title: Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials.
abstract: BACKGROUND
  There is no curative treatment for chronic fatigue syndrome (CFS). Traditional Chinese medicine (TCM) is widely used in the treatment of CFS in China.
  
  
  OBJECTIVE
  To evaluate the effectiveness and safety of TCM for CFS.
  
  
  METHODS
  The protocol of this review is registered at PROSPERO. We searched six main databases for randomized clinical trials (RCTs) on TCM for CFS from their inception to September 2013. The Cochrane risk of bias tool was used to assess the methodological quality. We used RevMan 5.1 to synthesize the results.
  
  
  RESULTS
  23 RCTs involving 1776 participants were identified. The risk of bias of the included studies was high. The types of TCM interventions varied, including Chinese herbal medicine, acupuncture, qigong, moxibustion, and acupoint application. The results of meta-analyses and several individual studies showed that TCM alone or in combination with other interventions significantly alleviated fatigue symptoms as measured by Chalder's fatigue scale, fatigue severity scale, fatigue assessment instrument by Joseph E. Schwartz, Bell's fatigue scale, and guiding principle of clinical research on new drugs of TCM for fatigue symptom. There was no enough evidence that TCM could improve the quality of life for CFS patients. The included studies did not report serious adverse events.
  
  
  CONCLUSIONS
  TCM appears to be effective to alleviate the fatigue symptom for people with CFS. However, due to the high risk of bias of the included studies, larger, well-designed studies are needed to confirm the potential benefit in the future.
authors.affiliation: Center for Evidence-Based Medicine, Beijing University of Chinese Medicine, Beijing, China.
authors.forename: Yu-Yi
authors.initials: YY
authors.lastname: Wang
authors.affiliation: Department of Academic Exchange, World Federation of Chinese Medicine Societies, Beijing, China.
authors.forename: Xin-Xue
authors.initials: XX
authors.lastname: Li
authors.affiliation: Center for Evidence-Based Medicine, Beijing University of Chinese Medicine, Beijing, China. Electronic address: Liujp@bucm.edu.cn.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Liu
authors.affiliation: Institute for Tibetan Medicine, China Tibetology Research Center, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Luo
authors.affiliation: School of Public Health, Hebei University, Baoding, Hebei, China.
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Ma
authors.affiliation: The National Research Center in Complementary and Alternative Medicine, NAFKAM, Department of Community Medicine, Faculty of Health Science, UiT The Arctic University of Norway, 9037 Tromsø, Norway. Electronic address: terje.alrak@uit.no.
authors.forename: Terje
authors.initials: T
authors.lastname: Alraek
mesh_terms: D015670:Acupuncture Therapy; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D015673:Fatigue Syndrome, Chronic / Q000628:therapy*; D006801:Humans; D008516:Medicine, Chinese Traditional / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Chronic fatigue syndrome; Randomized clinical trials; Systematic review; Traditional Chinese medicine