Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (10): 928-943.doi: 10.3736/jcim20101004

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

A qualitative study of exploring the therapeutic components of traditional Chinese medicine as a complex intervention through grounded theory

He Yua,b, Jian-Ping Liua   

  1. a Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
    b Department of Clinical Foundation, Preclinical School, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2010-02-23 Accepted:2010-06-10 Online:2010-10-20 Published:2010-10-15


To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.

Data were collected through 41 half-day participant observations and 7 in-depth interviews, and the study design and data analysis were based on the grounded theory.

The components of TCM practice that emerged were: prescribed Chinese medicinal herbs, doctor’s medical advice, psychological intervention, doctor-patient relationship, and patient adherence. There were some overlaps in the TCM diagnosis and treatment process, and there were underlying therapeutic effects associated with diagnosis. TCM herbal intervention was considered as a main therapeutic component which might dominate patients’ outcome. We summarized this process as a process of problem finding and solving from macroscopic and microcosmic perspectives, which embodies the concept of a holistic approach and highly individualized pattern through syndrome differentiation and treatment.

TCM is a complex whole system, and all therapeutic components of TCM may contribute to global treatment effect. In the future, we need more participants to test and improve the model of grounded theory through qualitative and quantitative methods such as randomized controlled trials so as to identify and explore the relevance of each therapeutic component of TCM with the treatment effect.

Key words: Traditional Chinese medicine, Intervention study, Qualitative research, Grounded theory, Holistic medicine

Table 1

Basic information of practitioners of traditional Chinese medicine"

Table 2

Number of cases observed and interviewed among practitioners of traditional Chinese medicine"

Figure 1

Holistic diagnosis process and content model of traditional Chinese medicine"

Figure 2

Model about categories, core-category and their interaction"

Figure 3

Interaction among doctor-patient relationship, adherence and curative effect"

Figure 4

Interaction among doctor-patient relationship, adherence, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 5

Interaction among curative effect, adherence, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 6

Interaction among doctor-patient relationship, curative effect, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 7

Consultation process model of traditional Chinese medicine"

Figure 8

Consultation process theoretic model of traditional Chinese medicine"

