| Objective1. To learn clinical characteristics of influenza H1N1 in children.To evaluate theefficacy and safety of Traditional Chinese Medicine -GanMaoXiaoYan tablets treating children with influenza H1N1 infection.To find a new treatment for children with influenza H1N1 infection.2. To analyze the genome sequence variations and genetic characteristics ofH1N1 virus strains in Yunan and to provide the basis data for prevention and control of influenza outbreaks.Method:Influenza H1N1 suspected cases were enrolled from October to November in 2009 in Kunming Hospital, which was a completely random distribution of subjects to treatment group and control groups. Treatment group was treated with Gan Mao Xiao Yan tablets; control group was treated with Yin Qiao Detoxification tablets. The detail information of the clinical characters was collected via the structured questionnaire. Nasal swabs were collected and H1N1 was detected by Real-time RT-PCR before and after treatment. The positive samples of H1N1 virus HA gene fragments were amplified. PCR products were sequenced, analyzed and compared with influenza H1N1 virus epidemic strains in GenBank. Phylogenetic tree was constructed according to HA gene fragment to analyze their genetic characteristics and gene sequence variations. SPSS11.5 statistical software was used for statistical analysis.Result1. 77 cases were laboratory-confirmed as H1N1 among 146 suspected cases. The positive rate was 53%. All diagnosed cases are Han people, including 40 female cases and 37 male cases. The average age of the two groups was 7.12 years and 6.17 years respectively. There is no significant difference between the two groups.2. All the patients had fever (100%), 68 patients had cough (88%). There were 61 cases who could express their feelings accurately by themselves including 53 cases with sore throat (87%), 49 cases with headache (80%), 33 cases with fatigue (54%), 25 cases with muscle soreness (42%), 9 cases with abdominal pain (15%), 15 cases with diarrhea (19%) , 1 case with chest pain. Among 77 cases, there were 59 cases treated by antibiotics before they went to hospital, accounting for 76%. The result of Routine Blood showed that 14 cases blood leukocyte count increased, accounting for 19%, the highest up to 24.3×10~9/L. The proportion of Lymphocytes of 12 cases increased, accounting for 16%. There were 3 cases W BC count less than 4.0×10~9/L, accounting for 8%.3. Treatment group and control group fever subsided time (h) were 13.09±7.02, and 22.13±15.55, respectively, sore throat relief time(h) were 20.36±7.91 and 27.20±12.30, respectively. cough relief time (h) were 51.20±13.81 and 53.25±16.50, respectively. T test of treatment effects showed that fever subsided time and sore throat relif time were significantly different between the two groups (P <0.05). There was no significant difference of cough relief time between the two groups ( P> 0.05).4. Paired T test was used to analyze the quantitative PCR results of H1N1 before and after treatment of the two groups. The result showed that viral respiratory secretions were significantly different between the two groups before and after the treatment (P <0.05).5. X~2 test was used to anlyze the negative rate of two groups before and after treatment: X~2 = 4.023, P = 0.043 <0.05. It showed there was significant difference in negative rate of respiratory virus secretions between the two drugs.6.Gene sequence analysis showed that two separate strains of influenza A H1N1 virus are the same source, HA segment of the amino acid sequence are highly homologous ( 99.2%), a small cluster closely linked to the formation of the evolutionary tree, which showed a single origin. The rest of the country's epidemic strains and strains of influenza A H1N1 virus standard A/CALIFORNIA/04/2009 (H1N1) were highly homologous. Campared with the representative strains of seasonal influenza A/BRISBANE/59/2007 (H1N1) (GENBANK number CY0302320), homology was low (85.1%). It was also close proximity of epidemic strains in the genetic evolution in the United States and Mexico.Conclusion1. The most common clinical symptoms of influenza A H1N1 virus infected in childreare were fever, cough and sore throat. Blood cells changes are not meaningful to guide diagnosis. Abusing antibiotics in the treatment of respiratory infection is still serious in China.2. Gan Mao XiaoYan tablets is safe and efficient to treat children influenza A H1N1 virus infection. It can quickly alleviate the symptoms, such as fever, sore throat. There are no obvious side effects.3. Gan Mao XiaoYan tablets can quickly reduce influenza A virus respiratorysecretions, speed up the virus negative ratea, and promote heal rate in children.4. The two influenza A H1N1 virus strains construct high homology of phylogenetic trees. It is low variability. The strains comapared with mainland China strains and abroad standard strains is consistent, which further is confirmed that the strain in mainland of China is imported.
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