Traditional Chinese Medicine

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18 papers7 papers in the last four weeks, with none the four weeks before. 0.0% of all new papers.

Oct 17, 2026

TCMScience: An Autonomous Scientist for Traditional Chinese Medicine

Traditional Chinese medicine (TCM) research connects classical texts, medicinal entities, molecular assays, computational predictions, and clinical studies. An autonomous research agent must preserve the inferential boundaries between these evidence types while coordinating analysis across heterogeneous resources. We introduce TCMScience, a scientific knowledge-discovery agent that separates language-model proposals from execution and release authority. Its architecture combines a trusted kernel, a scientific compiler, and claim-support contracts: plans are compiled into typed operations, execution is bounded by explicit permissions, and candidate findings are checked against source provenance, study design, and claim scope before release. The full capability registry contains 117 public-source connectors with 444 typed operations across 29 domains and 150 native tools across 12 domains; the TCM data hub catalogs 136 databases, 76 dataset specifications, and 84,294 formula-source records. These resources support model-independent workflows through browser and local execution interfaces. In a network-pharmacology analysis of Gegen Qinlian Tang, replacing the whole-proteome background with the assayed-protein background changed the number of significant pathways from 66 to zero; incorporating inactive screening records identified nine pathways, including drug-metabolism signals retained as mechanistic hypotheses. A governance ablation over 121 constructed erroneous outputs spanning 26 classes released 121 errors without governance, 57 with the domain layer, seven with the kernel, and zero with both layers. All 10 compliant controls were retained. These results establish complementary control of known failure modes and show how explicit evidence contracts change the conclusions an agent is permitted to report.

Yanlan Kang, Ruiqi Liu, Xinpei Gu +4

Institute of Medical Philosophy & Future AI (IMPF-AI) · Shanghai Medical College, Fudan University · Guangdong Provincial Key Laboratory of New Drug Screening and Guangdong–Hong Kong–Macao Joint Laboratory for New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University +4

AI Agents for Scientific Discovery Scientific Workflow Automation AI Agent Governance Scientific Claim Verification Traditional Chinese Medicine

Oct 10, 2026

Lingdan-V2: Large language models for clinically grounded reasoning in traditional Chinese medicine

Large language models have advanced medical reasoning, but clinically grounded reasoning in traditional Chinese medicine (TCM) remains challenging because prescription decisions require integrating domain knowledge, syndrome differentiation, treatment principles, herbal prescription composition, and dosage determination. We develop a TCM language model family comprising models with 4 billion, 8 billion, and 14 billion parameters. The artificial intelligence contribution is a staged clinical alignment framework integrating large scale continued pretraining on TCM and clinical records, complementary reasoning supervision, and prescription-centered reinforcement learning (RL). We further formulate herbal prescription generation as a structured RL problem with prescription-level feedback, enabling direct optimization of clinical decision outputs beyond knowledge reproduction and generic instruction following. The engineering application is TCM clinical decision support, particularly herbal prescription recommendation. We evaluate the models on a public benchmark containing 25,620 expert-verified items across 13 TCM knowledge and clinical reasoning tasks and on a private retrospective dataset of 4,348 spleen and stomach disease prescription cases. The 14 billion parameter reinforcement aligned model achieves a prescription generation F1 of 37.0 on the public benchmark, compared with 32.3 for DeepSeek-R1 with 671 billion total parameters, and a herb-level F1 of 52.8 on the clinical dataset with improved dosage agreement. Reinforcement post-training consistently improves prescription recommendation across all scales, while physician-source analysis shows that expert heterogeneity affects reward stability. These findings demonstrate a scalable pathway from domain grounding and reasoning supervision to clinically oriented prescription decision support.

Rui Hua, Yu Wei, Ziri Jin +15

School of Computer Science & Technology, Beijing Jiaotong University, Beijing, 100044, China · Tianjin Tasly Digital Chinese Medicine Technology Co., Ltd., Tianjin, 300410, China · Tasly Biopharmaceuticals Co., Ltd., Tianjin, 300410, China +8

Traditional Chinese Medicine Medical LLMs Medication Recommendation RL for Language Model Reasoning Clinical Language Model Evaluation

Oct 3, 2026

TCMClinicalReason-Bench: Can Language Models Reason from Pathogenesis to Prescription over Real-World Clinical Cases?

