Traditional & Alternative Medicine

Introduction: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterized by chronic unexplained fatigue. Th e pathogenesis of CFS/ME remains unclear and there are no known eff ective medicinal therapies. Since we recognized that the pathophysiology of CFS/ME in some patients was consistent with “Lesser Yang disease (LYD)”, a traditional Chinese medical concept described in the Shanghan Lun, we prescribed a “Sho-saiko-to (SST)”-based extract. SST was more eff ective than some antidepressants (e.g. selective serotonin reuptake inhibitors) that are widely used for CFS/ME. We had fi ve female patients with similar clinical courses. We summarize the clinical course of a case. Case 1: A 14-year old girl presented with the chief complaint of recurrent fatigue and a slight fever. Her medical history included a high fever that occurred 20 months ago. Aft er being treated for a common cold, she was only able to attend school once a week due to recurrent fatigue and mild fever. Th e necessary examinations resulted in no abnormalities. Antibiotics, antidepressants, and a replenishing Kampo formula were prescribed based on her various provisional diagnoses. Th ey were ineff ective and her condition progressively worsened. Our department was consulted and we determined that she fi t the criteria for a diagnosis of CFS/ME. SST was started and aft er two weeks, she reported an improvement of her symptoms. Cases 2-5 will be shown in the presentation. Some studies reported infl ammation in the brain in cases of severe CFS/ME. SST has an anti-infl ammatory eff ect and we have recognized that it is a good choice of treatment for CFS/ME.