The onset of pediatric asthma can be acute or slow, with recurrent episodes of wheezing, shortness of breath, chest tightness, or coughing mostly associated with exposure to allergens, cold air, physical or chemical stimuli, viral infections, and exercise. In older children, the onset of the disease is more rapid, often with sudden onset and cessation, and in younger children, there is often a 1-2 day prodrome of upper respiratory tract infection before the onset of the disease. The child may have a pronounced cough, wheezing and croup, especially at night and in the early morning, with accelerated breathing. The child is often irritable, suffocating and dyspnea, especially expiratory difficulty, and often cannot lie down. The croupy sound from breathing is often described by parents as “throat sound like a saw”. In severe cases, there may be pale face, nasal agitation, blue finger (toe) nails of the mouth and lips, and cold sweat all over the body. The onset of the attack is only a dry cough, and the attack can gradually subside when thick sputum is coughed up. There is usually no fever. During an asthma attack, a diffuse or diffuse expiratory-phase croup can be heard on auscultation of both lungs, and a high-pitched croup can be heard when the parent places the ear against the child’s chest wall or back. In children with chronic recurrent attacks, they are thin and have a pale complexion, which may lead to impaired growth and development. Patients with cough variant asthma have atypical clinical symptoms and are often not diagnosed in time because they only exhibit a long-term chronic cough. The clinical features are 1. persistent cough for 1 month, often with attacks at night and/or early in the morning, aggravated by exercise, cold air or smell of a particular odor, low sputum, no signs of infection, or ineffective treatment with antibiotics 2. treatment with bronchodilators (e.g., Bolicamni, albuterol, aminophylline, etc.) can lead to cough relief 3. personal or family history of allergy, positive allergen test 4. exclusion of other causes of chronic cough. Xing Xianghui, Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine