Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial

Background: This study investigates the effects of various acupuncture techniques, specific acupuncture points, and their combinations on symptom improvement in chronic fatigue syndrome (CFS) patients as well as their influence on heart rate variability (HRV) indicators. Methods: We recruited 35 hea...

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Main Authors: Tong Li, Gerhard Litscher, Yudian Zhou, Yanjuan Song, Qing Shu, Li Chen, Qi Huang, Yayuan Wang, Haoran Tian, Rufeng Teng, Hua Wang, Fengxia Liang
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Complementary Therapies in Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S0965229925000597
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author Tong Li
Gerhard Litscher
Yudian Zhou
Yanjuan Song
Qing Shu
Li Chen
Qi Huang
Yayuan Wang
Haoran Tian
Rufeng Teng
Hua Wang
Fengxia Liang
author_facet Tong Li
Gerhard Litscher
Yudian Zhou
Yanjuan Song
Qing Shu
Li Chen
Qi Huang
Yayuan Wang
Haoran Tian
Rufeng Teng
Hua Wang
Fengxia Liang
author_sort Tong Li
collection DOAJ
description Background: This study investigates the effects of various acupuncture techniques, specific acupuncture points, and their combinations on symptom improvement in chronic fatigue syndrome (CFS) patients as well as their influence on heart rate variability (HRV) indicators. Methods: We recruited 35 healthy subjects as a healthy control group (Group A) and 175 patients with CFS, who were randomly divided into a fake acupuncture group (Group B), an acupuncture group targeting the Zusanli (ST36) point (Group C), an acupuncture group targeting the Guanyuan (CV4) point (Group D), a dual-acupoint acupuncture group (Group E), and a moxibustion group (Group F), with 35 patients in each group. Group B received fake acupuncture at both the bilateral Zusanli and Guanyuan points simultaneously. Group C received acupuncture at the bilateral Zusanli points along with fake acupuncture at the Guanyuan point. Group D received acupuncture at the Guanyuan point along with fake acupuncture at the bilateral Zusanli points. Group E received acupuncture at both the bilateral Zusanli and Guanyuan points simultaneously, and Group F received moxibustion at both the bilateral Zusanli and Guanyuan points simultaneously. Each group received a total of 10 treatments, administered every other day. Before treatment, the Qi-deficiency Syndrome Score, CFS Score, and SF36 Score were assessed for all subjects. HRV was measured before treatment, after the first treatment, after the fourth treatment, and at the end of treatment. Results: The results showed that both acupuncture and moxibustion can effectively alleviate fatigue symptoms in patients suffering from CFS, with combined acupuncture and moxibustion demonstrating greater effectiveness. Conclusion: Acupuncture excelled in regulating the immediate effects of HRV, while moxibustion excelled in regulating long-term effects. Acupuncture targeting both the Zusanli and Guanyuan points proved more effective than acupuncture targeting a single point, with this difference reflected in the distinct regulatory effects on the sympathetic and parasympathetic nervous systems. The intervention mechanism of Zusanli may involve the parasympathetic nervous system, whereas Guanyuan may operate through the sympathetic nervous system. Trial registration: Approved by the Medical Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine (Approval number: HBZY2016-C24-01), and registered with the North American Clinical Trials Data Center (Clinical Trials.gov) (05/10/2016) (registration number: NCT02924831).
