The Relative Importance of Traditional Chinese Medicine Diagnosis & Treatment Individualisation as Seen Through a Study on Irritable Bowel Syndrome

Background: The past forty years have seen an increase in the number of people with chronic illness and a struggle for biomedicine to provide effective treatments. The lack of effective biomedical treatments for conditions such as IBS creates opportunities for Chinese medicine; however, in its growing popularity, Chinese medicine has had to adapt to biomedicine’s dominant influence on research and practice. Purpose: The purpose of this thesis is to explore Chinese medicine’s adaptations to biomedicine regarding diagnosis differentiation and treatment individualisation through a study that places Chinese medicine in the context of IBS. Methods: Methods were selected based on a pragmatic mixed methodological underpinning that allowed for the research questions to dictate appropriateness. As such, a mixture of qualitative and quantitative methods were used to assess acupuncturists’ contextualisation and treatment of IBS; patient’ experiences with acupuncture and perceptions of outcome; and patients’, GPs’, and acupuncturists’ understanding of how acupuncture works and the impact of that understanding on outcome and acceptance of acupuncture. Findings: Acupuncturists contextualise IBS according to symptoms they perceive to be relevant, and do not perceive IBS to be a useful diagnosis. Acupuncture treatment of IBS incorporated three over-lapping approaches including: disease-specific, pragmatic, and individualised. The proportional influences of the approaches were different for different treatment aspects. Regarding how acupuncture works, patients, acupuncturists, and GPs used a variety of traditional, scientific, and physical explanations. Patients and acupuncturists perceived that the explanation may affect treatment outcome. Conclusions: Collective interpretation of the findings suggest that TCM diagnosis differentiation is fundamental to TCM treatment and plays a role similar to biomedical diagnoses in that it may validate patients’ symptoms and identify conditions that are treated effectively. Additionally, the use of combined treatment approaches notes an over-emphasis on individualisation that may be a by-product of TCM’s adaptation to biomedicine.