Chronic fatigue syndrome: symptoms and diagnosis. New in the diagnosis and treatment of chronic fatigue syndrome.

»» Issue 1 1998 (Own clinical observations)

I.N. Moroz, A.A. Podkolzin
National Gerontological Center
Central Research Laboratory of the Moscow Medical Dental Institute
Clinic of Neuroses and Borderline Conditions of the Chelyabinsk Regional Clinical Psychoneurological Hospital No. 1

Syndrome chronic fatigue(CFS) is a new pathology that is increasingly spreading in civilized countries around the world, but is poorly diagnosed and cannot be diagnosed effective treatment. It has been shown that for the treatment of CFS it is necessary A complex approach, including social-hygienic, psychological, clinical-diagnostic and therapeutic approaches, which have relative independence, but only in combination make it possible to obtain the entire amount of information necessary for sound medical diagnostic and therapeutic measures. This structural design of recommendations, in accordance with the principles of multifactor analysis, allows practitioners to identify and reliably evaluate the most significant and significant psychopathological, neurological and somatic manifestations, which dynamically determine the entire clinical spectrum of CFS and makes it possible early start treatment and preventive measures among people at risk.

1. PREVALENCE AND PATHOGENESIS OF CHRONIC FATIGUE SYNDROME

Chronic fatigue syndrome (CFS) is one of the most common pathologies of the present time, the development of which is associated primarily with the characteristics of modern life population of large cities, the type of life in developed countries and unfavorable sanitary and environmental conditions, as well as excessive emotional and mental stress on modern man.

IN Lately People are beginning to write and talk more and more about CFS. The global nature of the significance of this pathology for a modern developed society is revealed. However, specific studies of the pathogenesis and clinical picture of this pathology are practically absent.

The name CFS was first proposed as a separate diagnosis in 1988, and by 1990, more than 100,000 cases of this disease had been reported in the United States (about 80% of which were women) and the National Center for Chronic Fatigue was created. Since the symptoms of CFS are nonspecific and the pathogenesis is not clear, the determining factor in the diagnosis of CFS is still clinical symptoms. It is believed that to make a diagnosis of CFS, you need to have one “major” symptom and at least 6 “minor” symptoms.

A large symptom complex includes prolonged fatigue due to unknown reason, which does not go away after rest and a decrease in motor activity by more than 50%. Minor symptoms include muscle discomfort, fever, tender lymph nodes, arthralgia, memory loss and depression.

Other symptoms of CFS include: sore throat, pharyngitis, pain in the lymph nodes, confusion, dizziness, anxiety, chest pain and others. specific symptoms unknown pathogenesis, occurring with different frequency for CFS in the description of various authors.

In Russia, the first article describing CFS in people with occupational pathology working in environmentally unfavorable conditions appeared in 1991.

Among the objective indicators, they primarily describe changes in immune status: a decrease in IgG due primarily to G1 and G3 classes, a decrease in the number of lymphocytes with the CD3 and CD4 phenotype, a decrease in natural killer cells, an increase in the level of circulating complexes and antiviral antibodies different types, an increase in beta-endorphin, interleukin-1 (beta) and interferon, as well as tumor necrosis factor - all this, together with a 5-8 times increase in frequency allergic diseases in such patients indicates nonspecific activation and imbalance of the immune system, the causes of which are not clear. Special studies of the biochemistry of muscle tissue and energy metabolism did not show any changes.

The pathogenesis of CFS is unknown. Some authors attach importance to various viruses, nonspecific activation of immune reactions and mental factors. At the same time, the majority points to the connection of the disease with environmentally unfavorable conditions and that it is a “middle class disease,” thus giving an important role to social factors(however, without detailing the latter).

To date, no significant success has been achieved in the treatment of CFS. The only proposed pathogenetic treatment method, intravenous administration of IgG drugs, has now been abandoned due to the large number of complications (phlebitis in 55% of cases).

One of the leading symptoms of CFS is exhaustion, especially clearly detected when studying special methods of studying performance (Schulte tables, proof test, etc.), manifested as hyposthenic or hypersthenic syndromes.

The phenomena of exhaustion in CFS are directly related to a lack of active attention, which manifests itself as an increase in the number of errors.

2. CLINICAL GROUPS

In our practice, typical population groups among which CFS is common are:

• liquidators of the Chernobyl accident and persons living in environmentally contaminated areas;
• postoperative patients, especially cancer patients followed by radiation and chemotherapy;
• patients with chronic inflammatory diseases, including with hidden flow;
• a group of businessmen, as typical representatives of residents of large cities, exposed to excessive emotional and mental stress against the backdrop of material wealth and decline physical activity.

Typical risk factors for this pathology include:

• unfavorable environmental and hygienic living conditions, especially with increased radiation exposure on the body;
• influences that weaken the general, immunological and neuropsychic resistance of the body (anesthesia, surgical interventions, chronic diseases, chemotherapy and radiation therapy, and possibly other types of non-ionizing radiation (computers), etc.;
• frequent and prolonged stress as typical working and living conditions in a modern, highly technically developed society;
• one-sided hard work;
• constant insufficient physical activity and lack of physical education and sports activities with sufficient well-being and excess structural non-physiological nutrition;
• lack of life prospects and broad interest in life.

Typical for patients in this group are the following concomitant pathologies and bad habits, becoming pathogenetically significant moments in the development of CFS:

• irrational and caloric excess nutrition, leading to stage I-II obesity;
• alcoholism, often in the form of casual drunkenness, usually associated with an attempt to relieve nervous excitement in the evening;
• heavy smoking, which is an attempt to stimulate declining performance during the day;
• chronic diseases of the genital area, including currently chlamydia;
• hypertonic disease I-II stages, vegetative-vascular dystonia and others.

3. ISSUES IN DIAGNOSIS OF CFS

The issue of diagnosing CFS is very relevant, as can be seen from the above, due to its little knowledge among a wide range of doctors, it is hidden as a separate pathology behind a number of other neurological pathologies and conditions.

Meanwhile, a thorough clinical analysis allows us to fairly accurately paint the picture of chronic fatigue syndrome as a separate nosology. Typical clinical manifestations for developing CFS are: early stages are:

• weakness, fatigue, increasing attention disorders,
• increased irritability and instability of emotional and mental state;
• recurring and increasing headaches not associated with any pathology;
• sleep and wakefulness disorders in the form of drowsiness during the day and insomnia at night;
• A progressive decrease in performance against this background, which forces patients to use various psychostimulants on the one hand and sleeping pills on the other. Frequent and heavy smoking is typical for mental stimulation during the day and daily evening drinking of alcohol to relieve neuropsychic agitation in the evening, which leads to widespread domestic drunkenness;
• weight loss (insignificant, but clearly noted by patients) or, for groups of financially secure individuals leading a physically inactive lifestyle, obesity stages I-II;
• pain in the joints, usually large ones and in the spine;
• apathy, joyless mood, emotional depression.

It is very important that this symptomatology It flows progressively and cannot be explained by any somatic diseases. Moreover, with careful clinical examination it is not possible to identify any objective changes in the state of the body - laboratory research show no deviations from the norm.

There are no changes in the composition of blood and urine, no radiological changes, and no organic or functional abnormalities in ultrasound. The indicators of clinical biochemical studies are normal, no changes in endocrine and immune status. Such patients are usually diagnosed with “neuro-vegetative dystonia” and neuroses. At the same time, the usual courses of treatment prescribed for such cases usually do not give any effect at all. The disease typically progresses with deterioration and in advanced cases, severe memory and mental disorders are detected, confirmed by changes in the EEG.

Indirect data on undetectable organic nature CFS follows from clinical analysis CFS near a group of liquidators of the Chernobyl accident.

4. GENERAL PRINCIPLES OF TREATMENT OF CHRONIC FATIGUE SYNDROME

The complexity of treatment is the main principle, the non-acceptance of which, in our opinion, determines the low effectiveness of the proposed therapeutic and preventive approaches to the treatment of chronic fatigue syndrome. In the complex for the treatment of chronic fatigue syndrome in mandatory should include:

• normalization of rest and physical activity,
• fasting-dietary therapy,
• vitamin therapy with preparations of vitamins B1, B6, B12 and C, general or at least segmental massage together with hydrotherapy and physical therapy,
• autogenic training or other active methods of normalizing the psycho-emotional background, incl. group psychotherapy,
• immunocorrectors general plan with a clearly expressed general adaptogenic effect,
• other aids (daytime tranquilizers, enterosorbents, nootropics and other symptomatic medicinal preparations and impact).

It is also important to periodically monitor, repeat treatment and preventive courses in the hospital and adherence to preventive recommendations patients after discharge from hospital.

