DOI QR코드

DOI QR Code

귀비탕과 그 변방의 만성피로증후군 증상완화에 대한 효용성: 체계적인 문헌고찰

Is Gwibitang and its modification beneficial for alleviating symptoms in chronic fatigue syndrome: A systematic review and meta-analysis

  • 남동현 (상지대학교 한의과대학 진단.생기능의학교실)
  • Nam, Donghyun (Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University)
  • 투고 : 2020.04.13
  • 심사 : 2020.05.28
  • 발행 : 2020.05.31

초록

Objectives : The purpose of this systematic review is to confirm whether Gwibitang is beneficial in chronic fatigue syndrome (CFS). Methods : Clinical trials were searched from databases including Pubmed, Embase, Central Cochrane, CNKI, Wanfang, CQVIP, CiNii, OASIS, Koreamed, and NDSL. The eligible study design was limited into randomized controlled trial, quasi-randomized controlled trial and controlled clinical trial. The outcomes included general effectiveness as nominal scale, and fatigue severity, insomnia severity and quality of life as interval or ratio scale. The meta-analysis and assessment of risk of bias was performed based on the data extracted from the selected trials. Results : The results of eight randomized controlled trials (n=596) were included in the meta-analysis. The results of the synthesis showed Gwibitang is beneficial substantially for relieving and managing the general symptoms, and its heterogeneity was not in important level (RR 0.26 [95% CI 0.17, 0.39], Z=6.47, P<0.00001, I2=0%). Gwibitang was beneficial for alleviating fatigue (SMD -0.78 [95% CI -1.27, -0.30], Z=3.17, P=0.002), but its certainty was low. In case of insomnia, too few trials had been found and their risk of bias was substantial, so no conclusions had been brought to. Conclusions : We found an evidence that Gwibitang could be beneficial for managing and alleviating main symptoms in CFS patients.

