The Study Of The Correlation Between Branching Pathogens And TCM Symptom Types Based On MNGS Detection

ObjectiveThrough retrospective analysis,this study aims to explore the correlation between pathogens in the acute exacerbation of moderate and severe bronchiectasis and TCM symptom type and its clinical significance,use SPSS22.0 software for statistics,summarize the correlation between supporting pathogens and TCM symptom type based on mNGS detection and analysis,provide objective indicators for TCM TCM guidance treatment and expansion,and better play the advantages of TCM.MethodsA retrospective analysis of 90 patients diagnosed with moderate or severe acute exacerbation of bronchiectasis BE(hereinafter referred to as "bronchiectasis")in the inpatient and outpatient departments of the Department of Pulmonary Diseases,Foshan Hospital of Traditional Chinese Medicine from December 2020 to December 2021 was conducted to collect Basic information(including name,gender,and age),tongue,pulse,sputum culture,alveolar lavage fluid macro-genomics next-generation sequencing(mNGS)test results,high resolution CT(HRCT),T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+).The data were statistically analyzed using SPSS22.0 software.Results1.All 150 specimens were sent for sputum culture,and 66 sputum culture positive specimens yielded 75 strains of pathogens,with Gram negative bacteria(46.67%)>fungi(34.67%)>Gram positive bacteria(9.33%);148 mNGS positive samples were collected from alveolar lavage fluid,and a total of 386 strains of pathogens were cultured.Among them,Gram negative bacteria(38.70%)>Gram positive cocci(28.57%)>fungi(11.66%)>viruses(6.23%);2.During the acute exacerbation of bronchiectasis,the main pathogens are bacterial and fungal infections.Among the bacteria,77 strains(51.33%)were Gram negative,47 strains(31.33%)were Gram positive,and 22 strains(14.67%)were fungi.Among Gram negative bacteria,34 strains(22.67%)of Pseudomonas aeruginosa accounted for the largest proportion,while among Gram positive bacteria,14 strains(9.33%)of Staphylococcus aureus accounted for the largest proportion;Fungal infections are mainly caused by 11 strains of Candida albicans(7.33%),often accompanied by bacterial infections;3.There was no significant difference in the gender distribution of patients with traditional Chinese medicine syndrome types among each group.There is a significant difference in the age distribution of patients with traditional Chinese medicine syndrome types among each group.Compared with other groups of syndrome types,the age of patients with liver fire invading the lung syndrome group is relatively younger,while there is no significant difference in the age of other groups of syndrome types.There is a significant difference in the composition ratio of the number of years of disease course in each group of patients.Compared with other syndrome types,the lung spleen deficiency syndrome group has a longer disease course,while there is no significant difference in the number of years of disease course in other syndrome types compared in pairs.There was no significant difference in the distribution of imaging manifestations among different groups of patients with traditional Chinese medicine syndrome types.4.There was no significant difference in the CD3+cell count,CD4+cell count,and CD4+/CD8+pairwise comparison between the groups.There was a significant difference in the CD8+cell count between the phlegm dampness obstructing lung syndrome group and the yin deficiency fire excess syndrome group,while there was no significant difference between the other groups.5.In this study,there was no difference in the distribution of common pathogens of bronchiectasis,such as Pseudomonas aeruginosa,Haemophilus influenzae,Staphylococcus aureus,Klebsiella pneumoniae,Streptococcus pneumoniae,Candida albicans,and traditional Chinese medicine syndrome types among each group.ConclusionThe pathogens in the acute exacerbation stage of branch expansion were most infected with Pseudomonas aeruginosa,and the traditional Chinese medicine type was more common with sputum wet lung evidence,followed by sputum heat lung evidence,and the imaging was mainly cystic branch expansion,suggesting the importance of phlegm and dampness pathological factors in the pathogenesis of branch expansion.Fungi have become the main pathogenic bacteria in the acute exacerbation of branches,and most of them are combined with bacterial infection,and patients with Candida albicans infection are more likely to have evidence of lung and spleen deficiency,and clinically patients with low immunity should be vigilant about fungal infection.