The basis for the treatment of chronic fatigue syndrome is the normalization of rest and physical activity for patients, which justifies inpatient courses of treatment for these patients, which should preferably be carried out in specialized neurological departments, which provide the possibility of creating a special general regimen.

Recommended daily mandatory hiking in the park surrounding the clinic for 2-3 hours for all patients with chronic fatigue syndrome. In addition to walking, exercise therapy courses, massage, hydrotherapy and autogenic training were prescribed.

A general massage of the whole body was used once a day or a segmental massage of the collar area, as well as, without fail, paravertebral massage with elements manual therapy, which eliminates chronic subluxations, normalizes reverse afferentation nervous information about the state internal organs and systems, has a relaxing and at the same time activating effect. In our experience, the most effective hydro-procedures are circular showers and oxygen baths.

Therapeutic exercise is selected in a volume and complex sufficient to maintain normal physical condition patients in a hospital setting. During treatment complete fasting the loads are reduced, but exercise therapy should never be completely abandoned.

Autogenic training or other active methods of normalizing the psycho-emotional background, as can be seen from the pathogenesis of chronic fatigue syndrome, are the most important pathogenetic elements in the treatment of this pathology. It should be mentioned that in many cases of chronic fatigue syndrome, the prescription of daytime tranquilizers is justified, of which, in our conditions, rudatel and mazepam, used 1/2 - 1 tablet 1-3 times a day, turned out to be the most acceptable. A direct indication for the use of tranquilizers in chronic fatigue syndrome is the presence of alcoholism, usually in the form of domestic drunkenness, which is quite typical for this group of patients.

A variety of approaches to diets for chronic fatigue syndrome are recommended in the literature. We believe that the most effective is the use of therapeutic fasting, which allows you to achieve comprehensive therapeutic effect, affecting many pathogenetic aspects of this pathology.

The basis of the action of starvation diets is dosed stress, which leads to the activation of all systems, including increased metabolism. In this case, the breakdown of “slags” occurs, activation of cellular metabolism, stimulation of functions physiological systems, including stimulation of the release of growth hormone - STH, which, in general, has a clear bioactivating effect.

Dosed starvation diets are now powerful means of prevention and treatment for a number of pathological conditions. At the same time, they have the properties of biological activation at all levels: molecular, cellular, organ, and also generally increase physical activity and intellectual abilities, and general well-being.

During courses of fasting-dietary therapy (RDT), long walking walks (up to 5 hours), general massage and moderate exercise therapy, as well as hydrotherapy (oxygen baths and Charcot showers) are necessarily prescribed.

During the course of fasting, patients receive 1.5 liters of purified, chemically activated, environmentally friendly clean water. Daily mandatory procedure during fasting, cleansing enemas are given in a volume of 2 liters of warm water, slightly tinted with a solution of potassium permanganate.

Vitamin therapy is a mandatory element in the treatment of chronic fatigue syndrome, aimed at normalizing metabolism, which undoubtedly affects those suffering from this pathology.

The basis of action are neurotropic drugs, vitamins and adaptogenic agents that increase the release of endogenous ketosteroids by the adrenal glands. We settled on the use of the following drugs and dosages: B1 - 1-3 mg, B6 2 - 4 mg, B12 - 500 mcg daily for 10-15 days and vitamin C 3-5 mg IM or IV at 40% glucose only 10 - 15 injections.

The use of general immunocorrectors with a clearly expressed general adaptogenic effect for the treatment of CFS is very advisable. We selected them based on the chronic immunodeficiency observed in many cases.

Although immunological studies of a general plan do not show any pronounced deviations in the immune status of the body, however, the presence in a significant part of this contingent chronic infections, as well as the often noted decrease in body weight, general maladaptive reactions justify the use of these drugs, possibly as a pathogenetic component of treatment.

We used general immunocorrectors with pronounced adaptogenic and antiallergic effects on a plant basis: complex homeopathic medicine"Sandra" and herbal medicine "Biosenso", which was prepared on the basis of bioactivated (ECAS) water.

5. SOME RESULTS OF TREATMENT OF CHRONIC FATIGUE SYNDROME

In the Clinic of Neuroses and Borderline Conditions of the Chelyabinsk Regional Clinical Psychoneurological Hospital No. 1, over the past 3 years, a total of more than 100 patients have been observed who were diagnosed with Chronic Fatigue Syndrome. It was noted that this syndrome is currently observed with significant frequency and regularity, mainly among several groups of the population that we propose to classify as a risk group.

These are the following groups:
1. Liquidators of the Chernobyl accident and persons living for a long time in places of environmental disasters and radiation disasters.
2. Postoperative patients (in many cases, having undergone oncological diseases).
3. Patients with chronic inflammatory diseases, often not diagnosed until the moment of treatment for chronic fatigue syndrome itself.
4.Businessmen and people engaged in long-term, intense, monotonous work associated with severe stress, high responsibility and a sedentary lifestyle.

GROUP OF "LIQUIDATORS OF THE CHURNOPHONE ACCIDENT"

Of the patients who were diagnosed with Chronic Fatigue Syndrome, 60 people were regularly examined by the liquidators of the Chernobyl accident. nuclear power plant, who formed the first clinical observation group. The subjects first received a dose of ionizing radiation in 1986 and 1987. (40 people) and in 1988, 1989. (20 people). The observation group consisted of men aged 28 to 40 years without any serious previously diagnosed diseases.

Dose load and time spent in the accident zone, as it turned out when analyzing the clinical picture, did not play a special role.

Upon arrival from the irradiation zone 6-12 months later, the observed group of individuals developed the following typical general clinical manifestations, for which they were subsequently hospitalized for treatment course to the Clinic of Neuroses and Borderline Conditions of the Chelyabinsk Regional Clinical Psychoneurological Hospital No. 1.

The patients had weakness, rapid fatigue when engaging in physical activity and any intellectual work, a not too significant but clearly expressed decrease in body weight, pain in the bones and joints, especially in the large joints of the limbs, apathy, a joyless state of perception of the environment, decreased mood and debilitating headache.

It is characteristic that in almost all patients this symptomatology, with all its undoubted severity and intensity, was not explained either by somatic pathology or chronic diseases, and there were also no clear deviations in blood and biochemical parameters. Thus, the blood counts in the group of observed patients amounted to the usual figures for this climatic zone:
red blood cells - from 4 to 6.4 billion /L,
hemoglobin - 136 - 157 g/L,
leukocytes - 6.2 - 8.3 million/L,
ESR - 3 - 15 mm/h.

Likewise, there were no clear abnormalities in clinical laboratory parameters: FPP, blood sugar, biochemical parameters, ECG and other examination methods. The indicators of the humoral and cellular immunity systems also did not change. X-ray parameters of bones and joints were without pathology. EEG was shown in the first years of observation various options norms.

This symptom complex also did not fit into the usual clinical picture, diagnosed as “vegetative-vascular dystonia” or other similar neurological symptom complexes or nosologically defined forms. However, the usual means of treating the neuropsychiatric sphere and courses of therapy of various types, carried out to many observed patients in various, including specialized medical institutions, did not give lasting results, and for the most part were completely ineffective. The symptom complex increased in intensity and frequency of manifestation of individual symptoms and led to sharp deterioration general condition of patients.

All these patients were hospitalized for a comprehensive course of treatment at the Clinic of Neuroses and Borderline Conditions of the Chelyabinsk Regional Clinical Psycho-Neurological Hospital No. 1, where they were first diagnosed with Chronic Fatigue Syndrome based on the general typical symptom complex and examination results. All patients received complex treatment, recommended for this complex in the literature, as well as additional effects developed by us specifically for this category of patients.

The general treatment package included:
1. Dosed regimen of rest and physical activity, including primarily walking in the area surrounding the clinic from 2 to 5 hours daily (with breaks).
2. Vitamin therapy - mainly with B vitamins: B1 - 1-3 mg, B6 - 2-4 mg, B12 - 500 mcg daily for 10-15 days and vitamin C 3-5 mg IM or IV on 40% glucose 10 - 15 injections per course.
3. Small doses of daytime tranquilizers (rudate, mezapam).
4. Water treatments- oxygen baths and Charcot showers.
5. Autogenic training for muscle relaxation, general and mental relaxation.
6. Nootropic drugs or Cerebrolysin in the final phase of follow-up treatment.

Since the applied general complex methods treatments proposed in the literature did not give any pronounced result in 60% of patients, and in 40% of people who showed some positive dynamics, improvement began only after 1.5 - 2 months from the start of treatment, we were forced to look for additional -telial methods of influence. As original methods of pathogenetic influence on chronic fatigue syndrome, we used the following means:

1. Fasting-dietary therapy (RDT) in the form of dosed short-term fasting. As a rule, RDT included a 7-day course of complete fasting and a 7-day course of recovery from it on a rice-vegetable salt-free diet with mandatory cleansing daily enemas in an amount of 2 liters. warm water with a small amount of potassium permanganate (until the water turns light pink). In some cases, depending on general indications, the patient’s condition and the presence of additional obesity, the duration of fasting varied from 3 to 15 days.

