A cough is a kind of important defense mechanism, also is the most familiar breath way symptom in the meantime.The multifarious cough may cause various complications.The United States(1991) have 24,000,000 a cough sufferer go to the Medicine out-patient service cure, not the smoker be chronic to cough an outbreak rate 14~23%, average each sufferer of chronic cough once saw 7.4 doctors, average each sufferer have 8.5 checks.
Clinical up, cough a cause of disease to are of a great variety and involve noodles widely, especially the chest image learn a check have no obviously excrescent of chronic a cough sufferer.This kind of sufferer is most easily neglect by the clinical doctor, a lot of sufferers are in great quantities used for”chronic bronchitis” or”bronchitis” by the misdiagnosis over a long period of time anti-virus the medicine cure invalid, often not pure because of diagnose again and again carry on various check, not only increased a sufferer pain and sufferings, also aggravated a sufferer economy burden.Because of diagnosis not pure, these sufferers are used various antibiotics again and again to cure, or again and again carry on various nonsense check and result in a tremendous medical treatment waste of resources.
Abroad relevant cough of clinical research and related make a diagnosis and give treatment guidebook
Along with people’s concern to a cough, western countries 20 years to a cough reason and its treatment carried on a various research: the Irwin wait 1981 beginning of years first according to a cough glint of the dissection mechanism drew up a set of diagnosis and handle chronic a cough project, clinical up acquire very nice effect, its contents include: history, check-up, chest slice and paranasal sinus slice, lung function…etc. of disease.The Irwin carries on correction to this project in 1990 and increase the 24 h oesophagus pH a value a measurement item.Irwin diagnosis project establishment, developped an important function in the chronic a cough the cause of disease diagnosis of the research, basic explicit the familiar cause of disease of chronic cough
Along with the value making a diagnosis and give treatment to a cough, in recent years the United States, Japan and Europe successively in 1998 and 2001 drew up to cough to relatedly make a diagnosis and give treatment with 2004 guidebook.American chest section doctor’s association successively announced 1998 version and revise a version in 2006 of 《a cough make a diagnosis and give treatment guidebook 》.With other nation 《a cough make a diagnosis and give treatment guidebook 》compare, 《the ACCP a cough make a diagnosis and give treatment guidebook 》, emphasize more to follow a certificate medical science proof, contents abundant, involve noodles widely, to the defense mechanism of a cough, a cough reason, outbreak mechanism, diagnosis method, treatment management, and a cough of the complications all has a very detailed description, very in keeping with breath specialty doctor and researcher use.Revise a version in 2006 and compare in 1998, the new version has the following modification:
1.the point mainly aims at disease diagnosis and treatment that child’s sufferer and adult’s sufferer cough, concerning a cough of the defense mechanism then seldom discusses.
2.the dissimilarity for have a cough part, follow the certificate medical science method description and describe more careful.
3.all chapters all have appropriate enlargement and contents to renew.The new contents of complement include:Not the asthma loves a sour cell bronchitis(NAEP), impatient bronchitis, spirit way disease, after the hair is at the throat department paroxysm inhalation a cough.Cough related occupation and environment factor, tubercle and other infections, the dialysis sufferer’s a cough, the rare reason for cough, not clear and causal cough, this method is especially called to deliver sex a cough, quick cough management project, cough the evaluation of serious degree and curative effect in the clinical research.And the direction of further research.
4.emphasize that experience integral whole turns a cough treatment, the committee recommends the reason of this method BE:greatly parts of cause of diseases(include single factor or compound factor) cause chronic to cough of opposite all the rate has been already know and sensitivity and particularity of greatly part of checks have already know as well.What cause of disease make what treatment, when since the effect, to this of the understanding has been more thorough as well.Through the prospect research and the strategy theories analytical hint with to the experience treatment that the chronic coughs a familiar cause of disease commence, is make a diagnosis and give treatment successful key.
Because a cough usually not single cause of disease cause.Therefore make a whole evaluation in a row is very necessary.A cough of obviously alleviate usually is to cure successful necessity marking, committee recommend of this project for impatient or second impatient a cough also applies.
5.is reduce a cough diagnosis of confusion, carried on complement and modified to the part in common use technical term, if used a cough up the breath way comprehensive advertise for(UACS) act for after the nose the drop leak comprehensive advertise for(PNDS).
