Abstract：
For the last few decades, medical guidelines have recommended treating patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) with graded exercise therapy (GET) and cognitive behavioural therapy (CBT). Moreover, doctors have questioned the recovery behaviour of these patients and stimulated them to follow these treatments so that they would be able to go back to work. In this article, we reviewed trials of GET and CBT for ME/CFS that reported on work status before and after treatment to answer the question of whether doctors should continue to question the recovery behaviour of patients with ME/CFS. Our review shows that more patients are unable to work after treatment than before treatment with CBT and GET. It also highlights the fact that both treatments are unsafe for patients with ME/CFS. Therefore, questioning the recovery behaviour of patients with ME/CFS is pointless. This confirms the conclusion from the British National Institute for Health and Care Excellence (NICE), which has recently published its updated ME/CFS guideline and concluded that CBT and GET are not effective and do not lead to recovery. Studies on CBT and GET for long COVID have not yet been published. However, this review offers no support for their use in improving the recovery of patients with an ME/CFS-like illness after infection with COVID-19, nor does it lend any support to the practice of questioning the recovery behaviour of these patients.
摘要：
在过去的几十年里，医学指南建议采用分级运动疗法(GET)和认知行为疗法(CBT)治疗肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)患者.此外，医生质疑这些患者的康复行为，并刺激他们遵循这些治疗方法，以便他们能够重返工作岗位。在这篇文章中,我们回顾了针对ME/CFS的GET和CBT试验,这些试验报告了治疗前后的工作状态,以回答医生是否应继续质疑ME/CFS患者的康复行为这一问题.我们的审查表明，与CBT和GET治疗前相比，更多的患者在治疗后无法工作。它还强调了以下事实：两种治疗方法对ME/CFS患者都不安全。因此,质疑ME/CFS患者的康复行为毫无意义.这证实了英国国家健康与护理卓越研究所（NICE）的结论，该组织最近发布了更新的ME/CFS指南，并得出结论认为CBT和GET无效，不会导致恢复。关于长期COVID的CBT和GET的研究尚未发表。然而,本综述没有为其用于改善患有ME/CFS样疾病的患者在感染COVID-19后的康复提供支持,也没有为质疑这些患者的康复行为提供任何支持.
