University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.
Biostatistics & Health Informatics Department, Division of Psychology and Systems Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
BMC Psychol. 2019 Mar 12;7(1):15. doi: 10.1186/s40359-019-0288-x.
Chronic Fatigue Syndrome (CFS) is chronic disabling illness characterized by severe disabling fatigue, typically made worse by exertion. Myalgic Encephalomyelitis (ME) is thought by some to be the same disorder (then referred to as CFS/ME) and by others to be different. There is an urgent need to find effective treatments for CFS. The UK Medical Research Council PACE trial published in 2011 compared available treatments and concluded that when added to specialist medical care, cognitive behaviour therapy and graded exercise therapy were more effective in improving both fatigue and physical function in participants with CFS, than both adaptive pacing therapy and specialised medical care alone. In this paper, we respond to the methodological criticisms of the trial and a reanalysis of the trial data reported by Wilshire at al. We conclude that neither the criticisms nor the reanalysis offer any convincing reason to change the conclusions of the PACE trial.
慢性疲劳综合征（CFS）是一种慢性致残性疾病，其特征是严重的致残性疲劳，通常在劳累后加重。一些人认为肌痛性脑脊髓炎（ME）是同一种疾病（当时称为 CFS/ME），而另一些人则认为是不同的疾病。目前迫切需要找到有效的 CFS 治疗方法。英国医学研究理事会（MRC）于 2011 年发表的 PACE 试验比较了现有的治疗方法，得出的结论是，在专业医疗护理的基础上，认知行为疗法和分级运动疗法在改善 CFS 患者的疲劳和身体功能方面比适应性运动疗法和专业医疗护理更有效。在本文中，我们对试验的方法学批评和 Wilshire 等人报告的试验数据重新分析进行了回应。我们的结论是，这些批评和重新分析都没有提供令人信服的理由来改变 PACE 试验的结论。
