A survey on distribution of cough symptom in outpatients from respirologist in Guangzhou_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

XU Rong , ZHAN Chen , LIU Jiaxing , LUO Wei , CHEN Qiaoli , LAI Kefang ,  CHEN Ruchong

Guangzhou Institute of Respiratory Disease, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P. R. China;

Corresponding author：

CHEN Ruchong, Email: chen_rch@163.com

Keywords：

Distribution of cough symptom; Outpatient clinic; Gender difference

DOI：

10.7507/1671-6205.201704021

Video：

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ObjectiveTo explore the spectrum and frequency of respiratory symptoms in outpatients clinics.MethodsPatients were enrolled from outpatient clinic of Guangzhou Institute of Respiratory Disease. Information about respiratory symptoms especially cough was obtained from the survey questionnaire from July 2013 to August 2013 .ResultsA total of 900 were eligible out of 939 questionnaires. The mean age of the patients was (48.9±18.3) years, 453 (50.3%) were males, 447 (49.7%) were females. The cases of cough, wheeze, polypnea, chest distress, pharyngalgia, catarrh, chest pain, throat itching, fever, hemoptysis and other symptom was 687 (76.3%), 310 (34.4%), 307 (34.1%), 173 (19.2%), 107 (11.9%), 101 (11.2%), 82 (9.1%), 59 (6.6%), 36 (4.0%), 10 (1.1%) and 129 (14.3%) out of the patients, respectively. In patients with cough, 69.5% of them considered cough as their predominant symptom, and 22.1% of them reported that cough was the only symptom. 56.3% of cases were chronic cough, while acute and subacute cough accounted for 29.7% and 14.0%, separately. The proportion of female in acute cough was significantly higher than that of males (60.3%vs. 39.7%, P<0.01).ConclusionsCough, especially the chronic cough is the most common reason for patients who seeking health care in outpatient clinic of respirologist. There are more females suffered from acute cough than males.

Citation： XU Rong, ZHAN Chen, LIU Jiaxing, LUO Wei, CHEN Qiaoli, LAI Kefang, CHEN Ruchong. A survey on distribution of cough symptom in outpatients from respirologist in Guangzhou. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(5): 495-499. doi: 10.7507/1671-6205.201704021 Copy

