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Chronic fatigue syndrome is a complex condition characterised by persistent fatigue, poor sleep, anxiety, and depression. While non-pharmacological traditional Chinese medicine therapies are commonly used for chronic fatigue syndrome, their comparative effectiveness had not been rigorously examined until this study.
Researchers conducted a systematic review and network meta-analysis, searching ten major databases up to January 2026. A total of 29 studies involving 2,234 participants were included. The analysis compared several traditional Chinese medicine approaches — including moxibustion, massage, and cupping therapy — against conventional care across multiple symptom domains such as overall fatigue, physical and mental fatigue, sleep quality, anxiety, and depression.
Among the findings relevant to cupping, the therapy demonstrated the largest effect on sleep quality improvement compared to conventional care, with a substantial standardised mean difference, though the confidence intervals were wide, indicating some uncertainty in this estimate. Moxibustion performed best for overall fatigue reduction, while massage showed the broadest benefits across physical fatigue, mental fatigue, anxiety, and depression. The authors note that different traditional Chinese medicine therapies appear to target different symptom clusters within chronic fatigue syndrome.
The authors urge caution in interpretation, acknowledging limitations in the quality and consistency of the included studies.
Conclusion: This network meta-analysis suggests cupping therapy may be particularly beneficial for improving sleep quality in chronic fatigue syndrome, but findings should be considered preliminary given the uncertainties in the current evidence base.
Source: Zhang Y, Zhou Y, Xu H and colleagues. Frontiers in medicine (2026). View on PubMed (PMID 41994440) · doi:10.1016/j.ijnurstu.2025.105250