2. Environmentally friendly electro-activated water purified in “Emerald” type installations in the amount of 1-1.5 liters per day.

3. New patented herbal microelement product "BIOSENSO" as a bio-stimulating, immunocorrective and anti-allergic additive to purified water, 10-15 drops of a 5% solution per glass of water.

4. New phyto-homeopathic immunocorrector "Sandra" - from 4 to 6 tablets per day on average during the entire course of treatment (except for the period of fasting).

The therapy used was effective in 85% of patients in this group. There was a rapid improvement in general condition within 7-10 days. There was a clear decrease in asthenic symptoms, a decrease painful sensations in the joints, headaches went away, and my mood improved. As a result of the therapy, the patients' sleep normalized, daytime sleepiness decreased, endurance to physical activity increased, memory and intellectual activity improved.

A prerequisite for patients in this group was the use of medium doses of nootropil intravenously or intramuscularly at the end of the recovery period.

Good effect also provided Cerebrolysin in doses of 5 ml intravenously daily for a total of 10 injections. In 20% of patients with severe depressive symptoms Small doses of antidepressants were used daily - amitriptyline 25-50 mg per day.

The therapeutic effect of this treatment complex was persistent and long-lasting: in 20% of patients for up to a year or more, in 50% for 8 months, in 30% for up to 5 months the symptoms of chronic fatigue did not recur. In the future, such patients were recommended to undergo a preventive course of treatment 3 times a year as a day hospital.

All patients were also recommended to normalize the regime of rest and physical activity, use purified water and use some kind of relaxation autogenic training system every day for 25 minutes, and daily fasting once a week.

GROUP OF POSTOPERATIVE PATIENTS

There were 7 patients in this group. These were patients after undergoing surgical interventions for oncological pathology. Two patients underwent chemotherapy courses. Symptoms of chronic fatigue syndrome appeared a month after surgery and chemotherapy and manifested themselves in the form of weakness, fatigue, daytime sleepiness, slight weight loss, joyless mood, and headaches. At the same time, data from a general clinical study, including general and biochemical analysis blood tests, ultrasound, and x-ray examination indicated that the patients were practically healthy.

For this group of patients, the following set of treatment measures was used: a regimen of rest and physical activity, similar to the previous group; small groups of daytime tranquilizers at night; autogenic training courses; immuno-corrector "Sandra" 5 tablets daily at equal time intervals for 1.5-2 months.

The treatment effect was achieved in 100% of cases and was durable. The entire symptom complex of chronic fatigue syndrome disappeared completely. In two patients who received courses of chemotherapy and whose symptoms were more severe, the effect of treatment occurred much faster - on the 25-30th day from the start of therapy. In the remaining patients, clear improvement was recorded after 1.5 months.

GROUPS OF PATIENTS WITH CHRONIC INFLAMMATORY DISEASES

This group included 30 people (10 women and 20 men) with chlamydia. This disease has taken a chronic course in patients. The patients suffered from it for over three months. All patients in this group had specific symptoms of chronic fatigue syndrome - weakness, fatigue, loss of appetite, headaches, drowsiness. Chlamydia was detected upon admission of patients and was previously undiagnosed in almost all patients.

The basic therapy for this category of patients was etiotropic treatment of the underlying chronic infectious disease- chlamydia. In addition, therapy with the drug "Sandra" was used, 6 tablets per day for 1 month.

All symptoms of chronic fatigue syndrome disappeared a week after the end of treatment.

In 11 patients in this group, “Sandra” was not used, which reduced the effectiveness of treatment: the symptoms of chronic fatigue syndrome decreased more slowly and a pronounced improvement occurred only 1-1.5 months after the end of the course of treatment.

GROUP OF RESIDENTS OF LARGE CITIES

We identified this group as typical for the development of chronic fatigue syndrome among residents of large cities, since it was they who clearly manifested all the socio-ecological vices of modern life in big city and developed typical symptoms of chronic fatigue syndrome.

This group consisted of 25 people aged from 25 to 38 years with higher and completed secondary education, irregular working hours.

The risk factors were: in 21 people - alcoholism in the form of domestic drunkenness (usually 1-3 glasses of vodka every evening to relieve nervous tension); all 25 people have a sedentary lifestyle with stage I-II obesity and constant stress At work; 15 people have not been on vacation for the last 5-7 years; 20 people were smoking, 30% were diagnosed with latent chlamydia.

All of the above life circumstances, despite material well-being, led to the development of chronic fatigue syndrome in this group of patients with typical symptoms: weakness, fatigue and loss of memory, difficulty performing intellectual precise work, drowsiness during the day and insomnia at night, headaches, depression and lack of desires.

For this group of patients, complex therapy was used: a work-rest regime in the form of walking, general massage, exercise therapy and hydrotherapy; vitamin therapy with preparations B1, B12 and C; tranquilizers in higher doses of the Elenium group, 10 mg 3 times a day and after a week transfer to daytime tranquilizers (mezapam, rudatel); antidepressants in small doses - amitriptyline 12.5 mg 3 times a day (mainly in patients with alcoholism). A soft bioimmuno-corrector “Sandra” was also used, 6 tablets per day; autogenic training with psychophysical relaxation; fasting-dietary therapy was used.

In 90% of patients, the entire symptom complex of chronic fatigue syndrome was reduced within a week from the start of therapy: lethargy and fatigue disappeared, and mood became more stable.

After 10 - 12 days, the patients felt almost healthy. In 10% of patients, due to concomitant pathology (stage I-II hypertension), it was used therapeutic fasting within 7-15 days with a similar recovery period.

During the entire period of fasting and recovery, patients received water purified using the Izumrud apparatus with the addition of the Biosenso biocorrector. By the end of the 10th day, headaches disappeared in all patients and stabilization arterial pressure, sleep returned to normal. Recovery period proceeded favorably, no increase in pressure was observed, headaches did not recur.

After completion of inpatient treatment, all patients were recommended preventive therapy: a 2-week course of the “Sandra” immunocorrector, 1 tablet 4 times a day; daily 25-minute relaxation in the form of autogenic training, weekly daily fasting.

6. EXAMPLES OF TREATMENT FOR CHRONIC FATIGUE SYNDROME

The obvious successes in the treatment of chronic fatigue syndrome using complex pathogenetically determined therapy are illustrated by the following examples.

EXAMPLE 1. Patient A - x, 49 years old, was admitted to the department of the Chelyabinsk Regional Clinical Psychoneurological Hospital No. 1 in April 1995 with complaints of debilitating weakness, rapid fatigue when performing even light-intensity physical labor and dissipation of attention with decreased memory during performing work associated with intellectual effort, as well as frequent intense headaches that are difficult to relieve with analgesics, constant weakness regardless of physical activity and any other external conditions, drowsiness during the day and insomnia at night.

From the anamnesis it was established that the patient underwent 4 oncological operations (2 surgical interventions for breast fibroids and a year before admission to the department - hysterectomy and lipoma removal). The patient completed 2 courses radiation therapy and 2 courses of chemotherapy. After last operation the patient developed the subjective symptoms described above, and the severity and frequency of symptoms made her practically incapacitated; For this reason, the patient repeatedly applied to various medical departments, including specialized departments, but the courses of treatment provided no practical results. With increasing symptoms general weakness the patient was hospitalized in the Clinic of Neuroses and Borderline Conditions of the Chelyabinsk Regional Clinical Psycho-Neurological Hospital No. 1, where she was first diagnosed with Chronic Fatigue Syndrome.

An objective study did not reveal any pronounced deviations in the condition of the internal organs, blood system or biochemical parameters, which is very typical for patients in the initial periods of development of chronic fatigue syndrome.

In the department, the patient was prescribed therapy: a gentle general regimen, moderate physical activity in the form of 2-hour compulsory walks in the park adjacent to the hospital, physical therapy, paravertebral massage, and as an immunocorrective agent - the phytohomeopathic drug "Sandra" 6 tablets each per day at regular intervals. The patient also underwent courses of psychotherapy with elements of autogenic training. Tranquilizers commonly used in the treatment of chronic fatigue syndrome in in this case was not assigned.

A month later, the patient felt a clear relief of her condition, a surge of strength and energy, weakness and fatigue during physical activity decreased, headaches completely disappeared, sleep returned to normal, and daytime sleepiness disappeared.

