[Effect of ginger-separated moxibustion on fatigue, sleep quality and depression in patients with chronic fatigue syndrome: a randomized controlled trial].

OBJECTIVE: To observe the effect of ginger-separated moxibustion on fatigue, sleep quality and depression in the patients with chronic fatigue syndrome. METHODS: A total of 62 patients with chronic fatigue syndrome were randomized into an observation group (31 cases, 3 cases dropped off) and a control group (31 cases, 2 cases dropped off). In the control group, the patients had normal diet and proper physical exercise. In the observation group, on the basis of the control group, the ginger-separated moxibustion was added at Zhongwan (CV 12), Shenque (CV 8) and Guanyuan (CV 4), 30 min each time, once every two days, 3 times weekly. Separately, before treatment and after 4 weeks of treatment, the MOS item short form health survey (SF-36), the Pittsburgh sleep quality index (PSQI) scale and the self-rating depression scale (SDS) were adopted to evaluate the degrees of fatigue, sleep quality and depression in the patients of the two groups. RESULTS: In the observation group, the score of each item of SF-36, the score of each item of PSQI and SDS score after treatment were all improved significantly as compared with those before treatment respectively (P<0.05, P<0.01). In the control group, the scores of overall health, vitality and mental health in SF-36 and the score of sleep time of PSQI after treatment were improved as compared with those before treatment respectively (P<0.05). After treatment, the score of each item of SF-36, the scores of sleep quality, sleep time, sleep efficiency and sleep disorders of PSQI, as well as SDS score in the observation group were all better than those in the control group respectively (P<0.01, P<0.05). The score of SF-36 was relevant to the scores of PSQI and SDS in the patients of chronic fatigue syndrome (r =0.331, P<0.05; r =-0.706, P<0.01). The improvement value of SF-36 score was closely related to the improvement value of SDS score in the observation group (r =-0.657, P<0.01). CONCLUSION: The ginger-separated moxibustion effectively relieves fatigue and depression condition and improves sleep quality in the patients with chronic fatigue syndrome. The fatigue condition is relevant with sleep quality and depression condition to a certain extent in the patients.

Successful Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome with Chronic Febricula Using the Traditional Japanese Medicine Shosaikoto.

We herein report the case of a 14-year-old girl who had been experiencing chronic fatigue, febricula, and social withdrawal for 20 months. No notable abnormalities were identified during routine checkups at a general pediatric hospital; symptomatic treatments did not affect her condition. She was diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Based on the concepts of Japanese traditional medicine, she was administered shosaikoto-based treatment. After several weeks of treatment, all of the symptoms had been dramatically alleviated, consequently resolving the issue of non-attendance at school. Shosaikoto-based medication may be a therapeutic option for treating ME/CFS in patients presenting with chronic febricula.

Qigong exercise for chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) is often overlooked, has unclear etiology and no effective cure except some symptomatic treatments. Additionally, most people with CFS do not seek medical attention. Qigong exercise, an ancient Eastern body-mind-spirit practice, has been long practiced in Chinese communities and may powerfully trigger the self-healing process. Using full baseline data (n=1409), the average Hong Kong CFS respondent was found to be female, married, 42.5yo, highly educated and employed full-time, experiencing sleep disturbance (~95%), anxiety (>80%), and depressive symptoms (68%). Here, we summarized our previous studies to evaluate the potential of Qigong as a complementary and alternative therapy for CFS. Two randomized controlled trials were conducted (RCT1 n1=137, RCT2 n2=150). In both trials, extensive online questionnaires allowed individuals with CFS-like illness (i.e., symptoms match CFS, yet without clinical confirmation) to be identified. RCT1 included a 5-week intervention. The intervention in RCT2 was 8weeks. In RCT1 Qigong group had reduced fatigue (P<0.001) and depressive symptoms (P=0.002), and improved telomerase activity (P=0.029). An effective practice regimen was identified (≥3 days/week, at ≥30min/session). Methods were slightly adjusted for RCT2, which replicated RCT1 findings, and further documented improved subjective sleep quality (P=0.008) and adiponectin levels (P<0.05). A significant dose-response relationship was founded. Thus, Qigong exercise should be recognized as a possible standalone therapy and self-management skill in CFS. Strategies are needed to increase motivation for regular practice and to explore its possibility of self-management skill in brain health. Further clarity would come from studies comparing Qigong with other physical exercises.

Artificial intelligence based discovery of the association between depression and chronic fatigue syndrome.

