Background: According to classical sources of Traditional Mongolian Medicine, the Mana-4 decoction clears internal heat and fever, alleviates febrile and infectious diseases, resolves pale-brown Badgan disorders, and alleviates severe pneumonia. Chimedragchaa.Ch. et al. (2002) demonstrated that Mana-4 possesses heat-clearing, anti-inflammatory, and immunomodulatory effects. Chronic Fatigue Syndrome (CFS) is a disorder characterized by clinical manifestations including physical exhaustion, low-grade fever, headache, mood fluctuations, cognitive impairment, and sleep disturbances. In recent years, as the pace of modern life and workload have increased, physical, psychological, and mental stress have intensified, leading to dysregulation of the nervous and endocrine systems, impaired immune function, and a rising global prevalence of CFS—a trend that has attracted increasing attention from researchers worldwide. However, the etiology and pathogenesis of CFS remain incompletely understood, and effective, evidence-based treatments continue to be sought. Therefore, we developed Immunoflu soluble granules, derived from the constituents of Mana-4, and this study aimed to investigate its anti-fatigue effects, as no such investigation had previously been conducted. Aim: To evaluate the anti-fatigue effect of Immunoflu, a formulation derived from the traditional Mana-4 decoction widely used in Traditional Mongolian Medicine. Materials and Methods: A chronic-fatigue rat model was established by forced-swimming induction, following the method of Jia Wang et al. (2013). The behavioral effects of Immunoflu were assessed using the open-field test (locomotor activity) and the elevated plus-maze test (anxiety-related behavior). Result: Immunoflu was administered at 100, 200, and 400 mg/kg to evaluate its effects in a chronic-fatigue model. In the open-field test, no significant difference (p>0.05) in central-zone entries was observed between Immunoflu and the model control. However, vertical locomotor activity increased significantly: Immunal 50 mg/kg +80.4% (p=0.024), Immunoflu 100 mg/kg +82.6% (p=0.003), and 200 mg/kg +77.4% (p=0.035). From these findings, Immunoflu at 100 and 200 mg/kg clearly enhanced locomotor activity in rats with chronic fatigue. In the elevated plus-maze test, Immunal 50 mg/kg increased the time spent in the central zone (10×10cm) by 53.3% (p=0.021) and in open arms by 61.4% (p=0.032) compared with the model control. Although Immunoflu produced no significant changes (p>0.05) in central-zone entries or time spent in the central zone, the time spent in the open arms increased by 60.6% at 200 mg/kg (p=0.026), indicating a reduction in anxiety and improved behavioral response to stress. Conclusion In a forced-swimming–induced chronic-fatigue model, Immunoflu increased locomotor activity by 77.4–82.6% at 100 and 200 mg/kg, reduced anxiety by 60.6% at 200 mg/kg, and reduced behavioral despair and fatigue by 35.3% at 100 mg/kg.

Background: Chronic Fatigue Syndrome (CFS) is a poorly understood disorder of unknown etiology, characterized by clinical manifestations including physical exhaustion, low-grade fever, myalgia, dizziness, mood fluctuations, cognitive impairment, and sleep disturbances. CFS is highly prevalent and frequently comorbid with psychiatric conditions, particularly depression and anxiety. Symptoms exacerbate during physical or mental exertion and do not completely resolve with rest. Currently, there is a lack of proven, effective pharmacological treatments for CFS. Therefore, this study aimed to investigate the anti-fatigue effects of Immunoflu. Aim: To evaluate the anti-fatigue effects of Immunoflu, a technologically modernized formulation derived from the traditional Mana-4 decoction. Materials and Methods: A chronic fatigue rat model was established using the forced-swim protocol described by Jia Wang and Chengxin Sun (2013). The pharmacological effects of Immunoflu were evaluated by quantifying serum levels of cytokines (IL-1β, IL-2, IL-5, IL-10, and IL-17a) by ELISA and assessing behavioral despair using the forced swim test (FST). Results: We evaluated how Immunoflu affects the chronic fatigue model at doses of 100, 200, and 400 mg/kg by measuring serum levels of IL-1β, IL-2, IL-5, IL-10, and IL-17a and assessing despair using the “Forced swim test”. In the forced-swimming-induced chronic fatigue model in rats, Immunoflu at a dose of 100 mg/kg increased the serum IL-2 indicator by 23.8%, and Immunal at a dose of 50 mg/kg increased it by 23.3% compared to the model control group, a statistically significant difference (p < 0.05). Furthermore, Immunoflu at 200 mg/kg reduced IL-17a cytokine levels by 23.7% compared with the model control group. When evaluating the swimming state of the animals with the Forced swim test, the group given Immunal 50 mg/kg (52.03±9.3 sec) decreased by 31.6% (*p=0.038), and the group given Immunoflu 100 mg/kg (49.19±8.54 sec) decreased by 35.3% (*p=0.01) respectively compared to the model control group, while no statistically significant difference was observed in other groups. Conclusions 1. Immunoflu at 100 mg/kg demonstrates immunostimulatory effects in a chronic fatigue model by increasing serum IL-2 levels by 23.8%. Additionally, at 200 mg/kg, it exhibits anti-inflammatory properties, reducing IL-17a levels by 23.7%. 2. In the forced-swimming model, Immunoflu at 100 mg/kg effectively reduced behavioral despair and physical fatigue by 35.3%.