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Table 1 Summary of randomised clinical studies of complementary and alternative medicine for patients with chronic fatigue syndrome

From: Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review

First author (year) Sample size Diagnosis Intervention group (Regime) Control group (Regime) Main outcomes Intergroup differences Adverse events
  Gender (M/F)       
  Mean age (range)       
Clollinge (1998) [10] 70 Fukuda (A) Qigong (2 hr weekly for 9 weeks, n = 37) plus mindfulness meditation and group discussion (B) No treatment (n = 33) SF-36 Heath transition score No between group analysis n.r.
  (10/50)       
  27-61       
Dybwad (2007) [11] 31 (4/27) CDC (A) Qigong (2 hr weekly for 12 weeks), plus meditation, n = 15) (B) No treatment (n = 16) 1) Work capacity (VO2max) 1) P = 0.01 n.r.
  17-62     2) Fatigue severity 2) P < 0.05  
      3) SF36 3) NS  
Surawy (2005) [12] 18 Oxford (A) MBSR (once weekly for 8 weeks, n = 8) (B) Wait-list (once weekly for 8 weeks, n = 9) 1) HADS Anxiety 1) P = 0.00 n.r.
  10/8     2) HADS Depression 2) NS  
  18~65     3) Chalder Fatigue Scale 3) NS  
  (n.r)     4) SF36 Physical Functioning 4) NS  
Walach (2008) [13] 409 Fukuda or Oxford (A) Distant healing (blinded, n = 105) (C) No distant healing (blinded, n = 95) SF-36 NS for both the mental and physical component n.r.
    (B) Distant healing (not blinded, n = 102) (D) No distant healing (not blinded, n = 109)    
Field (1997) [14] 20 Not stated (A) Massage therapy (twice weekly for 5 weeks, n = 10) (B) Sham TENS (twice weekly for 5 weeks, n = 10) 1) CESD 1) P < 0.005 n.r.
  4/16     2) Fatigue 2) P < 0.05  
  n.r.     3) Pain 3) P < 0.005  
  -47     4) Sleep 4) P < 0.05  
Wang (2009) [15] 182 Fukuda (A) Intelligent-turtle massage (5 times weekly, 10 times as a course, for 2 courses with a one-week interval in between, n = 91) (B) Massage(45 min, 5 times a week, 10 times as a course, n = 91) Physical Symptoms P < 0.05 n.r.
  141/40       
  21-62       
  (n.r)       
Liu (2010) [16] 90 (44/46) Fukuda (A) Tuina (once 2 days for 15 times, n = 30) (C) Fluoxetine (20 mg/d, 1 month, n = 30) Total effective rate A vs. B, NS; A vs. C, P < 0.05; B vs. C, NS (C); 17 insomnia dizziness vexation nausea, hypodynamia
  26.4~46.2   (B) Tai chi (n.r., 1 month, n = 30)     
  (n.r.)       
Weatherley-Jones (2004) [17] 103/92 Oxford (A) Homeopathy (6 months, n = 47) (B) Placebo(6 months, n = 45) 1) MFI 1) NS except general fatigue, P = 0.04 n.r.
  n.r.     2) FIS 2) NS  
  Over 18 years     3) FLP 3) P = 0.04  
  (n.r)       
Awdry (1996) [18] 64/61 Oxford (A) Homeopathy (1 year, n = 30) (B) Placebo (n = 31) 1) Daily graphs 1-2) No between n.r.
  18/43     2) Symptoms score group analysis  
  <65       
  (n.r.)       
Hartz Hartz (2004) [19] 96/76 Fukuda (A) Ginseng (Siberian, 2 months, n = 40 (B) Placebo (16 weeks, 2 month, n = 36) RVI NS n.r.
  n.r.       
  21~65       
  (n.r)       
Forsyth (1999) [20] 26 CDC (A) NADH (10 mg, once daily for 4 weeks, n = 26, cross over design) (B) Placebo(n = 26) Symptom score P < 0.05 Overly stimulated, mild loss of appetite, heartburn, increased incidence of gas and an odd taste and dryness (1)
  (9/17)       
  26-57       
  -39.6       
Santaella (2004) [21] 31 Fukuda (A) NADH or nutritional (B) Psychological therapy (24 months, n = 11) Symptom score (month 3) P < 0.001 n.r.
  n.r.   supplements (5-10 mg, 24 months, n = 20)     
  22~54       
  (n.r)       
Brouwers (2002) [22] 53 CDC (A) General nutritional supplement (twice a day for 10 weeks, n = 27) (B) Placebo(n = 26) 1) Fatigue severity 1)-3) NS n.r.
  (16/37)     2) Functional impairment   
  n.r.     3) Physical activity levels   
  -39.3       
De Becker (2001) [23] 90 Fukuda or Holmes (A) Acclydine (250 mg, 4 times daily for 1st 4 weeks and 250 mg, twice daily for 2nd 4 weeks, n = 45) (B) Placebo (n = 45) CGI No between group analysis n.r.
  n.r.       
  n.r.       
  (n.r.)       
