咳嗽是初级医疗机构中最常见的首发症状之一。[1]Hermer L, Kang K, Rui P, et al. National ambulatory medical care survey - community health centers: 2014 state and national summary tables. 2019 [internet publication].
https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2014_namcs_chc_web_tables-508.pdf
成人亚急性咳嗽定义为咳嗽持续 3-8 周，慢性咳嗽定义为咳嗽超过 8 周。[2]Irwin RS, French CL, Chang AB, et al. Classification of cough as a symptom in adults and management algorithms: CHEST guideline and expert panel report. Chest. 2018 Jan;153(1):196-209.
http://journal.chestnet.org/article/S0012-3692(17)32918-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29080708?tool=bestpractice.com
[3]Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020 Jan;55(1):1901136.
https://erj.ersjournals.com/content/55/1/1901136.long
http://www.ncbi.nlm.nih.gov/pubmed/31515408?tool=bestpractice.com
儿童慢性咳嗽定义为每天咳嗽，持续 4 周或更长时间。[4]Chang AB, Oppenheimer JJ, Irwin RS, et al. Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2020 Jul;158(1):303-329.
https://www.doi.org/10.1016/j.chest.2020.01.042
http://www.ncbi.nlm.nih.gov/pubmed/32179109?tool=bestpractice.com
亚急性咳嗽常为自限性，而慢性咳嗽的评估和治疗仍是一大难题。困难在于确定咳嗽原因，因为一些“病因”属于综合征，缺乏准确诊断性检测。通常会依据典型的病史特征、排除其他可疑病因和相应的治疗反应（即诊断性治疗）来确定咳嗽病因。然而，仔细回顾病史、进行检查、精心挑选治疗试验和/或诊断性评估可在超过 90% 的咳嗽病例中取得满意疗效。
但是，对于≤14 岁的儿童，慢性咳嗽的常见病因可能不同于成人；应考虑到儿童的年龄、咳嗽特征、临床病史和地理环境。[4]Chang AB, Oppenheimer JJ, Irwin RS, et al. Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2020 Jul;158(1):303-329.
https://www.doi.org/10.1016/j.chest.2020.01.042
http://www.ncbi.nlm.nih.gov/pubmed/32179109?tool=bestpractice.com
有关儿童诊断流程和治疗试验的详细建议可能也不同于成人。[4]Chang AB, Oppenheimer JJ, Irwin RS, et al. Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report. Chest. 2020 Jul;158(1):303-329.
https://www.doi.org/10.1016/j.chest.2020.01.042
http://www.ncbi.nlm.nih.gov/pubmed/32179109?tool=bestpractice.com
非靶向的镇咳药物常不能有效治疗慢性咳嗽。