Upon discharge, the patient was recommended a prophylactic course of “Sandra” for 1.5 months. During this period, the patient led an intense lifestyle, including a sharp change in climate and a long flight, with pronounced psycho-emotional and significant physical stress. However, during a follow-up examination 1.5 months later, the patient did not present any complaints, noted vigor and good dream. A conclusion was made about actual recovery.

EXAMPLE 2. Patient A - s, 35 years old, higher education, businessman. Within 7 recent years heads a private company, the work involves intense intellectual and emotional stress, he has not been on vacation for the last 3 years, there was practically no physical activity, although a passion for sports was noted before. In the last 3 years, to relieve the growing symptoms of nervous tension and fatigue, I drank 1-3 glasses of strong alcohol almost every day. alcoholic drinks, began to gain weight. He has been smoking heavily for 10 years and believes that it helps him relax and relieve nervous tension. Over the last 1-1.5 years, he has been experiencing excessive irritability, increasing weakness, fatigue when doing things that require attention and memory, drowsiness during the day and insomnia at night, frequently recurring headaches, sexual weakness.

Upon admission of the patient to the department, latent chlamydia was diagnosed during an objective examination. No other significant objective deviations in the condition of internal organs or clinical biochemical parameters and blood parameters were found. A diagnosis of Chronic Fatigue Syndrome was made. Chronic chlamydia. Household alcoholism. Obesity I-II degree.

The patient was prescribed: a dosed regimen of rest and physical activity - 2 hours of walking; physical therapy and general massage including paravertebral massage; oxygen baths and Charcot showers; B vitamins (B1 and B12) and vitamin C in medium therapeutic doses; "Sandra" 4 tablets per day; elenium 10 mg 3 times a day with amitriptyline 12.5 mg 2 times a day.

Already a week after the start of treatment, the patient noted a significant improvement in his general condition, he became significantly calmer in communication, irritability and fatigue decreased, attention and memory improved, sleep normalized, daytime drowsiness disappeared, the pathological craving to relieve nervous tension by resorting to alcohol and smoking disappeared .

In the third week of stay in the department, fasting-dietary therapy was carried out in the form of a 7-day course of complete fasting with daily cleansing enemas, while the patient received up to 1.5 liters per day of electro-activated water purified by the Emerald apparatus with the addition of a bio-activating agent. plant-microelement complex "Biosenso". Against the background of fasting, walking continued, the duration of which was increased in total to 5 hours per day, and hydrotherapy with massage; courses of autogenic training for muscle relaxation and general neuropsychic relaxation were also conducted. By the 7th day of fasting, there was a decreased surge of strength, vigor, increased performance and general activity.

During the 7-day recovery period after fasting, a rice-vegetable salt-free diet, further improvement in the condition was noted.

The patient was discharged after 3 weeks of complete course treatment in a state of almost complete health without any complaints. As preventive treatment 1-day weekly fasting and daily 25-minute rest while lying down with relaxation were recommended. A repeat examination after 6 months showed the stability of the results achieved during the treatment process.

LITERATURE

1. Klebanova V.A. Chronic fatigue syndrome (review) // Hygiene and Sanitation. 1995. N1. P.144-148.
2. Podkolzin A.A., Dontsov V.I. Low intensity factors in bioactivation and immunocorrection. M.: 1995.
3. Podkolzin A.A., Dontsov V.I. Aging, longevity and bioactivation. M.: Moscow textbooks and cartolithography. 1996.
4. Abstract of the Second All-Russian Conf. "Application of electrochemical activation methods in medicine." Konakovo.1989.
5. Krivol L.R. Chronic fatigue syndrome // Pediatr. Ann. 1995. Vol.24. P.290-292.
6. Lawrie S.M. et al. Chronic fatigue syndrome in community. Prevalence and associations // Br. J. Psychiatry. 1995. Vol.166. P. 793-797.
7. McKenzie R. et al. Chronic fatigue syndrome // Adv. Intern. Med. 1995. Vol.40. P.119-153.
8. MurtaghJ. Patient education: chronic fatigue syndrome // Aust. Fam. Physician.1995. Vol.24. P.1297.
9. Przewlocka M. Chronic fatigue syndrome // Pol. Tyg. Lek. 1994 (pol).1994. Vol.49. P.593-595.
10. Schonfeld U. Chronic fatigue syndrome // Med. Monatsschr. Pharm. 1995. Vol.18. P.90-96.
11. Swannik C.M. et al. Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group // J. Int. Med. 1995. Vol.237. P.499-506.
12. Van Houdenhove B. et al. Does high "action-proneness" make people more vulnerable to chronic fatigue syndrome? // J. Psychosom. Res. 1995. Vol.39. P.633-640.
13. Wessely S. et al. Postinfectious fatigue: prospective cohort study in primary care // Lancet. 1995. Vol. 345. P. 1333-1338.
14. Wessely S. The epidemiology of chronic fatigue syndrome // Epid. Rev.1995. Vol.17. P.139-151.
15. Ziem G. et al. Chronic fatigue syndrome, fibromyalgia and chemical sensitivite overlapping disoders // Arch. Intern. Med. 1995. Vol.155. P.1913

The modern pace of life exhausts people. Numerous chores around the house and problems at work force you to give your best.

The body adapts to such conditions, but after a while it malfunctions - chronic fatigue syndrome occurs. How to get rid of it?

What is chronic fatigue syndrome

Chronic fatigue syndrome occurs more often in women of reproductive age

Chronic fatigue syndrome is a form of mental, physical and emotional fatigue that occurs in the absence of illness or other pathological condition.

Chronic fatigue syndrome is characterized by prolonged exposure to factors that lead to exhaustion of a person. Performance decreases, which is not restored even after a long rest. Problems with concentrating appear, and it becomes more difficult to cope with usual activities.

Fatigue refers to protective functions body. The presence of overwork indicates the need for rest to replenish strength and energy. The chronic nature of the pathology is long-lasting - this is the main danger. The patient’s quality of life deteriorates, and the usual life collapses.

People of all ages are at risk - chronic fatigue manifests itself in both adults and children. A person's lifestyle is of great importance. Irregular working hours, absence good sleep, frequent stress - all this can lead to fatigue.

According to statistics, representatives of the female half of humanity suffer more often from chronic fatigue. Increased likelihood of the syndrome occurring in reproductive age(20–45 years old).

In addition, there are different trends in recovery: some patients recover in a few months, others take a year or more. The cyclical nature of the syndrome has also been discovered - pathological condition alternates between stages of exacerbation and attenuation.

People most susceptible to developing the syndrome are:

• having chronic diseases;
• living in large cities;
• have undergone surgery;
• living in unfavorable environmental and sanitary conditions.

In addition, the risk group includes entrepreneurs and those whose profession involves risk and stress (doctors, brokers, military personnel, airport dispatchers).

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Reasons for development

Available internal reasons development of chronic fatigue. Prolonged stress affects the functioning of human organs and systems, so chronic fatigue often occurs against the background of a malfunction in the body. The following reasons are highlighted:

• heart failure - the heart does not work at a normal pace;
• hypothyroidism - decreased efficiency of the thyroid gland;
• allergic reactions;
• pathologies affecting the respiratory system - bronchitis, asthma;
• autoimmune disorders;
• infection with a virus (cytomegalovirus, enterovirus, retrovirus). Fatigue is often caused by Epstein-Barr virus- the most common type of herpes;
• chronic diseases: diabetes, anemia, pathologies of the liver, kidneys, lungs;
• recovery period after injuries and surgery;
• poisoning with salts of heavy metals;
• infectious diseases.

Factors leading to chronic fatigue are represented by the following:

• prolonged stress and tension;
• lack of sleep or poor sleep quality over a long period of time
• acute experience of failures;
• malnutrition;
• long-term use of medications or their improper use (cold medications, sleeping pills, antihypertensives, contraceptives, antihistamines);
• sedentary lifestyle;
• poor environmental situation;
• bad habits (smoking, drinking alcohol);
• loss of a loved one.

Chronic fatigue syndrome is a result of lifestyle and external influence. In some cases, the appearance of a problem indicates the development of mental, endocrine, oncological and immune diseases. You can’t hesitate, you should visit a doctor and get diagnosed.

Symptoms and signs

The syndrome does not occur suddenly; it is characterized by a gradual increase in symptoms. Initially, the patient mistakes the symptoms for flu or a cold, because:

• there is a runny nose and sore throat;
• headache appears;
• body temperature rises;
• lymph nodes enlarge.

After 2–3 days, symptoms intensify and new ones are added:

• muscle pain;
• muscle weakness;
• painful sensations in the joints;
• long and extreme fatigue after exercise.

The main symptom is prolonged fatigue that remains even after rest. Performance decreases, although diseases and causes that could lead to the condition are clearly absent.

