Zhang, Yihan, Zhou, You, Xu, Hangying et al. · Frontiers in medicine · 2026 · DOI
A systematic review of 29 studies examined whether traditional Chinese medicine therapies—including massage, moxibustion, and cupping—were associated with improvements in fatigue, sleep, anxiety, and depression in people with chronic fatigue syndrome. The review reported that massage and moxibustion showed associations with reduced fatigue and mood symptoms, while cupping was associated with better sleep quality, though the authors note these findings should be interpreted cautiously given limitations in the underlying studies.
This review provides a systematic synthesis of non-pharmacological approaches commonly used in traditional Chinese medicine for ME/CFS-like symptoms. The findings may be relevant to patients and clinicians exploring integrative management options, though the quality and generalisability of the underlying studies remain uncertain.
This systematic review does not establish causal mechanisms; it identifies associations reported across heterogeneous studies of varying methodological quality. The review does not confirm that any TCM therapy is clinically effective for ME/CFS, nor does it rule out bias from uncontrolled study designs or publication bias. Generalisation beyond the populations and settings in the included studies is not established.
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
Zhang, Yihan, Zhou, You, Xu, Hangying, Zhang, Chenxin, Guo, Lingyi, Zi, Aiqun, et al. (2026). Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1804710
BibTeX
@article{mecfsatlas-zhang-2026-comparative-effectiveness,
author = {Zhang, Yihan and Zhou, You and Xu, Hangying and Zhang, Chenxin and Guo, Lingyi and Zi, Aiqun and Xu, Yan and Xu, Min and Liu, Ting},
title = {Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.},
journal = {Frontiers in medicine},
year = {2026},
doi = {10.3389/fmed.2026.1804710},
note = {PubMed: 41994440},
url = {https://www.mecfsatlas.com/evidence/zhang-2026-comparative-effectiveness},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-06-07. https://www.mecfsatlas.com/evidence/zhang-2026-comparative-effectiveness
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