基于"火与元气不两立"理论论治EGFR-TKIs相关性口腔溃疡OA

Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)have become the first-line target-ed therapy for the patients with advanced non-small cell lung cancer(NSCLC)harboring EGFR-sensitive mutations.How-ever,oral mucositis is a common adverse reaction during treatment,seriously affecting both the quality of life and the treat-ment course.LI Dongyuan proposed that"fire and original Qi cannot coexist",positing that fire generated internally due to spleen-stomach injury and deficiency of original Qi is termed as Yin fire.The toxicity of targeted drugs invades the mid-dle Jiao,impairs original Qi and disrupts the normal ascent-descent of Qi dynamics,leading to the production of stagnant fire.Insufficiency of middle Qi results in the abnormal floating of ministerial fire upwards.This disruption of Qi-fire dy-namics and internal exuberance of Yin fire allow the pathogenic fire to ascend and attack,thereby leading to the occur-rence of oral ulcers.The treatment should follow the principles of fortifying spleen with sweet-warm medicinals,lifting Yang to dissipate fire,and reinforcing the earth to subdue Fire.This approach aims to restore original Qi,drain Yin fire and consolidate the root to heal ulcers.This article explored the pathogenesis and therapeutic strategies for oral ulcers af-ter targeted treatment of non-small cell lung cancer patients from the perspective of"fire and original Qi cannot coexist"in order to improve the patients'quality of life,reduce the recurrence rate of oral ulcers and provide new insights for TCM interventions in alleviating targeted therapy-related toxicities.