Frequent and persistent fatigue - main feature syndrome

In addition to the above-mentioned manifestations, other signs also occur:

• heartburn and disruption of the digestive system;
• hair loss;
• increased sensitivity to light and visual disturbances;
• increased heart rate;
• nervous tic;
• hearing loss and ringing in the ears;
• acne, acne;
• decreased sexual desire;
• deterioration mental abilities(decreased concentration, memory impairment).

The changes also affect the patient’s psycho-emotional health, so the following symptoms appear:

• sleep problems: insomnia or a strong desire to sleep during the day;
• depression;
• prolonged irritation;
• emotional depression;
• indifference to everything around;
• lack or lack of motivation;
• decreased self-esteem;
• desire for loneliness.

Insomnia is a frequent guest in chronic fatigue syndrome

Diagnostics

There are no specific tests for detecting chronic fatigue syndrome. diagnostic techniques. However, criteria have been developed by which the patient's condition is assessed. The presence of several indicators indicates the development of the syndrome, these include:

• muscle tension and pain;
• painful palpation lymph nodes(axillary and cervical);
• decreased concentration and memory impairment;
• painful sensations in the joints (without symptoms of other pathologies);
• poor quality of sleep (the body does not recover);
• headache;
• development of pharyngitis - inflammation of the lymph nodes and pharynx;
• increased fatigue after exertion (mental or physical) that lasts more than 1 day.

The symptoms of the syndrome are similar to those of other diseases, so the following pathologies are excluded:

To exclude other diseases, the following measures are used:

• analysis of biochemical parameters and samples: levels of calcium, potassium, sodium, glucose, protein, alkaline phosphatase, kidney and liver tests;
• general urine analysis;
• general blood test: determination of platelets, ESR, leukocyte formula;
• analysis of rheumatoid factor and C-reactive protein;
• specific tests: examination for herpes viruses, viral hepatitis, candidiasis, chlamydia, syphilis, HIV, toxoplasmosis;
• electrocardiography - study of heart rhythm;
• diagnostics of hormonal levels;
• polysomnography - diagnosis of sleep periods;
• Magnetic resonance imaging of the brain - to exclude tumors and other disorders.

Which doctor should I contact - table

Doctor	How will it help?
Immunologist	If chronic fatigue syndrome is accompanied by frequent colds, exacerbations chronic diseases or relapses of previously suffered diseases, you should contact an immunologist who will help restore the body’s immunity and vitality.
Endocrinologist	Sometimes chronic fatigue can accompany a more serious illness. endocrine system, therefore, consultation with an endocrinologist will help identify this disease in the early stages.
Neuropathologist	Chronic fatigue syndrome is directly related to overexertion nervous system, so specialists such as a neurologist or neuropathologist will be able to correctly diagnose and treat this disease.
Psychologist	If chronic fatigue syndrome is caused by frequent stress, anxiety, and is manifested mainly by insomnia, unreasonable fear or anxiety, then you should consult a psychologist or psychotherapist who will help you understand your feelings and overcome psycho-emotional stress.
Therapist	If it is difficult to understand the causes of the disease or to distinguish chronic fatigue from other diseases, you can seek help from a therapist who will prescribe the appropriate treatment or refer you to the right specialist.

Treatment

Drug therapy

After completing the diagnosis, treatment begins. Drugs are prescribed depending on the symptoms and factors that caused the development of the syndrome. It is forbidden to use medications independently, without a doctor’s prescription. The following groups of drugs are used:

1. Immunomodulators (Likopid, Dibazol, Polyoxidonium, Interferon). They influence the patient’s immunity, strengthen it and prevent the development of viral and colds. Prescribed for frequent relapses of diseases.
2. Non-steroidal anti-inflammatory drugs (Diclofenac, Naproxen, Ibuprofen, Ketorolac). Used for pain in muscles and joints.
3. Nootropic drugs (Phenibut, Aminolon, Piracetam) and antidepressants (Befol, Imipramine, Toloxatone). Prescribed for prolonged stress and prolonged depression. Also used for unreasonable feelings of fear and nightmares.
4. Antiviral drugs (Kagocel, Arbidol, Tamiflu, Anaferon). Used during the development of a viral infection.
5. Vitamin complexes (Triovit, Univit, Vitrum, Centrum). To improve well-being, strengthen the immune system and correct metabolic processes, drugs from this group are prescribed.

Homeopathic medicines are used to improve well-being:

1. Gelsemium. More often prescribed to older people who are faced with manifestations of the syndrome (feelings of anxiety, severe stress, hand tremors, weakness, fear of crowds).
2. Quininum arsenicosum. The drug is used to treat adult patients who have symptoms such as: insomnia, heaviness in the body, eye sensitivity to light, brain fog.
3. Acidum phosphoricum. The medicine is developed for patients adolescence having the following manifestations: mental instability, headaches, decreased concentration and loss of visual vigilance.

Medicines in the photo

The specialist’s task is to explain to the patient the essence of his problem, that it can be eliminated.

During psychotherapy, psychological blocks that interfere with the patient are removed. These can be fears, worries and other negative emotions that deplete the patient’s health. It is important for the specialist to find out the questions that interest the patient. This way the doctor will be able to better understand the situation and direct therapy in the right direction.

The duration of treatment depends on the patient’s condition and the severity of the problem - from 3 months to 1 year. Consultation alone will not solve all problems, as many people think. A person’s desire to cope with the difficulties that have arisen is of great importance, so the task of treatment is to make the patient believe in himself and his strength.

Normalization of lifestyle

Chronic fatigue syndrome occurs when problems and difficulties accumulate. This is largely due to lifestyle. An important goal of treatment is to eliminate factors that interfere with the patient’s daily life.

Lifestyle restoration occurs in the following areas:

1. They determine a person’s need for sleep, since the well-known 7–8 hours are advisory in nature, and they are not suitable for everyone. Some people need less time to recuperate, others need 10 hours of sleep or even more. The main condition is that after sleep a person must fully recover.
2. Bad habits. Addictions deplete the body, causing bouts of fatigue. We're not just talking about alcohol and smoking - addiction to coffee or energy drinks has a negative impact on a person's condition. The temporary increase in strength caused by such stimulants is replaced by decline, the body cannot work to its limits. The patient’s task is to get rid of such addictions.
3. Organization of rest. Knowing how to rest is a whole science; not everyone is able to recover properly: some people like TV, others prefer a computer. In both cases, the person does not rest, but only wants to think so. Doctors recommend walks in the park. Fresh air and atmosphere allow you to escape from everyday life. Interesting hobby- also a way out of the situation, since your favorite activity brings a lot of positive emotions.
4. Daily regime. It is easier for the body to work if it is accustomed to certain actions at a specific time: go to bed at 10 pm, wake up at 7 am. Leapfrogging between bedtimes and wake-ups is more debilitating than physical activity.

Healthy and adequate sleep is a necessary element for recuperation

Diet for chronic fatigue syndrome

Depression and bad mood are often associated with a lack of vitamins and nutrients in the body. The patient’s task is to compensate for the deficiency and balance the diet.

• seaweed;
• feijoa;
• cottage cheese;
• vegetable soups;
• porridge: buckwheat, rice, pea, oatmeal;
• kefir, yogurt, fermented baked milk;
• greens: spinach, lettuce, parsley, celery;
• honey with nuts;
• salted fish (200 g per week);
• shellfish and other seafood;
• rabbit meat;
• grape juice;
• lean veal;
• dark chocolate (but in small quantities).

What should you give up? The list of prohibited products is presented as follows:

• coffee;
• strong tea;
• fatty food;
• sweets: cakes, caramel;
• smoked products;
• cocoa;
• alcoholic products;
• carbonated drinks.

Prohibited products - photo gallery

Cocoa is excluded from the diet during treatment

Coffee has a stimulating effect, but its duration is short

Alcoholic drinks suppress the immune system, and deterioration of the immune system is one of the reasons for the development of the syndrome

Therapeutic exercise and massage

Has a complex effect physiotherapy. It activates all body systems, improves metabolism and helps remove harmful substances.

No exercise required special conditions, because you can do gymnastics in a chair without being distracted from the work process. Breathing is important - even and deep.

The initial stage is muscle relaxation. Then they begin to perform gymnastics:

1. Perform head turns to the right and left with fixation in the extreme position.
2. Lower your head forward all the way, fix the position for a few seconds and move your head back.
3. Pressing your chin to your chest, turn your head left and right (the chin should not come off your chest).
4. Pull your chin forward and pull your shoulders back.

A soothing massage is another way to relax. The technique eliminates muscle tension and soreness, improves blood circulation and tissue nutrition.

