张坚 张坚


2025

"This paper introduces an intelligent diagnostic system for Traditional Chinese Medicine (TCM) that emulates clinical reasoning through a phased multi-turn dialogue process. The system architecture is divided into three sequential stages: syndrome differentiation, disease diagnosis,and prescription generation. Each stage leverages Chain-of-Thought (CoT) techniques to ensure coherent reasoning, maintaining contextual continuity and consistency throughout the diagnostic process. To optimize model performance, we employ a multi-task fine-tuning approach, combin-ing data from all three stages for training the Qwen2.5-7B-Instruct model. Experimental results show that the system achieves strong performance across all diagnostic tasks. Error analysis re-veals that the accuracy of the first two stages, syndrome differentiation and disease diagnosis, has a significant impact on the quality of the generated prescriptions. This work provides a scalable framework for intelligent TCM diagnosis, advancing both medical knowledge reasoning and the application of domain-specific large language models."