Treatment Of Chronic Fatigue Syndrome Research Articles

Effect of electroacupuncture on behavior and hippocampal inflammatory factors in rats with chronic fatigue syndrome.

To observe the effect of electroacupuncture (EA) on the changes of behavior and hippocampal inflammatory factors in rats with chronic fatigue syndrome (CFS), so as to explore its possible mechanisms in the treatment of CFS. Twenty-seven SD rats were randomly divided into control, model and electroacupuncture (EA) groups (n=9 rats in each group). The CFS model was established by multi-factor compound stress stimulation method. Rats of the EA group received EA (10 Hz) at "Shenting" (GV24) penetrating "Baihui" (GV20), "Dazhui" (GV14) for 15 min, twice a day for 14 days. The general conditions, Morris water maze test, open field test, the exhausted running platform were conducted for determining the rats' locomotor and learning-memory activities. H.E. staining was used to observe the morphological structure of neurons in hippocampal CA1 region. The contents of interleukin (IL)-10, IL-17 and transforming growth factor (TGF) β1 in hippocampus and serum of rats were detected by ELISA, and the positive expressions of IL-10, IL-17 and TGF-β1 in hippocampal CA1 region were detected by immunofluorescence staining. Compared with the control group, the score of general condition was increased (P<0.05), the escape latency was prolonged (P<0.05), the number of crossing the original platform was decreased (P<0.05), the numbers of crossing the grid and entering the central area were increased (P<0.05), and the exhaustive treadmill time was shortened (P<0.05) in the model group. The contents of IL-10 in the hippocampus and serum were decreased (P<0.05), while IL-17 and TGF-β1 contents were increased (P<0.05). The immunofluorescence intensity of IL-10 in the hippocampus was decreased (P<0.05), while the intensity of IL-17 and TGF-β1 were increased (P<0.05). After treatment, compared with the model group, the score of general condition was decreased (P<0.05), the escape latency was shortened (P<0.05), the number of crossing the original platform was increased (P<0.05), the numbers of crossing the grid and entering the central area were decreased (P<0.05), and the exhaustive treadmill time was prolonged (P<0.05) in the EA group. The contents of IL-10 in the hippocampus and serum were increased (P<0.05), while IL-17 and TGF-β1 levels were decreased (P<0.05). The immunofluorescence intensity of IL-10 in the hippocampus was increased (P<0.05), while the intensity of IL-17 and TGF-β1 were decreased (P<0.05). H.E. staining showed that in the model group, the number of neurons in the hippocampus decreased, with disordered arrangement and loose structure, and a small numbers of neuronal nuclei were missing. The degree of tissue damage of the EA group was milder than that of the model group. EA can alleviate fatigue and spatial learning and memory impairment in CFS rats, which may be related to the regulation of peripheral and central inflammation.

Integrated causal inference modeling uncovers novel causal factors and potential therapeutic targets of Qingjin Yiqi granules for chronic fatigue syndrome

Objective: Chronic fatigue syndrome (CFS) is a prevalent symptom of post-coronavirus disease 2019 (COVID-19) and is associated with unclear disease mechanisms. The herbal medicine Qingjin Yiqi granules (QJYQ) constitute a clinically approved formula for treating post-COVID-19; however, its potential as a drug target for treating CFS remains largely unknown. This study aimed to identify novel causal factors for CFS and elucidate the potential targets and pharmacological mechanisms of action of QJYQ in treating CFS. Methods: This prospective cohort analysis included 4,212 adults aged ≥65 years who were followed up for 7 years with 435 incident CFS cases. Causal modeling and multivariate logistic regression analysis were performed to identify the potential causal determinants of CFS. A proteome-wide, two-sample Mendelian randomization (MR) analysis was employed to explore the proteins associated with the identified causal factors of CFS, which may serve as potential drug targets. Furthermore, we performed a virtual screening analysis to assess the binding affinity between the bioactive compounds in QJYQ and CFS-associated proteins. Results: Among 4,212 participants (47.5% men) with a median age of 69 years (interquartile range: 69–70 years) enrolled in 2004, 435 developed CFS by 2011. Causal graph analysis with multivariate logistic regression identified frequent cough (odds ratio: 1.74, 95% confidence interval [CI]: 1.15–2.63) and insomnia (odds ratio: 2.59, 95% CI: 1.77–3.79) as novel causal factors of CFS. Proteome-wide MR analysis revealed that the upregulation of endothelial cell-selective adhesion molecule (ESAM) was causally linked to both chronic cough (odds ratio: 1.019, 95% CI: 1.012–1.026, P = 2.75 e−05) and insomnia (odds ratio: 1.015, 95% CI: 1.008–1.022, P = 4.40 e−08) in CFS. The major bioactive compounds of QJYQ, ginsenoside Rb2 (docking score: −6.03) and RG4 (docking score: −6.15), bound to ESAM with high affinity based on virtual screening. Conclusions: Our integrated analytical framework combining epidemiological, genetic, and in silico data provides a novel strategy for elucidating complex disease mechanisms, such as CFS, and informing models of action of traditional Chinese medicines, such as QJYQ. Further validation in animal models is warranted to confirm the potential pharmacological effects of QJYQ on ESAM and as a treatment for CFS.

