When autumn and winter change, the coughing sounds around you are endless. Coughs that last for more than 8 weeks and have no obvious evidence of lung disease in chest X-rays are called "chronic cough". Many patients have been misdiagnosed as "chronic bronchitis" for a long time, and the use of antibacterial drugs is ineffective in the treatment, or have repeated various examinations due to unclear diagnosis, which not only increases the patient's pain, but also increases the economic burden.
Not only doctors, but patients themselves should also pay attention to it to increase their awareness of cough. Doctors and patients work together to improve the discomfort caused by the disease.
There are many causes of chronic cough, mainly as follows:
Cough variant asthma is a special type of asthma. Patients do not have obvious symptoms or signs such as wheezing and shortness of breath. It is mainly manifested as irritating dry cough, and night cough is an important feature. Anti-asthma treatment is effective.
Upper airway cough syndrome is mainly caused by nasal diseases to reflux secretions behind the nose and throat, which directly or indirectly stimulates cough receptors, leading to cough. The patient feels that the nasal drip flows back and mucus adhesion of the back wall of the pharynx.
Gastroesophageal reflux cough, contrary to upper airway cough syndrome, is a clinical manifestation that is prominent due to gastric acid and other gastric contents reflux into the esophagus. 40%-68% of patients with gastroesophageal reflux cough may be accompanied by typical reflux symptoms such as acid reflux, heartburn, and belching. Anti-reflux treatment is effective.
Eosinophil bronchitis is a type of bronchitis characterized by airway eosinophil infiltration. Induced sputum examination can confirm the diagnosis and glucocorticoid treatment is effective.
Allergic cough originates from a history of allergic diseases or a history of contact with allergic substances, and glucocorticoids and antihistamine drugs are effective in the treatment of glucocorticoids and antihistamines.
Exploring the cause is the basis for diagnosis and treatment of diseases. Relevant examinations are required to recognize and clarify it, so as to develop the treatment of causes. In addition to medical history and physical examinations, auxiliary examinations are also extremely important. However, certain specialized examination methods, such as inducible sputum cytology, bronchial excitation tests, and multi-channel esophageal impedance pH monitoring examinations, are only carried out in units specializing in chronic cough research. If the "culprit" of the disease can be found after a complete examination, the underlying cause can be treated, thereby eliminating or relieving cough. When objective conditions are limited, empirical treatment can also be used as an alternative measure, but if empirical treatment is not effective, the cause or referral should be determined in time.
Although chronic cough is not as fatal as a tumor, it seriously affects the quality of daily life. When a long-term cough fails to heal, seek medical treatment in time to clarify the cause and treat the cause to prevent the condition from worsening.
Xu Xianghuai (Section of Respiratory and Critical Care Medicine, Tongji Hospital Affiliated to Tongji University)
