Ischemic stroke has a high rate of disability and mortality and is often accompanied by white matter injury(WMI).WMI patients often have cognitive disorders,emotional disorders,sensorimotor disorders,urinary incontinence and other symptoms,which seriously affect daily life.WMI can be detected early through imaging techniques,but there is a lack of appropriate intervention and specific treatment.Studying the pathological mechanism of WMI after ischemic stroke is helpful to prevent the occurrence of WMI,delay its progression,and contribute to the development of effective drugs or specific treatments.This article reviewed the research progress of WMI mechanism after ischemic stroke in order to provide scientific basis for clinical prevention and treatment.

Objective To retrospectively analyze the clinical efficacy of Xuanfei Tongqiao Acupuncture for the treatment of allergic rhinitis(AR)based on real world studies.Methods Clinical data in the hospital information system of Acupuncture and Moxibustion Rehabilitation Department of the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to October 2022 and Excel sheet records were extracted.The data were screened according to the criteria.Based on the thresholds of receiver operating characteristic(ROC)curve,the treatment grouping thresholds were clarified.The acupuncture patients was divided into acupuncture group A and acupuncture group B,the treatment was Xuanfei Tongqiao Acupuncture.Groups A and B were compared using propensity score matching(PSM)to make the baseline balance comparable between groups.The efficacy,total effective rate,total nasal symptom score(TNSS),total non nasal symptoms score(TNNSS),adverse events,and recurrence were then compared between the two groups.In stratified analyses,the inverse probability of treatment weighting(IPTW)method was used for between-group comparisons.The efficacy,total effective rate,TNSS and TNNSS,incidence of adverse events,and recurrence were compared between the two groups,respectively.The TNSS and TNNSS before and after treatment within the group were also compared.Results A total of 209 patients'data were collected,including 7 non-acupuncture patients and 202 acupuncture patients,and the acupuncture patients was divided into acupuncture group A(<6 weeks of treatment)and acupuncture group B(≥6 weeks of treatment)according to the ROC curve characteristics,and there was a difference in comparing the conditions of the two groups(P<0.05).66 pairs of patients were successfully matched after PSM,and there was no significant difference between the two groups at baseline(P>0.05).After PSM,the efficacy,total effective rate,post-treatment TNSS and TNNSS and TNSS at the follow-up between the two groups were compared,and the post-treatment TNSS and TNNSS within the groups were also compared,with statistical significance(P<0.01).There was statistical significance in the recurrence rate between the two groups before PSM(P<0.05),while there was no statistical significance in the incidence of adverse events before PSM and in the recurrent rate after PSM between the two groups(P>0.05).Stratified analysis was conducted on patients in the acupuncture patients based on their condition.Mild and moderate to severe patients were divided into acupuncture group A and group B according to the course of treatment.The TNSS and TNNSS before and after treatment were compared within the two groups,with statistical significance(P<0.01).IPTW was performed on two groups to ensure baseline balance and comparability,and there was statistical significance in the distribution of efficacy levels between the two groups(P<0.05),but there was no statistical significance in the total effective rate,TNSS and TNNSS scores after treatment and at follow-up,incidence of adverse events,and recurrence rate between the two groups(P>0.05).The distribution of efficacy levels,total effective rate,TNSS and TNNSS after treatment and at follow-up were compared between the two groups of moderate to severe patients,and the differences were statistically significant(P<0.01).There was no statistical significance in the incidence of adverse events and recurrence rates between the two groups(P>0.05).The TNSS and TNNSS of two groups of moderate to severe patients significantly decreased after treatment compared with before treatment(P<0.01).Conclusion Xuanfei Tongqiao Acupuncture treatment for AR with a duration of 6 weeks or more shows more significant and long-lasting clinical efficacy compared with a duration of less than 6 weeks.Especially for patients with moderate-to-severe AR,this course of treatment can better reflect the advantages of its efficacy.