Large language models (LLMs) can generate clinical narratives that are insufficiently grounded in patient-specific evidence. In traditional Chinese medicine (TCM), errors can propagate from etiology and pathogenesis through syndrome diagnosis and treatment principles to prescription generation. We developed TCMClinicalReason-Bench using 2,000 multicenter electronic health record cases to distinguish case-grounded responses from fluent but unsupported diagnostic and therapeutic conclusions. Five general-purpose and two TCM-specific LLMs were evaluated in zero-shot settings. An evidence-constrained rubric assessed seven diagnostic and therapeutic components and three cross-block relations, allowing case-supported alternatives. Qwen3.7-Plus with TCM retrieval served as the automated judge, alongside parallel blinded ratings by five senior TCM clinicians on a 600-case subset. Structural completeness was nearly saturated (99.3-100.0%), but normalized content scores ranged from 40.7% to 54.1%. The five general-purpose models averaged 50.0%, versus 41.3% for the two smaller TCM-specific models. Cross-block logic consistency ranged from 60.8% to 66.8% and correlated moderately with content across cases (Pearson's r = 0.515-0.656). Deficits were greatest in prescription generation, prescription analysis, and symptom-guided modification. In judge stress testing on 100 independent cases, perturbation detection rates across the three relations were 57%, 56%, and 31%, with contradictions detected more reliably than omissions. Separating component quality from cross-block consistency localizes failures missed by endpoint and completeness metrics and identifies where clinician oversight remains necessary.

Jirui Dai, Chenkai Zhang, Yan Jia +4

the Department of Computer Science, Johns Hopkins University, Baltimore, USA · the School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China · the School of Information Engineering, Huzhou University, Huzhou, China +3

Traditional Chinese Medicine Clinical Language Model Evaluation Clinical Reasoning LLM Grounding Reasoning Consistency in Language Models

Sep 26, 2026

TCMQA: A 38K-Question Traditional Chinese Medicine Benchmark with a Licensed-Practitioner Reference

Medical benchmarks for language models are built almost entirely on Western biomedicine. Traditional Chinese Medicine (TCM) is a separate system, with its own diagnostic framework and its own literature, and it remains largely unmeasured. The few TCM evaluations that exist are small, narrow, and rarely paired with a human reference. We present TCMQA, an open benchmark of 38,279 questions from Chinese TCM licensing examinations, paired with 15,151 responses from 101 licensed practitioners. We evaluate 29 instruction-tuned models from 9 families, spanning 0.27B to 14.8B parameters. Accuracy ranges over 59 points, and no model approaches saturation. Pretraining data predicts TCM ability far better than scale: a 12B Western-pretrained model reaches 39.6%, while a Chinese-pretrained model an eighth its size reaches 60.8%. Nine models exceed the practitioner majority vote of 64.9%, the best by 21.8 points, and all nine come from that same Chinese-pretrained family. Yet difficulty does not transfer between models and practitioners: accuracy is flat across practitioner-rated difficulty, item-level agreement is near zero for all 29 models, and on

8.4\%

of items the practitioners are correct where the leading model is wrong. We release the corpus, the practitioner responses, the harness, and per-item model outputs at https://huggingface.co/datasets/TechTCM/TCMQA.

