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

摘要： 放射性口腔黏膜炎（radiation-induced oral mucositis，RIOM）是头颈部肿瘤放疗中常见且痛苦的并发症，严重影响患者的生存质量与治疗进程。现代医学对其防治手段有限，且多为对症处理。文章立足于中医理论，系统阐述RIOM的中医病因病机，并构建其分期辨治体系。RIOM的核心病机为热毒外侵、直中口舌、耗伤气阴，并累及心、肺、脾、肾等多脏；其病机演变呈现明显的阶段性，初期为热毒炽盛，中期为气阴两伤，后期为脾肾亏虚、余毒未清。在放疗前期、中期、后期及远期恢复期分别以“清热解毒，护膜生津”“益气养阴，化瘀生肌”“健脾补肾，化湿解毒”“扶正固本，调和气血”为核心治则；同时，附以内外治相结合的综合方案。旨在为中医诊治RIOM提供理论依据与临床实践指导，彰显中医药在肿瘤康复支持治疗中的独特优势。

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