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Sindrom kronične utrujenosti (CFS) je bolezen, za katero je značilna izjemna utrujenost, ki se ne izboljša niti s počitkom, ob telesnih in duševnih naporih pa se poslabša. Patofiziologija kljub intenzivnim raziskavam več patoloških dejavnikov ostaja neznana. Terapevtsko zdravljenje CFS je v okviru konvencionalne medicine zelo omejeno.
Tradicionalna kitajska medicina (TKM) je kot alternativna medicina zagotovila nekaj dokazov, ki temeljijo na starodavnih besedilih in nedavnih študijah. V zadnjem času je akupunkturno zdravljenje CFS postopoma pritegnilo pozornost zdravnikov in bolnikov. Pregled literature iz leta 2019 kaže, da akupunktura morda obeta zdravljenje, čeprav se strokovnjaki strinjajo, da so potrebne dodatne raziskave. [1]
Kaj je utrujenost?
Utrujenost v primeru CFS pomeni več kot le blago utrujenost ali zaspanost, temveč izčrpanost. Ljudje, ki trpijo za CFS, se počutijo tako izčrpani, da njihova izčrpanost moti njihovo vsakdanje življenje. Številna stanja in zdravila lahko povzročijo preveliko utrujenost. Do utrujenosti lahko privedejo tudi nezdrava prehrana, pomanjkanje spanja in premalo ali preveč telesne dejavnosti.
Če se spopadate z utrujenostjo, se lahko počutite preveč utrujeni za številne vsakodnevne dejavnosti, vključno z:
osebno higieno in nego
preživljanje časa z otroki
obveznosti na delovnem mestu
gospodinjska opravila
druženje in hobije
vadbo
pripravo obrokov
Utrujenost je lahko simptom številnih zdravstvenih stanj, vključno z:
Sindrom kronične utrujenosti (CFS) zahteva vašo pozornost
Če vaše utrujenosti ni mogoče pojasniti z drugim zdravstvenim stanjem, imate morda sindrom kronične utrujenosti (CFS). Ta bolezen vključuje trdovratno izčrpanost, ki vsaj 6 mesecev ovira delo, šolo in druge vidike vsakdanjega življenja.
Če imate CFS, lahko:
po fizični aktivnosti ali psihično zahtevni nalogi se vsaj en dan počutite izčrpani
po celonočnem spanju se še vedno počutite utrujeni
opažate dolgotrajne bolečine v mišicah in sklepih
imate pogoste glavobole in bolečine v grlu
opažate občutljivost bezgavk
se soočate z možgansko meglo ali težavami s koncentracijo, ohranjanjem informacij in pomnjenjem stvari
se počutite depresivno in nimate želje po dejavnostih, ki ste jih nekoč radi opravljali
se pojavi živčnost, tesnoba, nepotrpežljivost in razdražljivost
imate toga ramena
občutite zaspanost
Akupunktura za sindrom kronične utrujenosti
V tradicionalni kitajski medicini CFS spada med energijsko pomanjkanje (Xu Lao 虛勞), sindrom atrofije (Wei Zheng 痿症), depresivno motnjo (Yu Bing 鬱病) in bolezen lilij (Bai He Bing 百合病). Na podlagi teorije kitajske medicine lahko akupunktura spodbuja kroženje "meridiana qi", uravnava "qi" in "kri", uravnoveša "jin" in "jang" ter tako obnovi delovanje organov "Zang-Fu" s pomočjo akupunkturnih signalov, ki se tvorijo iz akupunkturnih točk.
Akupunkturne točke, ki se pogosto uporabljajo pri zdravljenju utrujenosti, vključujejo [2] [3]:
CV6 (Qihai 氣海)
CV4 (Guanyuan 關元)
ST36 (Zusanli足三里)
LI4, LV3 (Siguan: Hegu plus Taichung 四關穴:合谷配太沖)
BL23 (Shenshu 腎俞)
GB20 (Fengchi 風池)
Akupunkturne točke so bile izbrane za doseganje terapevtskih učinkov, ki jih vodijo načela zdravljenja. Baihui se nahaja na vodilni žili (Du Mai督脈). Izvajanje akupunkture na tej točki dviguje jang, krepi qi in oživlja duhovni um (shen). Qihai in Guanyuan se nahajata na žili spočetja (Ren Mai任脈). Akupunktura na teh dveh akupunkturnih točkah podpira pokončni qi (Zheng Qi 宗氣) in koristi ledvicam. Zusanli v kombinaciji s Sanyinjiao se pogosto uporablja v sodobnih kliničnih okoljih za krepitev vranice in želodca ter za korist qi-ja in krvi. Siguan se je uporabljal za obnovitev delovanja jeter, da bi nadzoroval nemoten pretok qi-ja ter aktiviral kroženje qi-ja in krvi. [2]
Akupunktura in zdravljenje s TKM za utrujenost ter njeni učinki
Zdravnik TKM bo izbral akupunkturne točke in kombinacijo zelišč, ki bodo pomagale uskladiti prizadete sisteme Zang-Fu. Z zelišči lahko v telo vnesemo energije, česar ne bi mogli doseči zgolj s hrano. Za povrnitev moči in energije sta pomembna tudi uravnotežena prehrana in primerna telesna vadba.
