The diagnostic criteria for cough variant asthma, it turns out that we should adhere to this treatment principle

Whether you have variant asthma after coughing needs to be diagnosed. Common criteria are that the cough persists or recurs for more than 1 month, with little sputum, worsened after exercise, but no wheezing attacks; symptoms often occur in the early morning, at night or at bedtime; and other chronic respiratory diseases are excluded.

When encountering a patient whose only complaint is a long-term cough (lasting more than 3 weeks), the possibility of asthma should be considered. Currently recognized diagnostic criteria in China:

1. Cough persists or recurs for more than 1 month, with little sputum, aggravated by exercise, but without wheezing;

2. Symptoms often occur in the early morning, at night or at bedtime;

3. Symptoms of airway hyperresponsiveness (AHR) such as breathlessness and unbearable coughing occur when the disease occurs seasonally or when exposed to irritating odors;

4. Exclude other chronic respiratory diseases;

5. Symptoms do not improve after antibiotics and symptomatic treatment for more than 2 weeks, but anti-allergic and bronchodilator treatment is effective;

6. With one or more of the following allergic diseases or medical history, history of allergic rhinitis or allergic tracheitis, increased peripheral blood eosinophils (EOS) or serum immunoglobulin E (IgE)>200mg/L, large amounts of EOS found in sputum, positive skin allergen test, family history of asthma

7. Positive bronchodilator test or provocation test, or positive 24-hour PEF variation rate.

2. Differential Diagnosis

Because many diseases can cause cough, the following common diseases must be excluded to confirm CVA: acute and chronic bronchitis, bronchial tuberculosis, allergic cough, bronchiectasis, upper airway cough syndrome, gastroesophageal reflux, and cough caused by taking angiotensin-converting enzyme inhibitors.

3. Treatment principles

The treatment principles for CVA are the same as those for typical bronchial asthma. The American College of Chest Physicians (ACCP) guidelines state that the vast majority of CVA patients respond to inhaled bronchodilators and inhaled corticosteroids. my country's cough guidelines recommend that most CVA patients can use inhaled low-dose glucocorticoids combined with bronchodilators (β2-receptor agonists or aminophylline, etc.), or a combination of the two. Similar to typical asthma, short-term oral low-dose corticosteroid therapy may also be effective for patients with CVA. The treatment duration of CVA should be no less than 8 weeks. Studies have shown that without intervention, 30% to 54% of CVA patients may develop into typical asthma, and early treatment with inhaled corticosteroids can effectively reduce the risk of CVA progressing to typical asthma. Therefore, early standardized treatment based mainly on inhaled hormones is of great significance to improving the prognosis of CVA patients. Since many CVA patients have atopy, avoiding exposure to corresponding allergens is also important to prevent the progression of CVA.