After catching a cold, coughing and coughing can last for a month. Many people think it's just a "cold that hasn't fully recovered" and can easily overcome it by taking some cough medicine. Don't be a 'minor flaw' and force yourself to handle it! Dr. Ma Yanliang from the Department of Respiratory and Critical Care Medicine and Dr. Feng Cuiling from the Department of Traditional Chinese Medicine at Peking University People's Hospital remind everyone that coughing for more than 8 weeks is chronic cough, which may hide hidden dangers such as asthma, gastric reflux, and upper airway diseases. Prolonged coughing can damage the lungs and even cause respiratory problems. Today, two experts will comprehensively analyze chronic cough from a medical perspective, teaching you how to quickly identify and scientifically respond to it, and avoid the misconception of coughing. Why is chronic cough divided by 8 weeks? The public's understanding of chronic cough is generally delayed, and many people only seek medical attention when their cough affects their daily life, missing the best opportunity for intervention. In medicine, coughing is classified into three categories based on its duration. Acute cough: lasting less than 3 weeks, mostly a cold or acute bronchitis. Subacute cough: lasting for 3 to 8 weeks, commonly coughing after a cold. Chronic cough: If the duration is ≥ 8 weeks, it must be included in the diagnosis and treatment of chronic cough and requires medical attention and professional examination to confirm the diagnosis. Why is 8 weeks a key milestone? Because at this point, the infection has mostly subsided, and persistent coughing often points to problems such as airway hyperresponsiveness, allergies, or gastric reflux, which cannot be solved by "carrying". Many patients feel that their cough is not severe and can be easily carried away, but long-term chronic coughing can lead to damage to the airway mucosa and exacerbate airway hyperresponsiveness; Affects lung function, leading to a decrease in lung capacity; Causing complications such as pneumothorax, mediastinal emphysema (severe coughing leading to alveolar rupture), anxiety and depression (long-term sleep disruption), etc. Don't get stuck in these four situations. Seek medical attention quickly. Many people think that "coughing is the body's detoxification and phlegm excretion, and there is no need to treat it". Experts remind that acute cough and phlegm discharge are good things, but chronic cough is an "abnormal inflammation of the airway". The more you cough, the more sensitive it becomes, which can form a vicious cycle. If there are four types of coughing, even if it has not been 8 weeks, it is necessary to seek medical attention in a timely manner to avoid delaying the condition. Dangerous symptoms include coughing accompanied by hemoptysis (blood streaks or fresh blood in sputum), chest pain, difficulty breathing, low-grade fever, rapid weight loss, etc. Be alert to serious diseases such as tuberculosis, lung cancer, bronchiectasis with infection, and emergency screening is necessary. Special cough mainly occurs at night or early morning, aggravated by exposure to cold air, pollen, and oil fumes, or accompanied by wheezing, chest tightness, acid reflux, heartburn, nasal congestion, and recurrent runny nose. It may be cough variant asthma, gastric reflux, etc. Patients with underlying diseases such as asthma, chronic obstructive pulmonary disease (COPD), heart disease, and stomach disease need to be prevented from worsening their condition when coughing. Self medication with cough suppressants and antibiotics for more than a week is ineffective, and the cough symptoms do not improve or even worsen. When it comes to chronic cough, many people associate it with "bronchitis" and "asthma", but in reality, its causes are complex and involve multiple fields such as respiratory, digestive, and otolaryngology. There is a saying in traditional Chinese medicine that "all five organs and six viscera make people cough, not just the lungs", which coincides with modern medicine's understanding of the multiple causes of chronic cough. The following are the most common types of clinical triggers, many of which are related to colds: Upper airway cough syndrome. It is the "number one killer" of cough after a cold, and more than 80% of coughs after a cold for more than one month may be caused by upper airway cough syndrome. Rhinitis and pharyngitis caused by a cold are difficult to clear, and nasal secretions flow back into the throat (dripping behind the nose), which can continuously stimulate the airway and cause coughing. The typical manifestations of upper airway cough syndrome are coughing accompanied by nasal congestion and runny nose, with phlegm sticking to the throat, and severe coughing when waking up or turning over in the morning. After catching a cold, if the airway mucosa is not repaired, it is easy to worsen when exposed to cold air and dust, and then develop into chronic cough. Cough variant asthma is a type of "hidden asthma" that only coughs without wheezing, accounting for 20% to 30% of the causes of chronic