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Complementary and alternative medicine treatments in the management of chronic fatigue syndrome: a systematic review of randomized controlled trials

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Abstract

Chronic fatigue greatly deteriorates the quality of life and is a frequent reason for consulting a physician. Since conventional medicine usually provides limited help, patients with chronic fatigue syndrome (CFS) tend to use complementary and alternative medicines (CAM). The objective of this review was to summarize the evidence of the effectiveness of CAM treatments in the management of CFS. Electronic databases were systematically searched up to December 2010. All randomized controlled trials (RCTs) of CAM used in patients with CFS were considered for inclusion if they included placebo controls or were controlled against a comparator intervention. Methodology quality was assessed using modified Jadad score and the Cochrane criteria for allocation concealment. A total of 414 possibly relevant articles were identified, of which eight RCTs met our inclusion criteria: three dietary interventions, two herbal medicines, one distant healing, one homeopathic medicine, and one massage. The methodology quality of the trials varied, and on average, was moderate (mean Jadad score, 3.625; range, 0–5). Details on allocation concealment were reported for seven of the trials, of which six were classified as adequate. Of the eight included RCTs, three reported significant differences between the treatment and placebo groups in the primary outcome measures. However, the total number of RCTs included in the analysis was too small to provide definite evidence for the effectiveness of CAM in treating CFS. More RCTs on the effectiveness of CAM in the management of CFS should be conducted with larger patient samples, longer treatment periods, and appropriate methodology.

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References

  • Adams D, Wu T, Yang X, Tai S, Vohra S (2009) Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome. Cochrane Database Syst Rev (4):CD006348. doi:10.1002/14651858.CD006348.pub2

  • Baranowsky J, Klose P, Musial F, Hauser W, Dobos G, Langhorst J (2009) Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatol Int 30(1):1–21. doi:10.1007/s00296-009-0977-5

    Article  PubMed  Google Scholar 

  • Brouwers FM, Van Der Werf S, Bleijenberg G, Van Der Zee L, Van Der Meer JW (2002) The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial. QJM 95(10):677–683

    Article  PubMed  CAS  Google Scholar 

  • Chaudhuri G (2008) Acupuncture treatment for an adolescent with chronic fatigue syndrome. Med Acupunct 20(1):61–62

    Article  Google Scholar 

  • Chen GL, Xiao GM, Zheng XL (2008) Observation on therapeutic effect of multiple cupping at back-shu points on chronic fatigue syndrome. J Trad Chin Med 28(6):405–407

    Google Scholar 

  • Chen XH, Li LQ, Zhang W, Yang J, Dai YS, Xu DH, Tang CZ (2012) Randomized controlled study on acupuncture treatment for chronic fatigue syndrome. Zhongguo Zhen Jiu 30(7):533–536

    CAS  Google Scholar 

  • Cho JH, Cho CK, Shin JW, Son JY, Kang W, Son CG (2009) Myelophil, an extract mix of Astragali Radix and Salviae Radix, ameliorates chronic fatigue: a randomised, double-blind, controlled pilot study. Complement Ther Med 17(3):141–146. doi:10.1016/j.ctim.2008.11.003

    Article  PubMed  CAS  Google Scholar 

  • Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A (1994) The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group Ann Intern Med 121(12):953–959

    Google Scholar 

  • Fulcher KY, White PD (1997) Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ 314(7095):1647–1652

    Article  PubMed  CAS  Google Scholar 

  • Guo J (2007) Chronic fatigue syndrome treated by acupuncture and moxibustion in combination with psychological approaches in 310 cases. J Trad Chin Med 27(2):92–95

    CAS  Google Scholar 

  • Hardy-Pickering R (2007) The use of complementary and alternative therapies for fibromyalgia. Phys Ther Rev 12(3):249–260

    Article  Google Scholar 

  • Hartz AJ, Bentler S, Noyes R, Hoehns J, Logemann C, Sinift S, Butani Y, Wang W, Brake K, Ernst M, Kautzman H (2004) Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 34(1):51–61

