A persistent cough is tiresome, and the cougher gets a lot of looks from people around him. Indeed, coughing air currents of up to 60 km/h, mixed with aerosol gels and odors, are not a comfortable thing to spray in front of anyone. Therefore, it is important to cover your nose and mouth with a hand towel as much as possible to minimize the pollution of your surroundings. Compared to the external manifestations of a cough, it is the hidden causes behind the cough that are more damaging. There are acute coughs and chronic coughs, what is a chronic cough? In general, chronic cough is usually defined clinically as “cough as the only or main symptom for more than 8 weeks, with no significant abnormalities on X-ray chest examination”. Due to the lack of typical symptoms, many patients are misdiagnosed and mistreated for a long time. The most common misdiagnosis is “bronchitis or chronic bronchitis”, and repeated use of various antibiotics and cough expectorants has no effect. Due to the long-term diagnosis, some patients repeatedly undergo various tests such as chest X-ray, CT and even fibrinoscopy, which not only causes a waste of medical resources, but also brings great distress to the patients’ working life and psychology. Some patients have had a cough for decades and have not been treated or properly diagnosed, will he develop into some more serious disease? Because coughing itself is a protective reflex, for example, if a foreign body falls into the trachea or if there is inflammation, it causes a protective cough, and as we know, coughing also helps to get the phlegm out of the respiratory tract. However, if you cough for a long time and always irritate the respiratory tract, the normal defenses of the respiratory tract will deteriorate and cause infections, pneumonia and other diseases. In addition, if a patient with poor heart and lung function coughs for a long time, it will add to the burden on the heart and lungs. If you have a long-term cough and the effect of your own medication is not good, you should go to a major hospital and seek medical attention in a timely manner. So what are the general causes of chronic cough? There are many different causes of chronic cough. I. Cough variant asthma: The main manifestation of the cough is when you visit the doctor. Many patients’ complaints are that their dry cough is more severe and more obvious at night or early in the morning, especially in the spring and autumn, when they smell pollen or smell a special smell, or when the climate is cold. II. Upper airway cough syndrome (postnasal drip syndrome): In terms of incidence, the most common cause of chronic cough is postnasal drip syndrome. The main symptom, besides coughing, is a feeling of something flowing into the throat, a feeling of mucous attachment in the pharynx, the need to clear the throat, throat itching, or nasal itching, nasal congestion, runny nose, sneezing, and sometimes hoarseness. Third, gastroesophageal reflux: A more common cause of chronic cough is gastroesophageal reflux. It is mainly a disease caused by a decrease in the function of the lower esophageal sphincter that leads to reflux of the contents of the gastroesophagus. Under normal conditions, there is a sphincter at the lower end of the esophagus that prevents gastroesophageal reflux. If the function of the lower esophageal sphincter decreases, the contents of the stomach will easily reflux up, especially in a lying position. Some patients have symptoms such as burning sensation behind the sternum, belching, and acid reflux. Allergy-related cough: e.g., eosinophilic bronchitis, allergic cough. V. Cough caused by other reasons: For example, drugs cause chronic cough by taking ACE-I drugs. ACE-I drugs are a common antihypertensive drug, and these drugs include Mono, Lodinexin, Kepone, Enalapril and Yashida, etc. It has a side effect of causing an irritating cough, mainly dry. If there was no long-term chronic cough before, and after taking this type of antihypertensive drugs, the patient develops a chronic cough, and at the same time exclude the cough caused by other diseases, we can consider that his cough may be caused by the side effects of the drug, and the cough can be slowly relieved after stopping the use of this type of drugs. In addition, chronic pharyngitis is another cause of chronic cough. Some people who need to speak frequently, such as teachers, are prone to chronic pharyngitis, laryngitis, and laryngitis, and may also have a chronic cough. Patients with chronic pharyngitis may have a small amount of phlegm when they cough, and patients who smoke may have more phlegm. So how can a patient with a chronic cough know exactly what is causing it? If you have a chronic cough that is not well treated with ordinary anti-inflammatory drugs, it is time to go to the doctor and have a chest X-ray and other necessary tests (such as lung function) to see if there is a lung infection or other disease causing the cough. Generally, if you have had a cough for more than three weeks, you should have a chest X-ray to rule out tuberculosis. An experienced respiratory specialist will usually do the necessary tests to come up with a definitive diagnosis or an empirical clinical diagnosis based on some other signs associated with the patient’s chronic cough. How to treat chronic cough once it has been diagnosed? Once the cause of the chronic cough is clarified, we need to treat the cause. Many patients with chronic cough take a lot of phlegm-suppressing and cough-suppressing drugs without a clear cause, but they are not very good. The only scientific approach to cough is to clarify the cause and treat it according to the cause. Can you give some guidance to some patients who buy cough and phlegm medicines or cough syrup on their own? Patients with a cough who really feel they have a respiratory infection or throat discomfort are considered to have an acute cough and can buy some simple cough and phlegm medicines on their own. However, if you have not improved after a week of taking medication on your own, it is time to go to a regular hospital to have a look at the cause. Because it may not be a respiratory tract infection, it may be due to other causes, such as cough variant asthma, postnasal drip, gastroesophageal reflux, etc. This requires a visit to a regular hospital for targeted treatment so that the cough can be relieved and cured. Some cough syrups contain codeine, which is a relatively strong central cough suppressant. We do not recommend here to buy and use codeine-containing cough suppressants at your own discretion, and it is better to use them under the guidance of a doctor. Why? It is also a mildly addictive drug and must be used with caution. Therefore, it is best to buy cough medicine under the guidance of a doctor. The treatment of cough in Chinese medicine focuses on “promoting the purification of lung qi”, that is, clearing the airways, because only when the irritants that cause coughing are eliminated can the cough be truly stopped.