Tzu-Heng Huang, Jet Lin, Eric Lin

University of Wisconsin-Madison · University of California, Merced · TechTCM

Traditional Chinese Medicine Medical QA Medical LLMs LLM Evaluation

Sep 22, 2026

Syndrome, Synergy, and Safety: Structured Reasoning and Knowledge-Driven Alignment for TCM Prescription Generation

Applying large language models to Traditional Chinese Medicine (TCM) prescription generation reveals three clinically critical gaps: models produce end-to-end mappings without auditable reasoning following the li-fa-fang-yao paradigm (SR Gap), treat each encounter in isolation without follow-up adjustment via sui zheng jia jian (LA Gap), and fail to enforce absolute contraindication rules such as Shi Ba Fan (SC Gap). We propose a progressive four-stage framework (SFT

\to

PG-CoT

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Dynamic

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K-RL) that addresses each gap: PG-CoT constrains CoT distillation under the li-fa-fang-yao paradigm to produce auditable diagnostic chains, Dynamic SFT models patient trajectories with explicit transition reasoning, and K-RL encodes deterministic pharmacological rules as rule-based DPO preference signals. Across 12 fine-tuned models and 6 zero-shot baselines, our framework substantially improves prescription quality over zero-shot baselines---with a 7B model (Mistral-7B) surpassing zero-shot GPT-5 on all three TCM evaluation metrics.

Zheng Chen, ZhiCheng Du, Haoxuan Li +1

Tsinghua University · Guangdong Provincial Laboratory of Traditional Chinese Medicine Hengqin

LLM Safety Alignment CoT Reasoning Text Generation LLM Alignment Clinical Reasoning Medical LLMs+1

Sep 22, 2026

LingLan: An Advancing Traditional Chinese Medicine Diagnosis LLM with Multimodal Data

Though artificial intelligence (AI) increasingly transforms modern medicine, its integration into Traditional Chinese Medicine (TCM) has been relatively slow, primarily due to TCM's reliance on holistic, subjective diagnostic methods---namely Inspection, Auscultation and Olfaction, Inquiry, and Palpation(I-AOI-P)---which are difficult to align with quantitative, standardized medical systems. In this work, we introduce a Unification Framework for Multimodal Data (UFMD), which automatically processes tongue and pulse images into structured, clinically standard descriptions, integrating multi-source diagnostic information into a unified digital record of I-AOI-P process. Building on this structured data, we create LingLan-14B, a TCM-specific large language model fine-tuned via supervised learning to emulate the diagnostic logic and workflow of I-AOI-P process. Experimental results show that our method significantly enhances diagnostic accuracy, achieving a relative improvement of 103.5% over the baseline (62.72% vs. 30.82%) and reaching an F1-score of up to 82%.

Zheng Chen, Zhicheng Du, Haoxuan Li +2

Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China · Guangdong Provincial Laboratory of Traditional Chinese Medicine Hengqin, Guangdong, China

Medical Diagnosis Traditional Chinese Medicine Multimodal Large Language Models Medical LLMs Multimodal Learning

Sep 22, 2026

TCMaster: Confidence-Aware Querying and Workload-Guided Physical Design for Multi-Source Traditional Chinese Medicine Knowledge Graphs

Multi-source knowledge graphs (KGs) need query mechanisms that expose reliability and exploit domain structure. This paper presents TCMaster, a property-graph query substrate for confidence-aware traversal and workload-guided physical design over Traditional Chinese Medicine KGs. TCMaster integrates pharmacopoeias, prescriptions, molecular databases, and LLM-extracted micro-semantics into a KG with approximately 221K entities and 723K base edges. It annotates edges with provenance-level confidence, rewrites Cypher queries with confidence predicates, ranks multi-hop paths under PRODUCT, MIN, or weighted-average policies, and uses ontology skew through direction selection, herb-attribute bitmaps, and materialized shortcut edges. On Neo4j, direction selection improves attribute lookup by a factor of 1.47, shortcuts accelerate high-fanout target counting by a factor of 4.42, confidence filtering removes 39.3 percent of low-quality heterogeneous paths, and KG retrieval improves TCMbench QA accuracy by 20.0 percentage points.

