The Clinical Efficacy and Safety of Complex Korean Medicine Treatments for Traffic Accident Patients: A Narrative Review

Dongmin Lee; Jong Uk Kim; Eui-Hyong Hwang; Chan-Ju Im; Jae-Eun Kim; Da-Kyung Jang; Yeonhak Kim; Jung-Hyun Kim; Yeon-Cheol Park; Yong-Hyeon Baek; Sang-Soo Nam; Eun Yong Lee; Byung-Kwan Seo; Lee, Dongmin; Kim, Jong Uk; Hwang, Eui-Hyong; Im, Chan-Ju; Kim, Jae-Eun; Jang, Da-Kyung; Kim, Yeonhak; Kim, Jung-Hyun; Park, Yeon-Cheol; Baek, Yong-Hyeon; Nam, Sang-Soo; Lee, Eun Yong; Seo, Byung-Kwan

doi:10.13048/jkm.26003

JKM > Volume 47(1); 2026 > Article

Lee, Kim, Hwang, Im, Kim, Jang, Kim, Kim, Park, Baek, Nam, Lee, and Seo: The Clinical Efficacy and Safety of Complex Korean Medicine Treatments for Traffic Accident Patients: A Narrative Review

Review Article

The Journal of Korean Medicine 2026; 47(1): 37-55.

Published online: March 1, 2026

DOI: https://doi.org/10.13048/jkm.26003

The Clinical Efficacy and Safety of Complex Korean Medicine Treatments for Traffic Accident Patients: A Narrative Review

Dongmin Lee¹

, Jong Uk Kim⁴

, Eui-Hyong Hwang⁵

, Chan-Ju Im¹

, Jae-Eun Kim¹

, Da-Kyung Jang¹

, Yeonhak Kim¹

, Jung-Hyun Kim¹

, Yeon-Cheol Park²

, Yong-Hyeon Baek²

, Sang-Soo Nam²

, Eun Yong Lee³

, Byung-Kwan Seo²^{, *}

¹Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong

²Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University

³Department of Acupuncture & Moxibustion Medicine, Chungju Korean Medicine Hospital of Semyung University

⁴Department of Acupuncture & Moxibustion Medicine, Korean Medicine Hospital of Woosuk University

⁵Department of Korean Medicine Rehabilitation, Pusan National University Korean Medicine Hospital

Correspondence to: Byung-Kwan Seo, Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea, Tel: +82-2-440-6239, E-mail: seohbk@hanmail.net

Received February 9, 2026 Revised February 13, 2026 Accepted February 19, 2026

Abstract

Objectives

This narrative review comprehensively evaluates the clinical efficacy and safety of complex Korean Medicine (KM) treatments in traffic accident patients, comparing them to single or limited interventions. It aims to provide foundational data for establishing revised treatment guidelines and enhancing insurance coverage within the restrictive automobile insurance system.

Methods

A literature search was conducted across PubMed, Embase, OASIS, and KoreaMed databases, covering literature up to October 2025. Search terms were based on PICO: Population (traffic accident patients), Intervention (Korean medicine, complex treatment), Comparator (single/limited treatment), Outcome (pain, function, quality of life, safety). The review included studies on musculoskeletal injuries from traffic accidents, utilizing two or more KM interventions, and reporting clinical outcomes. A narrative synthesis analyzed findings due to high study heterogeneity.

Results

A total of 16 studies involving approximately 3,000 patients were included. Complex KM treatments, integrating acupuncture, moxibustion, cupping, pharmacopuncture, herbal medicine, Chuna manual therapy, and physical therapy, significantly improved pain reduction (13 studies, average 50% decrease), functional recovery (10 studies, NDI 64.2% improvement, ODI 89.1% improvement), and quality of life (5 studies) in traffic accident patients, often outperforming single interventions. Early initiation of these treatments accelerated recovery and reduced hospitalization periods by 77.1%. Complex KM treatments also demonstrated a favorable safety profile, with no serious adverse events reported, even in vulnerable populations including pregnant women. These findings support the clinical utility and safety of multimodal KM approaches.

Conclusions

Complex KM treatments offer substantial clinical benefits and safety for traffic accident patients, highlighting their vital role in rehabilitation. This review emphasizes the importance of early, comprehensive intervention and advocates for re-evaluation of current automobile insurance guidelines to expand coverage for these effective therapies. This would enhance patient outcomes, accelerate recovery, and reduce socioeconomic burdens. Further high-quality randomized controlled trials and long-term follow-up studies are warranted to strengthen the evidence base.

