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

Chronic fatigue syndrome (CFS) is characterized by persistent, unexplained fatigue lasting six months or longer. This protocol describes a standardized copper Bian-stone Gua Sha procedure for application in human subjects with CFS. The procedure targets the Governor Vessel (from Dazhui DU14 to Yaoyangguan DU3) and the Bladder Meridian (from Feishu BL13 to Shenshu BL23). A copper Bian-stone scraper is used to apply light scraping along the meridians at approximately 5 cm/s, with moderate pressure applied for 30 s at Back-Shu points (Pishu BL20, Weishu BL21, Shenshu BL23). Scraping continues until uniform petechiae (sha) appear or 10 strokes per segment are completed. Sessions last approximately 20 min and are performed twice weekly for two weeks. Pre- and post-intervention assessments include the Fatigue Severity Scale (FSS), a TCM syndrome score, and the SF-36 Health Survey. Representative changes in these scores are documented to illustrate protocol execution. This protocol emphasizes standardized acupoint localization, pressure calibration, and safety monitoring to facilitate reproducibility in clinical research settings.