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

Article information

J Korean Med. 2026;47(1):37-55
Publication date (electronic) : 2026 March 1
doi : https://doi.org/10.13048/jkm.26003
Dongmin Lee1orcid_icon, Jong Uk Kim4orcid_icon, Eui-Hyong Hwang5orcid_icon, Chan-Ju Im1orcid_icon, Jae-Eun Kim1orcid_icon, Da-Kyung Jang1orcid_icon, Yeonhak Kim1orcid_icon, Jung-Hyun Kim1orcid_icon, Yeon-Cheol Park2orcid_icon, Yong-Hyeon Baek2orcid_icon, Sang-Soo Nam2orcid_icon, Eun Yong Lee3orcid_icon, Byung-Kwan Seo2,orcid_icon
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 2026 February 9; Revised 2026 February 13; Accepted 2026 February 19.

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.

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

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Article information Continued

Figure 1

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.