BACKGROUND: Both of the modern medicine and the traditional Chinese medicine classify depressive disorder (DD) and chronic fatigue syndrome (CFS) to one type of disease. Unveiling the association between depressive and the fatigue diseases provides a great opportunity to bridge the modern medicine with the traditional Chinese medicine. METHODS: In this work, 295 general participants were recruited to complete Zung Self-Rating Depression Scales and Chalder Fatigue Scales, and meanwhile, to donate plasma and urine samples for 1H NMR-metabolic profiling. Artificial intelligence methods was used to analysis the underlying association between DD and CFS. Principal components analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were used to analyze the metabolic profiles with respect to gender and age. Variable importance in projection and t-test were employed in conjunction with the PLS-DA models to identify the metabolite biomarkers. Considering the asymmetry and complexity of the data, convolutional neural networks (CNN) model, an artificial intelligence method, was built to analyze the data characteristics between each groups. RESULTS: The results showed the gender- and age-related differences for the candidate biomarkers of the DD and the CFS diseases, and indicated the same and different biomarkers of the two diseases. PCA analysis for the data characteristics reflected that DD and CFS was separated completely in plasma metabolite. However, DD and CFS was merged into one group. LIMITATION: Lack of transcriptomic analysis limits the understanding of the association of the DD and the CFS diseases on gene level. CONCLUSION: The unmasked candidate biomarkers provide reliable evidence to explore the commonality and differences of the depressive and the fatigue diseases, and thereby, bridge over the traditional Chinese medicine with the modern medicine.

Successful outcome of musculoskeletal injury leads to a reduction in chronic fatigue: A case report.

BACKGROUND: Chronic fatigue syndrome (CFS) is a general term used to describe a number of medical conditions that lead to persistent levels of fatigue and distress. OBJECTIVES: Osteopathic manipulative treatment (OMT) combined with shoulder exercises to resolve musculoskeletal sports injury may have also led to a reduction in pain and improved strength with the patient reporting a change in CFS levels. CLINICAL FEATURES: 19-year-old male student, (statue 194cm and mass 80kg) who had played county level cricket and hockey. Presented with a two-year history of left shoulder pain (VAS 8/10) and a diagnosis of chronic fatigue syndrome. INTERVENTION AND OUTCOMES: OMT was performed over four clinical visits throughout a four a month period. Management goal was pain reduction, neural regulation, and facilitation of breathing mechanics to improve lymphatic drainage and restoration of shoulder strength and control. CONCLUSION: Clinically a reduction in pain (VAS 8/10-0/10) over four treatments appeared to correlate with improved shoulder strength. It was also reported that due to pain reduction, CFS might have improved.

Supplementation with Guanidinoacetic Acid in Women with Chronic Fatigue Syndrome.

A variety of dietary interventions has been used in the management of chronic fatigue syndrome (CFS), yet no therapeutic modality has demonstrated conclusive positive results in terms of effectiveness. The main aim of this study was to evaluate the effects of orally administered guanidinoacetic acid (GAA) on multidimensional fatigue inventory (MFI), musculoskeletal soreness, health-related quality of life, exercise performance, screening laboratory studies, and the occurrence of adverse events in women with CFS. Twenty-one women (age 39.3 ± 8.8 years, weight 62.8 ± 8.5 kg, height 169.5 ± 5.8 cm) who fulfilled the 1994 Centers for Disease Control and Prevention criteria for CFS were randomized in a double-blind, cross-over design, from 1 September 2014 through 31 May 2015, to receive either GAA (2.4 grams per day) or placebo (cellulose) by oral administration for three months, with a two-month wash-out period. No effects of intervention were found for the primary efficacy outcome (MFI score for general fatigue), and musculoskeletal pain at rest and during activity. After three months of intervention, participants receiving GAA significantly increased muscular creatine levels compared with the placebo group (36.3% vs. 2.4%; p < 0.01). Furthermore, changes from baseline in muscular strength and aerobic power were significantly greater in the GAA group compared with placebo (p < 0.05). Results from this study indicated that supplemental GAA can positively affect creatine metabolism and work capacity in women with CFS, yet GAA had no effect on main clinical outcomes, such as general fatigue and musculoskeletal soreness.

¿Podemos descartar que la fibromialgia, el síndrome de fatiga crónica y la sensibilidad química múltiple sean enfermedades psicosomáticas? / Can we rule out that fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity are psychosomatic diseases?

No disponible

[Effectiveness of medical rehabilitation of women of reproductive age with fatigue syndrome].

Efficacy Erbisol in combination with Lymphomyosot and Echinacea compositum C in medical rehabilitation of women of reproductive age with fatigue syndrome and chronic gynecological pathology was studied. It was found that this complex of medications promotes faster and more effective reduction of the level of circulating immune complexes in the serum, achievement of persistent clinical remission of disease and liquidation of fatigue syndrome manifestations, what improves the quality of life of patients.

Treatment of orthostatic headache without intracranial hypotension: a case report.