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spelling doaj-art-084ca12c1b6e4f37a0bebb050cbcf26c2025-08-20T03:29:15ZengElsevierComplementary Therapies in Medicine0965-22992025-09-019210318410.1016/j.ctim.2025.103184Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trialTong Li0Gerhard Litscher1Yudian Zhou2Yanjuan Song3Qing Shu4Li Chen5Qi Huang6Yayuan Wang7Haoran Tian8Rufeng Teng9Hua Wang10Fengxia Liang11Acupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, China; Swiss University of Traditional Chinese Medicine (SWISS TCM UNI), High-Tech Acupuncture and Digital Chinese Medicine, Bad Zurzach 5330, SwitzerlandAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, China; School of Physical Education and Health, Hubei Business College, Wuhan 430079, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaDepartment of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaDepartment of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, China; Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, ChinaAcupuncture & Moxibustion Institute, Hubei University of Chinese Medicine, Wuhan 430061, China; Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion, Wuhan 430061, China; Correspondence to: No. 1, Tanhualin Special, Wuchang District, Wuhan City, Hubei Province, China.Background: This study investigates the effects of various acupuncture techniques, specific acupuncture points, and their combinations on symptom improvement in chronic fatigue syndrome (CFS) patients as well as their influence on heart rate variability (HRV) indicators. Methods: We recruited 35 healthy subjects as a healthy control group (Group A) and 175 patients with CFS, who were randomly divided into a fake acupuncture group (Group B), an acupuncture group targeting the Zusanli (ST36) point (Group C), an acupuncture group targeting the Guanyuan (CV4) point (Group D), a dual-acupoint acupuncture group (Group E), and a moxibustion group (Group F), with 35 patients in each group. Group B received fake acupuncture at both the bilateral Zusanli and Guanyuan points simultaneously. Group C received acupuncture at the bilateral Zusanli points along with fake acupuncture at the Guanyuan point. Group D received acupuncture at the Guanyuan point along with fake acupuncture at the bilateral Zusanli points. Group E received acupuncture at both the bilateral Zusanli and Guanyuan points simultaneously, and Group F received moxibustion at both the bilateral Zusanli and Guanyuan points simultaneously. Each group received a total of 10 treatments, administered every other day. Before treatment, the Qi-deficiency Syndrome Score, CFS Score, and SF36 Score were assessed for all subjects. HRV was measured before treatment, after the first treatment, after the fourth treatment, and at the end of treatment. Results: The results showed that both acupuncture and moxibustion can effectively alleviate fatigue symptoms in patients suffering from CFS, with combined acupuncture and moxibustion demonstrating greater effectiveness. Conclusion: Acupuncture excelled in regulating the immediate effects of HRV, while moxibustion excelled in regulating long-term effects. Acupuncture targeting both the Zusanli and Guanyuan points proved more effective than acupuncture targeting a single point, with this difference reflected in the distinct regulatory effects on the sympathetic and parasympathetic nervous systems. The intervention mechanism of Zusanli may involve the parasympathetic nervous system, whereas Guanyuan may operate through the sympathetic nervous system. Trial registration: Approved by the Medical Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine (Approval number: HBZY2016-C24-01), and registered with the North American Clinical Trials Data Center (Clinical Trials.gov) (05/10/2016) (registration number: NCT02924831).http://www.sciencedirect.com/science/article/pii/S0965229925000597Chronic fatigue syndrome (CFS)AcupunctureHeart rate variability (HRV)Autonomic nervous system (ANS)Acupuncture point combinations
spellingShingle Tong Li
Gerhard Litscher
Yudian Zhou
Yanjuan Song
Qing Shu
Li Chen
Qi Huang
Yayuan Wang
Haoran Tian
Rufeng Teng
Hua Wang
Fengxia Liang
Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
Complementary Therapies in Medicine
Chronic fatigue syndrome (CFS)
Acupuncture
Heart rate variability (HRV)
Autonomic nervous system (ANS)
Acupuncture point combinations
title Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
title_full Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
title_fullStr Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
title_full_unstemmed Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
title_short Effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients: Regulating the autonomic nervous system in a clinical randomized controlled trial
title_sort effects of acupuncture and moxibustion on heart rate variability in chronic fatigue syndrome patients regulating the autonomic nervous system in a clinical randomized controlled trial
topic Chronic fatigue syndrome (CFS)
Acupuncture
Heart rate variability (HRV)
Autonomic nervous system (ANS)
Acupuncture point combinations
url http://www.sciencedirect.com/science/article/pii/S0965229925000597
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