Keywords: Traffic Accident, Korean Medicine, Complex Treatment, Pain, Quality of Life, Safety

Figure 1

Flow diagram of the literature search and selection process.

Table 1

Characteristics of included studies on complex Korean treatments for traffic accident patients.

Author (Year)	Study Design	N	Patient Characteristics	Treatment Duration/ Frequency	Main Intervention	Comparison/ Control	Primary Outcomes	Key Results	Follow-up	Adverse Events
Jeon et al. (2016)¹⁹⁾	Retrospective chart review	486	MVA patients; Group A: sprain only (n=194); Group B: sprain + headache/dizzines s (n=292); Mean age 40.51±6.98 y; 43% male, 57% female	Hospitalizatio n period varied by group	Complex KM treatment	Group A vs. Group B (symptom complexity)	Hospitalization period; Age, Gender, Accident type factors	Early treatment (0–2 days) → faster recovery; Age ↑ → hospitalization ↑ (r=0.219–0.307, p<0.05); Female Group B: longer stays (p<0.05)	Discharge	NR
Bae et al. (2015)²³⁾	Cross-section al survey	103	MVA patients, various ages (20s–60s); 93.2% visited within 2 weeks of TA; Inpatients (n=47) & outpatients (n=56)	NR	Acupuncture + Pharmacopuncture + Moxibustion + Cupping + Chuna + PT	No comparison (satisfaction survey)	Patient satisfaction (5-point scale); Reason for selecting KM	90.3% satisfied; Acupuncture most preferred (46.6%); KM superior to Western medicine (4.10±0.96); 85.4% would use KM again	One-time survey	NR
Kim et al. (2018)¹⁷⁾	Cross-section al survey	122	MVA patients; Mean age 43.44 y; 43.4% male, 56.6% female; Cervical sprain (73%), Lumbar sprain (57%)	NR	Acupuncture (97.7%) + Cupping (89.8%) + Pharmacopuncture + Herbal medicine + Moxibustion + PT	No comparison (survey study)	NRS (0–10); Symptom improvement (5-point); Satisfaction (5-point)	NRS: 6.15±2.09→3.11±1.54 (↓49.4%, p<0.001); Symptom improvement 1.87±0.43; Satisfaction 1.71±0.60; 95.9% would recommend	Treatment end	9.0% AE (11/122): mainly pharmacopuncture (n=9), acupuncture (n=4), cupping (n=4); Most mild & transient
Kyung et al. (2024)¹⁸⁾	Retrospective chart review + Follow-up survey	126 (50 responded)	Pregnant women injured in MVA; Mean age 31.80±6.41 y; Gestational age at visit: 1st trimester 23%, 2nd 51%, 3rd 25%; Chief complaint: Neck pain 77%, LBP 67%, Shoulder pain 67%	Inpatients: Mean 13.79±12.85 days; Outpatients: Mean 16.84±21.05 days	Acupuncture (inpt 100%, outpt 97.7%) + Moxibustion (26.3%/43.2%) + Cupping (100%/89.8%) + Pharmacopuncture (55.3%/69.3%) ± Herbal medicine (15.8%) + Chuna (57.9%/59.1%) + Infrared (100%/96.6%) + Electroacupuncture (97.4% inpt)	No comparison (before-after)	NRS (neck, LBP, headache); NDI; ODI; EQ-5D-5L; Obstetric outcomes (delivery type, GA at delivery); Neonatal outcomes (weight, defects)	NDI: 31.80→23.30 (end, p<0.001)→11.40 (FU, p<0.001, ↓64.2%); ODI: 30.05→22.36 (p=0.002)→3.27 (FU, p<0.001, ↓89.1%); NRS neck: 5.35→3.85 (p<0.001)→1.54 (FU, p<0.001); 84% full-term delivery; No serious neonatal AE	Post-delivery (months after treatment)	Pregnancy symptoms n=10 (GDM, uterine contraction, etc., causality “unlikely”); Non-pregnancy n=3 (pain, dizziness, herpes); All mild-moderate; No serious AE
Jeong et al. (2021)⁷⁾	Retrospective single-center	342	Jeong et al. (2021)	Mean 37.68±45.11 days; Mean 11.68±10.63 sessions	Acupuncture + Pharmacopuncture (introduced during study period) + PT ± Herbal medicine	Before vs. After pharmacopuncture introduction	NRS (0-10, pain); Treatment period, frequency, correlation	NRS: 7.32±0.96→3.57±1.40 (↓51.2%, p<0.001); Treatment frequency ↑ → pain relief ↑ (positive correlation); Pharmacopuncture introduction did not ↑ treatment period or AE	Treatment end	No AE reported; Pharmacopuncture did not increase AE vs. traditional KM