Zheng Chen, Yuzhu Li, Haoxuan Li +3

Tsinghua University, China · Beijing University of Chinese Medicine, China · Guangdong Provincial Laboratory of Traditional Chinese Medicine, China

Graph-Based Retrieval Knowledge Graphs Biomedical KGs Traditional Chinese Medicine

Jul 30, 2026

What Makes Deep Learning Work for Traditional Chinese Medicine Tongue Diagnosis? A Comprehensive Ablation Study

Deep learning has shown promise for automated tongue diagnosis in traditional Chinese medicine (TCM), yet the design space remains underexplored. We conducted a systematic ablation study spanning 20+ model versions under rigorous 5-fold cross-validation on TongueDx2 (5,109 images, 976 expert-annotated) and a merged dataset of 11,101 samples. We compared six backbone architectures, four loss functions, five augmentation strategies, and six training strategies. The best 976-sample model achieved weighted-F1 of 0.6625 using ConvNeXt-Tiny with restrained augmentation and weak-group ensemble, while the best 11,101-sample model reached weighted-F1 of 0.7761. Six key design principles emerged: (1) ConvNeXt-Tiny offers optimal parameter efficiency; (2) BCE substantially outperforms Asymmetric Loss (+2.7%); (3) restrained color augmentation is critical; (4) weak-group ensemble replacement (+2.1%) outperforms probability averaging; (5) data scaling yielded +20.6% improvement; (6) expanding from 13 to 45 label dimensions caused catastrophic collapse (0.78 to 0.22). These principles are generalizable to multi-label medical image classification with class imbalance.

Longxia Gao, Linan Wang, Yuhe Han +3

College of Traditional Chinese Medicine, Hebei University, Baoding, Hebei, China

Medical Diagnosis Medical Image Classification Convolutional Neural Networks Image Classification Traditional Chinese Medicine

Jul 2, 2026

MMIR-TCM: Memory-Integrated Multimodal Inference and Retrieval for TCM Clinical Decision Support

Traditional Chinese Medicine (TCM) diagnosis, particularly through tongue inspection, faces persistent challenges in subjectivity and reproducibility. The application of multimodal artificial intelligence to TCM clinical tasks, such as syndrome differentiation and prescription generation, is significantly hampered by the semantic gap between visual tongue features and textual reasoning, as well as the lack of large-scale, standardized datasets. To address these challenges, we introduce MMIR-TCM, a novel framework that emulates the diagnostic process of TCM experts by integrating multimodal large language model(MLLM) with memory-augmented segmentation and retrieval-augmented generation (RAG). Employing a three-stage architecture, MMIR-TCM integrates a training-free Memory-SAM module for robust tongue extraction, a fine-tuned Qwen3-VL model for structured tongue diagnosis generation, and a Qwen3-based RAG component for evidence-grounded clinical decision support generation. The framework was developed and validated using MedTCM, a new large-scale multimodal dataset that we introduce specifically for advanced TCM research. To properly evaluate our framework's clinical accuracy, which existing metrics fail to capture, we also developed TDEU, a domain-specific evaluation metric incorporating semantic understanding and diagnostic importance. Our comprehensive experiments demonstrate that MMIR-TCM significantly outperforms leading models, including GPT-4o and Gemini 2.5 Flash.

Lihui Luo, Joongwon Chae, Ziyan Chen +13

Institute of Biopharmaceutics and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, 518000, China · Chinese Medicine Guangdong Laboratory, Zhuhai, 519000, China · XiaoMing TCM Hospital, Shenzhen, 518000 China +3

Multimodal RAG Medical Diagnosis Traditional Chinese Medicine Medical VLMs

Jun 26, 2026

Cross-view Multimodal Vision-Based Assessment Framework for Traditional Chinese Medicine Rehabilitation Training

