Correlation Between TCM Type H3N2 Subtype Influenza TCM Syndrome And Upper Respiratory Microecology

Objective:1.To analyze the characteristics of the microbiome community in the respiratory tract between healthy people and patients with type a H3N2 influenza.2.To study the distribution and abundance of respiratory Micro-ecology in different TCM Syndromes of influenza A?H3N2?influenza,and to explore relationship between different types of syndromes and the micro-ecology of the respiratory tract.Method:A retrospective research method was adopted.All the patient samples were from the Beijing Municipal Science and Technology Commission " influenza syndrome characteristics monitoring and the construction of TCM early warning system in Beijing area".From November 2016 to February 2017,in the emergency department of the DongZhiMen Hospital affiliated to Beijing University of Traditional Chinese Medicine and the Traditional Chinese Medicine Hospital affiliated to Capital Medical University,The fever clinic of the ChaoYang Hospital,LuHe Hospital,YouYi Hospital affiliated to Capital Medical University and the DongFang Hospital affiliated to Beijing University of Traditional Chinese Medicine,we included patients according to the inclusion and exclusion criteria,and also with influenza diagnostic criteria of Chinese and Western medicine.And we signed the informed consent each patient,collected the pharyngeal test samples,and more,the general information,initial symptoms,current symptoms,body signs,tongue and pulse characteristics,and then recorded the laboratory examination of patients.The database was set up by Epidata,and the patient's data were input one by one according to the self-made influenza observation table.All samples were tested with general influenza kits to determine the pathogeny of influenza like cases.We screened the positive H3N2 cases and summarized the TCM Syndromes of different influenza a H3N2 subtypes.According to the different TCM syndromes,we used Excel to do group random sampling,and selected samples to extract DNA,process PCR amplification,And then take the 16S rDNA detection?OTU analysis,clustering analysis,Alpha diversity analysis,Beta diversity analysis,functional gene analysis?.To observe the relationship between TCM syndrome of influenza and the micro-ecology in respiratory tract.Results:1.The microbiome structure of the upper respiratory tract in healthy people and seasonal influenza?H3N2?is mainly composed of Proteobacteria,Firmicutes and Bacteroidetes.Compared with patients,the abundance of Bacteroidetes,Ignavibacteriae,Gemmatimonadetes?P<0.01?,Acidobacteria,Chloroflexi,Latescibacteria and Nitrospirae?P<0.001?were higher in health group.In genus,the mainly Microflora were Sphingomonas,Alloprevotella,Bacteroides.The Anove Analysis and LEFSE confirmed that,compared with the patients,the health group had higher abundance?P<0.001,LDA>4?.In the Alpha index,the patient group CHAOl,ACE Index and Shannon Index were lower than the health group?P<0.05?.2.Among the seasonal influenza?H3N2?with different syndromes of TCM,the differences of flora structure among patients is mainly manifested that:Comparing the wind-heat syndrome,the wind-chill syndrome and external cold and internal heat syndromeof TCM?Traditional Chinese Medicine?by Out-venn,it was found that there were 39 specific OTUs in the pharynx of the wind-chill syndrome and the external cold and internal heat syndrome,who mainly belonged to Firmicutes and Bacteroidetes.The dominant were all performed Proteobacteria,Firmicutes and Bacteroidetes.The abundance of Proteobacteria in the wind-heat syndrome and wind-chill syndrome is higher than that in the external cold and internal heat syndrome?P<0.001?,while the Firmicutes and Bacteroidetes are higher in the the external cold and internal heat syndrome?P<0.001?.The dominant genus is mainly the Sphingomonas,Alloprevotella,Bacteroides.LEFSE?LDA>4?:The wind-heat syndrome is mainly the genus of streptococcus,Veillonella,Neisseria,Prevotella₇,and Roseburia;and the wind-chill syndrome is mainly the genus of Sphingomonas,while the external cold and internal heat syndrome was the genus of Bacteroides and Alloprevotella.From the Shannon Index,the syndrome of the external cold and internal heat syndrome is the largest one,and the Wind-heat syndrom second,Wind-cold syndrom smallest.The PCoA confirms that there are significant differences between the syndromes.The difference of COG and KEGG is mainly manifested in the contrast between wind-chill syndrome/wind-heat syndrome and the the external cold and internal heat syndrome of TCM.3.In the study of seasonal influenza?H3N2?patients,it was found that the genus Streptococcus and Neisseria were higher in the throat of female patients?p=0.046978?.4.With the lapse of time?D1-D3?,the abundance of Sphingomonas?D1:26.43%,D2:22.87%,D3:43.6%?increased.OTUs analysis found that D3 group was less P3 OB-42 than D1 and D2,while D1 was missing Chloroflexales in comparison with D2 and D3 group.LEFSE?LDA>4?:The specific Flora in D2 group was Lachnospiraceae?abundance 4.95%?and Gammaproteobacteria?abundance 4.72%?.In the D3 group,the specific microbiome was Alphaproteobacteria,Sphingomonadaceae,Sphingomonadaceae,Sphingomonas?abundance 5.64%?.In the Alpha index,the Shannon index of D3 Group was lower than that of D1 and D2 Group,with the Simpson index contemporarily was greater than that of D1 and D2?P<0.05?.5.To study the age group of seasonal influenza?H3N2?,we found that there were 4 specific OTUs among middle-aged and young patients compared with the elderly by OTU analysis,and the species flora was Chloroflexales,Bergeyella,Lentimicrobiaceae,and Leptotrichia.Conclusion:1.The Micro-ecology structure and diversity in the upper respiratory tract is significantly differences between Healthy and seasonal influenza?H3N2?people.2.There are significant differences between different TCM syndromes of influenza A virus subtype H3N2.3.The onset days,Gender and age of the patients has some influence on the the Oropharyngeal microorganism of Seasonal Influenza?H3N2?.