1.	马洪明, 朱礼星, 赖克方, 等. 不明原因慢性咳嗽的诊断探讨. 中华结核和呼吸杂志.2003, 26(11): 675-678.0.
2.	张莉, 黄东明, 邱少珍, 等. 广东省中山地区 2～12 岁儿童慢性咳嗽流行病学调查. 广东医学, 2012, 33(6): 848-850.0.
3.	陈如冲, 赖克方, 钟南山, 等. 广州地区 1087 名大学生咳嗽的流行病学调查. 中华流行病学杂志, 2006, 27(2): 123-126.0.
4.	赖克方, 李斌恺, 钟南山, 等. 慢性咳嗽患者的诊疗现状调查. 国际呼吸杂志, 2011, 31(9): 645-647.0.
5.	Schappert SM. National Ambulatory Medical Care Survey: 1991 summary. Vital Health Stat 13, 1994(116): 1-110.
6.	中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断和治疗指南 (2015). 中华结核和呼吸杂志, 2015. 39(5): 323-340.0.
7.	McGarvey LP, Heaney LG, MacMahon J. A retrospective survey of diagnosis and management of patients presenting with chronic cough to a general chest clinic. Int J Clin Pract, 1998. 52(3): 158-161.
8.	Hong Q, Bai CX, Wang XD. Characteristics of Chinese patients with cough in primary care centre. J Transl Med, 2011. 9: 149.
9.	赖克方. 不明原因慢性咳嗽病因的诊断思路. 中国呼吸与危重监护杂志, 2008, 08(6): 401-402.0.
10.	Kohno S, Ishida T, Uchida Y, et al. The Japanese Respiratory Society guidelines for management of cough. Respirology, 2006. 11 Suppl 4: S135-186.
11.	Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest, 2006. 129(1 Suppl): 1S-23S.
12.	Morice AH, Fontana GA, Belvisi SS, et al. ERS guidelines on the assessment of cough. Eur Respir J, 2007. 29(6): 1256-1276.
13.	Shields MD, Bush A, Everard ML, et al. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax, 2008. 63 Suppl 3: iii1-iii15.
14.	中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断与治疗指南 (草案). 中华结核和呼吸杂志, 2005. 28(11): 738-744.0.
15.	中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断与治疗指南 (2009 版). 中华结核和呼吸杂志, 2009. 32(6): 407-413.0.
16.	龙怀聪 , 张敏慧, 于露, 等. 成都地区慢性咳嗽病因及治疗探讨. 中国呼吸与危重监护杂志, 2012, 11(5): 475-479.0.
17.	曹国强, 程晓明, 戴晓天, 等. 重庆地区慢性咳嗽病因的多中心研究. 中国呼吸与危重监护杂志, 2009, 09(6): 565-568.0.
18.	陈如冲, 刘春丽, 罗炜, 等. 慢性咳嗽常见病因之间咳嗽敏感性的差异. 中国呼吸与危重监护杂志, 2013, 12(4): 384-389.0.
19.	何权瀛. 对于慢性咳嗽诊断治疗的几点考虑. 中国呼吸与危重监护杂志, 2008, 08(1): 1-2.0.
20.	Poe RH, Harder RV, Israel RH, et al. Chronic persistent cough. Experience in diagnosis and outcome using an anatomic diagnostic protocol. Chest. 1989; 95(4): 723-728.
21.	Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis. 1990; 141(3): 640-647.
22.	Mello CJ, Irwin RS, Curley FJ. Predictive values of the character, timing, and complications of chronic cough in diagnosing its cause. Arch Intern Med. 1996; 156(9): 997-1003.
23.	McGarvey LP, Heaney LG, Lawson JT, et al. Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol. Thorax. 1998 Sep; 53(9): 738-743.
24.	Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir J. 2005; 25(2): 235-243.
25.	Morice AH, Jakes AD; Faruqi S. et al. A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response. Eur Respir J, 2014. 44(5): 1149-1155.
26.	Dicpinigaitis PV, Rauf K. The influence of gender on cough reflex sensitivity. Chest, 1998. 113(5): 1319-1321.
27.	Fujimura M, Sakamoto S, Kamio Y, et al.Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects. Thorax, 1990. 45(8): 633-634.
28.	Yeo WW, Chadwick IG, Kraskiewicz M, et al., Resolution of ACE inhibitor cough: changes in subjective cough and responses to inhaled capsaicin, intradermal bradykinin and substance-P. Br J Clin Pharmacol, 1995. 40(5): 423-429.
29.	Mukae S, Aoki S, Itoh S, et al. Bradykinin B(2) receptor gene polymorphism is associated with angiotensin-converting enzyme inhibitor-related cough. Hypertension, 2000. 36(1): 127-131.
30.	杨存珍, 陈如冲, 李斌恺, 等. 女性慢性咳嗽患者生活质量及尿失禁调查. 国际呼吸杂志, 2010, 30(7): 391-394.0.
31.	杨忠民, 邱忠民, 吕寒静, 等. 慢性咳嗽病因的前瞻性研究. 同济大学学报 (医学版), 2005, 26(1): 62-64.0.
32.	赖克方, 陈如冲, 刘春丽等. 不明原因慢性咳嗽的病因分布及诊断程序的建立. 中华结核和呼吸杂志, 2006, 29(2): 96-99.0.
33.	王志虹, 林江涛, 李勇, 等. 慢性咳嗽的病因诊断及治疗效果. 中国医学科学院学报, 2007, 29(5): 665-668.0.
34.	Lai K, Chen R, Lin J, et al. A prospective, multicenter survey on causes of chronic cough in China. Chest, 2013. 143(3): 613-620.
35.	Pan G, Zhang S, Feng Y, et al. Air pollution and children's respiratory symptoms in six cities of Northern China. Respir Med, 2010. 104(12): 1903-1911.
36.	Ji H, Biagini Myers JM, Brandt EB, et al. Air pollution, epigenetics, and asthma. Allergy Asthma Clin Immunol, 2016. 12: 51.
37.	Gan WQ, FitzGerald JM, Carlsten C, et al. Associations of ambient air pollution with chronic obstructive pulmonary disease hospitalization and mortality. Am J Respir Crit Care Med, 2013. 187(7): 721-727.

