基于温病学说论治放射性口腔黏膜炎  

Treatment of Radiation Oral Mucositis Based on Warm Disease Doctrine

作　　者：陈露露 任德祥 夏小军[2] 郭炳涛 吕学颖 CHEN Lu-lu;REN De-xiang;XIA Xiao-jun;GUO Bing-tao;LV Xue-ying(Gansu University of Traditional Chinese Medicine,Lanzhou 730000 Gansu,China;Gansu Provincial Cancer Hospital,Lanzhou 730050 Gansu,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省肿瘤医院,甘肃兰州730050

出　　处：《中医肿瘤学杂志》2024年第5期25-28,34,共5页Journal of Oncology in Chinese Medicine

基　　金：甘肃省中医药人才培养重点学科建设项目(编号:甘财社〔2022〕48号);甘肃省中医药管理局科研课题(编号:GZKP-2020-22);2022年甘肃省名中医传承工作室建设项目(编号:国中医药规财函〔2021〕242号)。

摘　　要：放疗是头颈部恶性肿瘤的常用治疗手段之一,而口腔黏膜炎是头颈部肿瘤患者放疗后的常见不良反应。对于放射性口腔黏膜炎,中医药治疗可以缓解其咽干咽痛、口腔糜烂、出血等症状。中医理论认为放射线属于“火热毒邪”,火性炎上,上冲于口而致口疮。口疮的发病符合温病“卫气营血”“三焦”“湿热”等传变规律。因此,临床上可以分期论治,放疗初期,温邪在表,治宜辛凉解表;放疗中期,温邪传入气分,治宜清气泄热、祛湿清热;放疗后期,温邪传入营血分,治宜凉血散血、泻南补北;放疗恢复期,阴液亏损,治宜滋阴。中医药治疗放射性口腔黏膜炎需灵活辨证应用,方可取得满意疗效。Radiotherapy is one of the common treatments for head and neck malignancies,and oral mucositis is a common adverse reaction after radiotherapy in head and neck tumor patients.As for radiation oral mucositis,traditional Chinese medicine(TCM)treatment can alleviate symptoms such as dry throat and sore throat,oral erosion and bleeding.According to TCM theory,radiation belongs to“fire-heat toxicity”.Fire is characterized by flaming and causes aphtha.The onset of aphtha is in line with the transmission laws of warm disease,such as“Wei qi and Ying blood”,“Sanjiao”,and“dampness and heat”.Therefore,the treatment can be staged clinically.In the early stage of radiotherapy,warm pathogen is on the surface,so the treatment should be pungent and cool to relieve the surface;in the middle stage of radiotherapy,warm pathogen enters into the qi level,so the treatment should focus on clearing qi and draining heat,eliminating dampness and clearing heat;in the late stage of radiotherapy,warm pathogen enters into Ying blood level,so the treatment should cool blood and dissipate stasis,reduce south and reinforce north;and in the recovery period of radiotherapy,yin fluid loses and the treatment should nourish yin.The TCM treatment of radiation oral mucositis should be applied flexibly based on syndrome differentiation to achieve satisfactory therapeutic effect.

关 键 词：放射性口腔黏膜炎 温病学说 口疮 

分 类 号：R730.6[医药卫生—肿瘤] R730.52[医药卫生—临床医学] R273