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)” were 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.

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