中国中医药信息杂志2026，Vol.33Issue(6)：1-7,7.DOI:10.19879/j.cnki.1005-5304.202602211
大语言模型时代中医临床决策支持的方法论转向与认知建模研究
Study on the Methodological Shift and Cognitive Modeling in TCM Clinical Decision Support in the Era of Large Language Models
摘要
Abstract
Research on TCM clinical decision support is an important embodiment of keeping pace with the times.From a methodological perspective,this article systematically reviewed the evolution,major approaches,and core methodological challenges of TCM clinical decision support research,and argued that the deeper challenges arise from a misalignment between the cognitive characteristics of TCM and prevailing artificial intelligence modeling paradigms.In response to the new opportunities presented by the era of large language models(LLMs),this article proposed leveraging the strengths of LLMs in natural language understanding,multi-source knowledge integration,and complex semantic generation to facilitate a methodological shift in TCM clinical decision support—from task-oriented modeling to cognitive modeling.Within this framework,the plurality and complexity of TCM cognition can be effectively represented.Through knowledge constraints,structured reasoning chains,and feedback mechanisms,cognitive modeling and alignment in TCM can be achieved,enabling LLMs to be organically integrated into the clinical cognitive system.The methodological framework of cognitive modeling can not only lay the foundation for high-level modeling while preserving the disciplinary complexity and intrinsic characteristics of TCM,but also provide theoretical references for research on TCM-oriented artificial intelligence.关键词
中医临床决策支持/方法论/认知建模/大语言模型/辨证论治Key words
traditional Chinese medicine clinical decision support/methodology/cognitive modeling/large language model/syndrome differentiation and treatment分类
医药卫生引用本文复制引用
王梓怡,杨淑涵,胡宇鑫,李海燕,李盼飞..大语言模型时代中医临床决策支持的方法论转向与认知建模研究[J].中国中医药信息杂志,2026,33(6):1-7,7.基金项目
国家自然科学基金青年科学基金(82505804) （82505804）
国家中医药综合改革示范区科技共建重大项目(GZY-KJS-ZJ-2025-018) （GZY-KJS-ZJ-2025-018）
浙江省自然科学基金青年基金(QN26H270007) （QN26H270007）
浙江中医药大学校级科研项目(2024RCZXZK42) （2024RCZXZK42）
中国中医科学院科技创新工程(CI2021B002) （CI2021B002）
中国中医科学院中医药信息研究所中医药语言与认知人工智能重点实验室项目(ZZSYS-1901-CZ) （ZZSYS-1901-CZ）
