Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials

Background: Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection. Methods: Ten English and Chinese language databases and grey...

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Main Authors: Xiao-ying Chen, Chun-li Lu, Qian-yun Wang, Xing-ru Pan, Yang-yang Zhang, Jia-le Wang, Jun-Ya Liao, Nai-chong Hu, Chen-yang Wang, Bing-jie Duan, Xue-han Liu, Xin-yan Jin, Jennifer Hunter, Jian-ping Liu
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:Integrative Medicine Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213422024000192
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author Xiao-ying Chen
Chun-li Lu
Qian-yun Wang
Xing-ru Pan
Yang-yang Zhang
Jia-le Wang
Jun-Ya Liao
Nai-chong Hu
Chen-yang Wang
Bing-jie Duan
Xue-han Liu
Xin-yan Jin
Jennifer Hunter
Jian-ping Liu
author_facet Xiao-ying Chen
Chun-li Lu
Qian-yun Wang
Xing-ru Pan
Yang-yang Zhang
Jia-le Wang
Jun-Ya Liao
Nai-chong Hu
Chen-yang Wang
Bing-jie Duan
Xue-han Liu
Xin-yan Jin
Jennifer Hunter
Jian-ping Liu
author_sort Xiao-ying Chen
collection DOAJ
description Background: Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection. Methods: Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane “Risk of bias” (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). Results: Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported. Conclusions: Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings. Study Registration: The protocol of this review has been registered at PROSPERO: CRD42022384136.
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spelling doaj-art-df6864667e5f4f8e9ba3a0a1f8d0a3622025-08-20T03:25:59ZengElsevierIntegrative Medicine Research2213-42202024-06-0113210103910.1016/j.imr.2024.101039Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trialsXiao-ying Chen0Chun-li Lu1Qian-yun Wang2Xing-ru Pan3Yang-yang Zhang4Jia-le Wang5Jun-Ya Liao6Nai-chong Hu7Chen-yang Wang8Bing-jie Duan9Xue-han Liu10Xin-yan Jin11Jennifer Hunter12Jian-ping Liu13Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaGuangdong Pharmaceutical University, Guangzhou, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; The Second Clinical Medical School, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; The Second Clinical Medical School, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, China, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, China, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, China, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaHealth Research Group, Sydney, Australia; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, AustraliaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; Corresponding author at: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.Background: Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection. Methods: Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane “Risk of bias” (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). Results: Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported. Conclusions: Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings. Study Registration: The protocol of this review has been registered at PROSPERO: CRD42022384136.http://www.sciencedirect.com/science/article/pii/S2213422024000192Post COVID conditionChronic fatigueTraditional medicineComplementary medicineIntegrative medicine
spellingShingle Xiao-ying Chen
Chun-li Lu
Qian-yun Wang
Xing-ru Pan
Yang-yang Zhang
Jia-le Wang
Jun-Ya Liao
Nai-chong Hu
Chen-yang Wang
Bing-jie Duan
Xue-han Liu
Xin-yan Jin
Jennifer Hunter
Jian-ping Liu
Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
Integrative Medicine Research
Post COVID condition
Chronic fatigue
Traditional medicine
Complementary medicine
Integrative medicine
title Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
title_full Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
title_fullStr Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
title_full_unstemmed Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
title_short Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials
title_sort traditional complementary and integrative medicine for fatigue post covid 19 infection a systematic review of randomized controlled trials
topic Post COVID condition
Chronic fatigue
Traditional medicine
Complementary medicine
Integrative medicine
url http://www.sciencedirect.com/science/article/pii/S2213422024000192
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