A cross-sectional study exploring the relationship between symptoms of anxiety/depression and P50 sensory gating in adult patients diagnosed with chronic fatigue syndrome/myalgic encephalomyelitis.

Chronic fatigue syndrome (CFS) is a clinical disease that affects multiple body systems. It is characterized by persistent or recurring fatigue, which may be linked to immune, neuroendocrine, and energy metabolism dysfunctions. Individuals with CFS may experience pain, sleep disorders, anxiety, and depression. This research analyzed the fundamental characteristics of anxiety/depression symptoms in patients with CFS and investigated the association between these symptoms and the P50 SG (sensory gate) ratio. Two hundred and forty-nine subjects fulfilled the CDC-1994 criteria for CFS and were included in the study. The subjects successively completed the Symptom CheckList-90-Revised (SCL-90-R), Hamilton Anxiety Rating Scale-14 (HAMA-14), and Hamilton Depression Rating Scale-24 (HAMD-24). Auditory-evoked potential P50 were measured using the 128-lead-electroencephalograph. According to HAMA and HAMD, 17.3% (n = 43) of the patients did not exhibit anxiety/depression, with a threshold score of 7 and 7 for HAMA and HAMD. When the threshold score was 14 and 20 respectively, 43.3% (n = 108) of the patients did not exhibit anxiety/depression. The SCL-90-R results indicated that 69.5% (n = 173) of these individuals with the score arranging from 0 to 160 did not present mental problems. There was a correlation between somatization scores and P50 SG ratio in the overall sample and no anxiety or depression (NAOD) group delimited by 14 and 20, respectively, (p < 0.05). Regression analysis showed that anxiety and depression were risk factors associated with an abnormal P50 SG ratio. A significant correlation exists between the P50 SG ratio and clinical symptoms such as fatigue, anxiety, and depression. Abnormalities in brain function among patients with CFS may play a crucial role in the pathogenesis of the condition, leading to their classification as being prone to functional neurological disorders. The P50 SG ratio cannot be used as a diagnostic marker for CFS but show some significance on the mechanism, classification, treatment, and prognosis of CFS.

PLANT PIGMENTS IN PSYCHIATRY AND NEUROLOGY: HISTORICAL AND MODERN USES. PART II. A LITERATURE REVIEW WITH A CLINICAL CASE PRESENTATION

Purpose. To continue the narrative that we have started in the first part of this article, telling the reader about the history of the use of certain plant pigments in the treatment of several mental and neurological diseases, as well as in histological studies of brain tissue. To present to the reader the modern research data regarding the potential effectiveness and safety of some plant pigments in the treatment of various mental and psychosomatic pathologies, as well as some neurodegenerative diseases. Then, to present the reader a detailed description of a clinical case from the authors’ own practice. In the aforementioned case, the combined use of a low-calorie diet, exercise, metformin, chromium picolinate, thermogenic fat burners (caffeine and synephrine) and several different plant pigments and antioxidants — made it possible to achieve remission, both in terms of the mental state and in terms of endocrine and metabolic status in a young woman with obesity, polycystic ovary syndrome, depression, hyperuricemia, and an initial stage of urate-based urolithiasis, without the use of traditional psychopharmacotherapy.&#x0D; Methodology. For the purpose of second part of this review, we have selected primarily those plant pigments that are widely distributed in a variety of plants, and therefore cannot be attributed to any one plant (for example, the carotenoids lycopene, lutein and zeaxanthin, or anthocyanins, which are present in many berries and in the brightly colored flowers of some plants, such as hibiscus).&#x0D; Secondly, we were interested in the pigments from dyeing plants that some traditional medical systems (for example, traditional Chinese medicine, or  Indian Ayurvedic medicine, or traditional medicine of the American Indians) have historically used and/or still continue using for the treatment of mental and neurological diseases. Many of those plants, for example, madder, are relatively little known as medicinal plants to modern European doctors and patients.&#x0D; We then searched for information about the medical use of such plant pigments with the help of search engines and databases such as PubMed, Google Scholar, Science Direct, Web of Science. Then we have summarized the data we had found and collected, and presented the summarized data in this second part of the review. Then we described in detail a clinical case from our own clinical practice.&#x0D; Results. The data we have obtained in the process of compiling this review, in our opinion, indicate a significant therapeutic potential for the use of some plant pigments that we have reviewed there — in the treatment of several mental and neurological disorders. The evidence base for the use of such plant pigments in psychiatry and neurology — varies widely in quality. For some plant pigments (eg, for lycopene from tomatoes, for lutein and zeaxanthin, for anthocyanins from various berries or from hibiscus flowers, for resveratrol from red wine and from dark grape varieties) — there are positive data from small randomized clinical trials, in combination with data from population studies (for example, on the association between the consumption of tomatoes, of lycopene and of carotenoids in general, of resveratrol and of plant antioxidants in general — and the frequency of depressive and anxiety disorders).&#x0D; For some other plant pigments that were historically used and are still used in some traditional medical systems, among other their uses, specifically for the treatment of mental and neurological disorders — for example, madder extract — we so far were able to find only experimental data on animals and on neuronal cell cultures, combined with the empirical experience of such traditional medical systems.&#x0D; Practical implications. The results that we have presented in this review, in our opinion, can provide theoretical and practical grounds for the use of some of the plant pigments that we have reviewed there (for example, lycopene, lutein and zeaxanthin, resveratrol, etc.) in the combination treatment of chronic fatigue syndrome, of mild forms of anxiety and depressive disorders, mild cognitive impairment — especially in patients who refuse standard psychopharmacotherapy, or who do not tolerate it well.&#x0D; Some other plant pigments that were historically used in the treatment of mental and neurological disorders in some traditional medical systems (for example, madder extract) — in our opinion, deserve to be studied in humans in this role, preferably in the format of randomized controlled trials.