The drop leaks after the nose comprehensive advertise for(PNDS) is because the nose, nose swallow and the pathological changes of paranasal sinus, its secretion flow to swallow Houpi and will be disgusted with to even cause a cough thus inside windpipe behind.BE regardless common to catch cold with the result that of impatient a cough, be still a chronic cough, it may be one of the main cause of diseases.After hair after the PNDS of various nasosinusitis being think to be chronic to cough the most familiar cause of disease, but according to cultural heritage and in the physically clinical work, nose drop flow comprehensive advertise for of the diagnosis rate be low, and each hospital difference more big, analysis reason:
1)the drop flows a pathological changes to involve to dissect part after the nose though nose, paranasal sinus, and throat, belong to E.N.T. department, but cough a sufferer many cure at the Medicine and the breath specialty, the expert lacks enough experience and realizes the diagnosis and treatment which carries on this kind of a cough;
2)clinical up, after the nose drop leak comprehensive advertise for mainly is depend on in a sufferer of description, such as the felling have thing drop into the throat, nasal sound obvious, frequent pure larynx action etc..Hint PND of the body advertise for to swallow department or to swallow an existence to glue a liquid or glue the liquid Nong secretion for the nose, sometimes it is thus clear that the part glues the goose egg stone kind of film a change.However, not the elephant a cough variation asthma, ventilate function through a lung or stir up experiment then diagnose, up to now still confirm PND without the way of particularity, can’t the quantity turn after the nose drop to leak, and directly prove it whether is the reason of a cough.PNDS relativity the diagnosis of a cough should combine a clinical characteristic currently, include symptom, physical examination, the image learns a performance, and the reaction of particular treatment but settle.The particular treatment coughs the improvement of symptom to alleviate a solution behind, is confirm PNDS relativity a cough of essential condition.In the PNDS relativity a cough the sufferer, about 20% people can’t be aware of PND existence and it with a cough of relation, about 50% PNDS sufferers have no after the nose drop the symptom for flow, make PNDS as the reason of the chronic cough notter easy is diagnose, and difficult in swallow burning mutually discriminate;
3)different cough sufferer, the rhinitis related symptom is often more than after the nose drop to flow symptom, rhinitis not only pass drop after the secretion, also can pass pneumogastric nerves glint and physical function spirit a way a burning disease but cause a cough.The problem of key BE, up to now can’t make sure that the mechanism of this kind of a cough is a PND direct function, still PND’s cause be wait by body up burning disease and high reaction but incitement a cough of breath way many factor with the result that.Past ACCP a cough the guidebook committee put forward the last breath way a cough comprehensive disease(UACS) this all reads aloud.
Have a cough the merger have under the above-mentioned circumstance, ascend a breath way a cough a comprehensive disease this technical term more PNDS is iner keeping with.As a result, the from now on UACS will replace PNDS.
The ACCP coughs guidebook committee recommendation:For top spirit way abnormality relativity a cough sufferer, the committee think comprehensive advertise for(UACS) up the breath way more accurate, and can act for after the nose the drop flow comprehensive advertise for(PNDS).(Proof degree, the expert suggest;Beneficial, reliability;Recommendation degree, E/A)
Domestic concerning the clinical research of a cough with related make a diagnosis and give treatment guidebook
The our country recent years also opens an exhibition a cough cause of disease to make a diagnosis and give treatment of clinical research, and obtained first step a result.For the sake of further norm our country diagnosis and treatment of the nasty and chronic cough, strengthen to cough of clinical with the foundation study, the China medical science will breathe the credit of disease would the asthma learn a set to organize a related expert, reference domestic, outside relevant a cough of clinical research result, common establishment 《a cough of diagnosis and treatment guidebook (drafted plan)》.
The familiar reason of the chronic cough
Cough a variation type after the asthma(CVA), nose drop to flow comprehensive advertise for(PNDs), love a sour grain a cell bronchitis(EB), stomach oesophagus anti- flow sex a cough(GERC).These the reason had the breath Medicine Medicine out-patient service chronic a cough comparison of 70% ～s be 95%s.
Chronic cough other cause of diseases
Other cause of diseases less see, but involve noodles wide, extend such as the chronic bronchitis, bronchus, film tubercle inside the bronchus, become to cough(AC) in response to sex, mental sex a cough etc..
