Objective Chronic cough is often present as increasing cough reaction to various physical and chemical stimulating factors. This study is aimed to investigate the difference of cough sensitivity and its mechanisms which are not clear among different causes of chronic cough. Methods Patients with chronic cough were recruited from cough clinic of Guangzhou Institute of Respiratory Diseases between 2005 to 2010. Using a modified diagnostic algorithm of chronic cough, common causes were identified. Capsaicin cough provocation test was also performed in these patients to assess the cough threshold. The relations between cough reflex sensitivity and duration of cough, cough severity, pulmonary function, induced sputum cell counts were then investigated. Results Through the diagnostic algorithm of chronic cough, the current study evaluated 133 adult patients, including 24 cases with upper airway cough syndrome (UACS) , 26 patients with cough variant asthma (CVA) , 31 cases with eosinophilic bronchitis (EB) , 30 patients with atopic cough (AC) , 22 cases with gastroesophageal reflux induced cough (GERC) . There were 30 healthy volunteers recruited as normal control. The cough threshold of LgC5 in AC, CVA, EB, GERC and UACS was 1.70 ±0.70, 2.12 ±0.67, 2.13 ±0.69, 1.69 ±0.73, 2.16 ±0.66, respectively. The LgC5 of the normal group ( 2.63 ±0.39) was higher than those in chronic cough groups( All P lt; 0.05) . The LgC5 of AC and GERC were lower than CVA, EB and UACS ( all Plt;0.05) . Duration and daytime score of cough showed positive correlations with LgC5( r =-0. 280, -0. 168, all P lt;0.05) . Pulmonary function and differential cell count of induced sputumwere not associated with LgC5 ( all Pgt;0.05) . Conclusions Different cause of chronic cough exhbit high cough reflex sensitivity to different extent. The difference of cough sensitivity may reflect the different pathogenesis among different causes, and may be related to the type of nerve fiber dominating the cough reflex.
Objective To investigate the etiological diagnosis of chronic cough with pharyngitis-like manifestations. Methods Patients with chronic cough and pharyngitis-like manifestations were recruited from Outpatient Department of Guangzhou Institute of Respiratory Diseases between December 2002 to March 2010. The causes of chronic cough were investigated using a well-established diagnostic protocol, including history taking and physical examination, pulmonary function tests, induced sputum cytology, 24-h esophageal pH monitoring, etc. The final diagnosis depended on clinical manifestations, examination findings, and a successful response to therapy. Results 326 patients with chronic cough and pharyngitislike manifestations were included in the study with amedian duration of 24 ( 2 ～480) months, amean age of 41 ±13 years. The causes of chronic cough were identified as follows: post nasal drip syndrome or upper airway cough syndrome in 73 cases ( 23. 31% ) , cough variant asthma in 61 cases( 18. 71% ) , eosinophilic bronchitis in 70 cases( 22. 47% ) , gastroesophageal reflux-induced cough in 54 cases ( 16. 56% ) , atopiccough in 48 cases ( 14. 72% ) , and others in 40 cases ( 12. 27% ) . There is no significant difference in percentage of common causes of chronic cough ( P gt; 0. 05) . Conclusion The proportions of upper airway syndrome and other common causes are similar in chronic cough with pharyngitis-like manifestatioins, whichsuggest pharyngitis-like manifestations are not specific for diagnosis of upper airway cough syndrome.
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.