A randomized controlled trial demonstrated that acupuncture based on the traditional Chinese medicine (TCM) theory of “brain–kidney interaction” significantly improved fatigue, sleep quality, and inflammatory cytokine profiles in patients with chronic fatigue syndrome (CFS) [1].
The study enrolled 68 adult patients diagnosed with CFS and randomly assigned them to either an acupuncture group (n = 34) or a control group (n = 34). The acupuncture group received treatment five days per week for four consecutive weeks. The control group received oral oryzanol and vitamin B1, in addition to recommendations for rest and exercise. No acupuncture was administered to the control group [1].
Sterile, single-use filiform needles with a diameter of 0.25 mm were used in the acupuncture group. The needles were inserted to depths sufficient to elicit deqi, though the precise depth was not specified. All points were needled bilaterally, except for GV20, which was treated as a midline point. Manual stimulation was used to achieve deqi, after which the needles were retained for 30 minutes per session. No electrical stimulation was used [1].
The point prescription included GV20 (Baihui), GB20 (Fengchi), BL20 (Pishu), BL23 (Shenshu), SP6 (Sanyinjiao), and KD3 (Taixi). This protocol was based on the TCM understanding that fatigue in CFS arises from disharmony between the brain and kidney systems, with emphasis on tonifying kidney qi and calming the shen [1].
After the four-week treatment period, the acupuncture group exhibited significantly greater improvement than the control group on multiple clinical measures. Fatigue severity, assessed using the Fatigue Scale-14 (FS-14), decreased significantly in the acupuncture group compared with the control group (p < 0.05). Somatic and psychological symptoms, assessed using the SPHERE questionnaire, were also more significantly reduced in the acupuncture group (p < 0.01). Sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), improved in the acupuncture group but not in the control group (p < 0.01) [1].
Biochemical analysis revealed significant reductions in serum inflammatory cytokines in the acupuncture group. Levels of interleukin-6 (IL-6) and interferon-gamma (IFN-γ) were both significantly decreased after the treatment period (p < 0.01). These changes were not observed in the control group. Furthermore, the post-treatment levels of IL-6 and IFN-γ were significantly lower in the acupuncture group than in the control group (p < 0.05 and p < 0.01, respectively) [1].
The reduction in IL-6 and IFN-γ indicates that acupuncture likely exerts its therapeutic effect in CFS through immunomodulation. Both cytokines are known to play key roles in the pathophysiology of CFS, particularly in sustaining low-grade systemic inflammation and contributing to neuroimmune dysfunction. The authors of the study proposed that acupuncture may suppress Th1-dominant immune activity and restore neuroendocrine-immune balance by modulating central-peripheral feedback pathways associated with the hypothalamic–pituitary–adrenal axis [1].
The selection of GV20 and GB20 targets the central nervous system and was chosen for its proposed regulatory effect on brain function and cerebral circulation. BL20 and BL23 were selected to strengthen spleen and kidney function, which are central to fluid metabolism and qi production in TCM. SP6 and KI3 support kidney yin and yang while also calming the mind. All points in the protocol are commonly used in the treatment of fatigue, sleep disturbance, and mood disorders in classical and modern acupuncture practice [1].
The treatment involved daily manual acupuncture using 0.25 mm diameter filiform needles, with all points needled to achieve deqi and retained for 30 minutes per session. The protocol used bilateral needling of GB20, BL20, BL23, SP6, and KI3, with GV20 as a central point. Treatments were conducted five times per week for four weeks. Clinical outcomes were monitored using validated fatigue and sleep scales, and systemic immune responses were measured using ELISA assays for IL-6 and IFN-γ [1].
The results suggest that acupuncture may be an effective modality for reducing both symptom burden and systemic inflammation in patients with CFS. These findings support the use of acupuncture as a neuroimmune regulatory therapy. While the study did not include neuroimaging or hormone data, the biochemical and subjective outcomes provide a foundation for further research into the mechanisms by which acupuncture affects fatigue and immune dysfunction.
Source
1. Xu, Yu-Xin, Hua-Song Luo, Dong Sun, Rui Wang, and Jian Cai. “Acupuncture in the Treatment of Chronic Fatigue Syndrome Based on ‘Interaction of Brain and Kidney’ in TCM: A Randomized Controlled Trial.” Zhongguo Zhen Jiu 39, no. 2 (2019): 123–127.
