Study On The Infective Factors Of Epidemic Disease And Plague In Traditional Chinese Medicine Based On Active Surveillance On Respiratory Virus

Epidemic pathogenic factors,epidemic pathogens are a kind of exogenous disease with strong pathogenicity and infectivity,which is an important part of the etiology of traditional Chinese medicine(TCM).Epidemic pathogenic factors as the propose of febrile disease of TCM etiology,as derived from the book of Elbow Backup Nasty Party,later doctors also made important contributions to that theory.Until the late of the 17th century Ming dynasty period,Wu Youke pointed out that the Epidemic pathogenic factors were another exogenous cause outside from the Six Pathogens in WenyiLun(Treatise on Warm Pestilence).But those are objective existence,which are tiny pathogenic substances and can't be detected by the human eyes.Which are closely related to the seasons,climate and geography.Which can lead to an epidemic of the disease.Wu also described the characteristics of the epidemic pathogenic factors,which are violence,highly pathogenic,highly infectious,the specificity of the positioning of organs and meridians and selection of species.Wu Youke's theory are earlier more than 200 years than the the theory of infectious disease proposed by western in the 19th century,it was a rare science theory and anticipation under those historical conditions,and development a new area for the epidemic diseases,there are still profound theory and important practical value to today so far.But about how the epidemic of the pathogenic factors caused various diseases and the epidemiological characteristics is rarely researched.Acute respiratory virus infection(acute respiratory tract infection,ARTI)is the most common viral infectious diseases,include influenza,viral pneumonia,et al.But epidemic pathogenic factors,the cause of disease is not the same,different factors lead to different disease,one factor cause one kind of disease,and one disease different from other disease,include clinical characteristics and pathological changes of the disease.It' s important significance to make clear the clinical characteristic of every kind of pathogenic factor,and analyze its pathogenic factors,and investigate the pathology and pathogenesis for TCM in treatment the disease cause by epidemic pathogenic factors based on syndrome differentiation and "no disease prevention first".In this research,we combined the epidemic pathogenic factors with the active surveillance of the respiratory infection virus diseases for the first time.We used the influenza,the viral pneumonia and the COVID-19 as the breakthrough point,studied from eight aspects such as the transmission characteristics,onset time,geographical,pathological properties,symptoms and signs,physical factors and the change rule,rehabilitation and recurrence characteristics,microscopic quantitative virus disease,combined with western medicine study of warm disease of TCM of the epidemic pathogenic factors,so as to enrich and perfect the respiratory virus infection disease of TCM syndrome differentiation system,and provide the beneficial reference in the prevention and treatment of respiratory infectious diseases for the TCM.We depend on the national influenza network laboratory platform to study the popular features of influenza pathogenic factors.We carried out active monitoring of influenza-like cases,random selected 25059 cases of influenza-like cases(ILI)throat swab specimens in the region national influenza surveillance sentinel hospital.We carried out the Real-time PCR to detect the virus etiology and isolate the virus from MDCK cells,sequence the HA gene of the isolate virus and analyze the sequence evolution and the amino acid sites,in order to conclude the HA evolution characteristics,amino acid molecular variation characteristics of the influenza virus in the region's area.The results showed that there were two or more combinations of dominant virus strains of influenza in the region,and the dominant strains varied from year to year.Evolution and variation analysis showed that 6B virus type were the main type isolated in recent years,and only two strains were 6C virus type.The H3N2 was dominated by 3C virus type,and the H3N2 was dominated by 3C.2a virus type after 2014.The strains isolated in the same year were not entirely on the same evolutionary branch,and some of them were far from the vaccine strains.The difference between the isolate virus and the vaccine virus,will lead to the difference of the immune protect in humans.Both H1N1 and H3N2 showed mutations in the antigenicity and receptor binding sites of HA,suggesting potential changes in the antigenicity and virulence of the virus.We analyzed data which included information of case monitoring and data of climate and environment in the same period were collected,combined with monitoring data of etiology by SPSS20.0,and found that the epidemiological characteristics of influenza virus showed obvious winter and spring seasonality,which was positively correlated with temperature,relative humidity and air quality PM 10,and negatively correlated with O3 index.The main symptoms of influenza are fever,cough,cold aversion and headache.The etiological attributes of influenza gas are "wind,cold,wet and hot".The students aged 7-17 are the dominant people because they were stressed in study,weak in constitution and lack of healthy qi,and the learning environment makes the influenza easy to gather and spread.Influenza pathogenic factors are mainly impacted by the season environment,because of low temperature,or big change in temperature in a short time.The right-Qi of the body will decline,and the cold evil invasion was the main inducement(H3N2 will combined with the Wet evil),and that time the influenza pathogenic factors will be impacted by the environment such as the "wind","dryness","coldness" and the PM 10 suspended particulate matter in the air.These reasons will cause the influenza pathogenic factors active and spread widely,if the human body immune function was decline,and deficient right-Qi,the body was easy to infect by the influenza pathogenic and diseased.In order to study the epidemic characteristics,etiological attributes and related factors of the viral pneumonia,we carried out active surveillance of the viral pneumonia from January 2017 to July 2020.A total of 1109 throat swabbed samples of hospitalized pneumonia cases were randomly selected,and nucleic acid of five common respiratory viruses which including influenza virus,respiratory syncytial virus,respiratory adenopathy,parainfluenza ? type virus,human enterovirus was detected by Real-time quantitative PCR.We