Učinki akupunkture pri utrujenosti so dobro raziskani:
Štirje tedni zdravljenja z akupunkturo so privedli do izboljšanja simptomov CFS. [4]
Zmanjšanje stopnje utrujenosti. [5]
Urejanje imunske disfunkcije, uravnavanje nenormalne aktivnosti v osi hipotalamus-hipofiza-nadledvična žleza (HPA) in delovanje kot antioksidant. [6]
Zlasti zdravljenje z mokso je postalo vse bolj učinkovito, ko so se terapije nadaljevale po 10. obravnavi. Pokazalo se je, da moksibustija vpliva na vagusni živec, ki nadzoruje parasimpatični živčni sistem. [7]
Akupunktura in TKM imata prednosti, saj sta naravni, učinkoviti in varni za lajšanje simptomov CFS, kot so utrujenost, motnje spanja, kognitivne motnje in druge kompleksne težave. Koliko časa je potrebno, da pride do rezultatov zdravljenja kronične utrujenosti z akupunkturo, se razlikuje od osebe do osebe, odvisno od tega, kako dolgo ima oseba CFS in kako globoko so prizadeti organski sistemi. Zdravljenje s TKM ima kumulativni učinek, ki se sčasoma in z več terapijami okrepi. Če se vi ali nekdo, ki ga imate radi, že več mesecev počutite izčrpani brez izboljšanja, je morda čas, da razmislite o poskusu akupunkture za kronično utrujenost.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Lu C, Yang XJ, Hu J. [Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients]. Zhen Ci Yan Jiu. 2014 Aug;39(4):313-7. Chinese. PMID: 25219128.
Lin, W., Chen, Xl., Chen, Q. et al. Jin’s three-needle acupuncture technique for chronic fatigue syndrome: a study protocol for a multicentre, randomized, controlled trial. Trials 20, 155 (2019). https://doi.org/10.1186/s13063-019-3243-5
Kim JE, Seo BK, Choi JB, Kim HJ, Kim TH, Lee MH, Kang KW, Kim JH, Shin KM, Lee S, Jung SY, Kim AR, Shin MS, Jung HJ, Park HJ, Kim SP, Baek YH, Hong KE, Choi SM. Acupuncture for chronic fatigue syndrome and idiopathic chronic fatigue: a multicenter, nonblinded, randomized controlled trial. Trials. 2015 Jul 26;16:314. doi: 10.1186/s13063-015-0857-0. PMID: 26211002; PMCID: PMC4515016.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Chen R, Moriya J, Yamakawa J, Takahashi T, Kanda T. Traditional chinese medicine for chronic fatigue syndrome. Evid Based Complement Alternat Med. 2010 Mar;7(1):3-10. doi: 10.1093/ecam/nen017. Epub 2008 Feb 27. PMID: 18955323; PMCID: PMC2816380.
Shu, Q., Wang, H., Litscher, D. et al. Acupuncture and Moxibustion have Different Effects on Fatigue by Regulating the Autonomic Nervous System: A Pilot Controlled Clinical Trial. Sci Rep 6, 37846 (2016). https://doi.org/10.1038/srep37846
Acupuncture Found Effective for Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) is a condition marked by extreme fatigue that does not get better, even with rest, and gets worse with physical and mental exertion. Its pathophysiology remains unknown despite of intensive research on several pathological factors. The therapeutic treatment for CFS is very limited in conventional medicine settings.
As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies. Recently, acupuncture treatment for CFS has gradually attracted physicians’ and patients’ attention. A 2019 literature review suggests acupuncture may have promise as a treatment, though experts agree on the need for more research. [1]
What is fatigue?
Fatigue is more than being tired or sleepy. People who have fatigue feel so drained that their exhaustion interrupts their daily life. Many conditions and medications can cause overwhelming tiredness. An unhealthy diet, lack of sleep and too little or too much physical activity can also lead to fatigue.
If you live with fatigue, you might feel too tired for many daily activities, including:
Personal hygiene and grooming
Spending time with children
Workplace responsibilities
Household chores
Socializing and hobbies
Exercise
Arranging meals
Fatigue can happen as a symptom of many health conditions, including:
Chronic fatigue syndrome (CFS) requires your attention
If your tiredness can’t be explained by another medical condition, you could have chronic fatigue syndrome (CFS). This condition involves persistent fatigue that interferes with work, school, and other aspects of daily life for at least 6 months.