The history and physical examination of disease
Careful inquire disease of the history has an important function to the cause of disease diagnosis, pass history and physical examination of detailed disease, can contract the diagnosis scope of chronic cough, get the initial diagnosis carry on a treatment or provide now according to the history of disease of the clues choose a relevant check.Notice a cough property, tone color, stanza Lyu and a cough time, and induct or aggravate a factor, body influence, chaperonage symptom etc., understand amount, color, smell and sex form of spit out phlegm the liquid to have important value to the diagnosis.The amount of phlegm is more and cough the Nong phlegm and should consider a breath way an infection disease first.
Hint when check-up smelt and breathed out the period Xiao Ming sound the diagnosis that the bronchus breathe heavily, if smell and inhale a sex Xiao Ming sound, watch out for the center lung cancer or film tubercle inside the bronchus.
The related assistance check
1.induce phlegm cytology a check:Cytology check’s loving sour grain cell to increase Gao is the main index sign that the diagnosis loves sour cell a bronchitis.The method which adopts super voice fog to turn to inhale high Shen brine carries on the inducement of phlegm liquid.
2.the image learn a check:X line chest slice part, scope and appearance that can make sure a lung department a pathological changes, even can make sure its property, get first step diagnosis, guide experience treatment and related room to check.X line chest slice the normal regulations check which be a chronic cough, if discover machine quality the sexually transmitted disease changec and choose a related check according to the pathological changes characteristic.
3.the chest CT check:Contribute to discovering that the Zong separates in front and back the sub-footing stanza, Zong inside the lung department pathological changes, lung to separate swollen greatly lymphoid knot and edge lung wild inside smaller swollen thing.The Gao distinguishes CT to contribute to diagnosis earlier period the quality lung disease and non- typical model bronchus extend.
4.ventilate function and the bronchus comfortable piece to experiment:Can help diagnosis and discriminate a spirit way to jam sex disease, like asthma, chronic bronchitis and atmosphere way tumor etc..Normal regulations lung the function be normal and stir up to experiment masculine gender to contribute to diagnosing CVA.
5.fiber bronchus mirror:Can effectively diagnose the pathological changes in the windpipe chamber, like bronchus lung cancer, foreign body, inside film tubercle etc..
6.the oesophagus 24 h the pH be worth a monitor:The assurance has already had no stomach-oesophagus anti- flow, it is current to diagnose the most valid method of GERC.The dynamic state monitor oesophagus pH value of variety, acquire the 24 h oesophagus pH<4 number of timeses, the most long return to flow time, oesophagus pH<4 have the percentage of time of monitor’s etc. is 6 parameters, finally mean an anti- process degree by Demeester integral calculus.While check solid hour record to return to flow related symptom to acquire anti- flow with a cough symptom of related all rate(SAP).Definitely anti- flow hour mutually with a cough of relation.
7.cough a sensitivity check: Turn a way to make the test-receiver inhale the incitement thing spirit of one fixed amount to dissolve gum grain through fog, stimulate homologous cough to feel a machine but induct a cough, and with inhale thing density as the index sign which coughs sensitivity.The in common use capsaicin inhalation carries on a cough to stir up to experiment and cough sensitivity to increase Gao familiar at the AC, EB, GERC.
8.other checks:
1)the outside week blood check love sour grain cell to increase high hint parasite an infection and change in response to sex disease.
2)change should the skin tries at first with the serum particularity IgE measurement help the diagnosis to change to change in response to sex disease and the assurance should original type.
Impatient cough
The cause of disease of impatient cough is opposite simple, the most familiar cause of disease is common common cold.The common common cold a cough often has something to do with drop flowing after the nose.
The treatment of common common cold:With to disease treatment is lord, general have never need to use anti-virus medicine.In common use reduce a Chong blood, such as false ma-huang hemp alkali etc..The anti- allergic medicine much uses the generation anti- set an An medicine.Stop coughing medicine:Include axis a town to cough a medicine, medium patent medicine etc..Clinical up usually adopt the compound prescribe product of above-mentioned medicine, the head chooses the generation anti- set an An medicine+false ma-huang alkali treatment, can effectively alleviate to sneeze, stuffed-up nose etc. symptom.Cough obvious choose to use axis a town to cough a medicine, such as right and beautiful sand aroma or can treat because of etc..
Familiar chronic cough make a diagnosis and give treatment of cause of disease
The cause of disease of most chronic coughs is opposite and complicated and the explicit cause of disease cures a successful key.