cough. These patients have normal chest X-rays and blood routine tests, and relying solely on coughing to 'report' can easily be mistaken for bronchitis. Its pathogenesis is the same as that of ordinary asthma, both of which are spasmodic coughs caused by airway hyperresponsiveness. They often occur at night, in the early morning, or after exposure to allergens such as pollen, dust mites, and cold air. When the cough is severe, it may be accompanied by chest tightness, but there is no obvious wheezing sound. Experts remind people with allergies and a family history of asthma to be particularly vigilant after catching a cold. Gastroesophageal reflux cough is a cough caused by "eating out". Many people do not expect that 10% to 20% of coughs are related to the stomach. In traditional Chinese medicine, it is said that "if the stomach is not in harmony, one will feel restless when lying down", and if the stomach qi is reversed, it will affect lung function. After catching a cold, the intestines and stomach are weak. If one overeats or eats spicy food, it is easy for stomach acid to reflux to the throat, stimulating the airway and causing coughing. Among them, middle-aged and elderly people as well as obese individuals are more susceptible to being targeted. Experts remind us to be careful when these signals appear: cough accompanied by acid reflux and heartburn, which becomes more severe after eating and lying flat. Some people only cough without acid reflux. Chronic bronchitis is a "health killer" for middle-aged and elderly people. Patients with chronic bronchitis are often accompanied by expectoration (white foam sputum or yellow purulent sputum), most of which starts in the morning and coughs heavily after activities. Cold is the "trigger" of chronic bronchitis, and repeated colds can worsen airway damage. Experts suggest that old smokers and those who have been exposed to dust for a long time should pay attention. Coughing for more than 3 months every year for 2 consecutive years is a typical symptom, and it is necessary to promptly check for chronic bronchitis. Patients with shortness of breath symptoms are recommended to undergo lung function tests to detect chronic obstructive pulmonary disease early. In addition to the common causes mentioned above, medication, environment, and psychology may all become the "root cause". Antihypertensive drugs (such as Captopril), oil fumes, dust, anxiety, and tension can all trigger coughing. In addition, after catching a cold, the airway becomes sensitive and there may be "post infection cough", which some people may experience as chronic cough. These symptoms indicate that coughing is "dragging on". Coughing after a cold is common, but not all can "heal" on their own. Pay attention to the following danger signals, indicating that coughing may have developed from a minor problem to a major issue that requires immediate medical attention: coughing has become "severe" from occasional coughing to continuous coughing day and night. The cough in the early stages of a cold is often paroxysmal, accompanied by symptoms such as runny nose and sore throat. As the cold improves, the cough will gradually alleviate. If the cough changes from "occasional" to "persistent and severe", even affecting sleep and eating, or presenting with "irritating dry cough" or "spasmodic cough", it suggests that there may be chronic inflammation or spasms in the airway, such as cough variant asthma or airway hyperresponsiveness. The appearance of a 'red signal', whether with blood streaks or fresh blood in sputum, accompanied by chest pain (aggravated by deep breathing) and wheezing, is the most dangerous situation, which may be a sign of tuberculosis, lung cancer, or pulmonary embolism, and must be urgently investigated. If there is something wrong with the whole body, persistent low-grade fever (37.3 ℃~38 ℃), more than 5% weight loss in one month, night sweats and fatigue, be alert to wasting diseases such as tuberculosis and tumors. Traditional Chinese medicine believes that "prolonged coughing can harm qi". Long term coughing can lead to qi deficiency, but if accompanied by "hot flashes, night sweats, and restlessness of the five hearts", it may be a manifestation of "lung yin deficiency", and it is necessary to first combine Western medicine examination to rule out organic diseases. The "precise examination" checklist for chronic cough: regardless of whether the cough is accompanied by other symptoms, as long as it lasts for more than 8 weeks, it is necessary to seek medical attention at the respiratory department and determine the cause through professional examination. The examination of chronic cough emphasizes a gradual approach, first ruling out fatal problems, and then finding the specific cause. Basic chest X-ray and blood routine examination are necessary to rule out serious illness and check for pneumonia, tuberculosis, and tumors. If necessary, further CT should be performed; the type of infection should be determined through blood routine examination to check for allergies or parasitic infections. Key examination: Pulmonary function test. Pulmonary