2019年《德国呼吸学会成人急性、亚急性和慢性咳嗽诊断和治疗指南》要点介绍与专家点评

Introduction and expert opinion on 2019 German Respiratory Society Guidelines on Diagnosis and Treatment of Adults Suffering from Acute,Subacute and Chronic cough

咳嗽是呼吸道疾病的常见病症,其病因复杂,临床误诊误治率高。近年来随着对咳嗽的病因、发病机制、治疗认识的不断提高,中华医学会呼吸病学分会、美国胸科医师协会、欧洲呼吸学会等一直致力于不断更新完善所颁布的咳嗽指南,旨在更好地指导临床。2019年德国肺病和呼吸医学学会为肺科医师专门颁布了最新版的《德国呼吸学会成人急性、亚急性和慢性咳嗽诊断和治疗指南》。该指南包含了流行病学、发病机制、咳嗽分类,诊断与治疗、难治性/特发性咳嗽等共9个部分,其中重点关注由全科医师转诊的咳嗽患者的鉴别诊断与治疗。本文将介绍德国2019成人咳嗽指南的重点内容并给予点评,以期为国内成人咳嗽的诊疗工作提供参考。

Cough is a common complaint for patients who seek medical attention.It is involved in a range of etiologieswhich lead to a large number of misdiagnosis and inappropriate treatment.As increased understanding of the etiologies,pathogenesis and treatment of cough,the Chinese Thoracic Society(CTS),the American College of Chest Physicians,the European Respiratory Society have been committed to develop the practical guidelines on diagnosis and treatment of cough in recent decades,aiming to guide the clinical practice.In 2019,the German Respiratory Society(DGP)published the latest guideline titled"Diagnosis and Treatment of Adults Suffering from Acute Subacute and Chronic Cough"for pulmonologists which consists of nine chapters:epidemiology,physiology,classification,acute subacute or chronic cough,diagnostics and therapy,chronic refractory/idiopathic cough,focusing on the differential diagnosis and treatment of cough patients referred by general practitioners.In order to provide reference for the diagnosis and treatment of adult cough in China,we will comment the key points of the 2019 DGP guideline on cough in adults compared with CTS guideline on cough.