Chronic Fatigue Syndrome (CFS) is a syndrome characterized primarily by persistent or recurrent severe fatigue. Common accompanying symptoms include memory impairment, headaches, sore throat, joint pain, sleep disturbances, depression, and various other physical and neuropsychiatric manifestations. Traditional Chinese Medicine (TCM) has no direct historical record of this disease, but its presentation resembles the TCM concept of "consumptive disease" (虚劳).The pathological location of this disease involves multiple organs including the heart (brain), spleen, liver, and gallbladder. It is closely related to prolonged physical and mental exhaustion, emotional imbalance, and resulting multi-organ dysfunction. The modern medical pathogenesis of Chronic Fatigue Syndrome remains unclear, but it is generally believed to stem from prolonged exposure to high stress and fatigue, leading to dysfunction of the central nervous system and immune system abnormalities, which cause systemic and multi-organ functional decline.
【Etiology and Pathogenesis】
1. Inherent deficiency of heart qi, prolonged overwork, chronic illness, or excessive mental strain may damage the heart's yang qi and deplete yin blood. Heart yang deficiency fails to propel qi and blood; alternatively, yin blood insufficiency deprives the spirit of nourishment.
2. Spleen qi deficiency due to dietary imbalances, excessive exertion, or chronic illness depletes spleen qi. This impairs qi and blood production, leading to inadequate nourishment of the limbs; or spleen dysfunction causes internal phlegm-dampness accumulation.
3. Liver qi stagnation from constitutional depression, prolonged stress, or sudden emotional shock disrupts liver's free flow, causing qi stagnation. Prolonged stagnation leads to liver-kidney yin deficiency.
4. Gallbladder Qi Stagnation with Phlegm Disturbance: Emotional distress impairs gallbladder regulation, generating phlegm and transforming it into fire. Phlegm-heat ascends along meridians to cause this condition.
【Diagnosis】
1. Heart Qi Deficiency Syndrome: Persistent or recurrent severe fatigue. Heart Qi deficiency presents with palpitations, chest tightness, and shortness of breath worsening with exertion. Pale tongue with white coating, weak pulse.Heart blood deficiency may also present with palpitations, insomnia with frequent dreams, dizziness, forgetfulness, difficulty concentrating, pale complexion without luster, pale tongue, and weak pulse.Spleen qi deficiency may also present with poor appetite, lethargy, shortness of breath, reluctance to speak, sallow or pale complexion, or edema. Spleen yang deficiency may additionally manifest as abdominal distension, poor appetite, loose stools, cold limbs, heaviness in the limbs, or generalized edema. The tongue appears pale and swollen with a white, slippery coating, and the pulse is deep, slow, and weak.
3. Liver Qi Stagnation Syndrome: Persistent or recurrent severe fatigue, worsening with exertion; distension and pain in the chest, ribs, or lower abdomen; chest tightness with frequent sighing; emotional depression and irritability; globus sensation in the throat; in women, irregular menstruation or dysmenorrhea. Pale tongue with thin white coating; wiry pulse. If liver stagnation transforms into fire, symptoms may include dizziness, headache, bitter taste in mouth, dry mouth, sore throat, red tongue with yellow coating, wiry and rapid pulse.If liver-kidney yin deficiency occurs, symptoms may include soreness and weakness in the lower back and knees, tinnitus, nocturnal emissions, insomnia with frequent dreams, dry throat and mouth, heat in the palms and soles, night sweats, a red tongue with little coating, and a fine, rapid pulse.
4. Gallbladder Qi Stagnation with Phlegm Disturbance Persistent or recurrent severe fatigue, worsening with exertion; palpitations with insomnia; restlessness and irritability; bitter taste in mouth with nausea and vomiting; distension and fullness in chest and ribs; dizziness and vertigo; tinnitus; yellow greasy coating on tongue; wiry and rapid pulse.【Treatment】
Principles: Regulate qi and blood, harmonize and tonify the five zang organs. For heart qi deficiency: tonify heart qi and nourish spirit. For heart blood deficiency: nourish heart and calm spirit. For spleen qi deficiency: strengthen spleen, harmonize stomach, and replenish qi and blood. For spleen yang deficiency: warm yang and fortify spleen.For Liver Qi Stagnation: Regulate Liver Qi and resolve depression. If accompanied by Liver Yang Rising: Calm Liver Yang. If accompanied by Liver-Kidney Yin Deficiency: Nourish Liver and Kidney Yin. For Gallbladder Qi Stagnation with Phlegm Disturbance: Promote Gallbladder Function, Resolve Phlegm, and Open Orifices.
Body Regions and Acupoint Selection: Head and face, chest and abdomen, flanks and ribs, shoulders and back, lumbar and sacral region, limbs, hand and foot Yin and Yang meridians, Bladder Meridian on the back, and Governor Vessel;Qiaogong (BL1), Xingmen (BL10), Dazhui (GV14), Ba (BL8), Shanzhong (CV17), Shenmen (HT7), Neiguan (PC6), Xinshu (BL15), Feishu (BL13), Zhongwan (CV12), Tianshu (ST25), Guanyuan (CV4), Qihai (CV6), Zusanli (ST36), Pishu (BL20), Weishu (BL21), Zhangmen (LR13), Qimen (LR14), Yanglingquan (GB34), Fenglong (ST40).
Techniques: Pushing, Grasping, Percussion, Tapping, Rubbing, Shaking, Shaking, Scattering, Pressing and Kneading, Rubbing, One-Finger Zen Pushing.
Procedure:
(1) Basic Operations
1) Head, Face, and Neck: Use the five-finger grasping technique from the front hairline to the vertex, then to the occipital region, 3–6 times;Use the thumb flat-pushing technique to push down one side of the nasal bridge 15–20 times, then repeat on the other side; Use the dividing-pushing technique to push from the forehead outward toward the jawline on both sides (i.e., dividing the forehead, dividing the Yintang point, dividing the Yingxiang point, dividing the Renzhong point, dividing the Chengjiang point), repeating 2–5 times;Use sweeping technique along one side of the Gallbladder Meridian pathway (from Jiaosun to occipital region), moving forward-backward-downward over 10 times, then repeat on the other side.
2) Trunk Manipulation: Use flat palm push technique along the lower clavicle margin, moving straight back-and-forth from top to bottom while slowly descending to the 12th rib, then ascending. Repeat 3–5 times;Use the palm-flat push method to push along both shoulders (Jiansheng) and the Dazhui point in straight lines from left to right, slowly moving downward to the lumbosacral region. Repeat 3–5 times. Use the palm-flat push method to push forward from behind the armpits, slowly moving downward. Repeat 2–5 times.