“阳微阴弦”是东汉时期的医圣张仲景在其 《金匮要略》 中对胸痹的脉象及病机的高度概括。历代医家对其各有阐 发，众说纷纭，分歧主要在于对“阴”“阳”的理解。中医学认为，上焦连心肺，三焦为运化水液并主气化的管道，与主纳 气的“胸”这一容器相连。基于隐喻认知分析胸痹之病症及其“阳微阴弦”病机，可发现“容器-管道”的实体隐喻，为 胸、三焦及胸痹概念的构建与理解提供了直观的结构，而过程隐喻则有利于胸痹“阳微阴弦”病机的解释。基于隐喻认知， 对胸痹的病症表现及其“阳微阴弦”病机的解释如下：生理状态下，胸-三焦在气化和运化水液时保持着阴阳动态平衡；若 阳消阴长超过限度则发为胸痹，即阳气消、阴气长，继续发展而引起质变，产生痰饮等阴邪在胸-三焦内滞留不去而出现胸 痹；胸痹之“阳微阴弦”的病机中，以“上焦阳虚”（胸受纳宣发的过程减弱）为本，以阳消阴长超过限度后产生质变（形成 阴邪留滞上逆）为标。实体隐喻与过程隐喻相结合的分析方法，可展现中医病因病机理论的动态性与整体性，有利于对中医 学概念的深层理解，可为中医理论的解读与创新带来新角度。

The term Yangwei Yinxian（weak pulse at yang and wiry pulse at yin） is a concise summary of the pulse presentation and pathogenesis of chest qi-obstruction by Zhang Zhongjing，the Medical Sage of the Eastern Han Dynasty，in his Jin Gui Yao Lve（Essentials from the Golden Cabinet）. Successive generations of physicians have offered various interpretations of Yangwei Yinxian，and the primary divergence lies in the understanding of yin and yang within this context. Traditional Chinese medicine（TCM） posits that the upper jiao connects to the heart and lung，and the sanjiao，as a system of pathways for transporting and transforming fluids and governing qi activity， connects to the chest， which is a cavity that receives and regulates qi. From the perspective of metaphorical analysis of the symptoms of chest qi-obstruction and its Yangwei Yinxian pathogenesis，the ontological metaphor of “container-pathway” provides an intuitive structural framework for conceptualizing and understanding the chest， sanjiao， and chest qi-obstruction， and the process metaphors facilitate the explanation of its Yangwei Yinxian pathogenesis. Based on metaphorical cognition， the symptoms of chest qi-obstruction and its Yangwei Yinxian pathogenesis can be interpreted as follows：Under physiological conditions，the chest-sanjiao system maintains a dynamic yin-yang balance during qi transformation and fluid transport，but when the decline of yang and growth of yin exceed a critical threshold， chest qi-obstruction arises， leading to a qualitative transformation and then resulting in the retention and stagnation of pathogenic yin factors， such as phlegm-fluid retention， within the chest-sanjiao system； for the Yangwei Yinxian pathogenesis of chest qi-obstruction， the root lies in yang deficiency of the upper jiao（manifesting as a weakened process of reception and diffusion by the chest），while the branch is due to the qualitative transformation occurring after the excessive decline of yang and growth of yin （leading to the retention and upward rebellion of pathogenic yin）. The analytical approach by combining ontological metaphor and process metaphor can elucidate the dynamic and holistic nature of TCM etiology and pathogenesis theory，being helpful for a deeper understanding of TCM concepts and potentially offering new perspectives for the interpretation and innovation of TCM theory.

R256.22

国家社科基金后期资助项目（编号：22FYYB034）