Chronic cough is defined as a person with cough as the only or main symptom that persists for more than 8 weeks without any significant abnormality on chest radiograph. The 2009 guidelines for cough in China state that the most common causes of chronic cough include upper airway cough syndrome (UACS), cough allergic asthma (CVA), eosinophilic bronchitis (EB), and gastroesophageal reflux cough (GERC), which account for 70%-95% of the causes of chronic cough in respiratory medicine outpatient clinics. These four causes account for 70-95% of the causes of chronic cough in respiratory medicine clinics. Previous guidelines advocate cause-oriented therapy, which requires identifying the cause of chronic cough and then providing targeted treatment. However, it is clearly not practical to perform comprehensive ancillary tests for all causes of chronic cough, especially in primary care, as these include paranasal sinus radiographs, bronchodilatation or provocation tests, induced sputum cytometry, 24-h pH monitoring of the esophagus, and chest CT. The advantage of etiology-oriented treatment is that it can rapidly identify the cause (except for a few) and reduce the blindness of diagnosis and treatment, but as mentioned above, it is difficult to do so in primary hospitals or large hospitals that are not equipped for it, and patients need to pay higher medical costs, etc. Even if the test results are positive, it only establishes a suspicious diagnosis, and there is no way to judge whether the subsequent targeted treatment is necessarily effective. Because of the disadvantages (and of course the advantages) of etiologically oriented treatment, empirical treatment is extremely valuable, and in recent years many scholars have begun to focus on empirical treatment of chronic cough. By empirical treatment, we mean that in the absence of an etiologic diagnostic basis, appropriate therapeutic measures are given according to the condition and the possible etiology, and the diagnosis is established or excluded by the therapeutic response in order to control cough symptoms and treat the disease as soon as possible. It is important to note that empirical treatment is somewhat blind compared to etiologically oriented treatment and is not a first-line treatment. However, in primary care or when the patient refuses to be tested relative to the test, empirical treatment becomes important. Clinical cue-oriented strategy: In primary care hospitals, there are no relatively high level tests such as sputum induction, pulmonary function and esophageal 24h pH monitoring, but chest radiographs are usually available, and according to the definition of chronic cough, primary care hospitals can make a clinical diagnosis of chronic cough. For example, patients with UACS (formerly called “postnasal drip syndrome”) may have postnasal drip flu and repeated throat clearing, patients with GERC may have acid reflux, heartburn, and retrosternal pain, and patients with CVA usually have an irritating dry cough. Nocturnal cough is an important idiosyncrasy, which can be exacerbated or triggered by cold, cold air, dust, and oil smoke. Clinicians can make preliminary judgments based on these clues and then provide targeted treatment, such as antihistamines for UACS, bronchodilators or glucocorticoids for CVA, and gastrointestinal prokinetics or acid suppressants for GERC, in adequate doses and courses, otherwise misdiagnosis may occur due to human problems. For example, postnasal drip is not unique to UACS, and many UACS patients do not have postnasal drip or repeated throat clearing, and some studies even point out that 75% of GERCs have cough as the only symptom, not reflux or burning sensation as we would expect. Common etiology-oriented strategies: As mentioned above, the most common causes of chronic cough in our country include CVA, UACS, EB, GERC, in addition to allergic cough, chronic bronchitis, bronchiectasis, tracheobronchial tuberculosis, AECI-induced cough, and others. Because previous epidemiological and statistical data have shown that these are the most common causes, it is logical to think of these common causes first when dealing with chronic cough, rather than considering rare causes (e.g., bronchial foreign bodies) at the outset. The order of empirical etiological treatment is determined after taking into account the frequency of etiological distribution, the specificity of the treatment, the time of onset of action and the duration of treatment. A three-step approach to empirical treatment has been proposed by national professors: because UACS and CVA alone and together can account for 65-87% of chronic cough, the first step in treatment is to take oral antihistamines and bronchodilators simultaneously for 1 week, and to continue maintenance for those who are effective. If this does not work, the second step is to administer 25 mg of oral prednisone for 1 week in the second week and switch to inhalation for those who are in remission, mainly for CVA where EB and bronchodilators are not effective. Studies have shown that approximately 2/3 of patients can effectively relieve their cough without moving on to the subsequent steps 2 and 3. Of course, empirical treatment can be combined with some of the ancillary tests to compensate for each other, such as provocation tests to rule out or diagnose CVA in hospitals that perform pulmonary function. However, its advantages are also evident, and clinicians should choose the best strategy for chronic cough diagnosis and treatment on a case-by-case basis.