基于HSC"线粒体异常激活"探讨放疗相关骨髓抑制"相火妄动"病机及其辨治思路OA

The multidirectional differentiation(mobilization)and self-renewal(mobilization-maintenance)of bone marrow hematopoietic stem cells(HSCs)ensure hematopoietic homeostasis.Radiotherapy-induced"mitochondrial dysregulation"in HSCs disrupts the"mobilization-maintenance"equilibrium,serving as a key mechanism underlying radiotherapy-related myelosuppression.In traditional Chinese medicine(TCM),radiation is categorized as a"fire-toxin heat pathogen".With cumulative radiation doses,it depletes Yin essence,damages marrow sources,and triggers"Ministerial Fire Hyperactivity",ultimately manifesting as myelosuppression.Based on the microcosmic correspondence between HSCs/mitochondria and TCM concepts of Kidney Essence/"Ministerial Fire Hyperactivity",we propose that both HSC"mitochondrial dysregulation"and"Ministerial Fire Hyperactivity"originate from Kidney Essence deficiency,progress through deficiency-induced hyperactivity,and culminate in a pathological state of deficient healthy qi and entrenched pathogenic factors.This study elucidates the scientific connotation of the"Ministerial Fire Hyperactivity"pathomechanism in radiation-induced myelosuppression through the lens of HSC mitochondrial dysregulation.Furthermore,guided by the therapeutic principles of"consolidating the root,subduing fire,and purging marrow toxins",we highlight the significance of kidney-focused treatment strategies in maintaining hematopoietic function during radiotherapy.