Chinese herbal medicine for the treatment of chronic fatigue syndrome: A systematic review and meta-analysis 2022

[Sly Saint]

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.

https://www.frontiersin.org/articles/10.3389/fphar.2022.958005/full

 

[Sly Saint]

A lot of the information in this paper is incorrect/out of date.

Current recommendations for the treatment of CFS include cognitive behavioral therapy (CBT), graded exercise therapy (GET), western conventional medicine (WCM), complementary or alternative medicine, and nutritional support therapy. CBT challenges patients’ thoughts to relieve patients’ psychological stress, and this may provide short-term benefits but does not permanently reduce symptoms (Fernie et al., 2016; Geraghty and Blease, 2018). Exercise therapy, including aerobic exercises (e.g., walking, jogging, swimming, and cycling) and anaerobic exercises (e.g., strength and stability exercises), could improve physical function and reduce fatigue (Marques et al., 2015; Larun et al., 2017). However, some patients have expressed disappointment with GET because it can interfere with the outcome of alternative treatments and may indirectly exacerbate symptoms in patients (Goudsmit and Howes, 2017; Geraghty and Blease, 2019).

 

[Sean]

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.​

If the data are not robust then all they should have said was there is no clear evidence of either benefit or safety.

There is no 'seems' in that space.

 

[RedFox]

Agreed. A meta-analysis of low-quality trials will be of similarly low quality. If all the studies have systemic bias, combining them can't help. Garbage in, garbage out.