基于“态靶理论”探讨放射性食管炎的治疗策略

Exploring Treatment Strategies for Radiation Esophagitis Based on the “Status-Target Theory”

摘要: 放射性食管炎是胸部恶性肿瘤放疗后常见的并发症之一，治疗难度大、效果不甚理想。目前中医对放射性食管炎的发生发展及变化规律正在逐步深化，但临床上仍以对症治疗为主。本文基于仝小林院士的“态靶辨治”体系和中医对放射性食管炎的认识，重新对疾病进行分类、辨态、识靶。辨治放射性食管炎辨以“热、毒、瘀、虚”四态；识“吞咽困难、恶心、呃逆、胸骨后刺痛”之症靶；“白细胞介素-6、内镜下黏膜损伤分级”之标靶。治疗以“清热、解毒、补虚、化瘀”为主。文章通过初步构建放射性食管炎的态靶辨治体系，为提高放射性食管炎治疗效果提供新的临床思路。

Abstract: Radiation esophagitis is one of the common complications following radiotherapy for thoracic malignancies, and it is difficult to treat with poor outcomes. Currently, traditional Chinese medicine (TCM) is gradually deepening its understanding of the occurrence, development, and progression of radiation esophagitis, with clinical treatment mainly focused on symptom management. This article, based on Academician Tong Xiaolin’s “status-target differentiation and treatment” system and TCM’s understanding of radiation esophagitis, reclassifies, differentiates, and identifies the disease. Radiation esophagitis is differentiated according to four states: “heat, toxin, stasis, and deficiency”; symptoms are identified as targets including “difficulty swallowing, nausea, hiccups, and retrosternal stabbing pain”; and markers are identified as “interleukin-6 and endoscopic mucosal injury grading”. Treatment mainly focuses on “clearing heat, detoxifying, tonifying deficiency, and resolving stasis”. By preliminarily establishing a status-target differentiation and treatment system for radiation esophagitis, this article provides new clinical ideas to improve treatment effectiveness.