Post-stroke fatigue (PSF) is a common yet frequently overlooked complication that severely impacts patients' quality of life and rehabilitation progress. In recent years, external therapies of Traditional Chinese Medicine (TCM) have gained widespread application in stroke rehabilitation due to their characteristics of being simple, convenient, effective, and cost-effective, emerging as a prominent research focus in the field. This review summarizes advances in TCM external therapies for PSF, including TCM perspectives on PSF, clinically utilized TCM external techniques, and current limitations in research. The aim is to provide a foundation and direction for future studies, as well as a reference for clinical implementation of appropriate TCM external therapies for PSF patients. 

Tianzi Du, Yanmei Liu, Fan Cheng, Min Guo. Research Progress and Reflections on External Treatments of Traditional Chinese Medicine for Post-Stroke Fatigue. Academic Journal of Medicine & Health Sciences (2025), Vol. 6, Issue 8: 11-17. https://doi.org/10.25236/AJMHS.2025.060802.

[1] GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol.2021;20(10):795–820.

[2] Summary of China Stroke Center Report 2022. Chinese Journal of Cerebrovascular Diseases. 2024; 21(08): 565–576. 

[3] Xue C, Li J, Fang Q, et al. Prevalence and trends of post-stroke fatigue in China: a meta-analysis. Chinese General Practice. 2024;27(03):364–374. 

[4] Miller T, Stockley R, Drummond A, Watkins C, Georgiou R, Ahuja KDK, Bird ML. Online advice for the symptomatic management of post-stroke fatigue: a scoping review. J Psychosom Res. 2022; 162: 111039.

[5] Alghamdi I, Ariti C, Williams A. Prevalence of fatigue after stroke: a systematic review and meta-analysis. Eur Stroke J. 2021;6(4):319–332.

[6] Du T. Correlation between post-stroke fatigue and self-efficacy in patients with ischemic stroke [Master’s thesis]. Jilin University; 2018. 

[7] Mandliya A, Das A, Unnikrishnan JP. Post-stroke fatigue is an independent predictor of post-stroke disability and burden of care: a path analysis study. Top Stroke Rehabil. 2016;23(1):1–7.

[8] Department of Medical Administration, National Administration of Traditional Chinese Medicine. Standards for Syndrome Differentiation and Therapeutic Evaluation in Traditional Chinese Medicine. Beijing: China Press of Traditional Chinese Medicine; 1994. 

[9] Zhang B. Ten Treatises of the Eastern Yuan. Beijing: China Press of Traditional Chinese Medicine; 2006. 

[10] Hu X. Lectures on Treatise on Cold Damage. Beijing: China Press of Traditional Chinese Medicine; 2003. 

[11] Staub F, Bogousslavsky J. Fatigue after stroke: a major but neglected issue. Cerebrovasc Dis. 2001 Aug;12(2):75-81.

[12] Wang Y. Symptoms in Traditional Chinese Medicine. Beijing: China Press of Traditional Chinese Medicine; 2010. 

[13] Sui R, Wang Y, Xiao M, et al. Clinical evaluation of needling Baihui penetrating Qubin for post-stroke fatigue. Chinese Journal of Geriatric Health Medicine. 2023;21(3):9–11. 

[14] Chen L, Lin Y, Lin W, et al. Clinical observation of scalp acupuncture combined with abdominal acupuncture for post-stroke fatigue with Qi deficiency pattern. Fujian Journal of Traditional Chinese Medicine. 2022;53(09):5–8.

[15] Wang B, Cao Y, Yang Q, et al. “Moxibustion-acupuncture on the Governor Vessel” combined with repetitive transcranial magnetic stimulation for post-stroke fatigue: a randomized controlled trial. Chinese Acupuncture & Moxibustion. 2024;44(12):1363–1369. 

[16] Ban W, Teng X, Qi H. Research progress on the role of acupuncture in regulating microRNA expression in basic experimental studies. Journal of Traditional Chinese Medicine & Pharmacology. 2021; 27(07):138–142, 147. 

[17] An C, Ning J, Guo J, et al. Research progress on the clinical efficacy and mechanism of moxibustion in the treatment of functional dyspepsia. Liaoning Journal of Traditional Chinese Medicine. Published online July 4, 2025:1–7. 

[18] Yu K, Ying S, Sun Z, et al. Research progress on the mechanism of moxibustion in treating essential hypertension. Journal of Nanjing University of Traditional Chinese Medicine. 2025;(05):609–614. Published online July 4, 2025. 

[19] Xiao B, Zheng T, Li L. Clinical observation of constant-temperature moxibustion on the Hand Yangming Meridian acupoints for post-stroke fatigue: 36 cases. Fujian Journal of Traditional Chinese Medicine. 2022;53(11):27–29. 

[20] Xie G, Huang L, Deng L, et al. Effect of heat-sensitive moxibustion combined with exercise therapy on post-stroke fatigue and inflammatory cytokines. China Contemporary Medicine. 2023; 30(17): 49–52. 

[21] Liu C, Lei B. Effect of moxibustion on Shenque (CV8) on exercise capacity in rats with chronic fatigue syndrome. Youjiang Medical Journal. 2022;50(09):653–656. 

[22] Li D, Hu K, Han L, et al. Effects of moxibustion on immuno-neuroendocrine function in mice with cancer-related fatigue.China Journal of Traditional Chinese Medicine and Pharmacy. 2023; 38(04): 1799–1803. 

[23] Chen P. Fundamentals of Traditional Chinese Nursing. Beijing: People’s Medical Publishing House; 2012:244. 

[24] Kuppuswamy A, Clark EV, Turner IF, Rothwell JC, Ward NS. Post-stroke fatigue: a deficit in corticomotor excitability? Brain. 2015;138(Pt 1):136–148.

[25] Dong X, Li H, Wang Y. Effects of auricular magnetic acupressure on fatigue severity and quality of life in patients with post-stroke fatigue. Guangming Journal of Chinese Medicine. 2023; 38(21): 4209–4212. 

[26] Li R. Study on the intervention effect of auricular acupressure in patients with post-stroke fatigue of Qi deficiency and blood stasis pattern [Master’s thesis]. Liaoning University of Traditional Chinese Medicine; 2024. 

[27] Yang L, Sun Q, Shen Q, et al. Clinical study on auricular acupressure in relieving post-stroke fatigue. Journal of Nursing Science. 2012;27(03):34–36. 

[28] Liang YH, Gong WJ, Yang AR, et al. Clinical study on herbal fumigation for post-stroke fatigue [J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2022, 20(07): 1316-1318. 

[29] Li J. Application effect of early comprehensive rehabilitation exercise combined with acupoint application in post-stroke fatigue patients. Journal of Medical Frontier, 2021,11(17):132-133.

[30] Wang QL, Zhi CJ, Jiang SQ, et al. Therapeutic observation of head meridian massage combined with acupoint application for post-stroke fatigue. Journal of Medical Frontier, 2021, 11(19): 169-170.