Study On The Difference Of Respiratory Tract Microecology In TCM Syndrome Types Of AECOPD In Kunming

Objective:To investigate metagenomics profiling on the respiratory tract and diversity of respiratory tract in patients with Acute exacerbation of chronic obstructive pulmonary disease（AECOPD）in Kunming area,and to compare the differences of microecological composition among traditional Chinese medicine（TCM）syndrome groups,so as to provide reference for the treatment of TCM syndrome types of AECOPD.Methods:From October 2019 to October 2020,37 AECOPD patients and 25 normal family members diagnosed as phlegm heat obstructing lung syndrome,phlegm dampness obstructing lung syndrome and phlegm damp stasis lung syndrome in the Department of respiratory and critical care medicine,the first people’s Hospital of Yunnan Province were collected.Using high-throughput sequencing technology,the V3-V4 regions of bacterial 16S rDNA in the upper and lower respiratory tract samples were amplified and sequenced,and the sequencing data was analyzed by the Mothur workflow.Results:1.Compared with 14 cases of phlegm heat obstructing lung syndrome,11 cases of phlegm dampness obstructing lung syndrome and 12 cases of phlegm damp stasis lung syndrome,FVC%pre and FEV1%pre（P<0.05）in phlegm heat obstructing lung syndrome group and phlegm damp stasis lung syndrome group were lower than those in phlegm dampness obstructing lung group,and PaCO₂（P<0.05）were higher than those in phlegm damp stasis lung syndrome group;2.Alpha diversity analysis showed that the microecological diversity of upper and lower respiratory tract in AECOPD group was lower than that in healthy group;the microecological diversity of upper respiratory tract of phlegm heat obstructing lung syndrome was lower than that of phlegm dampness obstructing lung syndrome（P<0.05）;3.OTU Venn analysis showed that there were 60 common core strains in the upper and lower respiratory tract,4 unique core strains were detected in the upper respiratory tract,and 10 unique core strains were detected in the lower respiratory tract;4.Heatmap cluster analysis showed that the top 10 species in upper and lower respiratory tract of AECOPD group and healthy group were consistent,but the relative abundance of species was different,and the TCM syndrome types of AECOPD in the three groups were mainly enriched by Firmicutes,Proteobacteria and Bacteroidota;5.Based on the weighted UniFrac PCoA analysis,there were differences in respiratory tract microecology between the upper and lower respiratory tract TCM syndrome groups;6.Deseq2 difference analysis showed that there were abundance differences between upper and lower respiratory tract phlegm heat obstructing lung,phlegm damp stasis lung and phlegm dampness obstructing lung（P<0.05）.Conclusion:The imbalance of respiratory tract microecology is one of the reasons to induce acute exacerbation of AECOPD,and there are differences among phlegm heat obstructing lung syndrome,phlegm dampness obstructing lung syndrome,and phlegm damp stasis lung syndrome groups.In the treatment,the principle of TCM syndrome differentiation and treatment should be strengthened to balance the respiratory tract Microecology.