放射性口腔黏膜炎的中医病因病机与分期辨治体系构建OA

Radiation-induced oral mucositis(RIOM)is a common and painful complication of radiotherapy for head and neck tumours,significantly impairing patients' quality of life and treatment progression.Modern medicine offers limited pre-ventive and therapeutic measures,predominantly symptomatic management.This article,grounded in traditional Chinese medicine theory,systematically elucidates the etiology and pathogenesis of RIOM and establishes a staged treatment sys-tem.The core pathogenesis of RIOM involves the invasion of"heat-toxin"directly affecting the mouth and tongue,deplet-ing qi and yin,and subsequently compromising multiple or-gans including the heart,lungs,spleen,and kidneys.Its pro-gression exhibits distinct stages:the initial stage involves a heat-toxin blaze;the middle stage involves dual damage to qi and yin;the late stage involves spleen-kidney deficiency with residual toxins not cleared.Core therapeutic principles for the pre-treatment,mid-treatment and post-treatment of radiother-apy,and the future recovery phases are,respectively:"clear-ing heat and detoxifying,protecting mucosa and promoting flu-id production";"tonifying qi and nourishing yin,resolving sta-sis and promoting tissue regeneration";"strengthening the spleen and replenishing the kidneys,transforming dampness and eliminating toxins";"fortifying the constitution and consol-idating the foundation,harmonising qi and blood".Comple-mented by integrated internal and external therapeutic ap-proaches,this framework aims to provide theoretical founda-tions and clinical practice guidance for traditional Chinese medicine management of RIOM,highlighting the distinctive advantages of traditional Chinese medicine in supportive on-cology rehabilitation.