Articles

Chronic Fatigue Syndrome

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Chronic Fatigue Syndrome

Introduction

In traditional Chinese medicine, this disease is categorized as yu zheng (depression syndrome), pi wei nei shsng (internal injury of the spleen-stomach), xu lao (consumptive disorder), and tong zheng (pain syndrome), etc. (1)

Etiology/Pathogenesis

Zhu et al. hold that chronic fatigue syndrome is closely related to heat-dampness pathogens, which tend to invade deficient visceral organs, in particular the spleen and stomach, causing damp-heat accumulation and internal retainment of damp-heat pathogens. When the patients are infected with a virus or catch a cold, the internal and external pathogens work together to cause damages to the spleen and stomach, and the internal damp-heat pathogens progress to hinder the normal flow of qi and disturb the heart and other visceral organs, resulting in a wide series of chronic fatigue symptoms. (2) Zhou et al., on the other hand, hold that the etiology of chronic fatigue syndrome is due to long-term anxiety, exhaustion, and mental fatigue. (3) And Quan thinks that chronic fatigue syndrome could also result from stagnation and depression of the liver-qi. (4)

Primary Treatments with Chinese Medicinal Herbs

Ren Shen Yang Rong Tang

Gu et al. reviewed the results of treating chronic fatigue syndrome with Ren Shen Yang Rong Tang by some Japanese practitioners of oriental medicine. The treatment is credited for enhancing cellular immunity and for relieving clinical symptoms. (5)

Other Treatments with Chinese Medicinal Herbs

Bu Zhong Yi Qi Tang

Shu et al. treated 30 cases of chronic fatigue syndrome with Bu Zhong Yi Qi Tang (Decoction for Reinforcing Middle-jiao and Replenishing Qi). The formula contained the following single herbs: Huang Qi (Astragalus Root), Dang Shen (Codonopsis), Dang Gui (Chinese Angelica Root), Bai Zhu (Atractylodes), Chai Hui (Bupleurum), Chen Pi (Citrus), Sheng Ma (Cimicifuga), Gan Cao (processed Licorice), etc. The formula was modified to suit individual patients’ symptoms. One dose of the formula in decoction was administered daily, and one course of treatment lasted 30 days. A comparison group of 28 cases was treated with oryzanol, nitrazepam, Ci Wu Jia Pian (Acanthopanax tablets), multivitamins, etc. The results: after two courses of treatment, of the treatment group, 18 cases significantly improved, 6 improved, and the remaining 6 did not respond to the treatment, with a total effective rate of 80%; of the comparison group, 3 cases significantly improved, 6 improved, and the remaining 19 did not respond to the treatment, with a total effective rate of 32.15%. (6)

Sheng Xian Tang

Xie treated 23 cases of chronic fatigue syndrome with Sheng Xian Tang (Decoction for Lifting and Reinforcing Vital Energy). The formula consisted of the following herbs: Huang Qi (Astragalus Root), Xian He Cao (Agrimony), Tai Zi Shen (Pseudostellaria), Nan Sha Shen (Adenophora Root), Sheng Di Huang (Rehmannia), Gou Qi Zi (Lycium Fruit), Dang Gui (Chinese Angelica Root), Chai Hu (Bupleurum), Jie Geng (Platycodon), and Sheng Ma (Cimicifuga). One dose of the formula in decoction was administered daily. The results: 3 cases significantly improved, 16 improved, and the remaining 4 did not respond to the treatment, with a total effective rate of 86.4%. (7)

Si Jun Zi Tang

Yin treated 32 cases of chronic fatigue syndrome mainly with a combination of three decoctions: Si Jun Zi Tang (Decoction of Four Noble Herbs), Bai He Di Huang Tang (Decoction of Lily and Rehmannia), and Xiao Yao San (Ease Powder). The herbal treatment was supplemented with psychotherapy. The results: 11 cases were resolved, 12 greatly improved, 7 improved, and the remaining 2 did not respond to the treatment, with a total effective rate of 93.8%. (8)

Acupunture & Acupressure

Acupuncture and moxibustion therapy

Zeng et al. treated 38 cases of chronic fatigue syndrome with acupuncture and moxibustion. Based on syndrome differentiation, acupoints were selected to receive treatment as follows: for deficiency of spleen-kidney yang, acupoints Bai Hui (GV20), Guan Yuan (CV4), Zu San Li (ST36), Shen Shu (BL23), and Fu Liu (KI7) were treated, 3-5 points at a time, and after acupuncture, moxibustion (5-7 moxa cones) was applied to Bai Hui (GV20), Guan Yuan (CV4), Zu San Li (ST36); for deficiency in heart and spleen, acupoints Nei Guan (PC6), Xin Shu (BL15), San Yin Jiao (SP6), Qi Hai (CV6) were treated, 3-5 points at a time, and after acupuncture, moxibustion (3-5 moxa-cones) was applied at Xin Shu (BL15) and Qi Hai (CV6). The acupuncture treatment used weak stimulation and the needles were retained for 15 minutes after insertion. The results: 9 cases greatly improve, 21 improved, and the remaining 8 did not respond to the treatment. (9)

Gao treated 21 cases of chronic fatigue syndrome with acupuncture. One point was selected alternatively each time from the following 3 groups: (1) the upper region: Bai Hui (GV20) and Yin Tang (EX-HN3); (2) the middle region: Qi Hai (CV6) and Guan Yuan (CV4); (3) the lower region: Zu San Li (ST36) and San Yin Jiao (SP6). The needles were maneuvered using either the reinforcing method or the uniform reinforcing-reducing method. All the patients received the treatment once a day, and once course of treatment consisted ten sessions. The results: after 2-3 courses of treatment, 17 cases were resolved, and the remaining 4 improved, with a total effective rate of 100%. (10)

References

  1. Tang Zhi Peng, et al. A survey of TCM treatment of chronic fatigue syndrome. Journal of Guangzhou University of TCM. 1998;15:39-42.
  2. Zhu Wen Ju, et al. The TCM treatment of fatigue syndrome. Tianjin Journal of TCM. 1994;11(4):14.
  3. Zhou Yuan Long, et al. Treating 27 cases of chronic fatigue syndrome by replenishing yin, nourishing blood, and tonifying qi. Beijing Journal of TCM. 1994;(4):17.
  4. Quan Jing. Treating 13 cases of chronic fatigue syndrome: The liver approach. Journal of Traditional Chinese Medicine. 1999;40(6):378.
  5. Gu Hong Yan, et al. Clinical application of Ren Shen Yang Rong Tang in Japan. Journal of Chinese Materia Medica. 1997;28(2):121-122.
  6. Shu Yi Qiong, et al. Treating 30 cases of chronic fatigue syndrome with modified Bu Zhong Yi Qi Tang. Journal of Anhui College of TCM. 1997;16(5):11-12.
  7. Xie Hai Ning. Treating 23 cases of chronic fatigue syndrome with modified Sheng Xian Tang. Jiangsu Journal of TCM. 1998;19(1):20.
  8. Yin Heng Ze. Treating 32 cases of chronic fatigue syndrome with San He Tang. Shanghai Journal of Traditional Chinese Medicine and Herbs. 1999;(3):19-20.
  9. Zeng Zheng, et al. Treating 38 cases of chronic fatigue syndrome with acupuncture and moxibustion. Shanghai Journal of Acupuncture. 1999;18(3):24.
  10. Gao Jie. Treating 21 cases of chronic fatigue syndrome with acupuncture. Liaoning Journal of Traditional Chinese Medicine. 1998;25(5):224.