基于“虚滞络损”论治抗肿瘤药物相关性口腔黏膜炎

Treating Antitumor Drug-Associated Oral Mucositis Based on the Theory of “Deficiency-Stagnation-Collateral Damage”

  • 摘要: 抗肿瘤药物相关性口腔黏膜炎(ADOM)是肿瘤患者接受化疗药物、靶向药物、免疫检查点抑制剂等药物治疗最常见的口腔并发症之一。江苏省名中医霍介格教授根据ADOM的病机特点,提出“虚滞络损”理论,认为ADOM的发生以“虚”为本、以“滞”为变、以“络”为所、以“损”为果,其病机演变规律为“虚-滞-络损”。抗肿瘤药物(药毒)作为一种特殊的“攻伐邪气”,首先耗伤人体气血阴阳,导致正气亏虚;气滞、血瘀、痰湿等病理因素相互搏结,形成局部壅滞状态;最终导致滞久化热、热腐络损的结局。并据此制定“益气扶正补虚固本、行气活血化痰散滞、凉血通络生肌复损”的复合治法。该理论为临床防治ADOM提供了重要理论依据与诊疗参考。

     

    Abstract: Antitumor drug-related oral mucositis (ADOM) is one of the most common oral complications in cancer patients receiving chemotherapeutic agents, targeted drugs, immune checkpoint inhibitors (ICIs), and other medications. Professor Huo Jiege, a renowned Traditional Chinese Medicine (TCM) practitioner in Jiangsu Province, based on the pathogenesis of ADOM, proposed the theory of “deficiency-stagnation-collateral damage”. He posits that the occurrence of ADOM is rooted in “deficiency”, manifested as “stagnation”, localized in the “collaterals”, and resulting in “damage”, with the pathological evolution following the pattern of “deficiency-stagnation-collateral damage”. Antitumor drugs (medicinal toxins), as a special form of “attacking pathogenic factors”, first consume the body’s qi, blood, yin, and yang, leading to a deficiency of healthy qi. Subsequently, pathological factors such as qi stagnation, blood stasis, and phlegm-dampness intertwine, forming a local state of congestion. Ultimately, this results in prolonged stasis transforming into heat, causing heat-induced decay and collateral damage. Based on this, a composite treatment method of “supplementing qi, reinforcing the body, replenishing deficiency, consolidating the foundation; promoting qi circulation, activating blood, resolving phlegm, dispersing stagnation; cooling blood, unblocking collaterals, generating tissue, and repairing damage” was formulated. This theory provides an important theoretical basis and clinical reference for the prevention and treatment of ADOM.

     

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