Construction and verification of an immune signature model for chronic fatigue syndrome: Leveraging TCM syndromes and elements for enhanced assessment.

OBJECTIVE

The purpose of this study is to establish an immune function assessment model that considers clinical symptoms and laboratory tests by combining traditional Chinese medicine (TCM) syndromes and syndrome elements with lymphocyte cell counts for evaluating immune function in patients with chronic fatigue syndrome (CFS).

METHODS

A survey was conducted involving 473 CFS patients who were categorized based on immune function and divided into training and validation sets at a 7:3 ratio. Logistic analyses were performed on clinical data, leading to a nomogram model whose discrimination and sensitivity were assessed, along with clinical applicability via decision curve analysis.

RESULTS

Among the 473 CFS patients, 225 (47.6%) had weakened immune function. Multivariate logistic regression identified CD4+ T cells, CD4+/CD8+, natural killer cells, age, body mass index, Fatigue Assessment Instrument, insomnia, TCM syndrome type, and kidney, lung and qi deficiency as factors associated with low immune function. These eleven factors were used to create a nomogram model, achieving a receiver operating characteristic curve area of 0.849 for the training set and 0.792 for the validation set, indicating good prediction accuracy. Decision curve analysis showed that the model provides clinical benefits for CFS patients at risk of low immune function.

CONCLUSION

Our CFS immune function evaluation model combines TCM syndromes and elements and shows predictive value and clinical applicability. Please cite this article as: Qin LL, Zhang ZX, Wang JH, Shi JN, Shao X, Yang F, Chen M, Jiang TJ, Ge WJ. Construction and verification of an immune signature model for chronic fatigue syndrome: Leveraging TCM syndromes and elements for enhanced assessment. J Integr Med. 2026; Epub ahead of print.