关键词: 放射性口腔黏膜炎, 中医病机, 分期辨治, 热毒伤阴, 益气养阴

Abstract: Radiation-induced oral mucositis（RIOM）is a common and painful complication of radiotherapy for head and neck tumours，significantly impairing patients' quality of life and treatment progression. Modern medicine offers limited preventive and therapeutic measures，predominantly symptomatic management. This article，grounded in traditional Chinese medicine theory，systematically elucidates the etiology and pathogenesis of RIOM and establishes a staged treatment system. The core pathogenesis of RIOM involves the invasion of "heat-toxin" directly affecting the mouth and tongue，depleting qi and yin，and subsequently compromising multiple organs including the heart，lungs，spleen，and kidneys. Its progression exhibits distinct stages：the initial stage involves a heat-toxin blaze；the middle stage involves dual damage to qi and yin；the late stage involves spleen-kidney deficiency with residual toxins not cleared. Core therapeutic principles for the pre-treatment，mid-treatment and post-treatment of radiotherapy，and the future recovery phases are，respectively："clearing heat and detoxifying，protecting mucosa and promoting fluid production"；"tonifying qi and nourishing yin，resolving stasis and promoting tissue regeneration"；"strengthening the spleen and replenishing the kidneys，transforming dampness and eliminating toxins"；"fortifying the constitution and consolidating the foundation，harmonising qi and blood". Complemented by integrated internal and external therapeutic approaches，this framework aims to provide theoretical foundations and clinical practice guidance for traditional Chinese medicine management of RIOM，highlighting the distinctive advantages of traditional Chinese medicine in supportive oncology rehabilitation.

Key words: radiation-induced oral mucositis, traditional Chinese medicine pathogenesis, staged differential treatment, heat-toxin damaging yin, tonifying qi and nourishing yin