慢性咳嗽诊断流程及临床检查方法OA

Chronic cough is a common complaint in specialty outpatient clinics.Its definition of duration varies across populations:≥8 weeks in adults and≥4 weeks in children.Chronic cough has a high prevalence worldwide,accounting for more than one third of patients in respiratory outpatient clinics in China,and has become an important public health issue.The etiology of chronic cough is complex and diverse,involving multiple anatomical regions including the trachea,lungs,esophagus,stomach,nose,and throat.The causes include upper airway cough syndrome,cough-variant asthma,eosinophilic bronchitis,allergic cough,gastroesophageal reflux-related cough,and other refractory coughs.However,in clinical practice,unclear diagnostic workflows and inappropriate selection of examination methods often lead to misdiagnosis and missed diagnosis.This review aims to systematically summarize the diagnostic workflow and clinical examination methods for chronic cough and to propose optimized diagnostic strategies.The main aspects discussed include etiological composition,a stepwise diagnostic algorithm,and the indications and limitations of imaging examinations,routine blood tests,pulmonary function tests,induced sputum cytology and fractional exhaled nitric oxide measurement.The review concludes that optimizing the diagnostic workflow and selecting relevant examinations appropriately can improve the etiological diagnosis rate of chronic cough,reduce patient burden,and enhance quality of life.Future efforts should further promote the application of novel biomarkers and primary-care appropriate techniques in the etiological identification and individualized treatment of chronic cough,promoting precision medicine.