Perspectives on Integrative Medicine

Protocols

Study Protocol for a Randomized Pragmatic Clinical Trial Evaluating Pharmacopuncture Versus Acupuncture for Chronic Neck Pain: Ju Yeon Kim, Suna Kim, Yeonsun Lee, Hyun-Woo Cho, Yejin Hong, Dongwoo Nam, Yeoncheol Park, Eun-Jung Kim, Sook-Hyun Lee, Yoon Jae Lee, In-Hyuk Ha; Perspect Integr Med. 2025;4(3):181-189. Published online October 22, 2025; DOI: https://doi.org/10.56986/pim.2025.10.007

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Graphical Abstract Abstract PDF Supplementary Material: Background
Neck pain is a common musculoskeletal disorder, which is becoming increasingly common with the rise in computer and smartphone use. For many, this condition leads to chronic discomfort, and disability in daily life. Although pharmacopuncture represents a major treatment modality for neck pain in Korean medicine, its effectiveness and safety as compared with standard acupuncture has not been thoroughly investigated.
Methods
A study protocol for a multicenter, pragmatic, randomized clinical trial was designed with a parallel-group approach. A total of 128 participants, each experiencing chronic neck pain for at least 3 months, will be recruited. Participants will be randomly assigned to either the pharmacopuncture or acupuncture group and receive treatment twice weekly for 4 weeks. The primary outcome will be the change in score for neck pain, as assessed using the numeric rating scale, 5 weeks after baseline. Secondary outcomes will include evaluations using the visual analog scale, Northwick Park Questionnaire, Neck Disability Index, Patient Global Impression of Change, Health-Related Quality of Life Instrument with eight items, and the EuroQol-5 Dimension. In addition, a cost-effectiveness analysis will be conducted and reported separately.
Discussion
The rigorous study design is intended to ultimately provide practical evidence for clinicians and policymakers regarding the use of pharmacopuncture treatment for chronic neck pain. By directly comparing its effectiveness with standard acupuncture, the results of the trial outcomes will offer insights that may inform future healthcare decisions. Trial registration: This protocol has been registered at ClinicalTrials.gov (NCT06520462) on July 25, 2024.

Study Protocol for a Systematic Review of the Methods and Reliability of Sham Electroacupuncture in Randomized Controlled Trials: Sung Min Lim; Perspect Integr Med. 2025;4(1):62-64. Published online February 21, 2025; DOI: https://doi.org/10.56986/pim.2025.02.008

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Abstract PDF: Background
Electroacupuncture (traditional acupuncture combined with electrical stimulation) is used to treat various medical conditions. However, the lack of standardized sham electroacupuncture options (placebo controls) poses a challenge in ensuring the validity of the results gained from randomized controlled trials (RCTs). This study presents a protocol for a systematic review to evaluate the methods and validity of sham electroacupuncture used in RCTs.
Methods
To provide evidence for establishing an optimal control model for sham electroacupuncture, a systematic review will be conducted by searching major English language electronic databases (including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) for studies published up to May 2024. RCTs that utilized sham electroacupuncture as a control group will be included. Two independent reviewers will screen the studies and extract the data, and the quality of the selected studies will be assessed using the Cochrane Risk of Bias Tool 2. Frequency analysis will be conducted, and to assess blinding in RCTs the Blinding Index will be reported. This systematic review protocol is registered with PROSPERO (no.: CRD42024542514).
Results
/Conclusion: This systematic review will provide a comprehensive analysis of the methods and reliability of sham electroacupuncture in RCTs and thus help identify current practices and gaps. The findings may contribute to the development of standardized sham electroacupuncture controls and improve the design RCT in the future which will facilitate treatment validation of electroacupuncture.

Review Article

An Umbrella Review of Systematic Reviews for Chuna (or Tuina) Manual Therapy on Musculoskeletal Disorders: Doori Kim, Gil Geun Baek, Byung-Cheul Shin; Perspect Integr Med. 2023;2(3):142-154. Published online October 23, 2023; DOI: https://doi.org/10.56986/pim.2023.10.002