Vision-based assessment can provide convenient and cost-effective evaluation in Traditional Chinese Medicine (TCM) rehabilitation training, where action quality assessment (AQA) from computer vision offers a promising solution. Existing automatic AQA frameworks for physical therapy typically rely on skeletal data captured from a single viewpoint, which is inefficient for TCM techniques such as acupuncture or Tuina that involve dense hand self-occlusion and complex hand-object interactions. To address these challenges, we propose CME-AQA, a cross-view, multimodal vision-based assessment framework that integrates visual-pose fusion to enhance understanding of environmental context and leverages both first-person and third-person videos during training to improve inference robustness. We collected two dual-view datasets, TCM-AQA61-A (Acupuncture) and TCM-AQA61-T (Tuina), each containing synchronized first-person and third-person recordings of 61 subjects with expert annotations. Experimental results show that our approach achieves superior or comparable mean performance against competitive baselines, achieving over 10% relative improvement in weighted F1 over the best competing method on key rating tasks such as Needle Depth and Quick Needle Insertion, while also reducing mean absolute error in quantitative measures such as insertion time and manipulation frequency. Testing on a CPR dataset further demonstrates comparable performance on several posture-based criteria, suggesting applicability to related structured simulated clinical skill assessments where participant motion is central to evaluation. Overall, CME-AQA enhances assessment accuracy for structured TCM rehabilitation training and facilitates more convenient and effective training-oriented skill evaluation.

Francis Xiatian Zhang, Hao Yao, Shengxuan Chen +4

Department of Computer Science, Durham University, UK · Institute for Regeneration and Repair, The University of Edinburgh, UK · Ningbo Hospital of Traditional Chinese Medicine, Ningbo, China +2

Multimodal Robustness Healthcare Action Quality Assessment Traditional Chinese Medicine

Jun 5, 2026

Evidence-Based Intelligent Diagnostic and Therapeutic Visualization System with Large Language Models: Multi-Turn Interaction and Multimodal Treatment Plan Generation

Aim: Existing AI-assisted traditional Chinese medicine diagnostic tools suffer from opaque reasoning processes, passive interaction, and limited treatment plan presentation. This study proposes a knowledge-enhanced visual diagnostic system to improve the transparency and interpretability of syndrome differentiation and treatment. Methods: The system is built upon a Neo4j knowledge graph comprising 241 syndromes, 1,263 symptoms, and 2,485 relations. It incorporates a four-stage symptom matching pipeline (exact, semantic, fuzzy, and large language model verification), an information gain-driven proactive questioning strategy optimized with genetic algorithms, and a multimodal treatment presentation integrating artificial intelligence-generated illustrations, three-dimensional meridian-acupoint models, and evidence-based literature. Results: Knowledge graph constraints reduced non-standard outputs by 32%. Case studies validated the effectiveness of the interactive workflow across patient self-assessment, clinician-assisted diagnosis, and traditional Chinese medicine education. Automated paired-comparison evaluation across 30 cases further demonstrated significant improvements in diagnostic trust (Cohen's d = 1.82, p < 0.001), reduced cognitive load (improvements in four of five dimensions), and higher credibility of evidence-based references (4.21 vs. 2.95). Conclusions: The proposed system enhances the transparency of traditional Chinese medicine diagnostic reasoning and the interpretability of treatment plans through knowledge graph-driven visualization and multimodal interaction, offering a practical solution for trustworthy artificial intelligence-assisted traditional Chinese medicine applications.

Yunhan Wang, Yuda Wang, Zhiying Tu +5

Harbin Institute of Technology, Weihai, Weihai, Shandong, China · Shandong Key Laboratory of Digital Service Computing Technology and Systems, China · Weihai Municipal Hospital, Weihai, Shandong, China +3

Medical Diagnosis Clinical Decision Support Active Information Gathering Traditional Chinese Medicine

May 8, 2026

TCMIIES: A Browser-Based LLM-Powered Intelligent Information Extraction System for Academic Literature

The exponential growth of academic publications has created an urgent need for automated tools capable of extracting structured knowledge from unstructured scientific texts. While large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and information extraction, existing solutions often require specialized infrastructure, programming expertise, or fine-tuned domain-specific models that create barriers for researchers in specialized fields. This paper presents TCMIIES, a browser-based, zero-installation platform that leverages commercial LLM APIs to perform structured information extraction from academic literature. The system employs a novel schema-guided prompting framework with automatic system prompt generation, enabling researchers to define custom extraction schemas through an intuitive graphical interface without any programming. TCMIIES features a pure front-end architecture that ensures data privacy by processing all information locally in the browser, supports five major LLM providers, implements concurrent batch processing with automatic retry mechanisms, and provides intelligent field mapping for Chinese academic databases including CNKI and Wanfang. We demonstrate the system's effectiveness through comprehensive evaluation across multiple extraction scenarios in Traditional Chinese Medicine research, achieving structured output compliance rates exceeding 94% and information extraction accuracy comparable to domain-expert annotation. The system represents a practical, accessible solution that bridges the gap between advanced LLM capabilities and domain-specific academic information extraction needs, particularly for researchers in specialized fields who require flexible, privacy-preserving, and cost-effective extraction tools.