Lee et al. (2024)⁸⁾	Cross-section al analysis (EHR)	3 hospitals (exact n NR)	Traffic injury patients at 3 hospitals (Pusan, Kyung Hee, Jaseng); Diverse musculoskeletal injury patterns	Various (real-world data)	Complex KM combinations: Acupuncture, Moxibustion, Pharmacopuncture, Cupping, PT, Herbal medicine	No comparison (utilization pattern analysis)	Utilization patterns; Treatment characteristics; Patient demographics; Temporal trends	↑ Trend of complex KM use over time (2015–2022); Complex treatment (≥2 interventions) became standard practice; Real-world effectiveness demonstrated	Various	NR in abstract
Shin & Oh (2013)⁹⁾	Retrospective analysis	1,162	Hospitalized MVA patients; Various musculoskeletal injuries (cervical/lumbar sprain, extremity injuries)	Hospitalizatio n period varied	Acupuncture (100%) + Moxibustion (39.8%) + Pharmacopuncture (56.1%) + Infrared (99.9%) + Cupping (99.1%) + Hot pack (97.9%)	No comparison (before-after)	Symptom improvement rate; Mean improvement score (scale NR)	71.52% showed symptom improvement; Mean improvement score 3.22; Visiting 0–2 days after accident → faster improvement; Earlier treatment → shorter hospitalization	Discharge	NR
Kim et al. (2020)¹²⁾	Systematic review	17 studies	Cervical pain patients after TA; Various RCT & clinical study designs from Korean journals	Varied across 17 studies	Pharmacopuncture (Hwangryunhaedok-ta ng, Bee venom, Eohyul) combined with: Acupuncture + PT + Chuna + Herbal medicine	Varied across studies (pharmacopuncture combinations vs. control)	NDI; VAS/NRS (pain); PGA; Functional improvement scales	Combined treatments (pharmacopuncture + other KM) → significant NDI & PGA reduction across reviewed studies; Hwangryunhaedok-tang for inflammation; Bee venom for pain; Combined superior to single intervention	Varied	Minimal AE in reviewed studies; Generally safe
Kim et al. (2021)²⁰⁾	Retrospective observational	30 (15/15)	Whiplash injury with cervical pain & headache; Acute stage post-MVA	NR	Group A: Complex KM (Acupuncture + Moxibustion + Cupping + Pharmacopuncture + PT + Herbal medicine) + Chuna (supine cervical JS traction); Group B: Same complex KM without Chuna	Group A (with Chuna) vs. Group B (without Chuna)	Pain reduction (scale NR); Recovery speed; Functional improvement	Group A (with Chuna) → superior pain ↓ & faster recovery vs. Group B; Statistical significance noted but p-value NR	Treatment end	NR
Kim et al. (2020)²⁴⁾	RCT	97 (48/49)	Acute whiplash injury; Hospitalized in KM hospital; Young to middle-aged adults	Experimental: Mean 2.7±1.1 days; Control: Mean 11.8±2.7 days (hospital stay)	Experimental: MSAT (Acupuncture + Doin exercise/active movement) + Integrated KM; Control: Integrated KM only	MSAT + Integrated KM vs. Integrated KM alone	Primary: Hospital stay duration; Secondary: Pain improvement, functional recovery	MSAT group: Hospital stay ↓77.1% (11.8±2.7 days→2.7±1.1 days, p<0.01); Significant pain reduction; Cost-effective approach; Accelerated recovery	Discharge	NR
Park et al. (2022)¹³⁾	Retrospective chart review	NR	Low back pain patients following MVA	NR (short-term treatment noted)	Acupuncture + Moxibustion + Cupping + Pharmacopuncture + Herbal medicine + PT (integrative package)	No comparison (before-after, real-world data)	Pain intensity; Functional status; Safety outcomes	Positive short-term effects for LBP; Low AE rate; Complex treatment ≠ ↑ complication rates vs. single interventions; Real-world practice data supported efficacy	Short-term (weeks)	No significant ↑ AE; Favorable safety profile similar to single interventions