P149: Chronic fatigue syndrome and its response to the use of a multimodal antidepressant

Objective:We present a case that shows a very favourable response of the antidepressant vortioxetine in the functional and cognitive recovery in a patient with Chronic Fatigue Syndrome and its role as a pain modulator.Methods:This is an observational study using a clinical case. An 80-year-old female patient admitted to the Postacute care unit for recovering her functional baseline following surgical intervention for a hip fracture. On admission, the main symptom was residual pain at the level of the operated lower limb, as well as allodynia and a tingling sensation, which did not subside with conventional analgesia. During admission she also presented, insomnia, daytime hypersomnolence, bradypsychia, and emotional instability in the form of easy crying. It is worth mentioning that prior to admission the patient presented with multiple nonspecific somatic complaints, such as fatigue, headache, myalgia, and arthralgia, adding over time, great difficulty in planning and performing household tasks. The functional progress of the patient during admission was very slow, mainly due to the combination of lack of engagement, together with episodes of irritability, restlessness and suffering from fear of falling syndrome. Given the suspicion of previously undiagnosed Chronic Fatigue Syndrome, exacerbated by the decline in her functional baseline after surgery, treatment was started with vortioxetine in addition to non-pharmacological measures and psychotherapy, obtaining excellent results in approximately 4 weeks.Results:Great effectiveness of vortioxetine in the treatment of Chronic Fatigue Syndrome and in the control of concomitant pain (despite that indication is not included in the molecule's data sheet). The patient followed a very favourable evolution achieving, on discharge, an ad integrum recovery of her functional state.Conclusion:As presented in this case, treatment with multimodal antidepressant treatment (vortioxetine) could have positive impact for patients with Chronic Fatigue Syndrome, achieving improvements in the affective-cognitive aspect and controlling the pain related to this syndrome, avoiding polypharmacy.

Multi-omics techniques to compare the potential of raw and processed licorice as food supplements for ameliorating chronic fatigue syndrome

Licorice is the dried root or rhizome of Glycyrrhiza uralensis Fisch., Glycyrrhiza inflata Bat., and Glycyrrhiza glabra L., which has attracted considerable interest as a well-known dietary and medicinal plant. Licorice possesses a number of biological activities, including anti-inflammatory and antitumor, and is used as a major ingredient in various healthy food products. According to traditional Chinese medicine, raw licorice effectively eliminates heat and detoxifies, and processed licorice is effective in regulating the spleen and qi. Thus, we compared the effectiveness of raw and processed licorice in treating chronic fatigue syndrome (CFS) and found that processed licorice is more effective than raw licorice. The mechanisms underlying the effects of raw and processed licorice in the treatment of CFS were clarified in this study through multi-omics analysis. Results demonstrated that processed licorice increased the expression levels of the pyruvate kinase, acetyl coenzyme A acetyltransferase, and cytochrome P-450 4A2 genes, which in turn promoted glycolytic processes, cholesterol metabolism, and glycerolipid metabolism. After processing, licorice's total flavone and saponin content decreased, and the decrease in flavonoid content was more pronounced. This finding is in line with the findings of plant metabolomics, which showed that the content of saponins in the total licorice extract increased, possibly accounting for the majority of the enhanced effects. In conclusion, processed licorice is more suitable as a raw material or ingredient for medicines and functional food for CFS than raw licorice.