키워드

참고문헌

  1. Committee on the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Beyond myalgic encephalomyelitis/chronic fatigue syndrome. Institute of medicine of the national academies. 2015:2-10.
  2. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121(12):953-9. https://doi.org/10.7326/0003-4819-121-12-199412150-00009
  3. Centers for Disease Control and Prevention. Treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). 2019 November 19, 2019; Available from: https://www.cdc.gov/mecfs/treatment/index.html.
  4. Lim EJ, Ahn YC, Jang ES, Lee SW, Lee SH, Son CG. Systematic review and meta- analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). J Transl Med. 2020;18(1):100. https://doi.org/10.1186/s12967-020-02269-0
  5. Kim JW, Kim HJ, Jang ES, Jung HJ, Hwang MW, Nam DH. Survey on pattern identification and treatment of chronic fatigue in Korea medicine. J Physiol and Pathol Korean Med. 2018;32(2):126-33. https://doi.org/10.15188/kjopp.2018.04.32.2.126
  6. Chen R, Moriya J, Yamakawa JI, Takahashi T, Kanda T. Traditional Chinese medicine for chronic fatigue syndrome. Evidence-Based Complementary and Alternative Medicine, 2010;7(1):3-10. https://doi.org/10.1093/ecam/nen017
  7. Shin HY, An NH, Cha YJ, Shin EJ, Shin TY, Baek SH, et al. Effect of Kuibitang on lipopolysaccharide-induced cytokine production in peripheral blood mononuclear cells of chronic fatigue syndrome patients. J Ethnopharmacol. 2004;90(2-3):253-9. https://doi.org/10.1016/j.jep.2003.10.006
  8. Zheng Y. Guiding principles for clinical research of new drugs in traditional Chinese medicine. China Medical Science and Technology Press. 2002.
  9. Nam DH. The effectiveness of Bojungikgi-tang and its modifications on chronic fatigue syndrome: a systematic review and metaanalysis. J Korean Med. 2020;41(1):93-106. https://doi.org/10.13048/jkm.20007
  10. Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988;108(3):387-9. https://doi.org/10.7326/0003-4819-108-3-387
  11. Higgins J, Green S, Cochrane handbook for systematic reviews of interventions. ver 5.1.0 ed. The Cochrane collaboration. 2011.
  12. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6. https://doi.org/10.1136/bmj.39489.470347.AD
  13. Kim S, Park J, Seo H, Lee Y, Jang B, Son H, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. National evidence-based healthcare collaborating agency. 2011:101-115.
  14. Ding XM. Clinical analysis of Guipi decoction in treating chronic fatigue syndrome of heart and spleen deficiency Type. China Foreign Medical Treatment. 2019;2019(32):169-71.
  15. Gong JH. Observation on therapeutic effect of 30 cases of chronic fatigue syndrome treated with modified Guipi decoction. Zhejiang Journal of Integrated Traditional Chinese and Western Medicine. 2007;17(10):627-8. https://doi.org/10.3969/j.issn.1005-4561.2007.10.019
  16. Hau ZD, Zheng GD, Mo XL, Xiao WX, Li SS, Cheng LM. Application of traditional Chinese medicine decoction combined with auricular acupoint sticking in treating chronic fatigue syndrome of heart and spleen deficiency type. Nursing Practice and Research. 2018;15(15):144-6.
  17. Jiang Q. Observation on therapeutic effect of Buzhongyiqi decoction and Guipi decoction on chronic fatigue syndrome. Beijing Journal of Traditional Chinese Medicine. 2012;31(2):121-2.
  18. Li CD, Chen ZL, Huang N. The clinical study of soothing liver and activating spleen in treatment of chronic fatigue syndrome. Liaoning Journal of Traditional Chinese Medicine. 2011;38(10):2037-8.
  19. Wang CF, Lin XY, Hua ZD. Clinical study on treatment of chronic fatigue syndrome with traditional Chinese medicine and auricular point sticking. Journal of Practical Traditional Chinese Medicine. 2013;29(9):709-10.
  20. Wu JD, Zhang XQ, Zhang Y, Zhu AS. Clinical effect of Guipi decoction in treating chronic fatigue syndrome of heart and spleen deficiency type. Liaoning Journal of Traditional Chinese Medicine. 2018;45(2):305-6.
  21. Zhang L, Chen HL, Wang XX, Fan D, Yue S, Ma J. Effect of electro-acupuncture combined with Guipi pill on serum cortisol level in chronic fatigue syndrome with heart-spleen deficiency pattern. Journal of Clinical Medical Literature. 2018;5(28):64-5.
  22. Abbi B, Natelson BH. Is chronic fatigue syndrome the same illness as fibromyalgia: evaluating the 'single syndrome' hypothesis. QJM, 2013;106(1):3-9. https://doi.org/10.1093/qjmed/hcs156
  23. Natelson BH, Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: definitions, similarities, and differences. Clin Ther. 2019;41(4):612-8. https://doi.org/10.1016/j.clinthera.2018.12.016
  24. Alraek T, Lee MS, Choi TY, Cao H, Liu J. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complement Altern Med. 2011;11:87. https://doi.org/10.1186/1472-6882-11-87
  25. Wang YY, Li XX, Liu JP, Luo H, Ma LX, Alraek T. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014;22(4):826-33. https://doi.org/10.1016/j.ctim.2014.06.004
  26. Wang T, Xu C, Pan K, Xiong H. Acupuncture and moxibustion for chronic fatigue syndrome in traditional Chinese medicine: a systematic review and meta-analysis. BMC Complement Altern Med. 2017;17(1):163. https://doi.org/10.1186/s12906-017-1647-x
  27. Wang T, Zhang Q, Xue X, Yeung A. A systematic review of acupuncture and moxibustion treatment for chronic fatigue syndrome in China. Am J Chin Med. 2008;36(1):1-24. https://doi.org/10.1142/S0192415X08005540
  28. Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and metaanalysis. Acupunct Med. 2019;37(4):211-22. https://doi.org/10.1136/acupmed-2017-011582
  29. Adams D, Wu T, Yang X, Tai S, Vohra S, Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome. Cochrane Database of Systematic Reviews, 2018;10:CD006348.