Hanqing Zhao

Hebei University, College of Traditional Chinese Medicine Baoding, Hebei 071002, China

Traditional Chinese Medicine Document Information Extraction LLM Information Extraction

Mar 30, 2026

DongYuan: An LLM-Based Framework for Integrative Chinese and Western Medicine Spleen-Stomach Disorders Diagnosis

The clinical burden of spleen-stomach disorders is substantial. While large language models (LLMs) offer new potential for medical applications, they face three major challenges in the context of integrative Chinese and Western medicine (ICWM): a lack of high-quality data, the absence of models capable of effectively integrating the reasoning logic of traditional Chinese medicine (TCM) syndrome differentiation with that of Western medical (WM) disease diagnosis, and the shortage of a standardized evaluation benchmark. To address these interrelated challenges, we propose DongYuan, an ICWM spleen-stomach diagnostic framework. Specifically, three ICWM datasets (SSDF-Syndrome, SSDF-Dialogue, and SSDF-PD) were curated to fill the gap in high-quality data for spleen-stomach disorders. We then developed SSDF-Core, a core diagnostic LLM that acquires robust ICWM reasoning capabilities through a two-stage training regimen of supervised fine-tuning. tuning (SFT) and direct preference optimization (DPO), and complemented it with SSDF-Navigator, a pluggable consultation navigation model designed to optimize clinical inquiry strategies. Additionally, we established SSDF-Bench, a comprehensive evaluation benchmark focused on ICWM diagnosis of spleen-stomach disorders. Experimental results demonstrate that SSDF-Core significantly outperforms 12 mainstream baselines on SSDF-Bench. DongYuan lays a solid methodological foundation and provides practical technical references for the future development of intelligent ICWM diagnostic systems.

Hua Li, Yingying Li, Xiaobin Feng +8

Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, China · Beijing Wenge Technology Co., Ltd., Beijing, China · Institute of Automation, Chinese Academy of Sciences, Beijing, China +1

Medical Diagnosis Medical LLMs Traditional Chinese Medicine

Mar 6, 2026

DERM-3R: A Resource-Efficient Multimodal Agents Framework for Dermatologic Diagnosis and Treatment in Real-World Clinical Settings

Skin diseases impose a substantial and growing global health burden. Modern dermatologic therapies control acute manifestations rapidly, but single-target treatment paradigms, recurrent disease courses, and neglected systemic comorbidities limit their long-term effectiveness. Traditional Chinese medicine (TCM) offers a complementary, holistic approach through syndrome differentiation and individualized treatment, yet its clinical practice is hindered by non-standardized knowledge, incomplete multimodal records, and the difficulty of scaling expert-driven reasoning. We propose DERM-3R, a resource-efficient multimodal agents framework that models TCM dermatologic diagnosis and treatment under limited data and computational resources. We decompose and redefine real-world dermatologic decision-making into three essential issues: fine-grained lesion recognition, multi-view lesion representation with specialist-level pathogenesis modeling, and holistic clinical reasoning for syndrome differentiation and treatment planning. DERM-3R comprises three collaborative agents, DERM-Rec, DERM-Rep, and DERM-Reason, each addressing one of these issues. Built on a lightweight multimodal large language model and fine-tuned by partial-parameter finetuning on 103 real-world TCM psoriasis cases, DERM-3R performs strongly across multiple dermatologic reasoning tasks. Automatic metrics, LLM-as-a-Judge assessments, and human doctors show that, despite extremely limited training data and parameter updates, DERM-3R matches or even surpasses hundred-billion-parameter general-purpose multimodal models such as GPT-5.1 and Gemini-3-Flash. Our results indicate that structured, domain-aware multi-agent modeling is an effective alternative to brute-force scaling for complex clinical tasks, offering a practical and scalable paradigm for multimodal AI in dermatology and integrative medicine.

