Research Design

Objectives: This meta-analysis aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) in treating chronic fatigue syndrome (CFS).

Methods: Nine electronic databases were searched from inception to May 2022. Two reviewers screened studies, extracted the data, and assessed the risk of bias independently. The meta-analysis was performed using the Stata 12.0 software.

Results: Eighty-four RCTs that explored the efficacy of 69 kinds of Chinese herbal formulas with various dosage forms (decoction, granule, oral liquid, pill, ointment, capsule, and herbal porridge), involving 6,944 participants were identified. This meta-analysis showed that the application of CHM for CFS can decrease Fatigue Scale scores (WMD: –1.77; 95%CI: –1.96 to –1.57; p < 0.001), Fatigue Assessment Instrument scores (WMD: –15.75; 95%CI: –26.89 to –4.61; p < 0.01), Self-Rating Scale of mental state scores (WMD: –9.72; 95%CI:–12.26 to –7.18; p < 0.001), Self-Rating Anxiety Scale scores (WMD: –7.07; 95%CI: –9.96 to –4.19; p < 0.001), Self-Rating Depression Scale scores (WMD: –5.45; 95%CI: –6.82 to –4.08; p < 0.001), and clinical symptom scores (WMD: –5.37; 95%CI: –6.13 to –4.60; p < 0.001) and improve IGA (WMD: 0.30; 95%CI: 0.20–0.41; p < 0.001), IGG (WMD: 1.74; 95%CI: 0.87–2.62; p < 0.001), IGM (WMD: 0.21; 95%CI: 0.14–0.29; p < 0.001), and the effective rate (RR = 1.41; 95%CI: 1.33–1.49; p < 0.001). However, natural killer cell levels did not change significantly. The included studies did not report any serious adverse events. In addition, the methodology quality of the included RCTs was generally not high.

Conclusion: Our study showed that CHM seems to be effective and safe in the treatment of CFS. However, given the poor quality of reports from these studies, the results should be interpreted cautiously. More international multi-centered, double-blinded, well-designed, randomized controlled trials are needed in future research.

Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319680], identifier [CRD42022319680].

The reductionist concept, based on the ligand–receptor interaction, is not a suitable model for adaptogens, and herbal preparations affect multiple physiological functions, revealing polyvalent pharmacological activities, and are traditionally used in many conditions. This review, for the first time, provides a rationale for the pleiotropic therapeutic efficacy of adaptogens based on evidence from recent gene expression studies in target cells and where the network pharmacology and systems biology approaches were applied. The specific molecular targets and adaptive stress response signaling mechanisms involved in nonspecific modes of action of adaptogens are identified.

• fatigue
• intelligent diagnosis
• machine learning
• pulse diagnosis
• tongue diagnosis

• COVID-19
• Chronic fatigue syndrome
• Drug discovery
• Myalgic encephalomyelitis
• Systemic exertion intolerance disease

• Chronic fatigue syndrome
• Intervention
• Myalgic encephalomyelitis
• Physiotherapy
• Post-exertional malaise
• Systematic review

• Adult
• Fatigue Syndrome, Chronic/therapy
• Humans
• Physical Therapy Modalities

• E2F1
• Fatigue
• KEGG
• PI3K-AKT
• network pharmacology
• polygonati rhizoma (PR).

• Chronic fatigue syndrome
• Complementary therapies
• Herbal medicine
• Randomized controlled trial

• Chronic fatigue syndrome
• Complementary and alternative medicine
• Delphinium denudatum
• Fatigue
• Herbal medicine
• Jadwar
• Persian medicine

• Adult
• Delphinium/chemistry
• Double-Blind Method
• Fatigue/drug therapy
• Female
• Humans
• Male
• Plant Preparations/therapeutic use
• Surveys and Questionnaires
• Treatment Outcome
• Young Adult

With an unclear pathomechanism, no confirmed treatment regimen has been established for chronic fatigue syndrome (CFS). Acupuncture is applied as an alternative therapy for CFS. As a kind of acupuncture therapy, Jin’s three-needle acupuncture (JTN) has been applied to treat CFS. However, few large-sample randomised controlled trials on JTN treatment for CFS have been reported. We designed this study to evaluate the efficacy and safety of JTN treatment for CFS.

