The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
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Benefit of chuna for managing symptoms in chronic fatigue syndrome patients: A systematic review and meta-analysis

만성피로증후군의 증상관리를 위한 추나요법의 유용성: 체계적인 문헌고찰과 메타분석

  • Song, Jeongyun (Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University) ;
  • Kim, Junyeol (Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University) ;
  • Nam, Donghyun (Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University)
  • 송정윤 (상지대학교 한의과대학 진단.생기능의학교실) ;
  • 김준열 (상지대학교 한의과대학 진단.생기능의학교실) ;
  • 남동현 (상지대학교 한의과대학 진단.생기능의학교실)
  • Received : 2020.06.16
  • Accepted : 2020.08.04
  • Published : 2020.09.01
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Abstract

Objectives: The aim of this review is to assess the clinical benefit of chuna for managing symptoms in chronic fatigue syndrome (CFS) Methods: We searched eligible studies from the following 11 databases with no language restriction: Pubmed, CENTRAL, Embase, CNKI, CQVIP, Wanfang, CiNii, OASIS, RISS and Koreamed. We selected randomized controlled trial (RCT), quasi-randomized controlled trial (Quasi-RCT) and controlled clinical trial (CCT) in which patients with chronic fatigue syndrome were treated with chuna. The results of the included studies were synthesized through meta-analysis, and their risk of bias were also assessed. Results: We searched 914 potentially relevant studies, and only 20 studies were selected for this systematic review. Meta-analysis showed that chuna was more effective in improving general symptoms (n=291, RR 0.19 [95% CI 0.11 to 0.32], Z=6.08, p<0.00001, I2=0%), fatigue (n=487, SMD -0.95 [95% CI -1.19 to -0.71], Z=7.76, p<0.00001, I2=37%) and sleep disorder (n=139, SMD -0.58 [95% CI -0.92 to -0.24], Z=3.36, p=0.0008, I2=0%) compared to health supplements or usual care. When chuna was used as an added intervention, it was more effective in improving general symptoms(n=729, RR 0.25 [95% CI 0.15 to 0.42], Z=5.19, p<0.00001, I2=0%) and fatigue severity alone(n=217, SMD -1.21 [95% CI -1.53 to -0.89], Z=7.45, p<0.00001, I2=15%) compared to control. Conclusion: We found that chuna was beneficial for improving severity of general symptoms and fatigue at post treatment in CFS patients.