Jirui Dai, Zhendong Wang, Chongjing Wang +7

Traditional Chinese Medicine Dermatology Multimodal Agents Clinical Decision-Making Medical VLMs Clinical Reasoning+1

Mar 6, 2026

From Physician Expertise to Clinical Agents: Preserving, Standardizing, and Scaling Physicians' Medical Expertise with Lightweight LLM

Medicine is an empirical discipline refined through long-term observation and the messy, high-variance reality of clinical practice. Physicians build diagnostic and therapeutic competence through repeated cycles of application, reflection, and improvement, forming individualized methodologies. Yet outcomes vary widely, and master physicians' knowledge systems are slow to develop and hard to transmit at scale, contributing to the scarcity of high-quality clinical expertise. To address this, we propose Med-Shicheng, a general framework that enables large language models to systematically learn and transfer distinguished physicians' diagnostic-and-therapeutic philosophy and case-dependent adaptation rules in a standardized way. Built on Tianyi, Med-Shicheng consists of five stages. We target five National Masters of Chinese Medicine or distinguished TCM physicians, curate multi-source materials, and train a single model to internalize all five knowledge systems across seven tasks, including etiology-pathogenesis analysis, syndrome diagnosis, treatment principle selection, prescription generation, prescription explanation, symptom evolution with regimen adjustment, and clinical advice. Implemented on Qwen2.5-1.5B-Base, Med-Shicheng runs on resource-constrained GPUs while achieving performance comparable to DeepSeek-R1 and GPT-5. We also examine the reliability of LLM-as-a-judge versus physician evaluation: automated judging tracks overall trends but shows bias on fine-grained individualized distinctions, highlighting the need for physician involvement when ground truth is unavailable and for domain-adapted judge models.

Chanyong Luo, Jirui Dai, Zhendong Wang +14

the Infectious disease department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China · the Department of Computer Science, Johns Hopkins University, Baltimore, USA · the Gulou Hospital of Traditional Chinese Medicine of Beijing，Beijing, China +8

Traditional Chinese Medicine Medical LLMs Clinical Decision-Making

Feb 26, 2026

TCM-DiffRAG: Personalized Syndrome Differentiation Reasoning Method for Traditional Chinese Medicine based on Knowledge Graph and Chain of Thought

Background: Retrieval augmented generation (RAG) technology can empower large language models (LLMs) to generate more accurate, professional, and timely responses without fine tuning. However, due to the complex reasoning processes and substantial individual differences involved in traditional Chinese medicine (TCM) clinical diagnosis and treatment, traditional RAG methods often exhibit poor performance in this domain. Objective: To address the limitations of conventional RAG approaches in TCM applications, this study aims to develop an improved RAG framework tailored to the characteristics of TCM reasoning. Methods: We developed TCM-DiffRAG, an innovative RAG framework that integrates knowledge graphs (KG) with chains of thought (CoT). TCM-DiffRAG was evaluated on three distinctive TCM test datasets. Results: The experimental results demonstrated that TCM-DiffRAG achieved significant performance improvements over native LLMs. For example, the qwen-plus model achieved scores of 0.927, 0.361, and 0.038, which were significantly enhanced to 0.952, 0.788, and 0.356 with TCM-DiffRAG. The improvements were even more pronounced for non-Chinese LLMs. Additionally, TCM-DiffRAG outperformed directly supervised fine-tuned (SFT) LLMs and other benchmark RAG methods. Conclusions: TCM-DiffRAG shows that integrating structured TCM knowledge graphs with Chain of Thought based reasoning substantially improves performance in individualized diagnostic tasks. The joint use of universal and personalized knowledge graphs enables effective alignment between general knowledge and clinical reasoning. These results highlight the potential of reasoning-aware RAG frameworks for advancing LLM applications in traditional Chinese medicine.

