Tuina massage for chronic fatigue syndrome: trial plan studying changes in tryptophan metabolism, gut bacteria, and brain activity

Chronic fatigue syndrome (CFS) is a disabling disorder that may involve central nervous system dysfunction along with metabolic and gastrointestinal abnormalities.

• CFS is characterized by persistent fatigue, post-exertional malaise, unrefreshing sleep, and neurocognitive and gastrointestinal symptoms.
• Evidence suggests that altered tryptophan metabolism and gut-brain axis dysfunction may be involved in CFS's pathophysiology.
• Tuina, a manual therapy from traditional Chinese medicine, is hypothesized to affect various bodily pathways related to CFS.
• There is a scarcity of randomized controlled trials assessing the clinical effects of Tuina and its gut-brain correlates in CFS.

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