Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract 2024 Banihashemi et al

Abstract

Objective
This study aimed to evaluate the effect of Astragalus root extract on nurses suffering from post-COVID-19 chronic fatigue syndrome.

Materials and methods
The study was designed as a triple-blind, randomised, controlled trial in Iran in 2023. 64 chronic fatigue syndrome nurses were randomly assigned to one of two groups: an intervention group (n=32) that received Astragalus root extract (500 mg two times per day) or a control group (n=32) that received a placebo. Changes in chronic fatigue syndrome scores were measured before to, at the end of and 1 month after the intervention. Data were analysed using descriptive and analytical statistics (T-tests, χ2, analysis of variances, Cochran’s Q tests, McNemar and generalised estimating equations).

Results
In comparison to before, chronic fatigue prevalence decreased statistically significantly at the end of the intervention group (13.8%) and 1 month later (17.2%). Further, the frequency differed between before and after (p=0.0001) and 1 month later (p=0.0001). In the control group, chronic fatigue was statistically significantly different before and after the intervention (72.2%; p=0.003). Having an underlying disease (B=0.84, OR=2.33; p=0.04) and being in the control group (B=2.15, OR=12.36; p=0.01) increased the risk of chronic fatigue, whereas increasing the length of time decreased it (B=−0.67, OR=0.50; p=0.0001).

Conclusion
Astragalus root extract has been shown to reduce chronic fatigue in nurses. Therefore, this herbal extract can be used to reduce the incidence and treatment of chronic fatigue in nurses.

Paywall, https://spcare.bmj.com/content/early/2024/06/04/spcare-2023-004595

 

Being paywalled, I am unable to determine how "chronic fatigue syndrome" was specified. Given that they then refer only to chronic fatigue in the later part of the abstract I doubt they used any criteria that screened for PEM.

 

Inclusion criteria include not having the exclusion criteria...

 

It continues on. It's laughable, but not really any different to the prime BPS papers: predisposing to, precipitating and perpetuating their circular diagrams.

Also true of BPS: a vicious cycle which if not broken continues to occur.

 

Yes. #in-nurses instead of #in-mice.

I don't think it's worth spending any time on. The Canadian taurine paper is of more interest.

 

Based on just the objective results claimed in the abstract, I'm not sure why you guys are dismissing this so easily.

@SNT Gatchaman Can you paste any charts showing effect size?

Also, do they go into more detail on the DePaul questionnaire? MEpedia says:

 

I think given they mismatch between chronic fatigue and ME/CFS, gives a first hint why this might not be referring to what we see as ME/CFS.

Would be the second hint

also the depaul questionnaire is not used to diagnose alone and ME has many symptoms that would flag up in “Chronic fatigue”.

From me-pedia

 

If you're correct that there was more improvement in the control but they decided to claim the herb helps because the intervention group did improve from baseline, I might cry.

 

If you skim through the de-paul questionnaire, you can see why without proper testing it could identify someone with chronic fatigue who has some chronic pain.

 

Exactly. If that proportion of any profession were shown to have ME/CFS, (a) there'd be an enormous amount of interest, and (b) the profession would be in crisis with so many unable to work.

 

The five items they later added seem to help a bit:



A Brief Questionnaire to Assess Post-Exertional Malaise

 

I’m assuming this is referring to the CCC?

Given the CCC finds population prevalence of under 1%, and DePaul is based on the CCC. The findings of 17-39% are extremely suspect.

 

Sadly, every single one of the PEM questions are related to fatigue. So it is not hard to imagine why someone with depression or burnout (but without ME) might get flagged here.

 

Hmm..

I agree.

 

I wouldn't bother crying. I don't think these figures are what we call statistically significant at all. They are just differences between before and after. Not between groups.