Study On The Tongue Coating Microecology Of Yushen Decoction In The Treatment Of Children With Purpuric Nephritis (Qi Deficiency And Blood Stasis Type)

Purpose:To evaluate the clinical significance of tongue coating as biological specimen in children with renal disease by comparing the microecology of tongue coating before and after treatment of children with Henoch-Schonlein purpura nephritis(HSPN).Material and methods:1.Medical records: Clinically,HSPN children who met the inclusion criteria were selected.The diagnosis criteria of Western medicine were based on the Evidence-based Guidelines for the Diagnosis and Treatment of Henoch-Schonlein Schonlein purpura nephritis(2016) formulated by Pediatrics Society of Chinese Medical Association,and the diagnosis criteria of Chinese medicine were based on Pediatrics of Traditional Chinese Medicine(edited by Wang Youchuan).Under the guidance of syndrome differentiation and treatment by the tutor,16 cases of children with TCM syndrome type of "Qi deficiency and blood stasis"(referred to as group S)were enrolled into the treatment group,including 9 males and 7 females,with an average age of(11.75±2.81)years.There was no statistical difference in gender and age of the children.Into the group of children taking decoction after 2 courses of treatment,the kidney will be recovered after treatment group(N)to a group of children,and treatment of children before their relative ratio and symptoms before and after treatment was observed and micro ecology to study the difference of the coating on the tongue,11 cases health children(K),male 6 cases,5 cases were female,average age(10.18±2.75),There was no statistical difference in gender and age of children.2.Collection method of tongue coating: Under the guidance of the tutor,two licensed physicians observe the tongue image in accordance with the standard methods of traditional Chinese medicine,record relevant information of the tongue image,collect images under natural light,and place the collected tongue coating samples in the collection tube according to the five-point sampling method.Three parts of tongue coating were collected from each child and stored in a refrigerator at-80?.3.Tongue lichen flora test method: The collected tongue lichen samples were packed strictly with dry ice and sent to Shanghai Meji Biomedical Technology Co.,Ltd.,and the tongue lichen flora was tested by DNA extraction,PCR amplification and DNA sequencing.4.Analysis Methods: The 16 Sr DNA high-throughput sequencing technology was used to conduct OTU cluster analysis on the fungal flora,Venn diagram,Bar diagram,Heatmap analysis of species composition,Alpha and Beta diversity analysis of species diversity and difference analysis among species.Diversity and difference analysis and comparison were conducted according to the clustering results of different classification levels.Results:1.Western medicine clinical classification and tongue pattern distribution: Western medicine clinical classification: isolated hematuria type 10 cases(62.5%),hematuria proteinuria type 5cases(41.25%),isolated proteinuria type 1 case(6.25%).Tongue distribution: 11 cases had white tongue coating,3 cases had thin white tongue coating and 2 cases had thin yellow tongue coating.Out of the group,there were 12 cases with thin white coating,3 cases with white coating and 1 case with thin yellow coating.2.Analysis of microecological samples of tongue lichen flora: diversity analysis: there was no significant difference in the richness and diversity of flora between group S and group N.There were significant differences in the richness and diversity of flora between group S and group K.Difference analysis: there was significant difference between group S and group N in Veillonella;Rosia cecum was different.Gemella(clonus)was significantly different.There was significant difference between group S and group K in Veillonella.Porphyromonas(Porphyromonas)were different.The bacterium Solobacterium.Proteobacteria(Proteobacteria),Campilobacterota and Patescibacteria(Patella patella)in group S were significantly higher than those in group N,while Actinobacteriota and Cyanobacteria in group N were significantly higher than those in group S.Compared with group K,it was found that the Campilobacterota,unclassified?Bacteria(unnamed bacteria)and Actinobacteriota of group S were significantly higher than those of group K.Conclusion:1.There is a microflora imbalance in the tongue coating microecology of HSPN children with TCM syndrome differentiation of Qi deficiency and blood stasis.2.Veillonella,Rosia cecum and Gemella were the main differences in the microecology of tongue mosses in HSPN children with Qi-deficiency and blood stasis syndrome differentiation before and after treatment.It indicated that Yushen Decoction had positive significance on oral microecology of HSPN children with TCM syndrome differentiation of Qi deficiency and blood stasis type.3.Compared with normal children,there are great differences in the bacterial flora on the tongue of HSPN children with Qi-deficiency and blood-stasis syndrome differentiation,mainly including Veillonella,Porphyromonas,and Solobacterium.