1. 马洪明, 朱礼星, 赖克方, 等. 不明原因慢性咳嗽的诊断探讨. 中华结核和呼吸杂志.2003, 26(11): 675-678.0.
2. 张莉, 黄东明, 邱少珍, 等. 广东省中山地区 2～12 岁儿童慢性咳嗽流行病学调查. 广东医学, 2012, 33(6): 848-850.0.
3. 陈如冲, 赖克方, 钟南山, 等. 广州地区 1087 名大学生咳嗽的流行病学调查. 中华流行病学杂志, 2006, 27(2): 123-126.0.
4. 赖克方, 李斌恺, 钟南山, 等. 慢性咳嗽患者的诊疗现状调查. 国际呼吸杂志, 2011, 31(9): 645-647.0.
5. Schappert SM. National Ambulatory Medical Care Survey: 1991 summary. Vital Health Stat 13, 1994(116): 1-110.
6. 中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断和治疗指南 (2015). 中华结核和呼吸杂志, 2015. 39(5): 323-340.0.
7. McGarvey LP, Heaney LG, MacMahon J. A retrospective survey of diagnosis and management of patients presenting with chronic cough to a general chest clinic. Int J Clin Pract, 1998. 52(3): 158-161.
8. Hong Q, Bai CX, Wang XD. Characteristics of Chinese patients with cough in primary care centre. J Transl Med, 2011. 9: 149.
9. 赖克方. 不明原因慢性咳嗽病因的诊断思路. 中国呼吸与危重监护杂志, 2008, 08(6): 401-402.0.
10. Kohno S, Ishida T, Uchida Y, et al. The Japanese Respiratory Society guidelines for management of cough. Respirology, 2006. 11 Suppl 4: S135-186.
11. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest, 2006. 129(1 Suppl): 1S-23S.
12. Morice AH, Fontana GA, Belvisi SS, et al. ERS guidelines on the assessment of cough. Eur Respir J, 2007. 29(6): 1256-1276.
13. Shields MD, Bush A, Everard ML, et al. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax, 2008. 63 Suppl 3: iii1-iii15.
14. 中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断与治疗指南 (草案). 中华结核和呼吸杂志, 2005. 28(11): 738-744.0.
15. 中华医学会呼吸病学分会哮喘学组, 咳嗽的诊断与治疗指南 (2009 版). 中华结核和呼吸杂志, 2009. 32(6): 407-413.0.
16. 龙怀聪 , 张敏慧, 于露, 等. 成都地区慢性咳嗽病因及治疗探讨. 中国呼吸与危重监护杂志, 2012, 11(5): 475-479.0.
17. 曹国强, 程晓明, 戴晓天, 等. 重庆地区慢性咳嗽病因的多中心研究. 中国呼吸与危重监护杂志, 2009, 09(6): 565-568.0.
18. 陈如冲, 刘春丽, 罗炜, 等. 慢性咳嗽常见病因之间咳嗽敏感性的差异. 中国呼吸与危重监护杂志, 2013, 12(4): 384-389.0.
19. 何权瀛. 对于慢性咳嗽诊断治疗的几点考虑. 中国呼吸与危重监护杂志, 2008, 08(1): 1-2.0.
20. Poe RH, Harder RV, Israel RH, et al. Chronic persistent cough. Experience in diagnosis and outcome using an anatomic diagnostic protocol. Chest. 1989; 95(4): 723-728.
21. Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis. 1990; 141(3): 640-647.
22. Mello CJ, Irwin RS, Curley FJ. Predictive values of the character, timing, and complications of chronic cough in diagnosing its cause. Arch Intern Med. 1996; 156(9): 997-1003.
23. McGarvey LP, Heaney LG, Lawson JT, et al. Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol. Thorax. 1998 Sep; 53(9): 738-743.
24. Kastelik JA, Aziz I, Ojoo JC, et al. Investigation and management of chronic cough using a probability-based algorithm. Eur Respir J. 2005; 25(2): 235-243.
25. Morice AH, Jakes AD; Faruqi S. et al. A worldwide survey of chronic cough: a manifestation of enhanced somatosensory response. Eur Respir J, 2014. 44(5): 1149-1155.
26. Dicpinigaitis PV, Rauf K. The influence of gender on cough reflex sensitivity. Chest, 1998. 113(5): 1319-1321.
27. Fujimura M, Sakamoto S, Kamio Y, et al.Sex difference in the inhaled tartaric acid cough threshold in non-atopic healthy subjects. Thorax, 1990. 45(8): 633-634.
28. Yeo WW, Chadwick IG, Kraskiewicz M, et al., Resolution of ACE inhibitor cough: changes in subjective cough and responses to inhaled capsaicin, intradermal bradykinin and substance-P. Br J Clin Pharmacol, 1995. 40(5): 423-429.
29. Mukae S, Aoki S, Itoh S, et al. Bradykinin B(2) receptor gene polymorphism is associated with angiotensin-converting enzyme inhibitor-related cough. Hypertension, 2000. 36(1): 127-131.
30. 杨存珍, 陈如冲, 李斌恺, 等. 女性慢性咳嗽患者生活质量及尿失禁调查. 国际呼吸杂志, 2010, 30(7): 391-394.0.
31. 杨忠民, 邱忠民, 吕寒静, 等. 慢性咳嗽病因的前瞻性研究. 同济大学学报 (医学版), 2005, 26(1): 62-64.0.
32. 赖克方, 陈如冲, 刘春丽等. 不明原因慢性咳嗽的病因分布及诊断程序的建立. 中华结核和呼吸杂志, 2006, 29(2): 96-99.0.
33. 王志虹, 林江涛, 李勇, 等. 慢性咳嗽的病因诊断及治疗效果. 中国医学科学院学报, 2007, 29(5): 665-668.0.
34. Lai K, Chen R, Lin J, et al. A prospective, multicenter survey on causes of chronic cough in China. Chest, 2013. 143(3): 613-620.
35. Pan G, Zhang S, Feng Y, et al. Air pollution and children's respiratory symptoms in six cities of Northern China. Respir Med, 2010. 104(12): 1903-1911.
36. Ji H, Biagini Myers JM, Brandt EB, et al. Air pollution, epigenetics, and asthma. Allergy Asthma Clin Immunol, 2016. 12: 51.
37. Gan WQ, FitzGerald JM, Carlsten C, et al. Associations of ambient air pollution with chronic obstructive pulmonary disease hospitalization and mortality. Am J Respir Crit Care Med, 2013. 187(7): 721-727.

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