The (2007) [24] 57 CDC (A) Food supplement (Acclydine 1000 mg to 250 mg for 14 weeks, n = 30) (B) Placebo (n = 27) 1) Fatigue severity 1)-4) NS Mild nausea (1), exacerbation of CFS symptoms (1) and irritable bowel symptoms (1)
  (20/37)     2) Function impairment   
  n.r.     3) Activity level   
  (n.r.)     4) Daily fatigue level   
McDertmott (2006) [25] 71 CDC (A) Food supplement (Biobran 2 mg three times per day for 8 weeks, n = 37) (B) Placebo(n = 34) 1) Fatigue scale 1) NS  
  (20/51)     2) QOL 2) NS  
  n.r.     (WHOQOL_BREF)   
  (n.r.)       
Stewart (1987) [26] 12 Not stated (A) Supplements (subjects given supplements for 3 weeks, after first 3 weeks cross-over treatment arms for further 3 weeks, 2 multi-digestive enzymes, crossover design n = 12) (B) Placebo(n = 12) 1) Fatigue 1)-2) No between group analysis n.r.
  n.r.     2) Bowel movements   
  n.r.       
  (n.r.)       
Rothschild (2002) [27] 70/68 CDC (A) Supplement (mushrooms plus aloe vera and cat's claw, processed and fermented, 3 caplets taken 3 times daily before meals, n = 33) (B) Placebo (n = 35) Symptoms No between n.r.
  20/50      group analysis  
  n.r.       
  (n.r.)       
Vermeulen (2004) [28] 90 CDC (A) Acetyl-L-carnitine (2 g daily for 24 weeks, n = 30) (B) Propionyl-L-carnitine (n = 30) 1) Fatigue scale No between group analysis n.r.
  (21/69)    (C) A plus B (n = 30) 2) Pain   
  n.r.     3) Attention/concentration   
  (n.r.)       
Behan (1990) [29] 63 Not stated (A) Fatty acids((Efamol Marine, 8 capsules per day, n = 39) (B) Placebo (n = 24) 1) Symptom measure 1) P < 0.001 n.r.
  27/36     2) General health 2) P < 0.0001  
  21-63      3) n.r.  
  -40       
Warren (1999) [30] 50 Oxford (A) Essential fatty acids (Efamol Marine 1000 mg 4 times a day for 3 months, n = 25) (B) Placebo (n = 25) 1) Physical symptom 1) NS n.r.
  (21/29)     2) Depression (Beck Depression Inventory) 2) NS  
  18-59       
  -35.7       
Kaslow (1989) [31] 14 CDC (A) Liver extract-folic acid-cyanocobalamin (intramuscular injection 2 ml for 1-week, n = 14, crossover design) (B)Placebo (n = 14) Functional status questionnaire NS None
  (3/11)       
  30-48       
  (n.r.)       
Ockerman (2000) [32] 22 CDC (A)Antioxidant treatment (pollen and pistil 7 tablets per day for 3 months, n = 22, cross-over design) (B) Placebo (3 month, n = 22) 1) Total well-being 1) No between group analysis n.r.
  (3/19)     2) Clinical symptoms 2) No between group analysis  
  27-70       
  -50       
Cox (1991) [33] 34/31 other (A) Vitamin and minerals (Magnesium, 6 weeks, n = 14) (B) Placebo (6 weeks, n = 17) Mean Nottingham P = 0.001 n.r.
  11/23     health profile score   
  18~56       
  (n.r.)       
Tiev (1999) 326 Not stated (A) Sulbutiamine (400 mg (C) Placebo (n = 109) 1) MFI 1) Sleep disturbance (A):9,(B):6,(C):12 diarrhoea, cystitis, bronchitis, arthritic pain, back pain, asthma, abdominal pain, insomnia, constipation, gastroenteritis, diffuse pain, sinusitis, headache, renal coli, vertigo, pharyngitis, tracheitis.
    daily, n = 106)   2) Clinical global impression (p = 0.03)  
    (B) Sulbutiamine (600 mg   3) Baecke's measure of activity Pain (p = 0.044)  
    daily, n = 111)   4) Illness severity 2) NS  
       3) NS  
Willams (2002) [35] 30 Oxford (A) Melatonin (5 mg in the (B) phototherapy (2500 Lux for 1 1) VAS for symptom severity; SF-36 1) Sleep disturbance(p = 0.03);Pain (p = 0.044) n.r.
  13/17   evening, 12 week, n = 30) hour in the morning, 12 weeks, n = 30) 2) Mental fatigue 2) NS  
  n.r.     3) HADS 3) NS  
  -44.5       
  1. CDC: Centers for Disease Control and Prevention; CESD: Center for Epidemiological Studies Depression Scale; CFS: Chronic Fatigue Syndrome; CGI: Clinician's Global Impression Scale; FIS: Fatigue Impact Scale; FLP: Functional Limitations Profile; HADS: Hospital Anxiety and Depression Scale; MBSR: Mindfulness-Based Stress Reduction; MFI: Multidimensional Fatigue Inventory; n.r.: not reported; NS: Not significant; RVI: Rand Vitality Index; NADH: Nicotinamide adenine dinucleotide; QoL: Quality of life; SF-36: Short Form 36; VAS: Visual Analogue Scale; WHOQOL-BREF: WHO Quality of Life-BREF.