    Article  PubMed  CAS  Google Scholar 

  • Hobday RA, Thomas S, O’Donovan A, Murphy M, Pinching AJ (2008) Dietary intervention in chronic fatigue syndrome. J Hum Nutr Diet 21(2):141–149. doi:10.1111/j.1365-277X.2008.00857.x

    Article  PubMed  CAS  Google Scholar 

  • Huang Y, Jiang X (2006) A clinical observation of treating 30 cases of CFS by moving cupping on the back. J Trad Chin Med 15(1):21

    CAS  Google Scholar 

  • Huang Y, Liao XM, Li XX, Song YB (2008) Clinical observation on the effects of Bo’s abdominal acupuncture in 40 cases of chronic fatigue syndrome. J Trad Chin Med 28(4):264–266

    Article  Google Scholar 

  • Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12

    Article  PubMed  CAS  Google Scholar 

  • Juni P, Witschi A, Bloch R, Egger M (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282(11):1054–1060

    Article  PubMed  CAS  Google Scholar 

  • Lijue Z (2005) Acupuncture and Chinese patent drugs for treatment of chronic fatigue syndrome. J Tradit Chin Med 25(2):99–101

    PubMed  Google Scholar 

  • Moss-Morris R, Sharon C, Tobin R, Baldi JC (2005) A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. J Health Psychol 10(2):245–259. doi:10.1177/1359105305049774

    Article  PubMed  Google Scholar 

  • National Center for Complementary and Alternative Medicine (2007) What is CAM medicine? NCCAM Publication No. D347. Updated February

  • O’Dowd H, Gladwell P, Rogers CA, Hollinghurst S, Gregory A (2006) Cognitive behavioural therapy in chronic fatigue syndrome: a randomised controlled trial of an outpatient group programme. Health Technol Assess 10(37):iii–iv

    PubMed  Google Scholar 

  • Powell P, Bentall RP, Nye FJ, Edwards RH (2001) Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome. BMJ 322(7283):387–390

    Article  PubMed  CAS  Google Scholar 

  • Reitsma JB, Rutjes AWS, Whiting P, Vlassov VV, Leeflang MMG, Deeks JJ (ed) (2009) Assessing methodological quality. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy 1.0.0 edn. The Cochrane Collabaration 1–27

  • Sharpe MC, Archard LC, Banatvala JE, Borysiewicz LK, Clare AW, David A, Edwards RH, Hawton KE, Lambert HP, Lane RJ et al (1991) A report–chronic fatigue syndrome: guidelines for research. J R Soc Med 84(2):118–121

    PubMed  CAS  Google Scholar 

  • Sim J, Adams N (2002) Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia. Clin J Pain 18(5):324–336

    Article  PubMed  Google Scholar 

  • Stubhaug B, Lie SA, Ursin H, Eriksen HR (2008) Cognitive-behavioural therapy v. mirtazapine for chronic fatigue and neurasthenia: randomised placebo-controlled trial. Br J Psychiatry 192(3):217–223. doi:10.1192/bjp.bp.106.031815

    Article  PubMed  Google Scholar 

  • The GK, Bleijenberg G, van der Meer JW (2007) The effect of acclydine in chronic fatigue syndrome: a randomized controlled trial. PLoS Clin Trials 2(5):e19. doi:10.1371/journal.pctr.0020019

    Article  PubMed  Google Scholar 

  • Vinjamury SP, Singh BB (2005) Ayurvedic treatment of chronic fatigue syndrome–a case report. Altern Ther Health Med 11(5):76–78

    PubMed  Google Scholar 

  • 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 (2008) Effectiveness of distant healing for patients with chronic fatigue syndrome: a randomised controlled partially blinded trial (EUHEALS). Psychother Psychosom 77(3):158–166. doi:10.1159/000116609

    Article  PubMed  Google Scholar 

  • Wallman KE, Morton AR, Goodman C, Grove R, Guilfoyle AM (2004) Randomised controlled trial of graded exercise in chronic fatigue syndrome. Med J Aust 180(9):444–448