Most chronic a cough and infection irrelevant, have never need to use an anti-virus medicine treatment.Cough reason not clear or can’t excepted infect, carefully use the sugar skin quality hormone.
1.cough variation asthma
The CVA is a kind of asthma of special type, a cough is that it is unique or main clinical performance and have no obvious breather, spirit Cu etc. symptom or body advertise for, but have the spirit way the high reaction.
Clinical performance:Mainly is a stimulative the stem cough and usually cough more violent, the nighttime coughs for its important characteristic.Common cold ﹑ cold air, dust, soot…etc. easily induct or aggravate a cough.
Diagnose:The normal regulations anti- common cold, anti- infection cure invalid, the bronchus extends a treatment and can effectively alleviate a cough symptom, the lung ventilates function a friendly way high reaction-diagnose CVA key method.
Diagnosis standard:
1)chronic cough, often the companion have obvious nighttime stimulative a cough;
2)the bronchus stir up to experiment male or biggest breathe out discharge(PEF) day and night a variation rate>20%;
3)the bronchus treatment of comfortable Zhang Ji4, the sugar skin quality hormone be valid;
4)expel the chronic cough that other reason cause.
Cure the CVA treatment principle and the treatment homology of the bronchus asthma, most sufferers inhale a small the quantity sugar skin quality hormone to add b 2 then and seldom need to take orally the sugar skin quality hormone a treatment.Cure time: Be no less than for 6~8 weeks.
2.the drop flows after the nose comprehensive advertise for
The PNDs means to cause secretion to flow back a nose because of the nose department disease after and throat department, even anti- inflow voice door or windpipe, cause to take a cough as a main performance of comprehensive advertise for, in addition to a cough, spit out phlegm, have a throat department drop flu, to swallow sticky the liquid adhere to, multifarious and pure larynx, swallow Yang unwell or nose Yang, stuffed-up nose, flow Ti and sneeze etc..Sometimes main tell voice hoarse, talk will also induct a cough.Usually there is disease(common cold) history up the breath way before be taken bad.
Diagnose:The foundation disease includes seasonal to change a year to become in response to the sex rhinitis and often the year doesn’t become in response to etc. of the sex rhinitis, afferent and comfortable Suo rhinitis, infection rhinitis, fungi rhinitis, common common cold and vice- nasosinusitis in response to the sex rhinitis and often, the companion has a great deal of phlegm liquid much for chronic nasosinusitis with the result that.Afferent and comfortable Suo the characteristic of the rhinitis is a nasal cavity to sometimes produce in great quantities thin and diluted water kind secretion with the air temperature change.
The image of chronic nasosinusitis learns a check to advertise for elephant:The vice- paranasal sinus mucosa increase thick over the 6 mms, the spirit liquid flat surface or Dou chamber are misty.
Diagnosis standard:
1)go into action sex or keep on sex a cough, with the daytime cough for the lord less coughs after fallen asleep;
2)the drop flows after the nose with(or) swallow sticky liquid in Houpi to adhere to feeling;
3)there is the history check of the ﹑ breath meat or chronic relax throat etc. disease of rhinitis, nasosinusitis discovering that swallowing Houpi has a sticky liquid to adhere to, the goose egg stone kind view;
4)after aiming at sex treatment cough to alleviate.
The PNDs involves various foundation diseases and its diagnosis is mainly other familiar reason that the establishment diagnosis should expel to cause chronic cough before according to history and related check comprehensive judgment of disease.The scholar who has in recent years directly adopts rhinitis/nasosinusitis as the cause of disease diagnosis of the chronic cough, but the technical term of need not PNDs.
Cure:According to cause PNDs foundation disease but settle.The following cause of disease causes a PNDs head to choose the generation anti- set an An with reduce Chong blood:
1)do not become in response to sex rhinitis;
2)afferent and comfortable Suo rhinitis;
3)whole year rhinitis;
4)common common cold.Most sufferers after the beginning start treatment few day to two with in the week produce curative effect.
In common usely and the generation anti- set An with reduce Chong blood, includes the chlorine benzene of Ma3 Lai2 Suan that respectively quick, and the hydrochloric acid false ma-huang alkali.
Various An medicine is all effective to the treatment which becomes in response to sex rhinitis, head the next generation anti- set which choose to have no town a quiet function An, the in common use medicine is a chlorine thunder he settle or Si rice Shi etc..