PLANT PIGMENTS IN PSYCHIATRY AND NEUROLOGY: HISTORICAL AND MODERN USES. PART I (LITERATURE REVIEW)

Purpose. To provide the reader with a detailed historical overview of the human use of plant pigments for medical purposes, starting from ancient times. To show how modern chemical theory of color and evolutionary biology of plants explain, from their very different points of view — some commonly observed properties of many plant pigments, such as their antioxidant and anti-free radical activity. To present modern data on pharmacological properties and potential therapeutic utility in psychiatry and neurology of some selected plant pigments.&#x0D; Methodology. To get an idea of what originally were the rationales for human use of plant pigments for medical purposes, we turned to books on the history of medicine and on the history of pharmacology. To get an idea of what is the relationship between the absorption spectrum of a molecule and its chemical properties (in particular, properties of a reducing agent, an electron donor, an antioxidant and a free radical scavenger) — we turned to the book on the chemistry of pigments. And to get an idea of the evolutionary role of pigments in plant tissues — to the book on evolutionary biology. We then selected, based on the lists of plant pigments provided in two of the most authoritative manuals for DIY fabric dyeing with natural dyes — some of the plants that looked most interesting for our purposes. We then searched for information about the use of these plants in psychiatry and neurology and about their neuropharmacological properties, with the use of search engines such as PubMed, Google Scholar, Science Direct, Web of Science. The data we have collected were summarized and presented to the reader in this review.&#x0D; Results. The data that we have obtained in the process of compiling this review, in our opinion, do indicate a significant therapeutic potential for the use of certain plant pigments in psychiatry and neurology. The evidence base for the use of various plant pigments in psychiatry and neurology — significantly varies in quality. For some plant pigments (for example, for curcumin from turmeric, or for crocetin and crocin from saffron, or for roburin from common oak bark, epigallocatechin gallate from green tea leaves, chlorogenic acid and caffeic acid from coffee beans), there is positive data from small randomized clinical trials. For others, so far there is only data from population studies (for example, on the correlation between consumption of walnuts and olives with the lowered incidence of depression), combined with some open-label studies on dietary supplements that contain those pigments.&#x0D; Practical implications. Our results, in our opinion, provide theoretical and practical grounds for the use of some plant pigments (curcumin, crocin and crocetin, epigallocatechin gallate, chlorogenic and caffeic acids, roburin, oleuropein, juglone) in the combination treatment of chronic fatigue syndrome, mild forms of anxiety and depressive disorders, mild cognitive impairment, early stages of Alzheimer disease and other neurodegenerative diseases, especially in patients who refuse pharmacotherapy or who do not tolerate it well.

Integrated 'omics analysis for the gut microbiota response to moxibustion in a rat model of chronic fatigue syndrome.

To observe the efficacy of moxibustion in the treatment of chronic fatigue syndrome (CFS) and explore the effects on gut microbiota and metabolic profiles. Forty-eight male Sprague-Dawley rats were randomly assigned to control group (Con), CFS model group (Mod, established by multiple chronic stress for 35 d), MoxA group (CFS model with moxibustion Shenque (CV8) and Guanyuan (CV4), 10 min/d, 28 d) and MoxB group (CFS model with moxibustion Zusanli (ST36), 10 min/d, 28 d). Open-field test (OFT) and Morris-water-maze test (MWMT) were determined for assessment the CFS model and the therapeutic effects of moxibustion.16S rRNA gene sequencing analysis based gut microbiota integrated untargeted liquid chromatograph-mass spectrometer (LC-MS) based fecal metabolomics were executed, as well as Spearman correlation analysis, was utilized to uncover the functional relevance between the potential metabolites and gut microbiota. The results of our behavioral tests showed that moxibustion improved the performance of CFS rats in the OFT and the MWMT. Microbiome profiling analysis revealed that the gut microbiomes of CFS rats were less diverse with altered composition, including increases in pro-inflammatory species (such as Proteobacteria) and decreases in anti-inflammatory species (such as Bacteroides, Lactobacillus, Ruminococcus, and Prevotella). Moxibustion partially normalized these changes in the gut microbiota. Furthermore, CFS was associated with metabolic disorders, which were effectively ameliorated by moxibustion. This was demonstrated by the normalization of 33 microbiota-related metabolites, including mannose (P = 0.001), aspartic acid (P = 0.009), alanine (P = 0.007), serine (P = 0.000), threonine (P = 0.027), methionine (P = 0.023), 5-hydroxytryptamine (P = 0.008), alpha-linolenic acid (P = 0.003), eicosapentaenoic acid (P = 0.006), hypoxanthine (P = 0.000), vitamin B6 (P = 0.000), cholic acid (P = 0.013), and taurocholate (P = 0.002). Correlation analysis showed a significant association between the perturbed fecal microbiota and metabolite levels, with a notable negative relationship between LCA and Bacteroides. In this study, we demonstrated that moxibustion has an antifatigue-like effect. The results from the 16S rRNA gene sequencing and metabolomics analysis suggest that the therapeutic effects of moxibustion on CFS are related to the regulation of gut microorganisms and their metabolites. The increase in Bacteroides and decrease in LCA may be key targets for the moxibustion treatment of CFS.

