Epidemiological survey on the diagnosis and treatment status of cough patients in Tianjin

doi:10.11958/20252735

Abstract

Abstract:

Objective To investigate the prevalence of cough patients in the Tianjin region and to evaluate the etiological composition and current status of diagnosis and treatment for acute, subacute and chronic cough. Methods This observational study employed a cross-sectional design with short-term follow-up. Using stratified cluster sampling, patients were recruited from the respiratory outpatient departments of nine tertiary hospitals in Tianjin between November 1, 2022, and October 31, 2023. Eligible participants included those with cough as the sole or primary symptom, no severe comorbidities, and residence in Tianjin for at least one year. A unified epidemiological questionnaire was administered, covering general information, cough characteristics, diagnostic details and empirical treatment plans. Follow-up was conducted one month (±7 days) after treatment to assess therapeutic outcomes. Results A total of 2 247 patients were enrolled, including 998 males and 1 249 females, with a mean age of (46.05 ± 15.44) years. Among them, 1 051 cases (46.77%) were classified as chronic cough, 589 (26.21%) as subacute cough and 607 (27.01%) as acute cough. The main causes of chronic cough were corticosteroid-responsive cough (CRC, 58.61%), upper airway cough syndrome (UACS, 32.83%) and gastroesophageal reflux-related cough (GERC, 5.33%), collectively accounting for 96.77%. Acute cough was primarily attributed to acute tracheobronchitis (46.46%) and the common cold (43.99%), together representing 90.45%. The predominant cause of subacute cough was post-infectious cough (PIC, 66.72%). Symptomatic antitussive therapy was the mainly used for acute and subacute cough. For chronic cough, CRC patients primarily received corticosteroid therapy (inhaled or oral), while non-CRC patients received etiology-targeted treatment. Follow-up one-month after treatment, there were no significant differences in the overall treatment effectiveness rate between the three groups (98.66% vs. 98.58% vs. 98.46%, P>0.05). Conclusion This study preliminarily reveals the epidemiological characteristics and etiological distribution of cough patients in the Tianjin region. The findings validate the feasibility of empirical treatment in cough management and provide a reference for optimizing local diagnostic and therapeutic strategies.

Key words: cough, epidemiology, etiology, treatment outcome, Tianjin

CLC Number:

R563，R181.32

Figures/Tables 4

References 20

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组别	n	性别（男/女）	年龄/岁	吸烟史	基础疾病史
急性咳嗽组	607	270/337	45.01±15.11	140（23.1）	376（61.9）
亚急性咳嗽组	589	286/303	45.66±15.59	177（30.1）^a	313（53.1）^a
慢性咳嗽组	1 051	442/609^b	46.87±15.51^a	424（40.3）^ab	567（53.9）^a
F或χ²		6.465^＊	3.040^＊	55.065^＊	12.437^＊

组别	n	性别（男/女）	年龄/岁	吸烟史	基础疾病史
急性咳嗽组	607	270/337	45.01±15.11	140（23.1）	376（61.9）
亚急性咳嗽组	589	286/303	45.66±15.59	177（30.1）^a	313（53.1）^a
慢性咳嗽组	1 051	442/609^b	46.87±15.51^a	424（40.3）^ab	567（53.9）^a
F或χ²		6.465^＊	3.040^＊	55.065^＊	12.437^＊

组别		n		单药治疗
组别		n		止咳药		抗生素		ICS/LABA		白三烯受体拮抗剂		抗组胺药			口服糖皮质激素		PPI
急性咳嗽组		607		448（73.81）		18（2.97）		8（1.32）		-		21（3.46）			4（0.66）		3（0.49）
亚急性咳嗽组		589		426（72.33）		-		-		-		-			5（0.85）		3（0.51）
慢性咳嗽组
CRC		616		-		-		12（1.95）		-		-			-		-
非CRC		435		41（9.43）		-		-		32（7.36）		6（1.38）			-		53（12.18）
组别	联合用药
组别	止咳药+ 抗生素		止咳药+ 抗组胺药		止咳药+白三烯受体拮抗剂		止咳药+ICS/LABA		止咳药+ PPI		ICS/LABA+白三烯受体拮抗剂		白三烯受体拮抗剂+ 抗组胺药	ICS/LABA+ 口服糖皮质激素		ICS/LABA+ 白三烯+ 抗组胺药		ICS/LABA+ 止咳药+ 抗组胺药
急性咳嗽组	37（6.10）		33（5.44）		-		35（5.77）		-		-		-	-		-		-
亚急性咳嗽组	21（3.57）		29（4.92）		14（2.38）		52（8.83）		5（0.85）		29（4.92）		-	5（0.85）		-		-
慢性咳嗽组
CRC	-		-		-		268（43.51）		-		287（46.59）		-	4（0.65）		21（3.41）		24（3.90）
非CRC	34（7.82）		38（8.74）		199（45.75）		-		3（0.69）		-		29（6.67）	-		-		-

组别		n		单药治疗
组别		n		止咳药		抗生素		ICS/LABA		白三烯受体拮抗剂		抗组胺药			口服糖皮质激素		PPI
急性咳嗽组		607		448（73.81）		18（2.97）		8（1.32）		-		21（3.46）			4（0.66）		3（0.49）
亚急性咳嗽组		589		426（72.33）		-		-		-		-			5（0.85）		3（0.51）
慢性咳嗽组
CRC		616		-		-		12（1.95）		-		-			-		-
非CRC		435		41（9.43）		-		-		32（7.36）		6（1.38）			-		53（12.18）
组别	联合用药
组别	止咳药+ 抗生素		止咳药+ 抗组胺药		止咳药+白三烯受体拮抗剂		止咳药+ICS/LABA		止咳药+ PPI		ICS/LABA+白三烯受体拮抗剂		白三烯受体拮抗剂+ 抗组胺药	ICS/LABA+ 口服糖皮质激素		ICS/LABA+ 白三烯+ 抗组胺药		ICS/LABA+ 止咳药+ 抗组胺药
急性咳嗽组	37（6.10）		33（5.44）		-		35（5.77）		-		-		-	-		-		-
亚急性咳嗽组	21（3.57）		29（4.92）		14（2.38）		52（8.83）		5（0.85）		29（4.92）		-	5（0.85）		-		-
慢性咳嗽组
CRC	-		-		-		268（43.51）		-		287（46.59）		-	4（0.65）		21（3.41）		24（3.90）
非CRC	34（7.82）		38（8.74）		199（45.75）		-		3（0.69）		-		29（6.67）	-		-		-

组别	n	随访 [例（%）]	疗效
组别	n	随访 [例（%）]	明显缓解 [例（%）]	部分缓解 [例（%）]	无效 [例（%）]	有效率/%
急性咳嗽组	607	596（98.2）	470（78.9）	118（19.8）	8（1.3）	98.66
亚急性咳嗽组	589	563（95.6）	467（83.0）	88（15.6）	8（1.4）	98.58
慢性咳嗽组	1 051	1 037（98.7）	823（79.4）	198（19.1）	16（1.5）	98.46
χ²						0.113