Chronic cough is a common chronic respiratory disease in which cough is the only or main symptom. This cough typically lasts for more than eight weeks without significant abnormalities on the X-ray image. However, some chronic coughs may be diagnosed as chronic refractory cough (CRC) in two conditions; cough without definite causes after thorough examinations; symptoms without improving after conventional treatment. With the rapid advancement of science and society, CRC has received increased attention from clinicians, presenting the respiratory system research community with new challenges and opportunities. CRC has no specific name in the Chinese medicine system, but it can be named "Wan Ke" based on its "long duration". In the history of Chinese medicine, the treatment of "Wan Ke" has been scattered throughout the clinical theory and practice of Chinese medicine, but a systematic theory is still lacking. In this article, we use "multidimensionality" as an entry point to understand the pathogenesis of CRC in terms of its cause, nature, location, and syndrome, and to summarize the ideas of its syndrome differentiation and treatment variation. We believe that CRC is a disease of mixed deficiency and reality, with a mixture of cold and heat. The disease is located in the lungs, and its pathogenesis is closely related to the internal organs, with "lung and spleen related" being significant. The wind-evil hidden lung is the basic and central pathogenesis of CRC. In terms of treatment, the primary approach is Qufeng Xuanfei, combined with the identification of the symptoms and focusing on the lung and spleen. This is combined with syndrome differentiation to clear heat and dampness, invigorate the spleen, warm the lungs, dissolve drinks, and remove dampness and phlegm. In addition, we should also pay attention to the treatment of sparing the liver and regulating wood by changing the medication and dosage as the syndrome changes. [ABSTRACT FROM AUTHOR]