INTRODUCTION: Orthostatic headache is very suggestive of intracranial hypotension. It has a good prognosis as it usually responds to conservative treatment or epidural blood patches. CASE REPORT: A 36-year-old female presented with severe and prolonged orthostatic headache starting after a seizure. No stigma of intracranial hypotension was detected on brain MRI, and intracranial pressure was within normal range. No imaging evidence of a fistula was found. She was refractory to symptomatic treatment including five epidural blood patches. Progressive improvement occurred simultaneously to the introduction of vitamin A supplementation. DISCUSSION: A series of six similar patients is discussed, in which five patients remained severely symptomatic and workdisabled at an average follow-up of four years. It is proposed that the pathophysiological mechanism producing orthostatic headache might not be dependent on intracranial hypotension and could respond to vitamin A.

Pain in patients with chronic fatigue syndrome: time for specific pain treatment?

BACKGROUND: Besides chronic fatigue, patients with chronic fatigue syndrome (CFS) have debilitating widespread pain. Yet pain from CFS is often ignored by clinicians and researchers. OBJECTIVES: To examine whether pain is a unique feature of CFS, or does it share the same underlying mechanisms as other CFS symptoms? Second, it is examined whether effective treatments for pain from CFS are currently available. STUDY DESIGN: Narrative review covering the scientific literature up through December 2011. SETTING: Several universities. RESULTS: From the available literature, it is concluded that musculoskeletal factors are unlikely to account for pain from CFS. Pain seems to be one out of many symptoms related to central sensitization from CFS. This idea is supported by the findings of generalized hyperalgesia (including widespread increased responsiveness to painful stimuli) and dysfunctional endogenous analgesia in response to noxious thermal stimuli. Pain catastrophizing and depression partly account for pain from CFS. Pain increases during exercise is probably due to the lack of endogenous analgesia and activation of several genes in response to exercise in CFS. There is currently no evidence in support for the efficacy of complementary medicine in the treatment of pain from CFS. Intensive education about the biology of pain from CFS (within the framework of central sensitization) has positive short-term effects for patients with CFS, and fatigue-targeting cognitive behavioral therapy appears to be effective for pain from CFS as well. LIMITATIONS: The role of the deficient hypothalamus-pituitary-adrenal axis in relation to pain from CFS, as well as the interactions with immune (dys)functioning require further study. CONCLUSION: Recent research has increased our understanding of pain from CFS, including its treatment. It is advocated to optimize current CFS treatment protocols by targeting the underlying mechanism for those patients having severe pain.

A mind-body technique for symptoms related to fibromyalgia and chronic fatigue.

CONTEXT: A novel mind-body approach (amygdala retraining) is hypothesized to improve symptoms related to fibromyalgia and chronic fatigue. OBJECTIVE: To examine the use of a mind-body approach for improving symptoms related to fibromyalgia and chronic fatigue. DESIGN: This was a single-blind, randomized controlled trial. SETTING: The study was conducted in a tertiary-care fibromyalgia and chronic fatigue clinic. PATIENTS: Patients with fibromyalgia, chronic fatigue, or both were included. INTERVENTIONS: Patients were randomly assigned to receive amygdala retraining along with standard care or standard care alone. Standard care involved attending a 1.5-day multidisciplinary program. The amygdala retraining group received an additional 2.5-hour training course in which the key tools and techniques adapted from an existing program were taught to the patient. A home-study video course and associated text were provided to supplement the on-site program. Both groups received telephone calls twice a month to answer questions related to technique and to provide support. MAIN OUTCOME MEASURES: Validated self-report questionnaires related to general health, well-being, and symptoms, including Short Form-36, Measure Yourself Medical Outcome Profile, Multidimensional Fatigue Inventory, Epworth Sleepiness Scale, and Fibromyalgia Impact Questionnaire. RESULTS: Of the 44 patients randomly assigned who completed baseline assessments, 21 patients completed the study (14 in the standard care group and 7 in the study group). Median age was 48 years (range, 27-56 years), and female subjects comprised 91% of the group. Analyses demonstrated statistically significant improvements in scores for physical health, energy, pain, symptom distress, and fatigue in patients who received the amygdala retraining compared with standard care.

Cognitive deficits in patients with chronic fatigue syndrome compared to those with major depressive disorder and healthy controls.

OBJECT: Chronic fatigue syndrome (CFS) patients report usually cognitive complaints. They also have frequently comorbid depression that can be considered a possible explanation for their cognitive dysfunction. We evaluated the cognitive performance of patients with CFS in comparison with a control group of healthy volunteers and a group of patients with MDD. PATIENTS AND METHODS: Twenty-five patients with CFS, 25 patients with major depressive disorder (MDD), and 25 healthy control subjects were given standardized tests of attention, working memory, and verbal and visual episodic memory, and were also tested for effects related to lack of effort/simulation, suggestibility, and fatigue. RESULTS: Patients with CFS had slower phasic alertness, and also had impaired working, visual and verbal episodic memory compared to controls. They were, however, no more sensitive than the other groups to suggestibility or to fatigue induced during the cognitive session. Cognitive impairments in MDD patients were strongly associated with depression and subjective fatigue; in patients with CFS, there was a weaker correlation between cognition and depression (and no correlation with fatigue). CONCLUSIONS: This study confirms the presence of an objective impairment in attention and memory in patients with CFS but with good mobilization of effort and without exaggerated suggestibility.