function examination is the "gold standard" for screening cough variant asthma and chronic obstructive pulmonary disease. Allergy related tests and allergen testing are essential for individuals with allergies! Including skin prick test and serum specific IgE detection. Targeted examinations such as nasal endoscopy and sinus CT are used to diagnose upper airway cough syndrome, while gastroscopy and 24-hour esophageal pH monitoring are used to diagnose gastroesophageal problems. In special circumstances such as a family history of lung cancer, long-term smoking with hemoptysis, or rapid weight loss, chest enhanced CT, tumor markers, and bronchoscopy biopsy may be necessary. For patients suspected of psychogenic cough, psychological assessment should be combined to exclude psychological factors such as anxiety and depression. Coughing needs to be treated by "cutting off the root" and recuperating. Chronic cough requires targeted treatment, and stopping cough alone is not effective. It should be noted that blind use of cough suppressants, especially central potent cough suppressants such as codeine, is strictly prohibited for chronic cough, as it may mask the condition. Targeted medication should be selected according to different causes and following medical advice. Meanwhile, daily maintenance is crucial in reducing recurrence, especially during the high incidence seasons of spring and autumn, and comprehensive protection measures should be taken. Traditional Chinese medicine emphasizes the treatment of chronic cough based on syndrome differentiation and combined with physical fitness for recuperation. The following are suitable methods for home operation that can assist Western medicine treatment and reduce recurrence. Choose the appropriate "cough suppressant meal" for dietary therapy based on one's physical condition. Cough due to cold weather (chilly, runny nose, white phlegm): Congee with ginger and red dates, 3 pieces of ginger, 5 red dates, 50g of rice. Add ginger when cooking Congee, and eat it while it is hot to warm the lungs, dispel cold and stop coughing. Dry hot cough (fever, yellow mucus, yellow phlegm): Sichuan fritillary stews pears, and one snow pear is cored without peeling. Add 3 grams of Sichuan fritillary powder, stew for 30 minutes across water, eat pears and drink soup, which can clear heat, moisten the lungs, and stop coughing. Cough due to lung yin deficiency (dry cough with little sputum, dry mouth and dry throat, aggravated at night): lily Snow fungus soup, 30g lily, 15g tremella, 10 lotus seeds, boiled with water and a little rock sugar, can nourish yin and moisten lung. Lung stomach disharmony cough (cough accompanied by acid regurgitation and heartburn): yam millet porridge, 30g yam and 50g millet, cooked with Congee, can strengthen the spleen and stomach and reduce reflux. Acupoint massage can regulate the lung's descending function and relieve cough by massaging acupoints such as Lieque, Chize, Kongzhi, Feiyu, and Danzhong. 5 minutes a day to nourish the lungs and relieve cough. Abdominal breathing exercises can enhance diaphragm function and improve lung ventilation. Practice for 10-15 minutes each time, twice a day. The method is as follows: lie flat on the bed or in a sitting position, place hands on the abdomen, and relax the whole body; Slowly inhale through the nose, causing the abdomen to bulge, and inhale for 3-5 seconds; Exhale slowly with the mouth, causing the abdomen to sink in. Exhale for 5-7 seconds, with the lips whistling to increase exhalation resistance. Avoid staying up late. Traditional Chinese medicine believes that "the lungs control the qi, regulate the breathing, and open the orifices in the nose". Nighttime is the time for lung repair. Patients with chronic cough should try to ensure 7 to 8 hours of sleep every night. In addition, staying up late can lower immunity and worsen airway inflammation. Not eating again one hour before bedtime can also reduce the risk of gastroesophageal reflux. There are some misconceptions about chronic cough among the public, which often lead to delayed treatment or poor results. It is important to avoid them! Misconception 1: Using antibiotics for coughing is wrong! Antibiotics only kill bacteria, and 90% of chronic coughs are not caused by bacterial infections. Improper use of medication can lead to drug resistance and damage to the intestines. Only when coughing up yellow pus sputum, fever, and blood routine indicates bacterial infection, should it be used under the guidance of a doctor. Misconception 2: The stronger the cough suppressant, the better. It may not necessarily be able to relieve cough quickly! Strong cough suppressants such as codeine and dexmedetomidine work by inhibiting the cough center. Although they can quickly stop coughing, they can mask the condition and make it difficult to determine the cause in a timely manner; Using this type of medication when there is phlegm can cause the phlegm to be unable to be discharged, block the airway, and worsen the infection. It is recommended to first investigate the cause before treatment, and not pursue "quick results".