Efficacy of Different Traditional Chinese Medicine Techniques for Preventing Stroke-Associated Pneumonia in Patients with Stroke: A Network Meta-analysis

Objective: This study aimed to clarify the preventive benefits of different Traditional Chinese Medicine (TCM) techniques in preventing stroke-associated pneumonia(SAP) in patients with stroke. Methods: A comprehensive literature search was conducted in Cochrane Library, PubMed, Web of Science, MEDLINE, CINAHL, China National Knowledge Infrastructure, Wanfang, VIP, and the Chinese Biomedical Literature Service System from database inception to September 30, 2025. The primary outcome was the incidence of SAP. Two researchers independently performed study selection, data extraction, and quality assessment. A network meta-analysis was conducted using Stata 16.0. Results: A total of 27 randomized controlled trials were included, involving seven categories of TCM interventions. The network meta-analysis indicated that acupuncture combined with acupoint stimulation ranked highest in the surface under the cumulative ranking curve (SUCRA) analysis for reducing the incidence of SAP, followed by acupoint stimulation combined with Chinese herbal medicine and Chinese herbal medicine alone. Conclusion: Acupuncture combined with acupoint stimulation showed the highest probability of benefit in the current analysis and may be considered a promising adjunctive strategy for SAP prevention. However, given the methodological limitations of the included studies, further high-quality randomized controlled trials are required before definitive clinical recommendations can be made.