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Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis.
Acupunct Med. 2019 08; 37(4):211-222.AM

Abstract

OBJECTIVE

To evaluate evidence for the efficacy of acupuncture for chronic fatigue syndrome (CFS).

METHODS

Randomized controlled trials (RCTs) comparing acupuncture with sham acupuncture, other interventions that may have a therapeutic effect, or no intervention, for the treatment of CFS, were searched for in the following databases up to March 2018: Pubmed; Embase; the Cochrane Library; Web of Science; Wanfang database; China National Knowledge Infrastructure (CNKI); Chinese Biomedicine (CBM) database; and VIP database. Risk of bias was determined using the Cochrane tool. Meta-analyses were performed using RevMan V.5.3 software. The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) was adopted for levels of evidence.

RESULTS

Sixteen studies with 1346 subjects were included. Most studies had low methodological quality. Meta-analyses showed a favourable effect of acupuncture on overall response rate compared with sham acupuncture (four studies, 281 participants, RR=2.08, 95% CI 1.4 to 3.1, I2=64%, low certainty) and Chinese herbal medicine (three studies, 290 participants, RR=1.17, 95% CI 1.07 to 1.29, I2=0%, low certainty). Acupuncture also appeared to significantly reduce fatigue severity measured by Chalder's Fatigue Scale and the Fatigue Severity Scale compared with other types of control.

CONCLUSION

Our review indicated that acupuncture was more effective than sham acupuncture and other interventions (Chinese herbal medicine, mainly), but no firm conclusion could be reached owing to limited data, poor quality and potentially exaggerated effect size evaluation. Further large, rigorously designed and reported RCTs are required.

Authors+Show Affiliations

1 Institute of Interated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.1 Institute of Interated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.1 Institute of Interated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.2 Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.2 Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.1 Institute of Interated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31204859

Citation

Zhang, Qing, et al. "Acupuncture for Chronic Fatigue Syndrome: a Systematic Review and Meta-analysis." Acupuncture in Medicine : Journal of the British Medical Acupuncture Society, vol. 37, no. 4, 2019, pp. 211-222.
Zhang Q, Gong J, Dong H, et al. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019;37(4):211-222.
Zhang, Q., Gong, J., Dong, H., Xu, S., Wang, W., & Huang, G. (2019). Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupuncture in Medicine : Journal of the British Medical Acupuncture Society, 37(4), 211-222. https://doi.org/10.1136/acupmed-2017-011582
Zhang Q, et al. Acupuncture for Chronic Fatigue Syndrome: a Systematic Review and Meta-analysis. Acupunct Med. 2019;37(4):211-222. PubMed PMID: 31204859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. AU - Zhang,Qing, AU - Gong,Jing, AU - Dong,Haoxu, AU - Xu,Shabei, AU - Wang,Wei, AU - Huang,Guangying, Y1 - 2019/06/17/ PY - 2019/6/18/pubmed PY - 2020/2/25/medline PY - 2019/6/18/entrez KW - acupuncture KW - chronic fatigue syndrome KW - electroacupuncture KW - fatigue KW - systematic review SP - 211 EP - 222 JF - Acupuncture in medicine : journal of the British Medical Acupuncture Society JO - Acupunct Med VL - 37 IS - 4 N2 - OBJECTIVE: To evaluate evidence for the efficacy of acupuncture for chronic fatigue syndrome (CFS). METHODS: Randomized controlled trials (RCTs) comparing acupuncture with sham acupuncture, other interventions that may have a therapeutic effect, or no intervention, for the treatment of CFS, were searched for in the following databases up to March 2018: Pubmed; Embase; the Cochrane Library; Web of Science; Wanfang database; China National Knowledge Infrastructure (CNKI); Chinese Biomedicine (CBM) database; and VIP database. Risk of bias was determined using the Cochrane tool. Meta-analyses were performed using RevMan V.5.3 software. The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) was adopted for levels of evidence. RESULTS: Sixteen studies with 1346 subjects were included. Most studies had low methodological quality. Meta-analyses showed a favourable effect of acupuncture on overall response rate compared with sham acupuncture (four studies, 281 participants, RR=2.08, 95% CI 1.4 to 3.1, I2=64%, low certainty) and Chinese herbal medicine (three studies, 290 participants, RR=1.17, 95% CI 1.07 to 1.29, I2=0%, low certainty). Acupuncture also appeared to significantly reduce fatigue severity measured by Chalder's Fatigue Scale and the Fatigue Severity Scale compared with other types of control. CONCLUSION: Our review indicated that acupuncture was more effective than sham acupuncture and other interventions (Chinese herbal medicine, mainly), but no firm conclusion could be reached owing to limited data, poor quality and potentially exaggerated effect size evaluation. Further large, rigorously designed and reported RCTs are required. SN - 1759-9873 UR - https://www.unboundmedicine.com/medline/citation/31204859/Acupuncture_for_chronic_fatigue_syndrome:_a_systematic_review_and_meta_analysis_ L2 - http://journals.sagepub.com/doi/full/10.1136/acupmed-2017-011582?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -