A Standardized Copper Bian-Stone Gua Sha Protocol for Treating Chronic Fatigue Syndrome in Human Subjects

This protocols describe a standardized step-by-step procedure for performing copper Bian-Stone Gua Sha in human subjects diagnosed with chronic fatigue syndrome. This protocol offers a non-pharmacological procedure alternative that may avoid certain limitations associated with long-term pharmacotherapy. To begin, explain the procedure, expected sensations, and potential skin changes to the participant with a clinical diagnosis of chronic fatigue syndrome.

Confirm that they are not excessively hungry, full, fatigued, or stressed, and schedule the procedure one to two hours after a meal. Inspect the treatment site and exclude any areas with ulceration, infection, active dermatitis, open wounds, bleeding, severe bruising, or other unsafe skin findings. Position the participant in a seated posture with an approximately 15 degree forward lean, and place the participant's arms on a padded support.

Expose the posterior trunk region selected for scraping and drape all other areas with a blanket to maintain warmth and privacy. Determine the acupoint locations according to the Chinese national standard for nomenclature and location of meridian points. Select and measure the Governor Vessel and bilateral Bladder Meridian acupoints using the finger con method and vertebral landmarks.

Using medical forceps, hold a sterile cotton ball and disinfect the skin three times from Dazhui to Yaoyangguan and along the bilateral Bladder Meridian lines with 75%alcohol. After the skin dries, apply approximately five milliliters of Gua Sha oil evenly over the target area. Hold the sterilized copper Bian-Stone scraper at a 45 degree angle to the skin surface.

Begin at Dazhui and apply the light scraping technique along the spinal midline toward Yaoyangguan at approximately five centimeters per second. Repeat the downward scraping motion 10 times along the Governor Vessel. Increase pressure briefly to a moderate level at the Dazhui for 30 seconds, and then at the Yaoyangguan for 30 seconds.

Monitor participant discomfort continuously using a 0 to 10 visual analog scale, and do not exceed a participant reported pain score of 4. Reduce the pressure immediately when the pain score exceeds 4. Proceed to the bilateral bladder meridian lines.

Begin at Feishu, and scrape downward from Feishu to Shenshu, applying the light scraping technique along the meridian. Then apply moderate pressure for 30 seconds each at Feishu, Weishu, and Shenshu. Repeat the scraping sequence 10 times on each side of the spine.

Continue scraping until uniform petechiae or sha appear at a density of 10 to 15 petechiae per square centimeter or until 10 strokes per segment are completed. And check the skin to avoid excessive sha formation. Discontinue scraping once the defined endpoint is reached, and limit the total session duration to approximately 20 minutes.

Perform the procedure two times per week for two consecutive weeks. If the participant develops any concerning symptoms, stop the procedure immediately and position the participant supine on a bed. Assess the participant's breathing, level of consciousness, and vital signs if an adverse reaction occurs.

And confirm that oral intake is safe before administering fluids. Offer 200 milliliters of warm water containing 10 grams of glucose when the participant is conscious, able to swallow safely, and has no glucose-related contraindication. After completion, gently wipe the residual oil from the skin with a soft cloth and inspect the treated skin for excessive irritation, bleeding, blistering, or other abnormal findings.

Advise the participant to keep the scraped area warm and avoid exposure to wind or cold water for four to six hours. Finally, document the treatment details, participant response, adverse events, and post-treatment instructions. 20 participants meeting the inclusion criteria completed the intervention protocol.

Uniform light red to purplish petechiae were visible along the Bladder Meridian lines after the treatment. After the two-week protocol, the Fatigue Severity Scale score and the Traditional Chinese Medicine Syndrome score decreased significantly. The short form 36 health survey scores changed significantly after the treatment.

Key considerations during the procedure include accurate acupoint location, pressure calibration, and safety monitoring to ensure reproducibility and patient safety in clinical research settings. This study may provide a framework for investigating interventions, then address both physical and mental dimensions of fatigue related conditions.