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Your Name
2026-05-29 14:45:56 +08:00
parent 94e787ae80
commit 17ad153821
9 changed files with 1795 additions and 623 deletions
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server/app/api/logic/tcm/DailyDietAiLogic.php
+204 -29
View File
@@ -31,20 +31,24 @@ class DailyDietAiLogic
return ['ok' => false, 'error' => '缺少就诊卡'];
}
$context = self::buildPatientContext($diagnosisId);
if (!$context['ok']) {
return ['ok' => false, 'error' => $context['error'] ?? '获取档案失败'];
}
$analysis = self::buildAnalysisPayload($context['data']);
$exercise = self::buildExercisePayload($context['data']);
$cacheKey = self::recommendCacheKey($diagnosisId);
if (!$refresh) {
$cached = Cache::get($cacheKey);
if (is_array($cached) && !empty($cached['breakfast'])) {
$cached['cached'] = true;
$cached['cached'] = true;
$cached['analysis'] = $analysis;
$cached['exercise'] = $exercise;
return ['ok' => true, 'data' => $cached];
}
}
$context = self::buildPatientContext($diagnosisId);
if (!$context['ok']) {
return ['ok' => false, 'error' => $context['error'] ?? '获取档案失败'];
}
$data = null;
if (AiChatService::isEnabled()) {
$raw = self::aiDailyRecommend($context['data'], $refresh);
@@ -61,6 +65,8 @@ class DailyDietAiLogic
$data['date'] = date('Y-m-d');
$data['cached'] = false;
Cache::set($cacheKey, $data, self::CACHE_TTL);
$data['analysis'] = $analysis;
$data['exercise'] = $exercise;
return ['ok' => true, 'data' => $data];
}
@@ -117,21 +123,28 @@ class DailyDietAiLogic
return;
}
$cacheKey = self::recommendCacheKey($diagnosisId);
if (!$refresh) {
$cached = Cache::get($cacheKey);
if (is_array($cached) && !empty($cached['breakfast'])) {
$cached['cached'] = true;
$emit('done', $cached);
return;
}
}
$context = self::buildPatientContext($diagnosisId);
if (!$context['ok']) {
$emit('error', ['message' => $context['error'] ?? '获取档案失败']);
return;
}
$analysis = self::buildAnalysisPayload($context['data']);
$exercise = self::buildExercisePayload($context['data']);
// 先把「分析依据」「运动建议」推给前端，提升首屏感知
$emit('analysis', ['analysis' => $analysis]);
$emit('exercise', ['exercise' => $exercise]);
$cacheKey = self::recommendCacheKey($diagnosisId);
if (!$refresh) {
$cached = Cache::get($cacheKey);
if (is_array($cached) && !empty($cached['breakfast'])) {
$cached['cached'] = true;
$cached['analysis'] = $analysis;
$cached['exercise'] = $exercise;
$emit('done', $cached);
return;
}
}
$data = null;
$fullText = '';
@@ -168,6 +181,8 @@ class DailyDietAiLogic
$data['date'] = date('Y-m-d');
$data['cached'] = false;
Cache::set($cacheKey, $data, self::CACHE_TTL);
$data['analysis'] = $analysis;
$data['exercise'] = $exercise;
$emit('done', $data);
}
@@ -271,20 +286,27 @@ class DailyDietAiLogic
$row = $diagnosis->toArray();
$gender = (int) ($row['gender'] ?? 0);
$genderText = $gender === 1 ? '男' : ($gender === 0 ? '女' : '未知');
$age = (int) ($row['age'] ?? 0);
$since = strtotime('-7 days 00:00:00');
// 拉取近 30 天血糖（涵盖近 7 天），统一计算 7/30 天统计
$since30 = strtotime('-30 days 00:00:00');
$bloodList = BloodRecord::where('diagnosis_id', $diagnosisId)
->where('record_date', '>=', $since)
->where('record_date', '>=', $since30)
->where('delete_time', null)
->order('record_date', 'desc')
->limit(7)
->field('record_date,fasting_blood_sugar,postprandial_blood_sugar,other_blood_sugar')
->select()
->toArray();
$since7 = strtotime('-7 days 00:00:00');
$list7 = array_values(array_filter($bloodList, static function ($b) use ($since7) {
return (int) ($b['record_date'] ?? 0) >= $since7;
}));
// 近 7 天逐日明细（喂给 AI 的细节）
$bloodSummary = [];
foreach ($bloodList as $b) {
