In the respiratory department, I often encounter some patients with long-term cough, the course of disease lasts for more than 3 weeks, the chest X-ray examination is usually normal, and the diagnosis is not clear when I see a doctor everywhere, or the diagnosis is "bronchitis, chronic pharyngitis" ", but the treatment effect is not good, the patient is very distressed.

　　 Many studies at home and abroad show that there are many causes of the above chronic cough, but the common causes (about 95% or more) are: retronasal drip syndrome, asthma, gastroesophageal reflux disease, Chronic bronchitis, bronchiectasis, eosinophilic bronchitis, or taking angiotensin converting enzyme inhibitors; the remaining about 5% may be caused by tumors, such as bronchial lung cancer. Post-nasal drip syndrome, asthma, and gastroesophageal reflux disease are the most common clinically.

　　Post-nasal drip syndrome, caused by rhinitis and sinusitis, the patient will have excessive secretions from the back of the nasal cavity, causing itchy throat, often need to clear the throat, cough is oropharyngeal The main secretion is to treat nasal symptoms. Asthma typically presents with symptoms such as wheezing, shortness of breath, cough, chest tightness, etc., but a small number of patients may only present as a simple cough (also known as cough variant asthma), mostly at night cough, which affects the patient''s sleep, often misdiagnosed as bronchitis, given Antibiotics and other treatments have no effect. The diagnosis can be confirmed by bronchial provocation test. According to asthma treatment, it can have an immediate effect. Gastroesophageal reflux disease can cause cough due to esophageal mucosa stimulated by gastric juice or inhalation of gastric juice into the trachea, especially when the patient is lying down and resting. Patients often have heartburn, belching, acid reflux and other symptoms of gastroesophageal diseases , But there are many patients who are not accompanied by such symptoms. Therefore, this disease still needs to be highly valued by doctors, combined with diagnostic treatment to diagnose, treatment methods include weight loss, avoid drinking coffee, avoid sleeping within 4 hours after a meal, quit smoking, sleep with high pillows, use gastric acid suppression drugs and gastric motility drugs Wait for treatment. The diagnosis of chronic bronchitis and bronchiectasis is not too difficult, but the diagnosis of eosinophilic bronchitis is often negligent by patients and doctors, the clinical manifestation is cough, and the bronchial provocation test is negative, and the diagnosis depends on sputum eosinophilic examination. Patients with long-term cough who have a history of taking angiotensin-converting enzyme inhibitors such as captopril, etc. due to hypertension must consider cough caused by such drugs, and treatment only needs to stop the drug.

　　In addition, patients with chronic cough, who are not effective after the above targeted treatment, or are over 40 years old, heavy smoking, especially male patients, should pay attention to exclude bronchopulmonary neoplastic diseases; and young female patients should also pay attention Excluding tracheal and bronchial endometrial tuberculosis, bronchoscopy and lung CT can be performed if necessary, or regular follow-up.

　　In view of the complexity of the diagnosis and treatment of chronic cough, patients are advised not to take emergency treatment or misuse various anti-inflammatory and cough medicines before the diagnosis is clear, and it is best to see a specialist in respiratory medicine.