Jianmin Li, Ying Chang, Su-Kit Tang +4

1.Faculty of Applied Sciences, Macao Polytechnic University, R. de Luís Gonzaga Gomes, 999078, Macao, China. · 3.School of Basic Medical Sciences, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou 310053, China. · 6.Zhejiang Chinese Medical University – GANCAO DOCTOR Institute of Artificial Intelligence for Chinese Medicine +3

Traditional Chinese Medicine Graph Retrieval-Augmented Generation LLM Reasoning with Graphs Clinical Reasoning

Feb 2, 2026

LingLanMedBench: A Unified Benchmark for Evaluating Large Language Models in Traditional Chinese Medicine

Reliable evaluation of large language models in traditional Chinese medicine remains limited because existing benchmarks mainly focus on examination-style question answering or isolated generative tasks. We developed LingLanMedBench, a unified benchmark comprising 25,620 expert-verified items across 13 subtasks and five domains, covering knowledge, language understanding, information extraction, and diagnostic-therapeutic decision-making. LingLanMedBench standardizes task formats and evaluation metrics and further incorporates synonym-tolerant clinical-label matching, empirically derived hard subsets, and decision-recognition reformulations of open-ended clinical tasks. Fourteen open-source and proprietary models were evaluated under a standardized zero-shot protocol. Performance varied substantially across domains, model families, task formulations, and difficulty levels. The leading overall score decreased from 51.1 on the full benchmark to 31.9 on the hard subsets. Prescription performance also differed markedly between open-ended generation, with F1 scores of 32.7 and 20.3, and decision recognition, with accuracies of 90.6 and 56.8 on the full and hard subsets, respectively. These findings reveal a substantial gap between knowledge-oriented performance and clinically faithful reasoning. LingLanMedBench provides a standardized and reproducible framework for characterizing current capabilities, identifying systematic limitations, and tracking meaningful progress in large language models for traditional Chinese medicine.

Rui Hua, Yu Wei, Zixin Shu +17

Department of Computer Science and Technology, Beijing Jiaotong University, Beijing, China · Tianjin Tasly Digital Chinese Medicine Technology Co., Ltd., Tianjin, China · Tasly Biopharmaceuticals Co., Ltd., Tianjin, China +11

Traditional Chinese Medicine Medical LLMs LLM Evaluation Clinical Language Model Evaluation

Jan 17, 2026

Mapping the maturation of TCM as an adjuvant to radiotherapy

The integration of complementary medicine into oncology represents a paradigm shift that has seen to increasing adoption of Traditional Chinese Medicine (TCM) as an adjuvant to radiotherapy. About twenty-five years since the formal institutionalization of integrated oncology, it is opportune to synthesize the trajectory of evidence for TCM as an adjuvant to radiotherapy. Here we conduct a large-scale analysis of 69,745 publications (2000 - 2025), emerging a cyclical evolution defined by coordinated expansion and contraction in publication output, international collaboration, and funding commitments that mirrors a define-ideate-test pattern. Using a theme modeling workflow designed to determine a stable thematic structure of the field, we identify five dominant thematic axes - cancer types, supportive care, clinical endpoints, mechanisms, and methodology - that signal a focus on patient well-being, scientific rigor and mechanistic exploration. Cross-theme integration of TCM is patient-centered and systems-oriented. Together with the emergent cycles of evolution, the thematic structure demonstrates progressive specialization and potential defragmentation of the field or saturation of existing research agenda. The analysis points to a field that has matured its current research agenda and is likely at the cusp of something new. Additionally, the field exhibits positive reporting of findings that is homogeneous across publication types, thematic areas, and the cycles of evolution suggesting a system-wide positive reporting bias agnostic to structural drivers.

P. Bilha Githinji, Aikaterini Melliou, Xi Yuan +8

Guangdong Provincial Laboratory of Traditional Chinese Medicine, Hengqin, Guangdong, China · Affiliated Fifth Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China

Traditional Chinese Medicine Oncology Bibliometric Analysis