Chronic fatigue syndrome – challenge in diagnosis and management: a literature review

Introduction. Chronic fatigue syndrome is a disease that includes a number of various symptoms, among which the most characteristic symptom is fatigue. Diagnostic criteria are not unambiguous and vary depending on the scientific society by which they were developed. The aim of this review is to discuss the phenomenon of chronic fatigue, including its diagnostic criteria, epidemiology, pathophysiology, symptoms, and pharmacological and non-pharmacological strategies. Material and methods. 45 articles published were reviewed and placed in the PubMed and Google Scholar databases. Results. Chronic fatigue syndrome is defined as a group of symptoms whose dominant symptom is fatigue that persists after rest for at least 6 months. The Oxford or CDC criteria are most commonly used to make the diagnosis. Statistics on prevalence are inconclusive. There are several theories of origin - infectious, immunological, neuroendocrine, bioenergetic, neurological, autonomic and genetic. Other symptoms of chronic fatigue syndrome include sleep and memory disorders or muscle and joint pain. Current treatment focuses on symptomatic treatment, including education, diet, and physical activity, as well as pharmacotherapy for pain, sleep, and cognition. Discussion. Diagnosis and treatment of chronic fatigue syndrome undoubtedly is a medical challenge, due to non-specific symptoms, multifactorial pathogenesis and difficult to estimate prevalence of this disease. Future scientific development should focus especially on exploring the pathomechanism of CFS, which would enable the implementation of causal treatment.

[Current status of animal experiment report of acupuncture intervention in chronic fatigue syndrome based on ARRIVE guidelines and GSPC list].

To analyze the current status of animal experiments of acupuncture in intervening chronic fatigue syndrome, so as to search formethods to improve the quality of animal experiment reports. From the databases, such as CNKI, VIP, Wanfang, SinoMed, PubMed, Web of Science, Embase and Cochrane Library, the literature of animal experiment on acupuncture treatment for chronic fatigue syndrome was searched from January 1st, 2011 to April 2nd, 2022. Data were extracted according to the animal research reporting in vivo experiment (ARRIVE) guidelines 2.0 and gold standard publication checklist (GSPC), and statistical analysis was performed using Excel 2019. A total of 16 studies were finally included. The satis-faction rate of essential items in the ARRIVE guidelines 2.0 is 41.76%，while the satisfaction rate of recommended items is only 27.73% and of the GSPC is 25.89%. Out of 16 studies, 13 of them explained the reasons for animal exclusion in the experiment, 8 provided specific randomized methods, 8 described detailed information on animal species, strains, and quantities, 3 basically indicated that they had passed ethical review, 7 explained the limitations of the research. All 16 studies reported the main findings and elucidated their potential clinical or scientific value. Current animal studies on acupuncture in intervening the chronic fatigue syndrome are of certain limitation. Descriptions of multiple items are incomplete or missing, which prevents rea-ders from assessing reliability and authenticity of the animal experiment. It is recommended that in future research, experimental design, execution and report should be carried out according to the report guidelines for animal experiment to improve research quality.

Synbiotic Supplementation Improves Quality of Life and Inmunoneuroendocrine Response in Patients with Fibromyalgia: Influence of Codiagnosis with Chronic Fatigue Syndrome

Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are two medical conditions in which pain, fatigue, immune/inflammatory dysregulation, as well as various mental health disorders predominate in the diagnosis, without evidence of a clear consensus on the treatment of FM and CFS. The main aim of this research was to analyse the possible effects of a synbiotic (Synbiotic, Gasteel Plus® (Heel España S.A.U.), through the study of pro-inflammatory/anti-inflammatory cytokines (IL-8/IL-10) and neuroendocrine biomarkers (cortisol and DHEA), in order to evaluate the interaction between inflammatory and stress responses mediated by the cytokine-HPA (hypothalamic-pituitary-adrenal) axis, as well as mental and physical health using body composition analysis, accelerometry and previously validated questionnaires. The participants were women diagnosed with FM with or without a diagnostic of CFS. Each participant was evaluated at baseline and after the intervention, which lasted one month. Synbiotic intervention decreased levels of perceived stress, anxiety and depression, as well as improved quality of life during daily activities. In addition, the synbiotic generated an activation of HPA axis (physiological cortisol release) that can compensate the increased inflammatory status (elevated IL-8) observed at baseline in FM patients. There were no detrimental changes in body composition or sleep parameters, as well as in the most of the activity/sedentarism-related parameters studied by accelerometry. It is concluded that synbiotic nutritional supplements can improve the dysregulated immunoneuroendocrine interaction involving inflammatory and stress responses in women diagnosed with FM, particularly in those without a previous CFS diagnostic; as well as their perceived of levels stress, anxiety, depression and quality of life.