found that viral pneumonia can be detected throughout the total year,and the females had a higher proportion than males,and the children aged 0-6 years old had a higher incidence.The prevalent season was winter,and the main symptoms were nasal congestion,cough,chills,fatigue and suffocating.The etiological attributes were "wind,coldness,wet and heat".And the main pathogens were influenza virus and respiratory syncytial virus.These viruses only cause the common symptoms of upper respiratory tract infection in the body normally,in some times the virus don't make the body ill.When the virus makes the body ill mainly due to the body itself deficient right-Qi,it causes the insufficient function of the body and organs.Then the exogenous pathogen will make the body ill and the illness has a certain correlation with the epidemic of the pathogen,but it's not the main reason.The children aged 0-6 years old are the main susceptible population.Because of their low immunity and deficient right-Qi in the body,they accumulate in the gathering places such as nursery institutions,and are prone to cross infection of respiratory viruses,which are easy to develop into pneumonia.The prevalence of viral pneumonia is related to PM2.5 index,and the virus can be adsorbed on PM2.5 particles,thus staying in the air for a long time,drifting away for a long distance,and easy to spread.In order to explore the viral pneumonia epidemic characteristics,etiological attributes and pathogenic factors of local SARS-CoV-2 virus,we carried out active surveillance and screening of COVID-19 cases from January 21 to March 3,2020.A total of 8,433 cases were screened,and 37 patients with SARS-CoV-2 infection were found,among which 23 were confirmed cases of novel coronavirus and 14 were asymptomatic infected.The basic information of these 37 infected patients was collected by a cross-sectional study population investigation method.Laboratory test data,clinical symptoms,onset time,discharge time,epidemiological history,blood indicators and treatment conditions were analyzed to explore the use of the digital QuantStudioTM 3D digital PCR chip.A SARS-CoV-2 digital PCR method with higher sensitivity and accuracy was established and applied to active tracking and monitoring of the newly SARS-CoV-2 infection in this region.A total of 1190 samples of pharyngeal,anal,blood and urine samples were detected simultaneously with Real-time fluorescence PCR to locate the hiding places and detoxification times of the SARS-CoV-2 in different time periods.We found that the onset time of COVID-19 was concentrated from January 15 to February 11,the season was winter,the solar terms were Minor Cold,Major Cold and Beginning of Spring,the six qi were the last and the first qi,the average temperature was 5.15±2.60?,and the average humidity was 80.7±8.59%.Most of the confirmed cases were mild and common type,and only one severe case was found.The main clinical symptoms were fever and cough,accounting for 91.3%.The symptoms of wet of confirmed cases were mainly body weight and limb fatigue,fatigue and chest tightness,accounting for 43.48%.Seven of the 37 infected patients appeared "regaining positive" or even repeated "regaining positive" after discharge or release of isolation,accounting for 18.92%,99 days after the onset of disease.There were still cases where the nucleic acid test of throat swab was positive,and the number of reactivation was up to 5 times.The results of long-term follow-up of novel coronavirus positive infection showed that respiratory tract specimens were collected at the early stage of disease,and lower respiratory tract specimens were collected as far as possible.Two specimens of respiratory tract and anal swab were collected during the middle and late stages of onset and recovery.Blood and urine specimens are not suitable for the detection of novel corona virus samples.The sensitivity and accuracy of the established digital PCR detection method are better than the currently used fluorescence PCR nucleic acid detection method.It can be combined with the current fluorescence PCR method to improve the detection rate of viruses,clarify the determination of unclear samples by fluorescence PCR results,and reduce the collected times of samples.Influenza virus and viral pneumonia,have epidemic seasonality,the etiology attribute is "wind,coldness,wet,hot",susceptible population is young children,students,the incidence of both are related to the right-Qi.The incidence of influenza and the epidemic was greater related to degree of influenza pathogenic factors,and the incidence of viral pneumonia is more affected by the right-Qi.The COVID-19 broke out in winter,when the cold and high humidity,and the whole population was susceptible to the COVID-19.The pathogenesis of COVID-19 was characterized by wet pathogenic factors,which entered the lungs at the initial stage,and Wet inundation causes the disease to depress the lungs.The incidence of COVID-19 was not related to the right-Qi.However,the "recovery of positive" caused by the intermittent detoxification of the virus from the perspective of TCM,can be ascribed to the "recovery of disease after bad",but if we take the three principles of "eliminating the virus completely","supporting the right-Qi" and"improving the body constitution"can effectively prevent the occurrence of this phenomenon.The prevalence of SARS-CoV-2 was closely related to temperature,humidity and region,and its etiological attributes are mainly "wet and cold".which is as same as the Ye Tianshi who thought that "the lung is the first to be affected by warm-heat pathogens",which is the classic theory of fever in "Treatise on epidemic febrile diseases".Wet evil mainly harms the spleen and stomach,which is the consensus of existing theories.However,the COVID-19 in 2019 mainly depended on the cold and wet evil,and the main disease site is in the lung.Although the nature of virus is mostly warm-heat human,there are also cold people,such as Cold disease.According to the COVID-19 virus,we proposed"wet disease",which deserved further study.Asymptomatic infection found in the COVID-19 was common,and had been cured diagnosed patients became positive several times which made additional difficulties for the COVID-19 epidemic prevention.We must improve detection ability in the SARS-CoV-2 according to the virus' hidden features,and also concerned with the change of the pathogen virus,improve immunity of the susceptible body,active monitor the virus,found,diagnose and treatment as early as quickly,cure a disease before its onset combine with traditional Chinese medicine and western medicine,and can effectively control the COVID-19 outbreak.