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17 Citations

Graphical Abstract Abstract PDF Supplementary Material

Background
To provide clinicians with reliable evidence an umbrella review of systematic reviews (SRs) on Chuna manual therapy (CMT) for musculoskeletal disorders was performed to synthesize important outcomes.
Methods
There were eight databases (Cochrane, EMBASE, MEDLINE, CNKI, KMBASE, KISS, Scienceon, and OASIS) searched as well as the international database Prospective Register of Systematic Reviews in health and social care until August 2023. SRs of randomized controlled trials involving patients with musculoskeletal conditions, limited to interventions explicitly labeled as “Chuna” or “Tuina” in English, Chinese, or Korean language were retrieved. Two reviewers independently conducted selection and data extraction, and SR quality was assessed using A Measurement Tool to Assess Systematic Reviews tool (low, medium, or high quality).
Results
This review included 32 SRs, categorized by cervical (n = 4), thoracolumbar (n = 7), upper extremity (n = 5), lower extremity (n = 9), and other musculoskeletal disorders (n = 7). Quality assessments determined that three SRs were of “high” quality, two were “low” quality, and the remaining SRs were of “medium” quality. CMT was consistently reported to demonstrate superior outcomes: an effective rate was observed in 17 of 19 SRs, CMT was effective at reducing pain in 12 of the 16 SRs, and functional outcomes of CMT were observed in 8 of 12 SRs. No serious adverse events were reported.
Conclusion
CMT may be a safe and effective treatment for various musculoskeletal disorders based on the limited number of studies and the low quality of included SRs.

Citations

Citations to this article as recorded by

Pharmacopuncture for patients with psychological stress caused by traffic accidents: A pragmatic randomized controlled pilot trial
Ja-Yean Son, Seol Jung, Young-Hoon Lee, Dong-Gyu Kim, Joon-Woo Kim, Tae-Jun Lee, Sung-Hwan Cho, Jeong-Hyo Ji, Hyun-Woo Cho, Sang-Don Kim, Yoon Jae Lee, In-Hyuk Ha, Doori Kim, Byung-Cheul Shin
Integrative Medicine Research.2026; 15(1): 101251. CrossRef
Effectiveness and safety of manual therapy for inpatients with traffic accident-induced acute neck pain: A randomized controlled trial
Sung-Won Choi, Ka-Hyun Kim, Joo-Young Yoon, Si-Won Lee, Jae-Won Park, Hae-Won Hong, Da-Hyun Kyeong, Min-Kyung Kim, Su-Na Kim, Chang-Yeon Kim, Yoon-Jae Lee, Jin-Ho Lee, Ju-Yeon Kim, In-Hyuk Ha
Journal of Integrative Medicine.2026; 24(1): 81. CrossRef
Long-term follow-up of vertebral compression fractures in inpatients treated with integrative Korean medicine: An observational study
Hyun A. Sim, Woojin Jung, Soo-Duk Kim, Hyunsuk Park, Jonghyun Lee, Hyeri Jo, Yeonsun Lee, In Heo, Byung-Kwan Seo, Woo-Chul Shin, Jae-Heung Cho, Yoon Jae Lee, Doori Kim, In-Hyuk Ha
Medicine.2026; 105(2): e46883. CrossRef
Integrative Korean medicine for recurrent lumbar disc herniation after coronavirus disease vaccination: A case report and literature review
Ah-Ra Koh, Hyun-Woo Kim, Young-Jin Lee, Hye-Jeong Jo, Go-Eun Chae, Dong-Woo Kim, In-Hyuk Ha, Doori Kim
Medicine.2025; 104(1): e41079. CrossRef
Comparative Effectiveness of Non-Pharmacological and Pharmacological Treatments for Non-Acute Lumbar Disc Herniation: A Multicenter, Pragmatic, Randomized Controlled, Parallel-Grouped Pilot Study
Doori Kim, Jee Young Lee, Yoon Jae Lee, Chang Sop Yang, Chang-Hyun Han, In-Hyuk Ha
Journal of Clinical Medicine.2025; 14(4): 1204. CrossRef
Integrative Korean medicine treatment without surgery for the management of subacute radiating pain attributed to vertebral artery loop formation: A case report and literature review
Jung Min Yun, Dong Hyun Go, Sook-Hyun Lee
Medicine.2025; 104(9): e39483. CrossRef
Effectiveness and cost-effectiveness of Chuna manual therapy for temporomandibular disorder: A randomized clinical trial
Jae-Heung Cho, Koh-Woon Kim, Hyungsuk Kim, Woo-Chul Shin, Me-riong Kim, Joowon Kim, Min-Young Kim, Hyun-Woo Cho, In-Hyuk Ha, Yoon Jae Lee, Essam Al-Moraissi
PLOS One.2025; 20(5): e0322402. CrossRef
Integrative Postural Rehabilitation for Kyphotic Deformity in a Patient with Parkinson’s Disease: A Case Report and Literature Review
Ye-Rim Yun, Ji-Sung Yeom, Joon-Seok Lee, Doori Kim, Yoon Jae Lee, In-Hyuk Ha, Do-Young Kim
Journal of Clinical Medicine.2025; 14(11): 3705. CrossRef
Non-Pharmacological and Pharmacological Treatments for Non-Acute Lumbar Disc Herniation: A Protocol for a Multicenter Pragmatic Trial
Doori Kim, Yoon Lee, Changsop Yang, Yong-Jun Ahn, Suna Kim, YeonSun Lee, Hyun-Woo Cho, Chang-Hyun Han, In-Hyuk Ha
Journal of Pain Research.2025; Volume 18: 7167. CrossRef
Traditional Korean Medicine Services and Its Association with Knee Surgery and Opioid Use in Patients with Knee Osteoarthritis: A Nationwide Retrospective Study in Korea
Hwang Woo Seok, Ho-Yeon Go, Won-Hyung Ryu, Yoon Jae Lee, In-Hyuk Ha, Doori Kim
Journal of Clinical Medicine.2025; 14(20): 7152. CrossRef
Clinical Outcomes of Integrative Korean Medicine Treatment in Patients with Neck Pain Following Cervical Disc Surgery: A Multi-Center Retrospective Study
Sae Young Bong, Kyung-Rae Kang, Tae-Ha Kwon, Min-Seok Go, Cha-Young Lee, Seong-Chul Yeom, Yoon Jae Lee, Doori Kim, In-Hyuk Ha
Journal of Pain Research.2025; Volume 18: 5843. CrossRef
Analysis of the utilisation of Chuna manual therapy for musculoskeletal disorders after its coverage under national health insurance in Korea: a retrospective analysis
Gil Geun Baek, In-Hyuk Ha, Yoon Jae Lee, Yeong-Jae Shin, Byung-Cheul Shin
BMJ Open.2025; 15(8): e094099. CrossRef
Effect of Cervical Manual Therapy on Sleep Quality: A Scoping Review of Randomized Controlled Trials
Do-Young Kim, Dong-Hyun Go, Hak-Jae Kim, Nam-Woo Lee, Yoon Jae Lee, Sook-Hyun Lee, In-Hyuk Ha
Life.2025; 15(10): 1557. CrossRef
Real-world evidence on the safety and effectiveness of integrative Korean medicine for older patients post-traffic accident: A retrospective observational study
Ju-Yeun Shin, Ye-Seul Lee, Seung-Hee Lee, Jeong-Hee Noh, Yoon Jae Lee, In-Hyuk Ha, Su Won Lee
Medicine.2025; 104(48): e46144. CrossRef
Safety and Effectiveness of Integrative Korean Medicine Treatment for Pediatric Patients After Traffic Accidents: Retrospective Chart Review and Survey Research with a Focus on Emotional and Behavioral Symptoms
Yoon Jung Lee, Joo Hee Oh, Dong Jin Jang, Hyo Eun Lee, Ho-Yeon Go, Ju Yeon Kim, Yoon Jae Lee, In-Hyuk Ha
Healthcare.2025; 13(15): 1835. CrossRef
Reporting Overviews of Reviews: PRIORitizing a Reporting Guideline
Lisa Hartling, David Moher
Perspectives on Integrative Medicine.2024; 3(2): 65. CrossRef
Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial
Ja-Yean Son, Kangmoo Goo, Na-young Kim, Seok-Gyu Yang, Dong Hwan Lee, Yu-Ra Im, Oh Bin Kwon, Hyun-Woo Cho, Sang Don Kim, Doori Kim, In-Hyuk Ha
Journal of Clinical Medicine.2024; 13(15): 4457. CrossRef