Effects of Yijinjing Qigongin Alleviating Fatigue, Sleep Quality, and Health Status on Patients with Chronic Fatigue Syndrome: A Randomized, Controlled, and Parallel Group Clinical Study

Background: Chronic fatigue syndrome (CFS) is a chronic disease characterized by various symptoms such as pathological fatigue, cognitive dysfunction, and inability to recover energy after waking up. The Yijinjing, a kind of health care practice from ancient China, consists of 12 movements, and it is considered as one of the complementary and alternative medicine (CAM) for health maintenance, health care, and disease healing. In this study, multiple scales were used to evaluate the effects of Yijinjing intervention on the clinical symptoms of CFS. Patients and Methods: Forty patients with CFS were randomly assigned to Yijinjing group and the cognitive behavior therapy (CBT) group separately. The Yijinjing intervention was practiced 6 times per week, among which one exercise should be guided by the teacher of the faculty in the university, and another 5 times should be finished at home over 12 consecutive weeks. Similarly, the control group received cognitive education, including popular science lectures and psychological counseling related to CFS prevention and treatment for 12 weeks. Multidimensional Fatigue Inventory-20 (MFI-20), Short Form 36-item Health Survey (SF-36), and Pittsburgh Sleep Quality Index (PSQI) were assessed before and after intervention. Results: Intra-group analysis showed that the differences in MFI-20, SF-36, and PSQI were statistically significant (p < 0.05) after the intervention of 12 weeks Yijinjing intervention. Compared with the CBT group, the differences in MFI-20 and PSQI of the Yijinjing group were statistically significant (p < 0.05), but SF-36 was superior to the CBT group in terms of physical function, bodily pain, general health, and vitality (p < 0.05). Conclusion: Yijinjing can significantly improve sleep disorders, fatigue, and quality of life in patients with CFS and is superior to behavioral cognitive education in pain and vitality. The study was registered with Chinese Clinical Trial Registry: ChiCTR-INR-17010694.

Exploring the central mechanism of mind-regulation electroacupuncture in treatment of chronic fatigue syndrome with anxiety and depression comorbidity based on functional magnetic resonance imaging.

To observe the changes in the regional homogeneity (ReHo) and functional brain network in treatment of chronic fatigue syndrome (CFS) with anxiety and depression comorbidity with the mind-regulation electroacupuncture (EA), using resting-state functional magnetic resonance imaging (rs-fMRI). Thirty CFS patients with anxiety and depression comorbidity were enrolled from medical staffs as the observation group. The other 30 healthy subjects were recruited from medical university students as the control group, matching gender, age and education years with the observation group. No any acupuncture intervention was delivered in the control group, and EA for regulating the mind was operated in the observation group. Main points were the emotional area of Sun's scalp acupuncture, the regions 1 and 8 of Sun's abdominal acupuncture. Supplementary acupoints included Baihui (GV 20), Guanyuan (CV 4) and bilateral. The scores of the five domains in MFI-20 (i.e. general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity), the total score of MFI-20, and the scores of SDS, SAS and PSQI in the observation group before treatment were higher than those of the control group (P<0.05). Except the score of reduced motivation in MFI-20, the scores of the other domains and the total score of MFI-20, as well as the scores of SDS, SAS and PSQI after treatment were lower than those before treatment in the observation group (P<0.05). Compared with the values before treatment, ReHo value was increased in the the right precuneus and decreased in the left inferior temporal gyrus and the left angular gyrus of the brain in the observation group after treatment. In the observation group, when compared with the control group, ReHo values were increased in the left inferior cerebral lobe, the interhemispheric region, the right occipital lobe and the thalamus; and it was reduced in the left middle temporal gyrus, the right posterior central gyrus, the right middle temporal gyrus, the right orbital middle frontal gyrus, the paracentral lobule and the right fusiform gyrus before treatment. In the observation group, the functional connectivity was decreased between the right thalamus and the left posterior central gyrus, the right hippocampus and the right fusiform gyrus before treatment, respectively; it was re-constructed after treatment between the right thalamus and the left posterior central gyrus, and the right fusiform gyrus. Compared with the control group, the functional connectivity between the right thalamus and the left posterior central gyrus, the right hippocampus, and the right fusiform gyrus was reduced before treatment; while after treatment, the functional connectivity was reduced between the right thalamus and the hippocampus in the observation group. With Spearman correlation analysis between the differential brain regions and the scores of MFI-20, SAS, SDS and PSQI, it was found that the left middle temporal gyrus, the paracentral lobule, the right precuneus, and the left inferior temporal gyrus had a partial positive correlation with the above clinical scales; and the interhemispheric region, the thalamus, the right fusiform gyrus, and the right middle temporal gyrus showed a partial negative correlation. There is the decrease of ReHo in many brain regions and the numbers of the local brain functional network connectivity in CFS patients with anxiety and depression comorbidity. The mind-regulation electroacupuncture therapy may relieve the clinical symptoms of the patients through adjusting the abnormal brain regions and activating emotion-related brain regions.

