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.	馬洪明, 朱禮星, 賴克方, 等. 不明原因慢性咳嗽的診斷探討. 中華結核和呼吸雜志.2003, 26(11): 675-678.0.
2.	張莉, 黃東明, 邱少珍, 等. 廣東省中山地區 2～12 歲兒童慢性咳嗽流行病學調查. 廣東醫學, 2012, 33(6): 848-850.0.
3.	陳如沖, 賴克方, 鐘南山, 等. 廣州地區 1087 名大學生咳嗽的流行病學調查. 中華流行病學雜志, 2006, 27(2): 123-126.0.
4.	賴克方, 李斌愷, 鐘南山, 等. 慢性咳嗽患者的診療現狀調查. 國際呼吸雜志, 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.	中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷和治療指南 (2015). 中華結核和呼吸雜志, 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.	賴克方. 不明原因慢性咳嗽病因的診斷思路. 中國呼吸與危重監護雜志, 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.	中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷與治療指南 (草案). 中華結核和呼吸雜志, 2005. 28(11): 738-744.0.
15.	中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷與治療指南 (2009 版). 中華結核和呼吸雜志, 2009. 32(6): 407-413.0.
16.	龍懷聰 , 張敏慧, 于露, 等. 成都地區慢性咳嗽病因及治療探討. 中國呼吸與危重監護雜志, 2012, 11(5): 475-479.0.
17.	曹國強, 程曉明, 戴曉天, 等. 重慶地區慢性咳嗽病因的多中心研究. 中國呼吸與危重監護雜志, 2009, 09(6): 565-568.0.
18.	陳如沖, 劉春麗, 羅煒, 等. 慢性咳嗽常見病因之間咳嗽敏感性的差異. 中國呼吸與危重監護雜志, 2013, 12(4): 384-389.0.
19.	何權瀛. 對于慢性咳嗽診斷治療的幾點考慮. 中國呼吸與危重監護雜志, 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.	楊存珍, 陳如沖, 李斌愷, 等. 女性慢性咳嗽患者生活質量及尿失禁調查. 國際呼吸雜志, 2010, 30(7): 391-394.0.
31.	楊忠民, 邱忠民, 呂寒靜, 等. 慢性咳嗽病因的前瞻性研究. 同濟大學學報 (醫學版), 2005, 26(1): 62-64.0.
32.	賴克方, 陳如沖, 劉春麗等. 不明原因慢性咳嗽的病因分布及診斷程序的建立. 中華結核和呼吸雜志, 2006, 29(2): 96-99.0.
33.	王志虹, 林江濤, 李勇, 等. 慢性咳嗽的病因診斷及治療效果. 中國醫學科學院學報, 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. 馬洪明, 朱禮星, 賴克方, 等. 不明原因慢性咳嗽的診斷探討. 中華結核和呼吸雜志.2003, 26(11): 675-678.0.
2. 張莉, 黃東明, 邱少珍, 等. 廣東省中山地區 2～12 歲兒童慢性咳嗽流行病學調查. 廣東醫學, 2012, 33(6): 848-850.0.
3. 陳如沖, 賴克方, 鐘南山, 等. 廣州地區 1087 名大學生咳嗽的流行病學調查. 中華流行病學雜志, 2006, 27(2): 123-126.0.
4. 賴克方, 李斌愷, 鐘南山, 等. 慢性咳嗽患者的診療現狀調查. 國際呼吸雜志, 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. 中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷和治療指南 (2015). 中華結核和呼吸雜志, 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. 賴克方. 不明原因慢性咳嗽病因的診斷思路. 中國呼吸與危重監護雜志, 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. 中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷與治療指南 (草案). 中華結核和呼吸雜志, 2005. 28(11): 738-744.0.
15. 中華醫學會呼吸病學分會哮喘學組, 咳嗽的診斷與治療指南 (2009 版). 中華結核和呼吸雜志, 2009. 32(6): 407-413.0.
16. 龍懷聰 , 張敏慧, 于露, 等. 成都地區慢性咳嗽病因及治療探討. 中國呼吸與危重監護雜志, 2012, 11(5): 475-479.0.
17. 曹國強, 程曉明, 戴曉天, 等. 重慶地區慢性咳嗽病因的多中心研究. 中國呼吸與危重監護雜志, 2009, 09(6): 565-568.0.
18. 陳如沖, 劉春麗, 羅煒, 等. 慢性咳嗽常見病因之間咳嗽敏感性的差異. 中國呼吸與危重監護雜志, 2013, 12(4): 384-389.0.
19. 何權瀛. 對于慢性咳嗽診斷治療的幾點考慮. 中國呼吸與危重監護雜志, 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. 楊存珍, 陳如沖, 李斌愷, 等. 女性慢性咳嗽患者生活質量及尿失禁調查. 國際呼吸雜志, 2010, 30(7): 391-394.0.
31. 楊忠民, 邱忠民, 呂寒靜, 等. 慢性咳嗽病因的前瞻性研究. 同濟大學學報 (醫學版), 2005, 26(1): 62-64.0.
32. 賴克方, 陳如沖, 劉春麗等. 不明原因慢性咳嗽的病因分布及診斷程序的建立. 中華結核和呼吸雜志, 2006, 29(2): 96-99.0.
33. 王志虹, 林江濤, 李勇, 等. 慢性咳嗽的病因診斷及治療效果. 中國醫學科學院學報, 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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