Nasal cavity’s inhaling the sugar skin quality hormone is to become to choose medicine in response to the sex rhinitis head.Usually is the C sour times chlorine rice loosens or waits together quantity of other inhale the sugar skin quality hormone.The color sweet sour sodium inhalation has a good prevention function towards become in response to sex rhinitis as well and improve environment and avoid change should the incitement is the valid measure that the control becomes in response to sex rhinitis at first.Change should original immunity treatment may effectively, but since effect time be longer.
The anti-virus medicine is the main medicine which cures an impatient germ nasosinusitis, such as effect not quite right or secretion many, can use the nasal cavity inhalation sugar skin quality hormone and reduce Chong blood.
To chronic nasosinusitis, suggest that adopting the following beginning cures a project:Application to the germ of Ge Lanyang, the Ge orchid feminine gender germ with be disgusted with oxygen germ effectively anti-virus the medicine take orally for 3 weeks, the generation anti- set An with reduce Chong blood for 3 weeks, nose uses to reduce Chong blood for a week.The nose inhales the sugar skin quality hormone for 3 months.The Medicine cure ineffective hour can go negative press to lead to flow, wear to stab to lead to flow or surgical operation.
3.love sour cell a bronchitis
1 kind with the spirit way love sour cell gradually is characteristic of not asthma the bronchitis be the important reason of the chronic cough.The chronic stimulative a cough often is an only one clinical symptom, much cough for the stem, accidentally is few sticky the phlegm, daytime or nighttime cough.Have another sensitive to the soot, dust, strange smell or cold ir comparison.Have no symptoms, such as asthma and dyspnea…etc., check-up just like often.The lung ventilates function and breathes out the Feng current velocity variation rate(PEFR) normal.Have no the proof of spirit way high reaction(AHR).
Diagnose:Be mainly depend on inducing a phlegm cytology check, standard as follows:
1)chronic cough, much is stem for stimulative to cough, or the companion be a little amount sticky phlegm;
2)the X line chest slice be normal;
3)the lung ventilate function normal, AHR feminine gender, PEF variation the rate be normal;
4)phlegm cytology the check love a sour cell comparison ≥ 3%;
5)expel an other to love sour cell to increase sex disease;
6)take orally or inhale the sugar skin quality hormone valid.
Cure: Respond to the sugar skin quality hormone treatment good, treatment behind cough to disappear very quickly or obviously ease. Inhale the sugar skin quality hormone, two C sour times chlorine rices loosen or wait effect the other sugar skin quality hormone of the quantity, keep on to apply more than 4 week, can also recommend the usage stem powder inhalant.The beginning starts a treatment and can unite an application to sprinkle Ni loose take orally, keep on 3~7 day.
4.the stomach esophagus be anti- to flow(GER)
Because stomach acid and other stomach contents the thing be anti- to flow into oesophagus and cause to take a cough as outstanding clinical express.It is the familiar reason of the chronic cough.The typical model is anti- to flow a symptom performance to burn bright feeling after include the breastbone, anti- and sour, the Ai annoy, the chest stuffy etc..The GER sufferer who there is little mistake absorb altered to appear a cough symptom and throat department symptom in early days.Clinical up also haven’t a few GERC sufferers to have no anti- flow symptom, a cough is it only one clinical performance.A cough mostly takes place during daytime and erection and the stem coughs or coughs a little amount white sticky phlegm.
Diagnose:Cough a companion to cough after have anti-ly flow related symptom or take a meal, diagnose certain meaning towards hint.The 24 h oesophagus pH value monitor is currently to diagnose the most valid method of GERC.
Diagnosis standard:
1)chronic cough, with the daytime cough for lord;
2)the 24 h oesophagus pH the value monitor Demeester integral calculus ≥ 12.70, with 75% of SAP ≥(or);
3)expel CVA, EB, PNDs etc. disease;
4)the anti- after being anti- flow a treatment coughs to obviously ease or disappear.
Have no oesophagus pH value the monitor or economic condition be limited of chronic a cough sufferer, have a following to advertise for can consider carrying on diagnosing sex treatment:
1)obviously take a meal related cough, such as after meal a cough, take a meal a cough;
2)companion GER symptom, anti- and sour, the Ai spirit, breastbone burns behind bright feeling etc.;
3)expel CVA, EB and change etc. is in response to the sex rhinitis/nasosinusitis disease, or press these disease a treatment ineffective.The anti- after ising anti- flow a treatment coughs disappear or shows Zhao to alleviate and can be clinical diagnosis GERC.