This study is a multicentre, single-blind, randomised controlled trial. Patients who meet the inclusion criteria will be recruited and randomly assigned to either the JTN treatment group or the basic acupuncture group. Both interventions will be conducted for five consecutive days per week and last for 2 weeks. The primary outcome is the effective rate based on the 14-item Fatigue Scale (FS-14) score. Other outcome measures include the Fatigue Assessment Scale (FAI), the Depression Status Inventory (DSI), and the Self-rating Anxiety Scale (SAS). Plasma adrenocorticotropic hormone (ACTH), plasma cortisol, and serum levels of IL-2 and IFN-γ will also be measured in this study. Adverse events will be observed and recorded for the safety evaluation.

This study may help to identify the efficacy and safety of JTN acupuncture treatment for CFS.

Chinese Clinical Trial Registry, ID: ChiCTR-IOR-17011009. Registered on 29 March 2017.

The online version of this article (10.1186/s13063-019-3243-5) contains supplementary material, which is available to authorized users.

• Acupuncture
• Chronic fatigue syndrome
• Jin’s three-needle technique
• Randomised controlled trial

Ziyang green tea was considered a medicine food homology plant to improve chronic fatigue Ssyndrome (CFS) in China. The aim of this research was to study the therapeutic effect of selenium-polysaccharides (Se-TP) from Ziyang green tea on CFS and explore its metabolic mechanism. A CFS-rats model was established in the present research and Se-TP was administrated to evaluate the therapeutic effect on CFS. Some serum metabolites including blood urea nitrogen (BUN), blood lactate acid (BLA), corticosterone (CORT), and aldosterone (ALD) were checked. Urine metabolites were analyzed via gas chromatography-mass spectrometry (GC-MS). Multivariate statistical analysis was also used to check the data. The results selected biomarkers that were entered into the MetPA database to analyze their corresponding metabolic pathways. The results demonstrated that Se-TP markedly improved the level of BUN and CORT in CFS rats. A total of eight differential metabolites were detected in GC-MS analysis, which were benzoic acid, itaconic acid, glutaric acid, 4-acetamidobutyric acid, creatine, 2-hydroxy-3-isopropylbutanedioic acid, l-dopa, and 21-hydroxypregnenolone. These differential metabolites were entered into the MetPA database to search for the corresponding metabolic pathways and three related metabolic pathways were screened out. The first pathway was steroid hormone biosynthesis. The second was tyrosine metabolism, and the third was arginine-proline metabolism. The 21-hydroxypregnenolone level of rats in the CFS group markedly increased after the Se-TP administration. In conclusion, Se-TP treatments on CFS rats improved their condition. Its metabolic mechanism was closely related to that which regulates the steroid hormone biosynthesis.

• chronic fatigue syndrome
• metabonomics
• polysaccharide

• Bodily distress
• Functional somatic syndromes
• Management
• Review

Sarcodon imbricatus (SI), a precious edible fungus, contains 35.22% of total sugar, 18.33% of total protein, 24 types of fatty acid, 16 types of amino acid, and 8 types of minerals. Encouragingly, it is rich in potential antioxidants such as total polyphenols (0.41%), total sterols (3.16%), and vitamins (0.44%). In the present study, the antifatigue properties of SI and its potential mechanisms of action were explored by the experiments on acute excise-treated mice and chronic fatigue syndrome (CFS) mice. SI (0.25, 0.5, and 1 g/kg) significantly enhanced exercise tolerance in the weight-loaded forced swimming test (FST) and rota-rod test (RRT) and reduced the immobility in the tail suspension test on CFS mice. SI markedly increased the levels of glycogen in the liver and adenosine triphosphate (ATP) in the liver and muscle and decreased the lactic acid (LD) and blood urea nitrogen (BUN) content in both acute swimming-treated mice and CFS mice. SI improved the endogenous cellular antioxidant enzyme contents in the two mouse models by improving the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and reducing reactive oxygen species (ROS) and malondialdehyde (MDA) levels in serum, liver, and muscle, respectively. In CFS mice, the enhanced expression levels of nuclear factor erythroid-2-related factor 2 (Nrf2), SOD1, SOD2, heme oxygenase-1 (HO-1), and catalase (CAT) in the liver were observed after a 32-day SI administration. Our data indicated that SI possessed antifatigue activity, which may be related to its ability to normalize energy metabolism and Nrf2-mediated oxidative stress. Consequently, SI can be expected to serve as a novel natural antifatigue supplement in health foods.