Protocol

Effectiveness and Safety of Duantengyimu-tang for Rheumatoid Arthritis: A Protocol for a Systematic Review and Meta-Analysis: Gyoungeun Park, Jeong-Hyun Moon, Eun-Jung Kim, Won-Suk Sung; Perspect Integr Med. 2023;2(2):134-137. Published online June 23, 2023; DOI: https://doi.org/10.56986/pim.2023.06.009

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Abstract PDF: Background
Per-oral pharmacological medication is a representative treatment for rheumatoid arthritis (RA), and has improved over several guidelines. However, limitations of long-term use of these medications including adverse events, led to the introduction and utilization of complementary and alternative treatments for RA. Several herbal medicine decoctions have been reported to be effective and safe; a recent study introduced Duantengyimu-tang (DTYMT). Regardless of the pharmacological effects of the DTYMT components, there are concerns about its safety. Therefore, this systematic review (SR) will focus on the effectiveness and safety of DTYMT treatment for RA.
Methods
Searches for randomized controlled trials using DTYMT treatment for RA will be performed using multiple electronic databases, manual searches, and emails (if necessary). A summary will be written using data on outcome measurements of the study participants, interventions, adverse events, and risk of bias in the studies. The primary outcomes will be disease activity scores including effective rate, tender joints, swollen joints, and morning stiffness. The secondary outcomes will include adverse events and blood tests for RA (erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factors). This SR will use Review Manager software to perform a meta-analysis, the Cochrane Collaboration “risk of bias” tool, and determine the quality of evidence using the Grades of Recommendation, Assessment, Development, and Evaluation method.
Results
This SR will investigate the clinical effectiveness and safety of DTYMT treatment in patients with RA.
Conclusion
This SR aims to be informative for patients and clinicians in clinical practice, researchers, and policymakers in managing RA.

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