The search for pain relief in people with chronic fatigue syndrome: a descriptive study.

The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms. This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study. Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain. Each interview was conducted in the home of the participant. Fifty participants were recruited, of which, 10 participants were severely disabled by CFS. Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment. Three participants were currently receiving physiotherapy. Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief. Acupuncture was reported to provide the most pain relief (n=16). Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist. The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms. Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

Chronic fatigue syndrome: is there a role for non-antidepressant pharmacotherapy?

IMPORTANCE OF THE FIELD: Chronic fatigue syndrome (CFS) is a prevalent but poorly understood condition mainly characterized by debilitating, persistent or recurrent fatigue; increased physical and mental fatigability; cognitive impairment and widespread musculoskeletal pain. Despite intensive treatment research, the role of pharmacotherapy in the illness remains uncertain. AREAS COVERED IN THIS REVIEW: An updated review is given of pharmacotherapy in CFS, with a focus on non-antidepressant, controlled drug trials performed between 1988 and August 2009. WHAT THE READER WILL GAIN: Antiviral, immunological and antibiotic therapies, although sometimes associated with symptom amelioration, can be more harmful than beneficial in CFS. Stimulants seem to benefit some CFS patients but their long-term effects is uncertain. Although antidepressants are not curative for the illness, they might be useful for some symptomatic aspects and co-morbid anxiety and depression. There is little or no evidence that CFS patients benefit from other pharmacological agents (e.g., steroids) or from dietary supplements and complementary medicine products. Future research into treatment should take specific subgroups into account and should target immunological aspects of the illness as well as the complex relationships between CFS, stress and depression. TAKE HOME MESSAGE: Pharmacotherapy can currently not be considered first-line treatment in CFS and should always be used in a context of self-management and rehabilitation.

[Treatment of myalgia].

Fibromyalgia (FM) conceptualized by the American College of Rheumatology is characterized by long-lasting chronic widespread pain and stiffness of the fibro-muscular system associated with various unidentified symptoms. Since most of the patients are female and the onset and clinical course of FM involves various kinds of bio-psychosocial stress factors, it is very important to consider the psychosomatic background of the patient. The symptom of FM is not readily improved with conventional analgesic drugs, antirheumatic agents or various kinds of physiotherapy, however current guidelines recommend tricyclic antidepressants, SSRIs and SNRIs as first-line therapies to treat the multiple symptom of the FM. It is considered that antidepressants may operate the functional impairment of descending (efferent) analgesic system, in which serotonin and noradrenaline take an important role. Among 199 certified physicians of the Japanese Society of Psychosomatic Medicine, the largest number of respondents selected SSRI, SNRI and other antidepressants as first-line drugs. Because the psychological and physical exhaustion due to an irregular life style, physical strain, and accumulated fatigue may be the key stress factors for the organization of symptoms, psychosomatic approach and guidance should be conducted to enable patients to reduce stress in daily life. For the problems of personality and psychological stress, counseling and advanced psychotherapy such as cognitive behavioral therapy (CBT) should be also conducted.

Serum 25-hydroxy vitamin D levels in chronic fatigue syndrome: a retrospective survey.

INTRODUCTION: Patients with chronic fatigue syndrome (CFS) may be at risk of osteoporosis due to their relative lack of physical activity and excessive time spent indoors, leading to reduced vitamin D synthesis. We hypothesized that serum 25-OH vitamin D levels are lower in CFS patients than in the general British population. SUBJECTS AND METHODS: We performed a retrospective survey of serum 25-OH vitamin D levels in 221 CFS patients. We compared this to a group of patients attending the hospital for other chronic conditions and to a large British longitudinal survey of 45-year old women, using a variety of appropriate statistical approaches. RESULTS: 25-OH vitamin D levels are moderately to severely suboptimal in CFS patients, with a mean of 44.4 nmol/L (optimal levels >75 nmol/L). These levels are lower and the difference is statistically significant (p<0.0004) than those of the general British population from a recent national survey, but similar to those in patients with other chronic conditions. CONCLUSIONS: This data supports the recommendation made in recent NICE guidelines that all patients with moderate to severe CFS should be encouraged to obtain adequate sun exposure and eat foods high in vitamin D. Oral or intramuscular vitamin D supplementation should be considered for those whose levels remain suboptimal.