Table 1 The inclusion and exclusion criteria for patients and HCs

Patients with CFS

 Inclusion criteria

  1. Females aged 18 to 60 years old;

  2. Chronic fatigue is lasting and can’t be explained by illness;

  3. Debilitating fatigue predates and is accompanied by at least 4 out of the 8 designated symptoms: post-exertional malaise lasting more than 24 h; unrefreshing sleep; impaired short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities; headaches of a new type, pattern, or severity; muscle pain; multi-joint pain without swelling or redness; sore throat; and tender cervical/axillary lymph nodes. Accompanying symptoms must have persisted or recurred during 6 or more consecutive months of illness.

Patients should also meet the inclusion criteria of the pattern of Spleen-Kidney Yang deficiency, which include

  1. Presence of at least 3 out of the 5 main symptoms: fear of cold and cold extremities, lassitude and lack of strength, shortness of breath and laziness to speak, reduced food intake, soreness and weakness of waist and knees;

  2. Presence of at least 2 out of the 6 accompanied symptoms: lumbar cold pain, abdominal fullness and distention, loose stool, cold, more urine volume during night, teeth-mark tongue and a deep, weak pulse.

Exclusion criteria

  1. Pregnancy or lactation;

  2. Presence of diseases that definitely influence TTM results, such as scoliosis or limb deformity, etc.;

  3. Poor understanding or expression;

  4. Presence of obviously damaged, scarred skin, or sensitivity to ginger.

HCs

Inclusion criteria:

  1. Females aged 18 to 60 years old;

  2. No disorder in physical examination in the preceding one year, and in good physical and mental health during the study period;

  3. No family history of mental or nervous system disorders;

  4. No spinal diseases that definitely influence TTM results, such as scoliosis, limb deformity, etc.

Exclusion criteria

  1. Pregnant or lactating;

  2. Presence of obvious damage or scarring on the skin;

  3. Long term smoking, alcoholism, or adverse drug use;

  4. Participation in another concurrent research study.