Wang, Qianqian, Zhou, Jian, Gong, Guanwen · Frontiers in pharmacology · 2025 · DOI
This review looked at whether Xiaoyao San, a traditional Chinese herbal treatment, helps people with chronic fatigue syndrome (ME/CFS). Researchers examined 6 studies with 623 patients and found that Xiaoyao San improved fatigue, reduced anxiety and depression, and caused fewer side effects compared to standard treatments. However, the overall quality of evidence was low, so we need larger, better-designed studies to be confident about these results.
This review synthesizes emerging evidence on a widely-used herbal treatment for ME/CFS in clinical practice, particularly in China. For patients exploring complementary approaches and for clinicians seeking evidence-based guidance, this meta-analysis provides an initial systematic assessment of XYS efficacy and safety profiles.
This review does not establish causation or validate the biological mechanisms by which XYS might work; it only demonstrates association in controlled trials. The low quality of underlying evidence means results should be interpreted cautiously and cannot yet inform definitive clinical recommendations. Additionally, the findings may not generalize to populations outside the studied regions or to different XYS formulations.
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
Wang, Qianqian, Zhou, Jian, & Gong, Guanwen (2025). Efficacy and safety of Xiaoyao San in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis.. Frontiers in pharmacology. https://doi.org/10.3389/fphar.2025.1496774
BibTeX
@article{mecfsatlas-wang-2025-efficacy-safety,
author = {Wang, Qianqian and Zhou, Jian and Gong, Guanwen},
title = {Efficacy and safety of Xiaoyao San in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis.},
journal = {Frontiers in pharmacology},
year = {2025},
doi = {10.3389/fphar.2025.1496774},
note = {PubMed: 39981187},
url = {https://www.mecfsatlas.com/evidence/wang-2025-efficacy-safety},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/wang-2025-efficacy-safety
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