Abstract: Chronic cough in children（lasting >4 weeks with no significant abnormalities on chest X-ray）is a common yet challenging management issue in pediatric outpatient practice.This article focuses on this condition and proposes a clinical diagnostic and therapeutic framework based on initial classification of dry and productive cough.This framework helps clinicians quickly narrow down the focus to the most common etiologies，such as cough variant asthma，upper airway cough syndrome，and protracted bacterial bronchitis.It guides targeted evaluation and treatment，emphasizes time-limited diagnostic treatment trials in special outpatient settings，and standardizes the referral pathway.The goal is to reduce the misuse of antibiotics and antitussives，achieve precise management，and improve patient outcomes.

Key words: chronic cough in children, dry cough, productive cough, etiological diagnosis, treatment strategy

摘要： 儿童慢性咳嗽（持续时间大于4周，胸片无明显异常）是儿科门诊常见的诊疗难点。该文聚焦于此，提出以干性咳嗽与湿性咳嗽为初始分类的临床诊疗框架。为临床医生快速聚焦于咳嗽变异性哮喘、上气道咳嗽综合征、迁延性细菌性支气管炎等最常见病因，指导针对性评估与治疗，强调在专科门诊进行有明确时限的诊断性治疗试验，并规范转诊流程，旨在减少抗生素和镇咳药物的滥用，实现精准管理，改善患儿预后。

关键词: 儿童慢性咳嗽, 干性咳嗽, 湿性咳嗽, 病因诊断, 治疗策略