    PubMed  Google Scholar 

  • Wang W (2001) Clinical observations on the treatment of chronic fatigue syndrome by acupuncture and cupping. J Trad Chin Med 20(1):23

    CAS  Google Scholar 

  • Wang T, Zhang Q, Xue X, Yeung A (2008) A systematic review of acupuncture and moxibustion treatment for chronic fatigue syndrome in China. Am J Chin Med 36(1):1–24

    Article  PubMed  Google Scholar 

  • Wang JJ, Song YJ, Wu ZC, Chu XO, Wang QM, Wang XJ, Wei LN, Meng H, Wang XH (2009a) Randomized controlled clinical trials of acupuncture treatment of chronic fatigue syndrome. Zhen Ci Yan Jiu 34(2):120–124

    CAS  Google Scholar 

  • Wang JJ, Song YJ, Wu ZC, Chu XO, Wang QM, Wei LN, Wang XJ, Meng H (2009b) [Randomized controlled study on influence of acupuncture for life quality of patients with chronic fatigue syndrome]. Zhongguo Zhen Jiu 29 (10):780–784

    Google Scholar 

  • Wang JJ, Song YJ, Wu ZC, Chu XO, Wang XH, Wang XJ, Wei LN, Wang QM (2009c) A meta analysis on randomized controlled trials of acupuncture treatment of chronic fatigue syndrome. Zhen Ci Yan Jiu 34(6):421–428

    Google Scholar 

  • Wang J, Chai T, Lin G, Luo L (2009d) Effect of the intelligent-turtle massage on the physical symptoms and immune functions in patients with chronic fatigue syndrome. J Trad Chin Med 29(1):24–28

    Article  Google Scholar 

  • Weatherley-Jones E, Nicholl JP, Thomas KJ, Parry GJ, McKendrick MW, Green ST, Stanley PJ, Lynch SP (2004) A randomised, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatigue syndrome. J Psychosom Res 56(2):189–197. doi:10.1016/S0022-3999(03)00377-5 S0022399903003775

    Google Scholar 

  • Wessely S, Chalder T, Hirsch S, Wallace P, Wright D (1997) The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. Am J Public Health 87(9):1449–1455

    Article  PubMed  CAS  Google Scholar 

  • Whiting P, Bagnall AM, Sowden AJ, Cornell JE, Mulrow CD, Ramirez G (2001) Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. JAMA 286(11):1360–1368

    Article  PubMed  CAS  Google Scholar 

  • Yiu YM, Ng SM, Tsui YL, Chan YL (2007) A clinical trial of acupuncture for treating chronic fatigue syndrome in Hong Kong. Zhong Xi Yi Jie He Xue Bao 5(6):630–633

    Article  PubMed  Google Scholar 

  • Yuemei L, Hongping L, Shulan F, Dongfang G (2006) The therapeutic effects of electrical acupuncture and auricular-plaster in 32 cases of chronic fatigue syndrome. J Trad Chin Med 26(3):163–164

    Google Scholar 

Download references

Acknowledgments

The research was supported by the 2nd grant in 2010 for excellent research articles from Graduate School of Korean Medicine, College of Korean Medicine, Kyung Hee University.

Author’s contributions

KWK, SHC conceived the research project and designed the study. KWK, WSC validated and extracted data from the articles. Discrepancies were resolved through discussion with MYS and SHC. All authors contributed to the writing of the manuscript. All authors read and approved the final manuscript.

Conflict of interest

The authors declare that they have no competing interests.

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Correspondence to Seok-Hee Chung.

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The research was supported by the 2nd grant in 2010 for excellent research articles from Graduate School of Korean Medicine, College of Korean Medicine, Kyung Hee University.

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Kim, KW., Chung, WS., Song, MY. et al. Complementary and alternative medicine treatments in the management of chronic fatigue syndrome: a systematic review of randomized controlled trials. Orient Pharm Exp Med 13, 85–93 (2013). https://doi.org/10.1007/s13596-012-0096-9

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  • DOI: https://doi.org/10.1007/s13596-012-0096-9

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