Dai, Liang, Liu, Zhidong, Zhou, Wenjuan et al. · Phytomedicine : international journal of phytotherapy and phytopharmacology · 2024 · DOI
This study tested whether Sijunzi decoction, a traditional Chinese herbal formula, could reduce fatigue in ME/CFS patients. Over 100 people with ME/CFS took either the herbal formula or a placebo for 2 months. The herbal treatment group showed slightly more improvement in fatigue symptoms and overall health than the placebo group, and the improvement may be linked to changes in gut bacteria.
ME/CFS patients lack proven pharmacological treatments, and this rigorous double-blind trial provides preliminary evidence that Sijunzi decoction may offer symptom relief. The investigation of gut microbiota changes as a mechanism offers a new research direction for understanding how herbal treatments might work in ME/CFS.
This study does not prove that Sijunzi decoction is a standard effective treatment for all ME/CFS patients—the between-group differences were modest and the results apply only to patients also meeting traditional Chinese medicine spleen deficiency criteria. The finding of Pediococcus acidilactici changes shows correlation, not causation, and replication in larger, longer-term trials is needed. The 2-month duration cannot establish whether benefits persist or improve with longer treatment.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Dai, Liang, Liu, Zhidong, Zhou, Wenjuan, Zhang, Li, Miao, Minjie, Wang, Lei, et al. (2024). Sijunzi decoction, a classical Chinese herbal formula, improves fatigue symptoms with changes in gut microbiota in chronic fatigue syndrome: A randomized, double-blind, placebo-controlled, multi-center clinical trial.. Phytomedicine : international journal of phytotherapy and phytopharmacology. https://doi.org/10.1016/j.phymed.2024.155636
BibTeX
@article{mecfsatlas-dai-2024-sijunzi-decoction,
author = {Dai, Liang and Liu, Zhidong and Zhou, Wenjuan and Zhang, Li and Miao, Minjie and Wang, Lei and Hua, Haibing and Wang, Bing and Ji, Guang},
title = {Sijunzi decoction, a classical Chinese herbal formula, improves fatigue symptoms with changes in gut microbiota in chronic fatigue syndrome: A randomized, double-blind, placebo-controlled, multi-center clinical trial.},
journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology},
year = {2024},
doi = {10.1016/j.phymed.2024.155636},
note = {PubMed: 38640860},
url = {https://www.mecfsatlas.com/evidence/dai-2024-sijunzi-decoction},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/dai-2024-sijunzi-decoction
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