• Yang Fang, Bo-Wen Yue, Han-Bo Ma, and Yi-Peng Yuan.
• School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
• Medicine (Baltimore). 2022 Aug 5; 101 (31): e29310e29310.

BackgroundResearch into acupuncture and moxibustion and their application for chronic fatigue syndrome (CFS) has been growing, but the findings have been inconsistent.ObjectiveTo evaluate the existing randomized clinical trials (RCTs), compare the efficacy of acupuncture, moxibustion and other traditional Chinese medicine (TCM) treatments.Data SourcesThree English-language databases (PubMed, Embase, Web of Science, and The Cochrane Library) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through August 2021.Study SelectionRCTs include acupuncture, moxibustion, traditional Chinese herbal medicine, western medicine and no control.Data Extraction And SynthesisData were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. We conducted a random-effects network meta-analysis within a frequentist framework. We assessed the certainty of evidence contributing to network estimates of the main outcomes with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.Main Outcomes And MeasuresThe primary outcomes were the overall response rate and FS-14 scale.ResultsA total of 51 randomized controlled trials involving 3473 patients with CFS were included in this review. Forty one studies indicate low risk or unknown risk, and the GRADE scores of the combined results show low levels. Among the main indicators, traditional Chinese medicine therapies have excellent performance. However, the overall response rate is slightly different from the results obtained from the Fatigue Scale-14 total score. Moxibustion and traditional Chinese medicine (Odds ratios 48, 95% CrI 15-150) perform better in the total effective rate, while moxibustion plus acupuncture (MD 4.5, 95% CrI 3.0-5.9) is better in the FS-14 total score.ConclusionsThe effect of acupuncture and moxibustion in the treatment of CFS was significantly higher than that of other treatments. Traditional Chinese medicine should be used more widely in the treatment of CFS.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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