[Mechanism of acupuncture and moxibustion in treatment of chronic fatigue syndrome from perspective of intestinal flora].

Intestinal flora dysbiosis may play an important role in the occurrence and development of chronic fatigue syndrome (CFS), which may induce the inflammatory response and metabolic disturbance of patients with CFS. Acupuncture and moxibustion may achieve anti-fatigue effect by affecting the diversity and quantity of intestinal flora, improving intestinal barrier function, and regulating brain-gut peptides.

Acupuncture and moxibustion for chronic fatigue syndrome: A systematic review and network meta-analysis.

Background:Research into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent.Objective:To evaluate the existing randomized clinical trials (RCTs), compare the efficacy of acupuncture, moxibustion and other traditional Chinese medicine (TCM) treatments.Data sources:Three English-language databases (PubMed, Embase, Web of Science, and The Cochrane Library) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through August 2021.Study selection:RCTs include acupuncture, moxibustion, traditional Chinese herbal medicine, western medicine and no control.Data extraction and synthesis:Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. We conducted a random-effects network meta-analysis within a frequentist framework. We assessed the certainty of evidence contributing to network estimates of the main outcomes with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.Main outcomes and measures:The primary outcomes were the overall response rate and FS-14 scale.Results:A total of 51 randomized controlled trials involving 3473 patients with CFS were included in this review. Forty one studies indicate low risk or unknown risk, and the GRADE scores of the combined results show low levels. Among the main indicators, traditional Chinese medicine therapies have excellent performance. However, the overall response rate is slightly different from the results obtained from the Fatigue Scale-14 total score. Moxibustion and traditional Chinese medicine (Odds ratios 48, 95% CrI 15–150) perform better in the total effective rate, while moxibustion plus acupuncture (MD 4.5, 95% CrI 3.0–5.9) is better in the FS-14 total score.Conclusions:The effect of acupuncture and moxibustion in the treatment of CFS was significantly higher than that of other treatments. Traditional Chinese medicine should be used more widely in the treatment of CFS.

Mechanism of action of Bu Zhong Yi Qi Decoction in the treatment of chronic fatigue syndrome based on network pharmacology and molecular docking

ObjectiveBu Zhong Yi Qi (BZYQ) decoction is a classic prescription in Chinese history that has an obvious effect on improving fatigue symptoms. The objective was to investigate the substance basis and mechanism of BZYQ in the treatment of chronic fatigue syndrome (CFS) at the molecular level based on network pharmacology and molecular docking technology. MethodThe active components and their targets of Huangqi, Baizhu, Renshen, Gancao, Danggui, Chaihu, Chenpi, Shenma in BZYQ were screened by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database and the Encyclopedia of Traditional Chinese Medicine (ETCM). The UniProt database was used to calibrate the target information in BZYQ. CFS target genes were obtained from the GeneCards and DisGeNET databases. Cytoscape 3.7.2 software and the STRING 11.0 database were used to construct a protein–protein interaction (PPI) network and screen core targets. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed using the Database for Annotation, Visualization and Integrated Discovery (DAVID) database. Subsequently, the binding affinity of BZYQ with key target receptors was assessed by molecular docking analysis. ResultBZYQ consists of 329 active components, 198 targets, and 6490 CFS-related targets. There were 180 common targets of BZYQ and CFS, including nitric oxide synthase Ⅱ (NOS2), estrogen receptor beta (ESR2), interleukin-2 (IL2), interleukin-6 (IL6), interleukin-1 beta (IL1B), MAP kinase-activated protein kinase 3 (MAPK3), vascular endothelial growth factor A (VEGFA), nitric oxide synthase Ⅲ (NOS3), and matrix metallopeptidase 2 (MMP2). More than 600 GO terms were obtained (Biological Process 630; Cellular Component: 95; Molecular Function:152) and 185 related signaling pathways, involving the AGE-RAGE signaling pathway in diabetic complications, pathways in cancer, TNF signaling pathway, lipid and atherosclerosis, cAMP signaling pathway, VEGF signaling pathway, calcium signaling pathway, and NF-kappa B signaling pathway. ConclusionBZYQ achieves the purpose of treating CFS through the interaction mechanism of multiple components, multiple targets and multiple pathways. It advances the study of BZYQ to the clinical stage, expounds the effective mechanism of Traditional Chinese Medicine from an overall perspective, and provides ideas at the molecular level for future experimental study.