If you have CFS, you may:
Feel exhausted for at least a day after physical activity or a mentally challenging task
Still feel tired after a full night of sleep
Notice lingering aches and pains in your muscles and joints
Get headaches and sore throats frequently
Notice tenderness in your lymph nodes
Experience brain fog, or trouble concentrating, retaining information, and remembering things
Feel depressed and lack of desire to do the activities you once enjoyed
have nervousness, anxiety, impatience, and irritability
Have stiff shoulders
Feel sleepiness
Acupuncture for chronic fatigue syndrome
In Traditional Chinese Medicine, CFS falls in the scope of Energy Deficiency (Xu Lao 虛勞), Atrophy Syndrome (Wei Zheng 痿症), Depressive Disorder (Yu Bing 鬱病), and Lily Disease (Bai He Bing 百合病). Based on Chinese medicine theory, acupuncture can promote the circulation of “meridian Qi”, regulate “Qi” and “Blood”, balance “Yin” and “Yang”, and thus restore the function of “Zang-Fu” organs via acupuncture signals generated from acupoints.
Acupoints commonly used in fatigue treatment include [2] [3]:
CV6 (Qihai 氣海)
CV4 (Guanyuan關元)
ST36 (Zusanli足三里)
LI4, LV3 (Siguan: Hegu plus Taichung 四關穴:合谷配太沖)
BL23 (Shenshu 腎俞)
GB20 (Fengchi 風池)
Acupoints were selected to achieve the therapeutic actions guided by the treatment principles. Baihui is located on the Governing Vessel (Du Mai督脈). Administering acupuncture at this acupoint lifts Yang, boosts Qi, and revives the spirit mind (shen). Qihai, and Guanyuan are located on the Conception Vessel (Ren Mai任脈). Acupuncture at these two acupoints supports upright Qi (Zheng Qi 宗氣) and benefits the kidneys. Zusanli combined with Sanyinjiao is often used in modern clinical settings to strengthen the spleen and stomach and to benefit Qi and blood. Siguan was applied to restore the liver’s function to control the smooth flow of Qi and activate Qi and blood circulation. [2]
Acupuncture And TCM Treatment For Fatigue And Its Effects
A TCM doctor will choose acupuncture points and a combination of herbs that will help harmonize the affected Zang-Fu systems. With herbs, we are able to get energies into the body beyond what you can do with foods alone. A balanced diet and suitable exercise are also important for recovering strength and energy.
The effects of acupuncture for fatigue is well studied:
Four weeks of acupuncture treatment led to improvements in CFS symptoms. [4]
Reduction in the severity of fatigue. [5]
Adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant. [6]
Moxa treatment in particular became more and more effective as treatment sessions continued past the 10th treatment. Moxibustion was shown to have an effect on the vagus nerve, which controls the parasympathetic nervous system. [7]
Acupuncture and TCM has advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints. How long it takes to get results from acupuncture treatment for chronic fatigue will vary from person to person, depending on how long the person has been experiencing CFS, and how deeply the organ systems are affected. TCM treatment has a cumulative effect which strengthens over time and several sessions. If you or someone you love has been feeling exhausted for months without improvement, it may be time to consider trying acupuncture for chronic fatigue.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Lu C, Yang XJ, Hu J. [Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients]. Zhen Ci Yan Jiu. 2014 Aug;39(4):313-7. Chinese. PMID: 25219128.
Lin, W., Chen, Xl., Chen, Q. et al. Jin’s three-needle acupuncture technique for chronic fatigue syndrome: a study protocol for a multicentre, randomized, controlled trial. Trials 20, 155 (2019). https://doi.org/10.1186/s13063-019-3243-5
Kim JE, Seo BK, Choi JB, Kim HJ, Kim TH, Lee MH, Kang KW, Kim JH, Shin KM, Lee S, Jung SY, Kim AR, Shin MS, Jung HJ, Park HJ, Kim SP, Baek YH, Hong KE, Choi SM. Acupuncture for chronic fatigue syndrome and idiopathic chronic fatigue: a multicenter, nonblinded, randomized controlled trial. Trials. 2015 Jul 26;16:314. doi: 10.1186/s13063-015-0857-0. PMID: 26211002; PMCID: PMC4515016.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Chen R, Moriya J, Yamakawa J, Takahashi T, Kanda T. Traditional chinese medicine for chronic fatigue syndrome. Evid Based Complement Alternat Med. 2010 Mar;7(1):3-10. doi: 10.1093/ecam/nen017. Epub 2008 Feb 27. PMID: 18955323; PMCID: PMC2816380.
Shu, Q., Wang, H., Litscher, D. et al. Acupuncture and Moxibustion have Different Effects on Fatigue by Regulating the Autonomic Nervous System: A Pilot Controlled Clinical Trial. Sci Rep 6, 37846 (2016). https://doi.org/10.1038/srep37846
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