Efficacy and Mechanism of Suhexiang Wan in Post-Stroke Patients with Pulmonary Infection: A Retrospective Cohort Study

Corresponding author: 张婷婷, 984884918@qq.com

DOI: 10.12201/bmr.202611.00005

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  Abstract: 【Abstract】 Objective To evaluate the clinical efficacy of Suhexiang Wan as adjunctive therapy in post-stroke patients with pulmonary infection using real-world data, and to explore its mechanisms and factors influencing treatment response. Methods A total of 120 patients with post-stroke pulmonary infection admitted to the Department of Neurological Rehabilitation at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine between January 2025 and January 2026 were enrolled and divided into experimental group (n=60) and control group (n=60) based on Suhexiang Wan use. The primary outcome was the change in Clinical Pulmonary Infection Score (CPIS) from baseline to post-treatment (ΔCPIS). Secondary outcomes included white blood cell count (WBC), C-reactive protein (CRP), modified Barthel index (MBI), Functional Assessment Measure (FAM), albumin, and time to defervescence. Statistical analyses comprised independent samples t-test/Mann-Whitney U test, multivariable linear regression, subgroup analysis, and mediation analysis. Results Baseline characteristics were comparable between the two groups (P>0.05). The experimental group showed significantly greater ΔCPIS than the control group (β=0.526, 95% CI: 0.204 to 0.849, P=0.002). Improvements in ΔWBC, ΔMBI, Δalbumin, and time to defervescence were also significantly superior in the experimental group (P<0.05). Subgroup analyses revealed greater benefits in female patients (β=1.323, 95% CI: 0.507 to 2.139, P=0.030) and those with hypertension (β=0.648, 95% CI: 0.017 to 1.279, P=0.047). Multivariable regression identified baseline CPIS (β=0.541, 95% CI: 0.444 to 0.638, P<0.001) and group allocation (β=0.526, 95% CI: 0.204 to 0.849, P=0.002) as independent predictors of ΔCPIS. Mediation analysis indicated that ΔWBC did not mediate the improvement in CPIS (indirect effect: -0.052, 95% CI: -0.169 to 0.027, P=0.304). Sensitivity analyses yielded results consistent with the primary analysis. No adverse events were reported in either group. Conclusion Suhexiang Wan as adjunctive therapy significantly improves CPIS in post-stroke patients with pulmonary infection, with effects independent of conventional treatment. Female patients and those with hypertension may derive greater benefits. The mechanism may involve multi-target regulation rather than a single anti-inflammatory pathway.

  Key words: Stroke; Pulmonary infection; Suhexiang Wan; Clinical Pulmonary Infection Score; Retrospective cohort study

  Submit time: 4 November 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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