A middle-aged female patient with a dry cough for more than a year and no abnormalities on chest X-ray was diagnosed as “chronic pharyngitis” in several hospitals. She was diagnosed with “chronic pharyngitis” in several hospitals. She was treated with antibacterial drugs repeatedly, but had no obvious effect. She was referred to our Chinese medicine department and asked why she had used so many antimicrobial drugs for her cough with pharyngitis with no effect. Cough is a common symptom of respiratory diseases. On the one hand, it facilitates the removal of respiratory secretions and harmful factors, and on the other hand, frequent and severe coughing affects the patient’s work and life. In clinical practice, cough is the main or only symptom with no obvious abnormalities on X-ray chest radiographs, and it is called chronic cough of unknown origin, which is most likely to be misdiagnosed and mistreated by doctors. The common causes include cough variant asthma, postnasal drip syndrome, eosinophilic bronchitis and gastroesophageal reflux cough. These causes account for 70% to 95% of chronic cough in respiratory medicine outpatient clinics; less common causes include chronic bronchitis, bronchiectasis, endobronchial tuberculosis, allergic cough, and psychogenic cough. For this patient, the author found through a detailed TCM examination of the four diagnoses that although she exhibited symptoms of chronic pharyngitis such as dry cough and pharyngeal discomfort, she had more acid reflux, retrosternal discomfort and a yellowish tongue coating, and was considered to have a gastroesophageal reflux cough. She was then advised to undergo a gastroscopy, which revealed that she did have GERD and was positive for H. pylori. The first step was to kill H. pylori for one week with Western medicine’s “triple therapy”; the second step was to treat her cough with Chinese medicine’s “dredging the liver and stomach, and relieving the cough” method for one month, and the dry cough and digestive symptoms disappeared, and the chronic pharyngitis was cured. Thus, it is important to identify the cause of chronic cough before adopting the correct treatment method in order to achieve better treatment results. At the same time, it is important to remind patients with chronic cough, especially those who do not see any abnormalities in chest imaging, to go to a regular hospital for treatment and not to use antibacterial drugs indiscriminately to avoid delays and unnecessary financial burdens.