Table 1 Differentiation of theory, rationale, practice and outcome for two models of acupuncture (see text for more detailed definitions)
From: Getting inside acupuncture trials - Exploring intervention theory and rationale
TA | Component | MA |
|---|---|---|
Approach is orientated to the whole person based on an understanding that mind, body and spirit are integral | Theory | Approach is focused on the symptom |
Aetiology of the main complaint: a detailed history of the main complaint is integral to the diagnosis | Theory (Aetiology) | Aetiology of the symptom is prognostic only and does not affect process of treatment. |
   ▪ Differential Diagnosis: summary of the core curriculum theory of TCM encompassed by Bian Zheng or pattern differentiation | Theory (Diagnosis) | ▪ Symptom based diagnosis |
   ▪ Diagnostic Methods: principles of looking, listening, asking, touching (tongue and pulse) are part of differential diagnosis |  | ▪ Diagnostic Methods: concerned with nature and location of symptom |
   ▪ Treatment Principles: understanding of main complaint in terms of context, nature and location including concepts of xu and shi, and ben and biao (specific CM terminology) | Theory (Treatment) | ▪ Treatment Principles: the symptom and its underlying biomedical mechanism have a linear path |
   ▪ Responsiveness: diagnosis and treatment change in response to patient reported changes |  | ▪ Constant: treatment approach stays focussed on the principle of affecting change in the biomedical mechanism of the symptom |
   ▪ Mechanism of change is dependent on affecting the balance of Qi, Yin and Yang and other defined substances of the person as decided by the differential diagnosis | Rationale |    ▪ Mechanism of change is based in biomedical science and is linked to a direct expected action of acupuncture |
   ▪ Acupuncture works by affecting change in the balance of Qi, Yin and Yang and other imbalances as defined by the differential diagnosis. |  | ▪ Biomedical mechanism of acupuncture whether hypothesised or tested is t linked to the symptom |
An iterative, individualistic and interactive approach - At each session the practitioner uses the principles of looking, listening, asking, touching (tongue and pulse) to make a differential diagnosis and to formulate a new treatment. | Practice | At each session, the selection for the formulae of points remains fixed on the biomedical mechanism of the symptom. |
Non-linear, with degrees of uncertainty at each stage of treatment | Possible Causal Pathway | Linear, from acupuncture needling to symptom |
Desired changes in the balance of Qi, Yin and Yang and other imbalances as defined by the differential diagnosis which will manifest in various aspects of the person in mind and body, in addition to any specific symptom changes | Outcome | A change in dimensions of the symptom, for example, hot flushes, a change in the intensity and frequency. |