Cure:Gao Zhen3 Wo4, go up bedside.Adjust life style:Reduce weight, the little food is many meals, avoid supersaturation sleep to go forward a food and avoid taking a meal acidity, greasy food and beverage, and smoke cigarette.
Make a sour medicine:Proton pump depressant(such as Ao the United States pull Shi or H2 to be subjected to the body Jie anti-.(thunder Ni ground D or other similar medicine)
The Cu stomach motive medicine:Sign Tong etc. such as many Pans, if have stomach 12 bowel foundation disease companions to have a You door a Luo rod bacteria an infection the sufferer all should carry on homologous Medicine a treatment time to request for more than 3 months and generally need 2~4 weeks square show curative effect.A handful of severity of failure of the Medicine treatment are anti- to flow a sufferer, can consider that the anti- is anti- to flow a surgical operation treatment.
Other chronic a cough cause of disease, include a chronic bronchitis(ChB), the bronchus coughs after extend the disease, AC, common cold, film tubercle inside the bronchus, afferent strain vegetable conversion the Mao depressant(ACEI) induct of a cough.Some seldom seen lung diseases, turn such as the lung quality fiber, bronchus bronchus lung cancer, tiny stone calculus disease, the left heart function be not identically equal, may also become the reason of chronic cough.
The chronic cough cause of disease diagnoses procedure
The cause of disease diagnosis of the chronic cough should follow a following principle:
Value the history of disease, include the ear nose throat and digestive system disease history.Choose a relevant check according to the history of disease, from in brief arrive complications.Check a familiar disease first, the empress seldom seen disease.Diagnosis and cure both should synchronously or in proper order carry on.If when the former condition doesn’t have, carry on diagnosing sex treatment according to the clinical characteristic, and according to treatment reaction assurance a cough cause of disease, cure invalid hour again choice relevant check.
Chronic cough diagram concrete step of the cause of disease diagnostic process:
1.history and check-up of disease, the history inquiry which passes a disease contracts diagnosis scope and sometimes the history of disease can directly hint to correspond a cause of disease.
2.X line chest slice check, chronic a cough the sufferer’s normal regulations check.
3.chest slice the one who have obvious pathological changes, can choose a further check according to the appearance, property of pathological changes.
4.chest slice the one who have no obvious pathological changes, such as smoke cigarette, environment stimulate thing or take ACEI, then quit smoking, escape from incitement thing of contact or stop a medicine to observe for 4 weeks.A cough not yet alleviates or highest say to induct a factor, then get into the next move diagnosis procedure.
5.the lung ventilate function+the bronchus stir up to experiment, diagnosis with discriminate asthma.Ventilate function normal, stir up to experiment feminine gender, carry on inducing a phlegm check to diagnose EB.
6.the drop flows after the existence nose or multifarious and pure larynx, can press the PNDs treatment first, consociation usage the generation H1 is stop by body and nose reduce Chong blood.Add to use the nasal cavity inhalation sugar skin quality hormone towards becoming in response to sex rhinitis can.Cure for 1~2 weeks, the symptom can shoot paranasal sinus CT or nose to swallow a mirror without the improvement
7.above-mentioned check just like often, or sufferer’s companion be anti- to flow related symptom, can consider the 24 h oesophagus pH a value a monitor.Unconditional carry on a pH value monitor, the high doubt can carry on experience treatment.
8.the one who doubt to become in response to sex a cough, can go to change should the skin tries at first and serum IgE and a cough sensitivity examine.
9.the above-mentioned check not yet confirm, or experiments a treatment to still continue to cough, should consider carrying on high resolution CT and Xian pays mirror and heart a super voice a check, excepted the bronchus extends film tubercle inside the disease, bronchus and left heart function not identically equal disease.
10.the chronic cough sufferer again and again gone into action, the nighttime doesn’t cough, compare sensitive, as above say various checks and aim at sex treatment all invalid, in response to excepted the heart coughs because of sex.
Notice a point:
1.after corresponding a treatment cough to alleviate, the cause of disease diagnosis then can establish.
2.parts of sufferers can exist various cause of diseases in the meantime.If after sufferer cure, a cough symptom part alleviate, should consider whether merge in the meantime other cause of diseases
Powered by
Recent Comments