• acupuncture
• clinical practice guideline
• recommendation
• snowballing method
• systematic review
• treatment guideline

• Event Related Potential
• Mental fatigue
• P300
• magnetic stimulation

• Acupuncture
• Cancer-related fatigue
• Lung cancer
• Quality of life

Endometriosis is a common gynecological condition in childbearing age women and its therapy in modern medicine achieves usually temporary cure. Ping-Chong-Jiang-Ni formula (PCJNF), a Chinese herbal medicine (CHM), was shown to be clinically effective on endometriosis. Meanwhile, c-Jun N-terminal kinase (JNK) signaling pathway was involved in the therapeutic process of CHM on endometriosis. Here, we explored the effect of PCJNF on the ectopic endometrial stromal cells (EESCs) from endometriosis and test whether JNK signaling was involved. After being treated with PCJNF-containing serum obtained from Sprague Dawley rat, cell proliferation, migration, invasion, and apoptosis were evaluated in EESCs, and the total and phosphorylated JNK, ERK, and p38 proteins were detected. Our results showed that PCJNF could suppress cell proliferation, migration, and invasion and induce apoptosis in EESCs. The suppressed proliferation and increased apoptosis were dependent on JNK activation. Additionally, PCJNF caused cell cycle arrest at G2/M phase and this effect was mediated by JNK signaling, while the decreased cell migration and invasion treated by PCJNF were independent of JNK signaling. In summary, our results provided the first evidence that PCJNF could suppress cell proliferation, migration, and invasion, while increasing apoptosis in EESCs, and the suppressed proliferation and enhanced apoptosis were mediated by JNK signaling.

• Chronic fatigue syndrome
• Herba Epimedii
• Metabonomics
• Polysaccharide

• Animals
• Disease Models, Animal
• Drugs, Chinese Herbal/chemistry
• Fatigue Syndrome, Chronic/drug therapy
• Female
• Gas Chromatography-Mass Spectrometry
• Metabolomics
• Plant Extracts/pharmacology
• Plant Leaves
• Polysaccharides/isolation & purification
• Polysaccharides/pharmacology
• Rats
• Rats, Sprague-Dawley

As the etiology of chronic fatigue syndrome (CFS) is unclear and the treatment is still a big issue. There exists a wide range of literature about acupuncture and moxibustion (AM) for CFS in traditional Chinese medicine (TCM). But there are certain doubts as well in the effectiveness of its treatment due to the lack of a comprehensive and evidence-based medical proof to dispel the misgivings. Current study evaluated systematically the effectiveness of acupuncture and moxibustion treatments on CFS, and clarified the difference among them and Chinese herbal medicine, western medicine and sham-acupuncture.

We comprehensively reviewed literature including PubMed, EMBASE, Cochrane library, CBM (Chinese Biomedical Literature Database) and CNKI (China National Knowledge Infrastructure) up to May 2016, for RCT clinical research on CFS treated by acupuncture and moxibustion. Traditional direct meta-analysis was adopted to analyze the difference between AM and other treatments. Analysis was performed based on the treatment in experiment and control groups. Network meta-analysis was adopted to make comprehensive comparisons between any two kinds of treatments. The primary outcome was total effective rate, while relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics.

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 (RR (95% CI), 1.17 (1.09 ~ 1.25)). Compared with Chinese herbal medicine, western medicine and sham-acupuncture, SAM (single acupuncture or single moxibustion) had a higher total effective rate, with RR (95% CI) of 1.22 (1.14 ~ 1.30), 1.51 (1.31–1.74), 5.90 (3.64–9.56). In addition, compared with SAM, CbAM had a higher total effective rate (RR (95% CI), 1.23 (1.12 ~ 1.36)). 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.

The online version of this article (doi:10.1186/s12906-017-1647-x) contains supplementary material, which is available to authorized users.

• Acupoint
• Acupuncture and moxibustion
• Chronic fatigue syndrome
• Network meta-analysis
• Traditional meta-analysis

• Biological Products/chemistry
• Biological Products/therapeutic use
• Complementary Therapies
• Coronary Artery Disease/drug therapy
• Coronary Artery Disease/etiology
• Databases, Factual
• Drug Discovery/methods
• Drugs, Chinese Herbal/chemistry
• Drugs, Chinese Herbal/therapeutic use
• Humans
• Medicine, Chinese Traditional/methods
• Medicine, Chinese Traditional/trends
• Metabolic Networks and Pathways/drug effects
• Molecular Targeted Therapy/methods
• Phytotherapy/methods
• Proteins/antagonists & inhibitors
• Proteins/physiology
• Syndrome