Yuan (2008)¹⁵⁾	Clinical review / Case series	Multiple cases (exact n NR)	Severe multiple trauma from TA; Polytrauma requiring intensive care; Life-threatening injuries	Early intervention & rehabilitation emphasized	Integrated KM + Western medicine: Early acupuncture + Herbal medicine + Standard emergency/trauma care + Early rehabilitation protocols	No formal comparison (case series)	Recovery period; Functional outcomes; Survival rates; Quality of life post-trauma	High treatment success rates; Multidisciplinary integrated approach → improved functional outcomes; ↓ Hospital stay; Early KM intervention alongside conventional care beneficial for complex trauma	Long-term recovery monitored	NR in detail
Han et al. (2018)²¹⁾	Case report	2	Cervical spine fracture from MVA; Case 1: Male, details in paper; Conservative management candidates	Case-specific (weeks to months)	Acupuncture + Pharmacopuncture + Moxibustion + Herbal medicine (multimodal approach tailored to each case)	No comparison (case report)	NRS (0-10); NDI; EQ-5D; ROM (cervical); Radiological findings (X-ray, CT)	Both cases: NRS ↓ progressively, NDI ↓ significantly, EQ-5D ↑ (QOL improved), ROM ↑; Successful conservative management without surgery; Clinical & radiological improvement	Weeks to months	No AE noted during treatment course
Kang et al. (2022)²²⁾	Case report	2	Clavicle fracture from MVA; Hospitalized for conservative management	Hospital stay: weeks	Acupuncture + Pharmacopuncture + Moxibustion + Cupping + PT + Herbal medicine	No comparison (case report)	NRS (0–10); NDI; ROM (shoulder joint); EQ-5D; Radiological healing assessment (X-ray)	Both patients: Pain ↓ at 2 weeks & discharge, NDI ↓, ROM (shoulder) ↑ significantly, EQ-5D ↑; Radiological evidence of fracture healing; Successful conservative management avoiding surgery	2 weeks & discharge	Well-tolerated; No AE reported
Park & Jeong (2015)¹⁴⁾	Clinical study	NR	MVA patients with nocturnal pain (night pain with sleep disturbance); Both neck & low back pain patients	NR	Dangwisansan-Hapyu yang-jeongtonsan (當歸鬚散合乳香定痛散, herbal formula) + Acupuncture + Cupping + PT	No comparison (before-after)	Primary: VAS (0–10); NDI; ODI; Secondary: Sleep quality (total sleep time, nocturnal awakenings)	VAS ↓ (p<0.05), NDI ↓ (p<0.05), ODI ↓ (p<0.05); Total sleep time ↑ (p<0.05), nocturnal awakenings ↓ (p<0.05); Complex herbal-acupuncture approach effective for pain-related sleep disturbance	Treatment end	NR
Ottosson et al. (2007)¹⁶⁾	RCT	NR	Minor traffic injury patients; Non-life-threateni ng musculoskeletal injuries; Sweden	Early intervention group emphasized	Early comprehensive intervention (multimodal, various treatments) vs. Standard care	Early comprehensive intervention vs. Standard care (control)	Recovery period; Return to daily activities; Pain levels; Functional status	Early comprehensive treatment → accelerated recovery; Patients receiving early intervention returned to daily activities faster; ↓ Overall recovery time; Supports early, active, multimodal intervention for MVA injuries	Long-term (months)	NR

AE, Adverse Events; CT, Computed Tomography; EHR, Electronic health Record; EQ-5D, EuroQol-5 Dimension; EQ-5D-5L, EuroQol-5 Dimension-5 Level; FU, Follow-up; GA, Gestational Age; GDM, Gestational Diabetes Mellitus; inpt, Inpatient; KM, Korean Medicine; LBP, Low Back Pain; MSAT, Motion style Acupuncture Treatment; MVA, Motor Vehicle Accident; NDI, Neck Disability Index; NR, Not Reported; NRS, Numerical Rating Scale; ODI, Oswestry Disability Index; ouppt, Outpatient; PGA, Patient’s Global Assessment; PT, Physical Therapy; RCT, Randomized Controlled Trial; ROM, Range of Motion; SR, Systematic Review; TA, Traffic Accident; VAS Visual Analogue Scale.

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