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放射性口腔黏膜炎的发病机制及中西医防治研究进展

谢靖 盛沛 李博 吴勉华

谢靖, 盛沛, 李博, 吴勉华. 放射性口腔黏膜炎的发病机制及中西医防治研究进展[J]. 南京中医药大学学报, 2019, 35(3): 338-343.
引用本文: 谢靖, 盛沛, 李博, 吴勉华. 放射性口腔黏膜炎的发病机制及中西医防治研究进展[J]. 南京中医药大学学报, 2019, 35(3): 338-343.
XIEJing, SHENGPei, LIBo, WUMian-hua. Pathogenesis of Radiation-Induced Oral Mucositis and Prevention and Treatment in TCM and Modern Medicine: A Literature Review[J]. Journal of Nanjing University of traditional Chinese Medicine, 2019, 35(3): 338-343.
Citation: XIEJing, SHENGPei, LIBo, WUMian-hua. Pathogenesis of Radiation-Induced Oral Mucositis and Prevention and Treatment in TCM and Modern Medicine: A Literature Review[J]. Journal of Nanjing University of traditional Chinese Medicine, 2019, 35(3): 338-343.

放射性口腔黏膜炎的发病机制及中西医防治研究进展

Pathogenesis of Radiation-Induced Oral Mucositis and Prevention and Treatment in TCM and Modern Medicine: A Literature Review

  • 摘要: 放射性口腔黏膜炎是恶性肿瘤患者接受放射线综合治疗后出现的严重并发症之一,头颈部肿瘤患者发病率几乎为100%,主要症状包括口腔局部剧烈炎症表现、吞咽困难、进食减少、继发感染等。中医病机以“火毒伤阴”为关键,现代医学的病理始发机制尚未明确,以口腔分泌腺体损伤、血管内皮细胞损伤为主。当前治疗措施均以供给营养、控制疼痛、预防继发感染为主要目的。该文从中西医2个方面对放射性口腔黏膜炎的发病机制和防治研究进展进行了综述,以期为临床治疗提供依据。

     

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