• Universidade de Macau

Traditional Chinese herbal medicine (CHM), which is widely used to treat pain and urolithiasis, is a promising therapy for urinary stone prevention. This study investigated the clinical efficacy of a popular CHM, Wu-Ling-San (WLS), in Taiwan for the prophylaxis of recurrent nephrolithiasis as assessed by surgical stone treatment via a nationwide population-based cohort study. The National Health Insurance Research Database, 2000–2010, which included one million patient records. All patients diagnosed with stone disease at the beginning of the study. The matched controls (4-fold the number of WLS patients) were stone patients who did not take WLS. Data analysis included the stone surgeries following the first treatment. We enrolled 11 900 patients with stone disease, and the incidence of stone patients in this database was 1.19%. The prevalence of comorbidities such as benign prostate hyperplasia, chronic kidney disease, diabetes mellitus, and urinary tract infection, but not hypertension, was significantly higher in WLS users. Several patients in both groups were prescribed potassium citrate. The stone treatment rate was significantly higher in WLS users (17.85%) than in the non-WLS users (14.47%). WLS users with an associated comorbidity had a higher treatment rate than the non-WLS users: 21.05% versus 16.70%, respectively. The surgery rate for upper urinary tract stones was higher in WLS users than in the non-WLS users (adjusted hazard ratio, 1.28; 95% confidence interval, 1.08-1.52; P < .05). The stone treatment rate (52.79%) was significantly higher in patients who used a very high amount of WLS (adjusted hazard ratio, 3.02; 95% confidence interval, 2.30-3.98). Stone patients using a high amount of WLS use had a high stone surgical rate. Long-term therapy with WLS did not have a preventive effect on stone surgical treatment. Long-term potassium citrate therapy as a preventive measure appeared to be underutilized in this study.

• Chinese herbal formula
• National Health Insurance Research Database
• complementary and alternative medicine
• population-based study
• urolithiasis

In order to investigate the different effects of acupuncture and moxibustion on chronic fatigue syndrome (CFS) and alterations in the autonomic nervous system by measuring heart rate variability (HRV). Forty-five participants were recruited and randomly divided into 3 groups using a randomization schedule. The control group (CG, n = 15) and the acupuncture group (AG, n = 15) were treated by manipulation acupuncture, and the moxibustion group (MG, n = 15) was treated by indirect moxibustion. Primary outcomes were the scores of the Fatigue Assessment Instrument (FAI). Secondary outcomes were the HRV parameters which can reflect activity of the autonomic nervous system. This trial considered both instantaneous changes and long-term effectiveness. FAI scores decreased after the 4th and 10th treatments in the 3 groups. The decrease in FAI in the MG was greater than that in the AG. Acupuncture was more effective in instantaneous changes of HRV and moxibustion in long-term aspects. Both acupuncture and moxibustion improved fatigue in CFS patients, but moxibustion was more effective. The possible mechanism of the intervention may be through activation of the vagus nerve. Moxibustion was more effective than acupuncture in long-term treatment of CFS.

• Fatigue
• Protocol
• Randomised controlled trial
• Traditional herbal medicine

• Adult
• Biomarkers/blood
• Clinical Protocols
• Cross-Over Studies
• Double-Blind Method
• Fatigue/diagnosis
• Fatigue/drug therapy
• Fatigue/physiopathology
• Feasibility Studies
• Health Status
• Healthy Volunteers
• Humans
• Hydrocortisone/blood
• Male
• Middle Aged
• Plant Extracts/adverse effects
• Plant Extracts/therapeutic use
• Republic of Korea
• Research Design
• Sleep
• Sleep Deprivation/complications
• Sleep Deprivation/diagnosis
• Sleep Deprivation/physiopathology
• Time Factors
• Treatment Outcome
• Young Adult

• Korea Institute of Oriental Medicine

Chronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q).

Participants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants’ qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern.

The data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P < 0.05 was assumed. The QBYY-Q showed satisfactory internal consistency. Explanatory factor analysis extracted two factors for each deficiency pattern. The percentages of explained variance for qi, blood, yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin, and yang deficiency were 10.97, 10.69, and 14.64, respectively.

The QBYY-Q was suitable for estimating the influences of qi, blood, yin, and yang deficiencies in CF.

Trial registration This trial was registered with the Korean Clinical Trial Register (KCT0001199)

The online version of this article (doi:10.1186/s13020-016-0092-y) contains supplementary material, which is available to authorized users.

• Chronic fatigue
• Deficiency pattern
• Pattern identification
• Qi blood yin yang deficiencies
• Questionnaire

The aim of this study is to validate the pattern identification standard of qi, blood, yin, and yang deficiency patterns diagnosis. The current study will investigate the usefulness of the Qi Blood Yin Yang deficiency pattern questionnaire as a diagnostic tool for qi, blood, yin, and yang deficiencies by assessing the agreement between the scores and a gold standard established by assessors.

