What are the reasons for a cough lasting for a month without improvement?

Generally, if a cough persists for a month without improvement, it may be caused by environmental factors and substance allergies, unhealthy lifestyle habits, common cold, cough variant asthma, or gastroesophageal reflux cough. Prompt medical attention is advised, and treatment should follow medical guidance. Details are as follows:

1. Environmental factors: Prolonged exposure to dry or polluted environments may cause respiratory irritation or allergic reactions, leading to allergic cough. This type of cough typically does not accompany severe infection symptoms but may be difficult to relieve due to continuous environmental irritation. It is important to maintain fresh indoor air, regularly clean the home environment, and reduce exposure to allergens.

2. Unhealthy lifestyle habits: Long-term smoking, alcohol consumption, and staying up late can weaken immune function, increase the risk of respiratory infections, and the harmful substances in tobacco can directly irritate the respiratory tract, causing persistent cough. Smoking and alcohol consumption should be avoided, adequate sleep should be ensured, and staying up late should be avoided.

3. Common cold: A cough caused by a common cold may persist for weeks or even months. These conditions are typically caused by viral or bacterial infections, leading to respiratory inflammation and increased secretions, which trigger coughing, possibly accompanied by phlegm production. Antiviral medications such as oral antiviral liquid, Lianhua Qingwen capsules, and Ganmaoling granules should be used as directed by a physician.

4. Cough variant asthma: Cough variant asthma is a special type of asthma associated with airway hyperresponsiveness, which can be easily triggered by stimuli such as cold air and smoke. It mainly presents as an irritating dry cough, usually worsening at night or in the early morning, and may also be accompanied by throat itching. Anti-allergic and cough-relieving medications such as diphenhydramine hydrochloride tablets, prednisone acetate tablets, and ambroxol hydrochloride oral solution should be taken under a physician's guidance.

5. Gastroesophageal reflux cough: Gastroesophageal reflux cough occurs when stomach acid or gastric contents flow back into the esophagus, usually related to dysfunction of the lower esophageal sphincter. This irritates the esophageal mucosa and throat, triggering a cough reflex, and may also be accompanied by a burning sensation behind the breastbone. Medications such as lansoprazole enteric-coated capsules, hydrotalcite tablets, and itopride hydrochloride should be taken as directed by a physician to inhibit gastric acid secretion and provide anti-inflammatory effects.

During treatment, the underlying cause should be clearly identified, medications should be taken as prescribed, and daily care and monitoring should be enhanced to promote recovery.

References:

[1] Ge Junbo, Xu Yongjian, Wang Chen. Internal Medicine [M]. 9th Edition. Beijing: People's Medical Publishing House, 2018.

[2] Zhong Nanshan, Liu Youning, Wang Chen. Respiratory Medicine [M]. 3rd Edition. Beijing: People's Medical Publishing House, 2022.