从“火（热）”病机论治老年性痴呆  

Treating Senile Dementia from the Mechanism of Fire(heat)

作　　者：吴珊 胡镜清 王传池[2,3] 张逸雯 杨燕 张佳乐[2] 江丽杰 Wu Shan;Hu Jingqing;Wang Chuanchi;Zhang Yiwen;Yang Yan;Zhang Jiale;Jiang Lijie(The First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang 712046,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;College of Basic Medical Sciences,Hubei University of Chinese Medicine,Wuhan 430065,China)

机构地区：[1]陕西中医药大学第一临床医学院,咸阳712046 [2]中国中医科学院中医基础理论研究所,北京100700 [3]湖北中医药大学基础医学院,武汉430065

出　　处：《世界科学技术-中医药现代化》2019年第10期2017-2020,共4页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科技部重点基础研究计划“973计划”（2014CB542903）：中医证候临床辨证的基础研究，负责人：胡镜清;中国中医科学院中医基础理论研究所中央级公益性科研院所基本科研业务费专项资金资助项目（YZ-1802）：加味四妙勇安汤治疗冠心病、高血压病、脉管炎的临床疗效评价关键问题研究，负责人：江丽杰;中国中医科学院中医基础理论研究所中央级公益性科研院所基本科研业务费专项资金资助项目（YZ-1877）：从热结血脉论治老年性痴呆临床诊疗经验研究，负责人：吴珊

摘　　要：历代中医家认为老年性痴呆发病的基本病机为“虚”“痰”“瘀”。导师胡镜清研究员结合临床诊疗经验与多年理论探索,发现“虚”“痰”“瘀”三者相互影响可化热生火,火(热)与痰湿、瘀血之间又可相互搏结和转化,最终生毒、结癥并损伤脑络。在老年性痴呆基本病机基础上强调对患者病程各个阶段“火(热)”病机的辨治,尤其注重抓住老年性痴呆进展期“痰瘀化火,热结脑络”关键病机,在临床实践中取得良好效果。总结从“火(热)”病机论治老年性痴呆四点心得:肾精不足致虚火上炎,应滋阴泻火不可纯补无泻;痰湿可郁结化热,清热化痰应与燥湿化痰并重;瘀血常与热邪搏结,注意清热凉血散瘀;火(热)甚重继而蕴结成毒,急予清热解毒法攻之。The basic pathogenesis of senile dementia is“deficiency”,“phlegm”and“blood stasis”.Professor HU Jingqing,combined with clinical diagnosis and treatment experience and years of theoretical exploration,found that“deficiency”,“phlegm”and“blood stasis”can influence each other to make a fire,and fire(heat)and phlegm dampness and blood stasis can fight and transform each other,and eventually poison,knot and damage brain collateral.On the basis of basic pathogenesis of senile dementia,it is emphasized to distinguish and treat the pathogenesis of"fire(heat)"in various stages of the disease course of the patients,especially to grasp the key pathogenesis of"phlegm and blood stasis dissipates fire,and heat the brain"in the progressive stage of senile dementia,which has achieved good results in clinical practice.Four points about treating senile dementia from the pathogenesis of"fire(heat)"are summarized:flaming-up of asthenic fire,and the deficiency of kidney essence should nourish Yin and excrete fire,not purely replenish the absence of catharsis;Phlegm dampness can be stagnation heat,heat and phlegm should be paid equal attention to dry dampness and phlegm;Blood stasis and hot evil bow knot,pay attention to clear heat and cool blood stasis;Fire(heat)is very heavy and then accumulate into poison,urgent to clear heat and detoxification attack.

关 键 词：老年性痴呆 火(热) 痰瘀化火 热结脑络 

分 类 号：R229[医药卫生—中医基础理论]