Keywords

References

  1. Fukuda K, Straus SE, Hickie I, Sharpe MC, Psych M, Dobbins JG. Chronic fatigue syndrome: a working case definition. Ann Intern Med. Ann Intern Med. 1994;121(12):953-9. https://doi.org/10.7326/0003-4819-121-12-199412150-00009
  2. Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE. Chronic fatigue syndrome: a working case definition. Annals of Internal Medicine. 1988;108(3):387-9. https://doi.org/10.7326/0003-4819-108-3-387
  3. Gundro BK, Sporstol FM, Larun L, Flottorp S, Malterud K. Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review. BMJ Open. 2014;4.
  4. Son CG. Review of the prevalence of chronic fatigue worldwide. The Journal of Korean Oriental Medicine. 2012;33(2):25-33.
  5. Lim EJ, Ahn YC, Jang ES, Lee SW, Sh L, Son CG. Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Journal of Translational Medicine. 2020;18(100).
  6. Kim CH, Shin HC, Won CW. Prevalence of chronic fatigue and chronic fatigue syndrome in Korea: community-based primary care study. The Korean Academy of Medical Sciences. 2005;20:529-34.
  7. Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neuroscience, 2013:1-8.
  8. Hvidberg MF, Brinth LS, Olesen Av, Petersen KD, Ehlers L. The health-related quality of life for patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). PLoS ONE. 2015;10(7):e013242-e.
  9. Castro-Marrero J, Faro M, Zaragoza MC, Aliste L, de Sevilla TF, Alegre J. Unemployment and work disability in individuals with chronic fatigue syndrome/myalgic encephalomyelitis: a community-based cross-sectional study from Spain. BMC Public Health. 2019;19(1):840-. https://doi.org/10.1186/s12889-019-7225-z
  10. Centers for Disease Control and Prevention. T reatment of chronic fatigue syndrome/myalgicencephalomyelitis(CFS/ME). 2019 November 19, 2019; Available from http://www.cdc.gov/me-cfs/treatment/index.html/.
  11. Alraek TJ, Lee MS, Choi TY, Cao HJ, Liu JP. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complementary and Alternative Medicine. 2011;11(1):87. https://doi.org/10.1186/1472-6882-11-87
  12. Kim Hj, Byun DY, Gb K, Park J, Kwon YS, Yu JE. The statistics study on patients visiting a Korean medicine hospital according to the application of chuna therapy health insurance and medical benefits. Journal of Korean Medicine. 2019;40(3):188-97. https://doi.org/10.13048/jkm.19034
  13. Kim JW, Kim HJ, Jang ES, Jung H, Hwang MW, Nam DH. Survey on pattern identification and treatment of chronic fatigue in Korea medicine. Journal of Physiology & Pathology in Korean Medicine. 2018;32(2):126-33. https://doi.org/10.15188/kjopp.2018.04.32.2.126
  14. Nam D, The effectiveness of Bojungikgi-tang and its modification on chronic fatigue syndrome: a systematic review and meta-analysis. Journal of Korean Medicine. 2020;41(1):91-106.
  15. Higgins J, Green S, Cochrane handbook for systematic reviews of interventions Version 5.1.0. 2011.
  16. Kim SY, Park JE, Seo HJ, Jang BH, Son HJ, Suh HS, et al., NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. National Evidence-based Healthcare Collaborating Agency. 2011.
  17. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008:924-6.
  18. Zhao XD. Clinical evaluation of 60 cases of chronic fatigue syndrome treated by massage. Chinese medicine modern distance education of China. 2008;6(12):1494-5. https://doi.org/10.3969/j.issn.1672-2779.2008.12.024
  19. Chen YQ, Yang GY, Lai YL, Yang SY. Treatment of 65 cases of chronic fatigue syndrome of spleen deficiency and liver depression by massage and Chinese medicine. Journal of Fujian University of TCM. 2011;21(3):62-3.
  20. W L. Massage plus cupping on the clinical efficacy and plasma tryptophan in patients with chronic fatigue syndrome. Hunan University of Chinese Medicine, 2011. Master's thesis.
  21. Wang Y. Shujin decoction with manipulation therapy for chronic fatigue syndrome. Journal of Liaoning University of TCM. 2011;13(10):220-1.
  22. Yao F, Fang M, Zhu GF, Jiang SY, Ji Q. Channel points massage's effects on FS-14 and FAI evaluation for chronic fatigue syndrome. Journal of Nanjing University of TCM, 2012;28(3):12-30.
  23. Fan YX, Yan PF, Wu W. Clinical observation on 86 cases of fatigue syndrome treated by acupuncture and massage. Journal of Ningxia Medical University. 2013;35(9):1057-9.
  24. He CL. Clinical study of four-step spinal massage and scraping therapy for chronic fatigue syndrome. Guiyang University of Traditional Chinese Medicine. 2013. Master's thesis.
  25. Mao W. Clinical observation on treatment of chronic fatigue syndrome typed liver stagnation and spleen deficiency by acupuncture combined with massage. Hubei University of Chinese Medicine. 2013. Master's thesis.
  26. Peng L. Clinical observation on traditional Chinese medicine massage and serving xiaoyaosan modified formula for chronic fatigue syndrome. Chinese and Foreign Medical Research. 2013;11(28):172-3.
  27. Xiang H. Efficacy observation of acupuncture and massage on treating chronic fatigue syndrome. Clinical Journal of Chinese Medicine. 2013;5(4):39-40.
  28. Yao F, Fang M, Jiang S, Zhu Q, Liu K. Clinical effect observation of Chinese meridian point tuina on the sleep quality of chronic fatigue syndrome. China Journal of Traditional Chinese Medicine and Pharmacy. 2013;28(2):559-61.
  29. Chen H, Li W, Peng L, Liu XW, Wang DJ, Yang Z. Regulatory effects of health massage based on bladder meridian and gall bladder meridian points on chronic fatigue syndrome. Yunnan Journal of Traditional Chinese Medicine and Materia Medica. 2014;35(6): 62-3.
  30. Qi L. Effect of acupoint massage on sleep quality in patients with chronic fatigue syndrome. Especially Healthy. 2014;1(1):41-2.
  31. Wang HG. Acupoint massage on sleep quality of patients with chronic fatigue syndrome. Chinese Archives of Traditional Chinese Medicine. 2016;34(9):2298-301.
  32. Chen FT. Clinical study on chronic fatigue syndrome treated with tuina of dredging meridian and regulating five-organs. Changchun University of Traditional Chinese Medicine. 2017. Master's thesis.
  33. Wang J, Wang L, Effect of massage on chronic fatigue syndrome. World Latest Medicine Information. 2018;18(59):135-.
  34. Xu YX. Back shu points combined with head acupoint massage in the treatment of chronic fatigue syndrome. Journal of Zhejiang University of Traditional Chinese Medicine and Pharmacy. 2018;42(6):491-3.
  35. Tang XN, Liu JH, Wei GK, Han J, Xu ZW, Zhang XY. Observation on dffect of Wei's manipulation combined with tianjiu therapy on CFS patients. Liaoning Journal of Traditional Chinese Medicine. 2019;46(2):325-7.
  36. E JS, Wen BL. Observation on therapeutic effect of acupuncture and massage on chronic fatigue syndrome. Chinese Archives of Traditional Chinese Medicine. 2005;23(2):349-64. https://doi.org/10.3969/j.issn.1673-7717.2005.02.080
  37. Qian LF, Yao Q, Zhu GF. Effect of channel points massage combined with yijing exercising on chronic fatigue syndrome with sleep disorder. Chinese Journal of General Practice. 2016;14(11):1886-8.
  38. Tang H, Wang X, Lu D, Lei L, He Y, Pang J. Systematic review of chronic fatigue syndrome treated by tuina. Chinese Archives of Traditional Chinese Medicine. 2018;36(6):1363-7.
  39. Zheng YY. Guiding principles for clinical research of new drugs in traditional Chinese medicine. Beijing: China Medical Science and Technology Press. 2002.
  40. Adams D, Wu T, Yang X, Tai S, Vohra S, WITHDRAWN: Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome. Cochrane Database Syst Rev. 2018;10(10): CD006348-CD.