This protocol is for a single center, prospective, observational study. A total of 248 eligible patients with unexplained chronic fatigue will be assigned to four groups in a 1:1:1:1 ratio as the qi deficiency group, blood deficiency group, yin deficiency group, and yang deficiency group. The primary outcome will be measured using the score of the Qi Blood Yin Yang deficiency pattern questionnaire and the secondary outcomes will be measured using the fatigue severity scale, Korean-translated chalder fatigue scale, computerized tongue image analysis system, and three types of pattern identification questionnaires (cold-heat, food accumulation, and seven emotions patterns). The safety of the clinical study will be assessed after measurements at every visit. All statistical analysis will be performed using the R Statistics program. Statistics experts will analyze the relationship between clinical data using the Pearson's Chi-squared test and independent t-test.

This study will provide reference data and good evidence that are applicable to future studies. Furthermore, the results of the present study are useful to improve the care of patients with unexplained chronic fatigue and unexplained chronic fatigue-related disorders.

• Qi Blood Yin Yang deficiency pattern questionnaire
• study protocol
• unexplained chronic fatigue
• validation

• Cancer
• Geriatrics
• Palliative care
• Symptom management

The causes of chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF) are not clearly known, and there are no definitive treatments for them. Therefore, patients with CFS and ICF are interested in Oriental medicine or complementary and alternative medicine. For this reason, the effectiveness of complementary and alternative treatments should be verified. We investigated the effectiveness of two forms of acupuncture added to usual care for CFS and ICF compared to usual care alone.

A three-arm parallel, non-blinded, randomized controlled trial was performed in four hospitals. We divided 150 participants into treatment and control groups at the same ratio. The treatment groups (Group A, body acupuncture; Group B, Sa-am acupuncture) received 10 sessions for 4 weeks. The control group (Group C) continued usual care alone. The primary outcome was the Fatigue Severity Scale (FSS) at 5 weeks after randomization. Secondary outcomes were the FSS at 13 weeks and a short form of the Stress Response Inventory (SRI), the Beck Depression Inventory (BDI), the Numeric Rating Scale (NRS), and the EuroQol-5 Dimension (EQ-5D) at 5 and 13 weeks.

Group A showed significantly lower FSS scores than Group C at 5 weeks (P = 0.023). SRI scores were significantly lower in the treatment groups than in the control group at 5 (Group A, P = 0.032; B, P <0.001) and 13 weeks (Group A, P = 0.037; B, P <0.001). Group B showed significantly lower BDI scores than Group C at 13 weeks (P = 0.007). NRS scores from the treatment groups were significantly reduced compared to control at 5 (Group A and B, P <0.001) and 13 weeks (Group A, P = 0.011; B, P = 0.002).

Body acupuncture for 4 weeks in addition to usual care may help improve fatigue in CFS and ICF patients.

Clinical Research Information Service (CRIS) KCT0000508; Registered on 12 August 2012.

The online version of this article (doi:10.1186/s13063-015-0857-0) contains supplementary material, which is available to authorized users.

Genetic studies indicate that aging is modulated by a great number of genetic pathways. We have used Drosophila longevity and stress assays to test a multipath intervention strategy. To carry out this strategy, we supplemented the flies with herbal extracts (SC100) that are predicted to modulate the expression of many genes involved in aging and stress resistance, such as mTOR, NOS, NF-KappaB, and VEGF. When flies were housed in large cages with SC100 added, daily mortality rates of both male and female flies were greatly diminished in mid to late life. Surprisingly, SC100 also stabilized midlife mortality rate increases so as to extend the maximum life span substantially beyond the limits previously reported for D. melanogaster. Under these conditions, SC100 also promoted robust resistance to partial starvation stress and to heat stress. Fertility was the same initially in both treated and control flies, but it became significantly higher in treated flies at older ages as the fertility of control flies declined. Mean and maximum life spans of flies in vials at the same test site were also extended by SC100, but the life spans were short in absolute terms. In contrast, at an independent test site where stress was minimized, the flies exhibited much longer mean life spans, but the survival curves became highly rectangular and the effects of SC100 on both mean and maximum life spans declined greatly or were abolished. The data indicate that SC100 is a novel herbal mix with striking effects on enhancing Drosophila stress resistance and life span in some environments, while minimizing mid to late life mortality rates. They also show that the environment and other factors can have transformative effects on both the length and distribution of survivorship, and on the ability of SC100 to extend the life span.