Abstract：Automated auscultation advances the detection of respiratory diseases, especially in areas with limited resources where traditional diagnostic methods are unavailable. On the other hand, the scarcity of auscultation datasets limits the automation performance, prompting the needs for data augmentation methods. However, most of the existing methods neglect the difference in acoustic sounds that requires personalized augmentation strategies. To address this, we propose a Progressive-Adaptive Spectral Augmentation (PASA), which is one of the first paradigms to adaptively select the best augmentation strategy for each sample. The PASA innovatively treats augmentation selection problem as a Markov Decision Process (MDP), creating an alternating loop between the diagnostic model and the augmentation selection. The agent selects the optimal augmentation operations and magnitudes via a task-specific design, including state construction, action sampling, Hybrid Batch-Sample (HBS) strategy execution, and reward guidance. The HBS strategy initially applies uniform augmentation across mini-batches while collecting sample-specific performance statistics. When model performance stabilizes, it transits to sample-level augmentation based on accumulated difficulty assessments. This two-phase design balances computational complexity with personalization. Extensive experiments across three benchmark datasets demonstrate that the PASA outperforms the state-of-the-art methods, pioneering a transformative paradigm for adaptive data augmentation in automated auscultation.