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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.

Benefit of chuna for managing symptoms in chronic fatigue syndrome patients: A systematic review and meta-analysis