Folk remedies

To increase the body's resistance at home, you can use traditional medicine. You should consult a doctor and consult before using them to rule out an allergic reaction.

Aqueous tinctures are very effective. A striking example- a remedy from St. John's wort. To prepare you need:

1. Add 1 tbsp to 100 ml of boiling water. l. dry herb St. John's wort.
2. Let the product sit for 30 minutes.
3. A glass of medicine is divided into 3 parts and consumed throughout the day 20 minutes before meals.

The common plantain also has a lot useful properties, the plant is also suitable for eliminating chronic fatigue. To prepare the composition you need:

1. Take 10 g of dry leaves and chop them, pour 300 ml of boiling water.
2. Set the composition for 30 minutes.
3. Take the product 3 times a day, 2 tbsp. l. Duration of treatment - 3 weeks. Take the medicine 30 minutes before meals.

Herbal remedies are effective for chronic fatigue syndrome. The recipe is simple:

1. Mix oats, prickly tartar leaves and dry leaves peppermint(2 tablespoons of each ingredient).
2. Pour the composition with 5 cups of boiling water.
3. Infuse the product for 60–90 minutes (the vessel is wrapped in a terry towel).
4. The duration of treatment is 15 days. Drink half a glass 3-4 times a day before meals.

Lingonberries and strawberries are rich in vitamins and have a general strengthening effect. It is not necessary to take berries; it is enough to use plant leaves. Prepare the medicine as follows:

1. Chopped plant leaves (1 tablespoon each) are mixed and poured with 500 ml of boiling water.
2. The medicine is infused in a thermos for 40 minutes. Take a teaspoon of tincture 3 times a day.

Clover remedy relieves fatigue and has a tonic effect. It is easy to prepare a decoction:

1. 1 l warm water put on fire, pour 300 g of dried clover flowers into the water.
2. Boil the product for 20 minutes.
3. Remove the broth from the heat and cool, add 100 g of sugar to it, stir thoroughly.
4. Take the infusion 3-4 times a day, 150 ml. Can be used as tea, but in the specified dosage.

Ginger is used to boost immunity. The plant has a positive effect on the emotional background and also strengthens strength.

First recipe:

1. Grind 150 g of ginger root, add 800 ml of alcohol or vodka.
2. Infuse the composition for 1 week, consume 1 tsp. 1 per day.

Second recipe:

1. A piece of root (about the size of a fingernail) thumb hands) grate, pour 200 ml of boiling water.
2. Leave the product for 15 minutes. To improve the taste, you can add a little lemon juice or honey.
3. The drug is drunk throughout the day.

Healing plants in the photo

Plantain has a calming effect

Prevention measures

Outdoor recreation restores strength and allows you to escape from problems

• diversify your diet;
• do not experiment with diets and fasting - to lose weight you need to visit a doctor and consult with him;
• relax after work as much as possible: take a bath, drink hot tea, have a session aromatherapy, do not take work home;
• take vitamin complexes, especially in winter and spring;
• take walks more often and be in the fresh air - walks relax and drive away bad thoughts, and fresh air tones up;
• alternate loads correctly: every 2 hours you should be distracted and change the type of activity - with physical activity on mental work and vice versa;
• When you spend a long time at your desk, exercise is useful - this good way relax and recover after tiring work;
• If you have prolonged stress, bad mood and headaches, you can go to the cinema or get out into nature.

Chronic fatigue syndrome is far from a harmless condition. Lack of intervention leads to serious problems: immunity deteriorates, the body’s resources are depleted, the psyche changes. It is easier to prevent the development of a condition than to eliminate it, so maintaining physical and mental health is a priority for every person.

The state of fatigue is familiar to each of us. After a hard day at work or strenuous physical activity, we feel tired. This condition usually goes away with good rest and sleep. However, symptoms of fatigue do not always disappear even after a long, proper rest. If the feeling of fatigue haunts you constantly and does not go away even when you put effort into it, then this is due to specific disease body. Its name is chronic fatigue syndrome. How to treat this disease?

What is chronic fatigue syndrome (CFS)?

Chronic fatigue syndrome is a feeling of constant overwork and weakness that does not disappear after proper rest and long sleep. This phenomenon is often found among residents of large cities in developed countries. Active men and women aged 25-40 who work hard to advance their careers are susceptible to CFS.

CFS is similar to the state of a person before the onset of an illness or after recovery, when the body is weakened and exhausted. People can live in this state for months or even years. The syndrome occurs in different people age groups– young people, teenagers, children, and this disease occurs more often in women than in men.

Causes of the disease

Doctors cannot yet pinpoint the exact causes of CFS, but experts have identified a number of factors that may increase the risk of developing this condition. The occurrence of CFS can be triggered by:

• Chronic diseases. They weaken the immune system, lead to overwork of the nervous system, and exhaustion of the entire body.
• Emotional disorders. A constant state of stress or depression, feelings of depression, anxiety, and fear negatively affect the nervous system, which leads to overwork.
• Not healthy image life. Constant lack of sleep, improperly organized daily routine, prolonged physical or mental stress, lack of fresh air, sunlight, a sedentary lifestyle can create the ground for the development of CFS.
• Poor nutrition. Eating low-quality foods, overeating or undereating, a diet poor in vitamins and useful substances– all this affects the functioning of metabolism, leads to a lack of energy in the body and to a condition constant fatigue.
• Polluted ecology. Living in an environment with poor environmental conditions negatively affects all body systems. He is forced to protect himself from harmful influences environment, working in maximum mode. At permanent job The wear and tear of the body results in chronic fatigue.
• Viruses and infections (cytomegalovirus, herpes, enterovirus, rotavirus and others) can lead the body to a state of constant fatigue.

Symptoms of chronic fatigue syndrome in adults

At normal fatigue after have a nice rest the body renews its strength. Chronic fatigue does not go away even if you sleep for 10 hours in a row. CFS is accompanied the following symptoms:

• Sleep problems. Insomnia or light, shallow sleep, as well as feelings of fear, anxiety, and worry can haunt a person with this syndrome.
• Headache, sensation of pulsation at the temples. These symptoms indicate an overload of the nervous system.
• Decreased concentration, memory loss.
• Constant feeling weakness, fatigue, apathy. Fatigue causes even simple tasks.
• Emotional disorders. People with CFS may suffer from depression. They are susceptible bad mood, dark thoughts, worry, feelings of anxiety.
• Pain in muscles, joints, as well as muscle weakness, hand tremors.
• Reduced immunity. People with CFS may suffer from persistent colds, chronic illnesses, and may experience relapses of past illnesses.

Signs of the disease in children

Not only adults, but also children can suffer from CFS. Busy daily routine, difficult school program, homework, hours of watching TV or sitting at the computer, problems in relationships with other children - all this contributes to the occurrence of chronic fatigue in children and adolescents.

The disease manifests itself not only in children with pathologies of the nervous system or in young patients suffering from any somatic disease. Even seemingly healthy children can get it. Often, CFS occurs in them during critical periods, which last from 6 to 7 years and from 11 to 14 years. The following signs may indicate CFS in a child:

• Constant whims, tearfulness, high mobility of the child. In the 2nd half of the day these signs intensify.
• It is difficult for a child to bear the slightest emotional stress; he quickly becomes exhausted and cries over trifles.
• Superficial, shallow, disturbing dream.
• Headache.
• Meteor dependence.
• The state of overwork negatively affects concentration, study, and performance.

Sometimes parents may attribute the above symptoms to the child’s capriciousness or disobedience, so they begin to punish him severely. But this only makes the situation worse. Children with CFS need the help of a qualified psychologist who will help the child get rid of fatigue.

How to treat CFS at home?

If a diagnosis of CFS is established, then home treatment It is necessary to eat a balanced diet containing sufficient amounts of proteins, fats, and carbohydrates. It is also important that the diet must be rich in vitamins, macro- and microelements. Balance is not easy to achieve, but nutrition will provide necessary support to the body and give it strength.

Proper diet can fill the body with energy and increase its resistance negative influence environment. It is recommended to exclude tea, carbonated drinks, coffee, and alcohol from the diet during treatment for CFS. Include grape juice in your daily menu, which is recommended to drink 2 tbsp every 2-2.5 hours. l. Also, eat some salted fish once a week.

Also, in case of CFS, proper rest and sleep of at least 8 hours a day are of great importance for recovery. When planning your day, it is recommended to create a daily routine in which periods of work and rest alternate. A daily 30-minute walk will have a beneficial effect on general state sick. Treatment of CFS is carried out at home with the help of medications and folk remedies.

Treatment with folk remedies

ethnoscience offers many recipes for the treatment of chronic fatigue syndrome. A good effect for overcoming the state of constant fatigue and apathy is provided by the use of tinctures of ginger, cinnamon and other natural ingredients. Let's look at some recipes for treating CFS.

