中西医论治放射性脑损伤

Treatment of Radiation-Induced Brain Injury by Traditional Chinese and Western Medicine

放射性脑损伤(radiation-induced brain injury,RBI)是指头颈部恶性肿瘤经过放射线照射治疗后产生的以认知能力显著下降、学习记忆功能受损为主要临床表现的严重并发症之一,已经影响患者的生活质量,严重者可危及生命。其发病机制尚未明确,可能与脑血管损伤、胶质细胞损伤、炎症反应、自由基损伤等有关;传统医学认为放射性脑损伤为本体羸弱外加射线热邪侵袭所致,实为本虚标实之证。除了西医的对症治疗,中医疗法正逐步走向临床,近期研究以突触可塑性为切入点阐述其作用机制,为推广中医治疗RBI提供了新的方向和理论依据。本文收集整理近几年的相关文献,从中西医两个方面对RBI的发病机制和治疗方法进行综述。

Radiation-induced brain injury(RBI)is one of the severe complications arising from the radiotherapy of head and neck malignant tumors,characterized by significant cognitive decline and impaired learning and memory.It adversely affects patients’quality of life and can even be life-threatening in severe cases.The pathogenesis of RBI remains unclear,but it may be related to factors such as cerebrovascular injury,glial cell injury,inflammatory responses and free radical injury.Traditional Chinese medicine(TCM)attributes RBI as a consequence of the body’s inherent weakness and the invasion nature of radiation,which is clinically manifested as a condition of original deficiency and solid injury.In addition to symptomatic treatment in Western medicine,TCM therapy has been progressively incorporated into clinical practice.Recent studies have focused on synaptic plasticity to elucidate the underlying mechanisms,offering novel perspectives and a theoretical foundation for advancing the role of TCM in the treatment of RBI.This article reviews the latest literature on the pathogenesis and treatment of RBI from the perspectives of both traditional Chinese andWestern medicine.