Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2013 Oct;88(10):1115-26. doi: 10.1016/j.mayocp.2013.08.007.
Cough persisting beyond 8 weeks (ie, chronic cough) is one of the most common reasons for an outpatient visit. A protracted cough can negatively affect one's quality of life by causing anxiety, physical discomfort, social isolation, and personal embarrassment. Herein, the anatomy and physiology of the cough reflex are reviewed. Upper airway cough syndrome, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease account for most chronic cough after excluding smoking, angiotensin-converting enzyme inhibitor use, and chronic bronchitis. Many patients have more than one reason for chronic cough. Treating the underlying cause(s) resolves cough in most instances. There are some coughs that seem refractory despite an extensive work-up. The possibility of a hypersensitive cough reflex response has been proposed to explain these cases. Several clinical algorithms to evaluate chronic cough are presented.
持续超过 8 周的咳嗽（即慢性咳嗽）是门诊就诊最常见的原因之一。持久的咳嗽会通过引起焦虑、身体不适、社交孤立和个人尴尬而对生活质量产生负面影响。在此，回顾了咳嗽反射的解剖和生理学。在上气道咳嗽综合征、哮喘、嗜酸性支气管炎和胃食管反流病中，大多数慢性咳嗽在排除吸烟、血管紧张素转换酶抑制剂使用和慢性支气管炎后都是如此。许多患者有不止一个导致慢性咳嗽的原因。在大多数情况下，治疗潜在病因可以解决咳嗽问题。有些咳嗽尽管经过广泛的检查，但似乎仍然无法治愈。有人提出，高敏性咳嗽反射反应的可能性可以解释这些情况。本文提出了几种评估慢性咳嗽的临床算法。