[1] Medical Research Council.A framework for development and evaluation of RCTs for complex interventions to improve health[M].London: Medical Research Council, 2000: 1-18
[2] Paterson C, Briten N . Acupuncture as a complex intervention: a holistic model[J]. J Altern Complement Med, 2004,10(5):791-801
doi: 10.1089/acm.2004.10.791 pmid: 15650468
[3] Draucker CB, Martsolf DS, Ross R, Rusk TB . Theoretical sampling and category development in grounded theory[J]. Qual Health Res, 2007,17(8):1137-1148
doi: 10.1177/1049732307308450 pmid: 17928484
[4] Corbin J, Strauss A . Grounded theory research: procedures, canons and evaluative criteria[J]. Qual Sociol, 1990,13(1):3-21
doi: 10.1007/BF00988593
[5] Holloway I .Basic concepts for qualitative research[M].Oxford: Blackwell Science, 1997: 82-83
[6] McLellan E, MacQueen MK, Neidig LJ . Beyond the qualitative interview: data preparation and transcription[J]. Field Methods, 2003,15(1):63-84
doi: 10.1177/1525822X02239573
[7] Walker D, Myrick F . Grounded theory: an exploration of process and procedure[J]. Qual Health Res, 2006,16(4):547-559
doi: 10.1177/1049732305285972 pmid: 16513996
[8] Charmaz K .Constructing grounded theory: a practical guide through qualitative analysis[M].London: Sage Publications Inc, 2006: 45-80
[9] Bradley EH, Curry L, Devers KJ . Qualitative data analysis for health services research: developing taxonomy, themes, and theory[J]. Health Serv Res, 2007,42(4):1758-1772
doi: 10.1111/j.1475-6773.2006.00684.x pmid: 1955280
[10] Thompson EA, Quinn T, Paterson C, Cooke H, McQuigan D, Butters G .Outcome measures for holistic, complex interventions within the palliative care setting[J]. Complement Ther Clin Pract, 2008,14(1):25-32
doi: 10.1016/j.ctcp.2007.10.001 pmid: 18243939
[11] Frankel RM, Sung SH, Hsu JT . Patients, doctors, and videotape: a prescription for creating optimal healing environments?[J]. J Altern Complement Med, 2005,11(Suppl 1):S31-S39
doi: 10.1089/acm.2005.11.s-31 pmid: 16332185
[12] Zhang YH. Transforming emotions with Chinese medicine: an ethnographic account from contemporary China[M]. New York: State University of New York Press,2007: 105-137
[1] Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[2] Xue-qing Yu, Shu-guang Yang, Yang Xie, Jian-sheng Li. Traditional Chinese medicine in the treatment of idiopathic pulmonary fibrosis based on syndrome differentiation: Study protocol of exploratory trial. Journal of Integrative Medicine, 2020, 18(2): 163-168.
[3] Chang-quan Ling. Traditional Chinese medicine is a resource for drug discovery against 2019 novel coronavirus (SARS-CoV-2). Journal of Integrative Medicine, 2020, 18(2): 87-88.
[4] Preecha Nootim, Nattiya Kapol, Waranee Bunchuailua, Panoopat Poompruek, Parankul Tungsukruthai . Current state of cancer patient care incorporating Thai traditional medicine in Thailand: A qualitative study. Journal of Integrative Medicine, 2020, 18(1): 41-45.
[5] Wen Qiang Lee, Jeremy Teoh, Pei Zheng Kenneth Lee, Zhi Xiong Gerard Low, Xueling Sim, Foong Fong Mary Chong, Norbert Ludwig Wagner. Factors influencing communication of traditional Chinese medicine use between patients and doctors: a multisite cross-sectional study. Journal of Integrative Medicine, 2019, 17(6): 396-403.
[6] Mikhail Teppone. Medicine has always been “Modern” and “Scientific” from ancient times to the present day. Journal of Integrative Medicine, 2019, 17(4): 229-237.
[7] Charles Dalcanale Tesser, Ari Ojeda Ocampo Moré, Melissa Costa Santos, Emiliana Domingues Cunha da Silva, Fátima Terezinha Pelachini Farias, Lúcio José Botelho. Auriculotherapy in primary health care: A large-scale educational experience in Brazil. Journal of Integrative Medicine, 2019, 17(4): 302-309.
[8] Rachael Farrington, Ian F.Musgrave, Roger W.Byard. Evidence for the efficacy and safety of herbal weight loss preparations. Journal of Integrative Medicine, 2019, 17(2): 87-92.
[9] Fung-Kei Cheng. An overview of the contribution of acupuncture to thyroid disorders. Journal of Integrative Medicine, 2018, 16(6): 375-383.
[10] Chang-quan Ling, Jia Fan, Hong-sheng Lin, Feng Shen, Zhen-ye Xu, Li-zhu Lin, Shu-kui Qin, Wei-ping Zhou, Xiao-feng Zhai, Bai Li, Qing-hui Zhou, on behalf of the Chinese Integrative Therapy of Primary Liver Cancer Working Group. Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine. Journal of Integrative Medicine, 2018, 16(4): 236-248.
[11] Andrian Liem, Kuncoro Dewi Rahmawati. The meaning of complementary, alternative and traditional medicine among the Indonesian psychology community: A pilot study. Journal of Integrative Medicine, 2017, 15(4): 288-294.
[12] Irene A. Kretchy, Harry A. Okere, Joseph Osafo, Barima Afrane, Joseph Sarkodie, Philip Debrah. Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare. Journal of Integrative Medicine, 2016, 14(5): 380-388.
[13] Qing Ji, Yun-quan Luo, Wen-hai Wang, Xuan Liu, Qi Li, Shi-bing Su. Research advances in traditional Chinese medicine syndromes in cancer patients. Journal of Integrative Medicine, 2016, 14(1): 12-21.
[14] Bing He, Ge Zhang, Ai-ping Lu. Integrative network analysis: Bridging the gap between Western medicine and traditional Chinese medicine. Journal of Integrative Medicine, 2015, 13(3): 133-135.
[15] Zhao-guo Li, Xi-ru Liu. Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases of Paediatrics (Part 3). Journal of Integrative Medicine, 2015, 13(3): 201-204.
Full text



[1] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)". Journal of Chinese Integrative Medicine, 2008, 6(1): 15-21
[2] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[3] Yi-ting He, Qing-lin Zha, Jian-ping Yu, Yong Tan, Cheng Lu, Ai-ping Lv. Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 32-36
[4] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[5] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[6] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[7] Wei Zhang, Xiang-feng Lu, Xiao-mei Zhang, Jian-jun Wu, Liang-duo Jiang. A rat model of pulmonary fibrosis induced by infusing bleomycin quickly through tracheal intubation. Journal of Chinese Integrative Medicine, 2008, 6(1): 60-67
[8] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[9] Hai-feng Wei, Bai-liu Ya, Ling Zhao, Cui-fei Ye, Li Zhang, Lin Li. Evaluation of tongue manifestation of blood stasis syndrome and its relationship with blood rheological disorder in a rat model of transient brain ischemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 73-76
[10] A-gao Zhou, Yong Zhang, Gang Kui, De-Yun Kong, Hai-liang Ge, Qiu-hua Ren, Jia-rong Dong, Sheng Hong, Xu-ming Mao, Yin Wang, Hui-zheng Zhang, Shu-jun Wang. Influence of traditional Chinese compound recipes with different efficacy on body weight, tumor weight and immune function in H22 cancer-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 77-82