Study on the active components and mechanism of Suanzaoren decoction in improving cognitive impairment caused by sleep deprivation

Ethnopharmacological relevanceSuanzaoren Decoction (SZRD) is a traditional and classic prescription for the treatment of insomnia, with a history of more than 1,000 years. It replenishes blood components, calms the nerves, reduces fever and irritability. It is commonly used in the clinical treatment of chronic fatigue syndrome, cardiac neurosis, and menopausal syndromes. Modern pharmacological studies have shown that it improves cognitive impairment; however, its mechanism of action remains unclear. Aim of the studyThis study preliminarily investigated the potential bioactive components and mechanism of SZRD in improving cognitive impairment by exploring network pharmacology, molecular docking, and conducting in vivo experiments. Materials and methodsThe components of various Chinese herbs in SZRD and their disease-related targets were identified through network pharmacology and literature. Gene ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of intersection targets were performed using the relevant database. Next, the “Components-Targets-Pathways” (C-T-P) and “Protein-Protein interaction” networks were constructed using the enrichment analysis results to further identify potential pathways, bioactive components, and hub genes. At the same time, molecular docking was used to further distinguish the key bioactive components and genes of SZRD responsible for improving cognitive impairment. Finally, the potential mechanism of action was further analysed and verified using in vivo experiments. ResultsA total of 117 potential active components and 138 intersection targets were identified by network pharmacology screening. The key bioactive components, including calycosin, 5-Prenylbutein, licochalcone G, glypallichalcone, and ZINC189892, were identified by analysing the networks and molecular docking results. Hub genes included ACHE, CYP19A1, EGFR, ESR1, and ESR2. The oestrogen signalling pathway was the most important in the enrichment analysis. In vivo experiments further proved that SZRD could improve cognitive impairment by affecting the oestrogen signalling pathway and the expression of ACHE and CYP19A1. ConclusionsNetwork pharmacology and in vivo experiments demonstrate that SZRD improves cognitive impairment caused by sleep disturbance through estrogen receptor pathway, which provides a basis for its clinical application.

Chronic Fatigue Syndrome

Background: Chronic fatigue syndrome is a collection of symptoms characterized by complaints of fatigue that lasts for at least six months or more. It can be accompanied by symptoms of low-grade fever, myalgia, arthralgia, cephalgia, and a sore throat that is sometimes accompanied by enlarged glands. The main psychological symptoms of chronic fatigue syndrome are depression and sleep disturbances.&#x0D; Case Presentation: A 26-year old male patient was treated with a main complaint of feeling tired since 6 months before he was admitted to the hospital. The patient claimed that he was unable to do activities independently because he experienced extreme tiredness. He also complained of a headache that was felt when under stress and was not relieved by rest along with a stabbing-like pain that moved around throughout his body, which also does not decrease with changes in position or rest. He also has heartburn felt since 4 months ago when eating spicy foods, eating late, and especially when experiencing mental stress, which often was accompanied by nausea and vomiting. The results of his physical, laboratory and supporting examinations were all within normal limits. The patient was then diagnosed with chronic fatigue syndrome and functional dyspepsia.&#x0D; Conclusion: Approaches to medical treatment of chronic fatigue syndrome can be done based on general treatment of physical and psychological symptoms experienced. In these circumstances, antidepressant drug therapy and psychotherapy such as cognitive behavioral therapy is needed. In addition, rehabilitation therapy may also be necessary because several studies show that gradual physical exercise yield significant improvement in chronic fatigue syndrome patients.

A case of chronic fatigue syndrome treated with long snake moxibustion

Background: Chronic fatigue syndrome is a syndrome whose pathogenesis is still unclear and whose incidence is increasing every year. There is no widely accepted international standard for the treatment of chronic fatigue syndrome. Objective: To discuss a 24-year-old patient with chronic fatigue syndrome for more than ten years, with a purpose to introduce a potentially effective treatment for chronic fatigue syndrome. Conclusion: In this case, long snake moxibustion not only had an immediate body temperature increase effect, but also performed well at early follow-up (5 days after treatments). Not only did long snake moxibustion objectively increase the patient’s cellular metabolic caloric value, but it was also effective in improving the patient’s fatigue and other symptoms, as well as in improving depressed mood

[Treatment of chronic fatigue syndrome from yangming meridian].

Based on the theory of "brain-gut communication" and "heart-stomach disease simultaneously", the thinking and method of treating chronic fatigue syndrome (CFS) from yangming meridian were discussed. CFS is related to brain and heart. Based on the analysis of meridian circulation, zang-fu function and the indication characteristics of yangming meridian, the indications of yangming meridian are closely related to brain and heart, so it is proposed to start from yangming meridian and use Chinese herbs combined with acupuncture to treat CFS, including the four methods of clearing away heat and moisturizing dryness, cooling blood and removing blood stasis, promoting qi to clear the organs, and strengthening and replenishing deficiency. It has certain guiding and reference significance for clinical treatment of CFS.