Recipe No. 1

Ingredients:

• Honey – 100 g
• Apple cider vinegar – 3 tsp.

Mix vinegar and honey. Take the product 1 tsp. per day for 10 days.

Recipe No. 2

Ingredients:

• Ginger – 150 g
• Vodka – 800 ml

Pour vodka over the root. Infuse for a week. Drink 1 tsp per day for the treatment of CFS. once. It is necessary to take into account such issues as driving a car, so it is most effective to take this remedy in the evening.

Recipe No. 3

• Ginger root – 1 pc.
• Water (boiling water) – 1 glass
• Honey (a little) or 1 small piece of lemon - optional

Cut the root into 6 parts. Pour boiling water over it. Add honey or lemon if desired. This pleasant-tasting drink is drunk 3 times a day for a month.

Recipe No. 4

Ingredients:

• Cinnamon – 50 g
• Vodka – 0.5 l

Pour cinnamon into a small container (break the stick or replace it with ground). Fill it with vodka. Close the container with a lid and leave in a dark and dry room for 21 days. Shake the tincture periodically for 3 weeks. Drink 1 tsp.

Recipe No. 5

• St. John's wort – 1 tbsp. l.
• Water (boiling water) – 1 glass.

Pour boiling water over the dry chopped herb. Leave for 30 minutes. Drink 1/3 cup of infusion 3 times a day for 21 days.

Recipe No. 6

Ingredients:

• Aloe juice – 100 g
• Lemon – 3 pcs.
• Walnuts(crushed) – 0.5 kg

Squeeze juice from lemons. Mix all ingredients. Use 1 tsp. 3 times a day.

Hot baths are good for getting rid of chronic fatigue. The temperature of the water in the bath should not exceed 38 degrees, and the duration of the procedure should be 20-30 minutes. When taking a bath to combat CFS, make sure that the heart area is not immersed in water. It is recommended to take baths no more than 2 times a week.

Medicines

To treat CFS, your doctor may prescribe medications. Depending on the general picture of the disease, they may be prescribed the following drugs:

• sleeping pills and sedatives;
• drugs that stimulate the production of the “joy hormone” (serotonin).
• psychotropic medicines;
• vitamins;
• immunomodulators;
• anti-inflammatory drugs.

Which doctor should I contact for diagnosis?

Symptoms of CFS often manifest themselves in complex ways. This disease responds well to treatment with initial stages diseases. If you experience constant fatigue due to insomnia, apathy, persistent colds or exacerbations of chronic diseases, it is recommended to consult a doctor. But which specialist should you go to for quality medical care with CFS?

It all depends on how the disease manifests itself and what symptoms of CFS are present. When choosing a doctor, you need to take into account the cause that provoked the disease. It is also important how the disease manifests itself, which body systems it affects. If you suspect CFS, it is best to immediately consult a therapist. This doctor will be able to assess the patient’s condition and, if necessary, refer him to a specialist.

Seeking advice from a psychotherapist or psychologist is appropriate if CFS arises as a result of ongoing stress, anxiety and manifests itself in the form of insomnia, anxiety state, causeless fear. A specialist will help you understand negative emotions, will show ways to overcome psychological problems.

If CFS is caused by overstrain of the nervous system, then it is better to consult a neurologist or neurologist. The doctor will prescribe a special therapy for the patient that will help him recover. Sometimes CFS accompanies serious illness endocrine system, so seeking advice from an endocrinologist will help diagnose the disease. With constant fatigue in the background frequent colds and exacerbations of chronic diseases, you should consult an immunologist. He will give recommendations for restoring the body’s immunity and strength.

Video about CFS and its treatment

Why does chronic fatigue syndrome occur? IN modern world This disease is becoming more common, so it is necessary to know the symptoms of this disease and how to treat it. Can drinking alcohol really solve the problem of stress and chronic fatigue? Find out the answers to these questions and tips for fighting CFS by watching the video:

Chronic fatigue is serious illness, therefore, its treatment should begin immediately after the first signs appear. In an advanced state, the period of treatment for this disease increases significantly, as does its cost. In addition, the risk of developing serious mental disorders increases.

Modern medicine has so far achieved little success in the treatment of chronic fatigue syndrome. Previously, a pathogenetic treatment route was used for this purpose, which consisted of intravenous administration immunoglobulin G preparations to the patient, but today this option has ceased to be used, since its use gives a large number of complications.

Today, chronic fatigue is treated using various methods of cleansing the body, special medications are administered in order to normalize the functioning of the central nervous system and brain activity, as well as to restore the functioning of the endocrine, immune and systemic systems. gastrointestinal tract. In addition, psychological rehabilitation plays an important role in solving this problem.

An integrated approach is crucial in the fight against chronic fatigue, since individually the above methods will be ineffective. Therefore, it is best to treat this disease in a hospital setting, because only in a hospital setting is the patient provided with complete peace.

The treatment package includes:

• The combination of a gentle regime of physical activity with complete rest and sleep.
• Methods of restoring the emotional and mental state, in particular autogenic training and group psychotherapy.
• Fortification of the body with preparations of group B vitamins (B1, B6, B12) and vitamin C. Group B vitamins plus the substance trionine are included in the preparation “Biotredin”. Thanks to the drug it improves brain activity, attention and mental performance increase, and also have a positive effect on the functioning of the nervous system.
• Mandatory walks in the fresh air lasting at least two hours.

Very often during treatment of this disease patients are prescribed daytime tranquilizers (Rudotel or Mazepam).

Normalization of blood circulation in the brain and prevention of stroke and a number of others cardiovascular diseases is very important. Eg, combination drug Vasobral stimulates blood circulation and metabolism in the brain. The active substances contained in the drug prevent thrombus formation, reduce the permeability of vascular walls, increase the resistance of brain tissue to oxygen deficiency, and also increase mental and physical performance. The drug prevents the development of chronic fatigue, which is clinically confirmed.

Physical activity.
Physical activity perfectly replenishes the reserves of necessary energy, but a sedentary lifestyle just contributes to the appearance of constant fatigue. Daily exercise, sports, and long walks help reduce blood pressure, normalize weight, and help eliminate anxiety and depression. Sitting less in front of the computer or watching TV, go out of town into nature more often. For this disorder, a course is also prescribed physical therapy in combination with hydrotherapy (oxygen baths and cold and hot shower) and massage of the whole body or collar area, as well as paravertebral massage with elements of manual therapy (massage along the spine using reflex-segmental massage techniques, aimed at eliminating pain and improving the functioning of the autonomic functions of the body). This effect has an activating and relaxing effect on the body, relieves fatigue and tension.

To treat this disorder, non-traditional methods of treatment are often used, in particular acupuncture (acupuncture, acupuncture), aimed at restoring normal operation internal organs, reduction pain syndromes and replenishment of energy. In some cases of chronic fatigue, yoga can be effective.

Volume physical exercise for each individual patient is selected individually, depending on the physical condition of the body.

Nutrition.
To achieve the maximum therapeutic effect, diet therapy, in particular therapeutic fasting, is often prescribed. Proper nutrition improves metabolic processes in the body, promoting increased physical and intellectual activity, and also improves overall well-being. Therefore, to treat this disorder, it is important to review your eating habits.

For productive work Our brain needs to maintain glucose at a certain level. Therefore, it is important to strictly follow a diet, do not refuse breakfast and do not skip meals, which reduces the level of sugar and insulin in the blood, which, in turn, makes us irritable. For breakfast, try to use cereals and whole grains. Meals throughout the day should be regular, five to six meals in small portions. This helps maintain energy at an optimal level.

Try to drink more fluids throughout the day, since a lack of fluids prevents our body from working at full capacity. If you have chronic fatigue, you should limit your consumption of drinks containing caffeine. You should not drink more than two cups of tea or coffee per day, since excess caffeine causes irritability, anxiety, and also contributes to decreased performance. It is also worth limiting or completely eliminating drinks such as Coca-Cola or Pepsi. In the fight against fatigue, it is also recommended to include seaweed, shadberry and feijoa in your diet, since they contain a high content of iodine, which is known to have calming properties for humans. If taken a teaspoon blue iodine daily, you can get rid of chronic irritability and stress, and also improve your mental abilities.

To relieve fatigue and overwork, it is effective to drink grape juice, two tablespoons every two hours for three days.

A mixture of chopped walnuts and honey, taken in equal proportions, will help relieve fatigue and get rid of accumulated stress. Take a teaspoon three times a day. The course lasts two to three weeks.

Drinking a mixture of cranberry (half a glass) and lemon juice(200 ml) with two tablespoons of sugar added. The mixture should be left for eight hours, after which 100 ml should be consumed twenty minutes before meals three times a day.

