A recent meta-analysis on the effects of acupuncture for chronic fatigue syndrome (CFS) concluded acupuncture and moxibustion may have ‘better effect than other treatments’. It was published in the peer reviewed journal Biomed central.

The study characterized CFS as, ‘unexplained fatigue that lasts for at least six months and accompanied by four or more of the following symptoms: unrefreshing sleep, lengthy malaise after exertion, impairment of concentration or short-term memory, sore throat, tender lymph nodes, multi-joint and muscle pain and headaches.’

31 randomized-controlled trials (RCTs – the gold standard of evidence based medicine) were identified and used for the analysis. Papers included had to be of high quality. i.e. were RCTs, published or unpublished, improvements had to be at least 30% to be considered relevant. These papers were then independently assessed following the Cochrane Collaborations tool (the most well respected research analysis group).

The studies represented a total of 2255 participants aged 18-78. Treatment duration ranged from 10-90 days. Combined acupuncture and moxibustion was compared with just acupuncture or moxibustion, Chinese herbal medicine, western medicine, and placebo (sham acupuncture – which has been known to cause some changes, but that is a different discussion). When compared with each other combined acupuncture and moxibustion was the most effective, followed by single acupuncture or moxibustion, then Chinese herbal medicine, western medicine, and lastly sham acupuncture.

Although the mechanisms are still unclear, research has pointed to changes in the immune system functioning, particularly regulating the immune system, calming inflammatory responses and boosting anti-inflammatory responses.

However, the authors also concluded ‘high quality studies are needed to confirm our finding’. When the Cochrane risk of bias tool was applied some of the studies showed possible signs of bias. Thus, even though this is the most complete and up-to-date meta-analysis so far. In order for the findings to be fully accepted, stronger evidence is needed.

The full text can be found here


My approach

I always ground my practice in the most up-to-date research available. Therefore, I would follow some of the treatment protocol shown in this study. However, I consider that the above approach for CFS is not strong, or broad, enough. Being that CFS is such a pernicious and often chronic syndrome I would always look at dietary and lifestyle patterns and recommend changes where necessary.

I would likely use many of the acupoints adopted in the above research, but I would always tailor it to the individual. From a Chinese medicine point of view the underlying issues in the system can differ, Kidney-Yin deficiency and Spleen-Qi deficiency are common, but they are not the only pathologies associated with CFS. I would not limit my practice to a one size fits all approach as we are all so different.

I would also consider adding herbal medicine if and where necessary, as it can work very well alongside acupuncture.

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