Center for Community Research, DePaul University, Chicago, IL 60614, USA.
J Altern Complement Med. 2010 Mar;16(3):235-49. doi: 10.1089/acm.2008.0376.
There have been several systematic reviews attempting to evaluate the efficacy of possible treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM). However, information regarding the efficacy of complementary and alternative medicine (CAM) has not been comprehensively or systematically covered in these reviews, despite its frequent use in the patient community.
The purpose of this study was to systematically review and evaluate the current literature related to alternative and complementary treatments for ME/CFS and FM. It should be stressed that the treatments evaluated in this review do not reflect the clinical approach used by most practitioners to treat these illnesses, which include a mix of natural and unconventionally used medications and natural hormones tailored to each individual case. However, nearly all clinical research has focused on the utility of single CAM interventions, and thus is the primary focus of this review.
Several databases (e.g., PubMed, MEDLINE,((R)) PsychInfo) were systematically searched for randomized and nonrandomized controlled trials of alternative treatments and nonpharmacological supplements. Included studies were checked for references and several experts were contacted for referred articles. Two leading subspecialty journals were also searched by hand. Data were then extracted from included studies and quality assessments were conducted using the Jadad scale.
Upon completion of the literature search and the exclusion of studies not meeting criterion, a total of 70 controlled clinical trials were included in the review. Sixty (60) of the 70 studies found at least one positive effect of the intervention (86%), and 52 studies also found improvement in an illness-specific symptom (74%). The methodological quality of reporting was generally poor.
Several types of alternative medicine have some potential for future clinical research. However, due to methodological inconsistencies across studies and the small body of evidence, no firm conclusions can be made at this time. Regarding alternative treatments, acupuncture and several types of meditative practice show the most promise for future scientific investigation. Likewise, magnesium, l-carnitine, and S-adenosylmethionine are nonpharmacological supplements with the most potential for further research. Individualized treatment plans that involve several pharmacological agents and natural remedies appear promising as well.
有几项系统评价试图评估肌痛性脑脊髓炎/慢性疲劳综合征 (ME/CFS) 和纤维肌痛 (FM) 可能治疗方法的疗效。然而，尽管在患者群体中经常使用补充和替代医学 (CAM)，但这些综述并未全面或系统地涵盖其疗效信息。
本研究旨在系统回顾和评估与 ME/CFS 和 FM 替代和补充治疗相关的当前文献。需要强调的是，本综述评估的治疗方法并不反映大多数医生治疗这些疾病的临床方法，这些方法包括针对每个病例的天然和非常规使用药物以及天然激素的混合。然而，几乎所有临床研究都集中在单一 CAM 干预措施的效用上，因此这是本综述的主要重点。
系统检索了几个数据库（例如，PubMed、MEDLINE、((R)) PsychInfo），以查找替代治疗和非药物补充的随机和非随机对照试验。检查了纳入的研究以获取参考文献，并联系了几位专家以获取引用文章。还通过手工搜索了两种主要的专科期刊。然后从纳入的研究中提取数据，并使用 Jadad 量表进行质量评估。
在完成文献搜索并排除不符合标准的研究后，共有 70 项对照临床试验纳入本综述。在 70 项研究中，有 60 项（60%）至少发现干预措施有一项积极效果，52 项研究还发现特定疾病症状有所改善（74%）。报告的方法学质量普遍较差。
几种类型的替代医学具有未来临床研究的潜力。然而，由于研究之间方法学的不一致性以及证据基础较小，目前无法得出明确的结论。关于替代治疗，针灸和几种类型的冥想练习显示出最有前途的未来科学研究。同样，镁、左旋肉碱和 S-腺苷甲硫氨酸是具有进一步研究潜力的非药物补充剂。涉及多种药物和天然疗法的个体化治疗方案也有很大的发展潜力。