Or mix half a glass of lemon juice and apple juice with 200 ml carrot juice and two tablespoons of sugar. Take 100 g twenty minutes before meals four times during the day.

Taking a mixture prepared from 100 g of aloe juice, 0.5 kg of chopped walnuts and lemon juice (three medium-sized lemons) will also relieve tension and fatigue. Take a teaspoon before meals three times a day.

Healthy sleep.
Poor quality or insufficient sleep is one of the causes of chronic fatigue. Our body requires an average of seven to eight hours of good sleep. If you are suffering from insomnia, it is important to throw everything away anxious thoughts, before going to bed, walks in the fresh air are recommended, and limit the consumption of invigorating drinks. Under no circumstances should you take sleeping pills; they can cause addiction to the body.

Vitamin therapy is also included in a set of measures to combat constant fatigue.

Psychological health.
A common cause of this disease is psychological problems. Try to reconsider your lifestyle, solve problems as they arise, do not accumulate them, as constant worries deplete your energy reserves, causing chronic fatigue. At least once a week you should disconnect from all your problems, do nothing and just have a good rest.

It is very important that the work you do every day brings moral and financial satisfaction. From the fact that everything turns out easily and simply when doing what you love, fatigue after working day not felt. You are happy with yourself. Therefore, in the fight against fatigue, it is also important to do what you love, and if necessary, change your occupation. You can try to compensate for dissatisfaction with your activities with other positive emotions (for example, communicating with loved ones, a new hobby, playing sports, or getting an animal).

Aromatherapy.
To relieve fatigue and tension, a massage using essential oils. Mix a tablespoon of almond or grape oil with four drops of lavender oil and the same amount of lemon oil. Or mix three drops of lavender oil or ylang-ylang oil with two drops of Roman chamomile oil and a tablespoon of almond or grapeseed oil.

Either add a mixture of a few drops of clary sage, juniper berries and lemongrass oils to the aroma lamp, or a few drops of rosemary oil - they have an excellent relaxing and calming effect. During pregnancy, the use of mixtures of these oils is contraindicated.

Aromatherapy from a mixture of essential oils of geranium, marjoram and rose petals in a ratio of 2:2:1 or a mixture of geranium, cedar, verbena, bergamot and lemon oils, taken in equal proportions, effectively relieves stress.

Folk remedies for treating chronic fatigue.
Traditional medicine in the fight against chronic fatigue recommends the use of soothing herbs such as echinacea, licorice root, tenacious bedstraw, valerian root, motherwort, ginseng.

To relieve nervous tension, eliminate insomnia, and tearfulness, it is good to use valerian tincture (10-15 drops).

Every day in the evenings it is recommended to take 10% infusion of motherwort herb. To prepare it, take ten tablespoons of dry herb and brew it with a liter of boiling water, preferably in a thermos. Let it brew and take 100 ml for thirty days.

As good sedative The following infusion is made: pour two tablespoons of spruce needles with 200 ml of boiling water, put on fire and boil from the moment of boiling for fifteen minutes, then add two tablespoons of dark honey to the liquid, stir well, cover with a lid and wrap in a warm cloth. After two hours, the infusion is ready for use. Take 50 g at night.

Ginseng tea helps relax the nervous system and increases the body's resistance to stress. For the same purpose, you can use catnip herb, chamomile, hops, and lemon balm, as they have a sedative and relaxing effect.

Lingonberry-strawberry infusion will also help in the fight against chronic fatigue. Take a tablespoon of lingonberry and strawberry leaves and pour 500 ml of boiling water, wrap in a warm cloth and let steep for forty minutes. Consume warm (heat in a water bath) three to four times a day before meals. Add a spoonful of honey to the infusion. Drink warm, adding honey to taste, 3-4 times a day.

Pour four tablespoons of dried raspberries into 400 ml of boiling water and let it brew for three hours. It is recommended to drink half a glass of infusion four times a day. Heat the infusion in a water bath before use.

Relaxing baths will also help relieve tension and fatigue. Mix a teaspoon of almond oil with two drops of geranium oil, add to the bath with warm water(37-38° C). The bath should take no more than fifteen minutes. The course consists of fifteen procedures.

Bath with valerian root decoction: pour cold water valerian root, put on fire and boil for fifteen minutes from the moment of boiling. Then remove from heat and let the liquid steep for an hour. After this, strain the broth and pour it into a bath filled with warm water (37 degrees). Take a bath for no more than fifteen minutes.

Coping with chronic fatigue is not easy, but it is possible, despite all the difficulties in diagnosing this disease. Rationally distribute your work and rest time, eat right, lead a healthy lifestyle, approach life with great positivity, and then chronic fatigue will not threaten you. But when the first ones appear alarms you should not delay visiting a specialist, otherwise the advanced disease will lead to serious violations nervous system and psyche.

The modern world requires maximum effort and constant tension from a person. All you have to do is relax a little and you're already out of your element. That's why most people are always in a hurry to get somewhere, live at a frantic pace and don't give themselves a moment's rest.

This behavior has reverse side medals in the form of health problems. Moreover, they result in completely various diseases: some people suffer from frequent acute respiratory infections, some experience hormonal imbalances, and some even get cancer this way. The formulations of the main diseases are more or less understandable to the common man. But since the end of the last century, an official separate disease has appeared in medicine under the strange name “chronic fatigue syndrome.” Yes, yes, chronic fatigue, today, is a disease, and not just a temporary condition. And like every disease, chronic fatigue syndrome has its own causes, symptoms and treatments. Since a state of prolonged fatigue has accompanied almost every one of us at least once in our lives, let’s try to figure out where is the line between normal and pathological? What is considered ordinary fatigue, and what is considered a disease? How to determine if a person has chronic fatigue syndrome? You can find answers to these questions by reading this article.

Definition

Females are more susceptible to developing chronic fatigue syndrome.

The official definition of chronic fatigue syndrome is something like this: chronic fatigue syndrome (CFS) is a disease characterized by excessive physical and mental fatigue, lasting at least 6 months, not relieved by rest or sleep, accompanied by numerous joint, muscle, infectious and neuropsychological symptoms. Thus, it becomes clear that fatigue can be considered a disease only if it exists for at least six months and in combination with other symptoms.

The first mention of chronic fatigue syndrome dates back to the 30s of the twentieth century, but until 1988 the wording was different. Synonyms for CFS are the following: benign myalgic encephalomyelitis, chronic mononucleosis, myalgic encephalopathy, post-viral fatigue syndrome. This is exactly what this disease was called throughout the 20th century. Such different formulations of the same condition were associated with the search for the immediate causes of CFS. Since the only cause was never established, scientists decided to associate the name with the main symptom. So, in 1988, the Americans proposed the term “chronic fatigue syndrome,” and since 1994 the name has become international.

Causes of CFS

A reliable source of development of CFS has not yet been established. There are only assumptions about the leading role of one or another process in each specific case. Among the conditions with which CFS is directly linked, it is worth noting the following:

• transferred viral infections(, Coxsackievirus group B, cytomegalovirus, herpes virus type 6, hepatitis C virus, enteroviruses);
• violations of control of body functions by the nervous system. This is especially true for the higher spheres nervous activity(memory, thinking, etc.);
• mental disorders. In most cases of CFS, precursors are identified in the form of changes in mood, feelings of unmotivated anxiety;
• being in a state of chronic stress;
• unfavorable environmental conditions combined with an unhealthy lifestyle. Residents of large cities, working "exhaustively", with an inadequate diet, without a sufficient amount of physical activity in the conditions constant lack of sleep– the first applicants for CFS.

It cannot be said that any one of the above factors is decisive or more significant. Modern scientists believe that it is the coincidence of a number of conditions that leads to the development of CFS.

There are predisposing factors for CFS. This:

• female gender (according to statistics, 60-85% of all those suffering from this pathology are women);
• increased emotionality (cholerics are more likely to suffer from CFS);
• age 30-49 years;
• presence of a responsible profession (doctors, firefighters, emergency workers, pilots, etc.).

Symptoms

The main symptom of CFS is physical and mental fatigue, which bothers the person for at least 6 months. Fatigue seems overwhelming to the patient. “I’m squeezed like a lemon,” “I’m exhausted to the point of exhaustion,” “it’s like I’ve been put through a meat grinder,” this is approximately how patients with CFS formulate their feelings. The difference between simple overwork and chronic fatigue syndrome is that with CFS, no rest helps restore the body's strength. Neither sleep nor vacation with a change of scenery in any way affects the feeling of fatigue. However, you should not confuse the condition of CFS with depression. With depression, a person does not want to do anything, does not strive for anything, but with CFS the situation is the opposite - desires do not coincide with possibilities.