$date = !empty($b['record_date']) ? date('Y-m-d', (int) $b['record_date']) : '';
foreach (array_slice($list7, 0, 7) as $b) {
$date = !empty($b['record_date']) ? date('Y-m-d', (int) $b['record_date']) : '';
$parts = [];
if ($b['fasting_blood_sugar'] !== null && $b['fasting_blood_sugar'] !== '') {
$parts[] = '空腹' . $b['fasting_blood_sugar'];
@@ -300,18 +322,163 @@ class DailyDietAiLogic
}
}
$stats7 = self::aggregateBloodStats($list7, $age, '近7天');
$stats30 = self::aggregateBloodStats($bloodList, $age, '近30天');
return [
'ok' => true,
'data' => [
'patient_name' => (string) ($row['patient_name'] ?? ''),
'age' => (int) ($row['age'] ?? 0),
'gender_text' => $genderText,
'blood_recent' => $bloodSummary,
'today' => date('Y-m-d'),
'patient_name' => (string) ($row['patient_name'] ?? ''),
'age' => $age,
'gender_text' => $genderText,
'blood_recent' => $bloodSummary,
'stats_7d' => $stats7,
'stats_30d' => $stats30,
'today' => date('Y-m-d'),
],
];
}
/**
* 根据年龄返回血糖偏高阈值（与前端 getBloodSugarThresholds 保持一致）
*
* @return array{fasting:float,postprandial:float}|null
*/
private static function bloodThresholds(int $age): array
{
// 年龄未知时用通用糖尿病控制目标兜底，避免「无阈值=全部达标」
if ($age <= 0) {
return ['fasting' => 7.0, 'postprandial' => 10.0];
}
return $age < 50
? ['fasting' => 7.0, 'postprandial' => 9.0]
: ['fasting' => 8.0, 'postprandial' => 10.0];
}
/**
* 汇总一段时间内的血糖统计：有记录天数、偏高天数、达标率、均值
*
* @param array<int,array<string,mixed>> $rows
* @return array<string,mixed>
*/
private static function aggregateBloodStats(array $rows, int $age, string $label): array
{
$thresholds = self::bloodThresholds($age);
$byDate = [];
$fastingSum = 0.0;
$fastingCnt = 0;
$postSum = 0.0;
$postCnt = 0;
foreach ($rows as $b) {
$ts = (int) ($b['record_date'] ?? 0);
if ($ts <= 0) {
continue;
}
$date = date('Y-m-d', $ts);
$fasting = ($b['fasting_blood_sugar'] !== null && $b['fasting_blood_sugar'] !== '') ? (float) $b['fasting_blood_sugar'] : null;
$post = ($b['postprandial_blood_sugar'] !== null && $b['postprandial_blood_sugar'] !== '') ? (float) $b['postprandial_blood_sugar'] : null;
if ($fasting === null && $post === null) {
continue;
}
if (!isset($byDate[$date])) {
$byDate[$date] = ['high' => false];
}
if ($fasting !== null) {
$fastingSum += $fasting;
$fastingCnt++;
if ($thresholds && $fasting >= $thresholds['fasting']) {
$byDate[$date]['high'] = true;
}
}
if ($post !== null) {
$postSum += $post;
$postCnt++;
if ($thresholds && $post >= $thresholds['postprandial']) {
$byDate[$date]['high'] = true;
}
}
}
$recordDays = count($byDate);
$highDays = 0;
foreach ($byDate as $d) {
if ($d['high']) {
$highDays++;
}
}
$normalDays = max(0, $recordDays - $highDays);
$compliance = $recordDays > 0 ? (int) round($normalDays / $recordDays * 100) : 0;
return [
'label' => $label,
'record_days' => $recordDays,
'high_days' => $highDays,
'normal_days' => $normalDays,
'compliance' => $compliance,
'fasting_avg' => $fastingCnt > 0 ? round($fastingSum / $fastingCnt, 1) : null,
'postprandial_avg' => $postCnt > 0 ? round($postSum / $postCnt, 1) : null,
];
}
/**
* 把统计数据拼成喂给 AI 的一行人类可读文本
*
* @param array<string,mixed> $stats
*/
private static function statsToLine(array $stats): string
{
if (($stats['record_days'] ?? 0) <= 0) {
return $stats['label'] . '无血糖记录';
}
$segs = [
$stats['label'] . "有记录{$stats['record_days']}天",
"偏高{$stats['high_days']}天",
"达标率{$stats['compliance']}%",
];
if ($stats['fasting_avg'] !== null) {
$segs[] = "空腹均值{$stats['fasting_avg']}";
}
if ($stats['postprandial_avg'] !== null) {
$segs[] = "餐后均值{$stats['postprandial_avg']}";
}
return implode('，', $segs);
}
/**
* 给前端展示的「分析依据」结构（近7天 + 近30天）
*
* @param array<string,mixed> $context
* @return array<int,array<string,mixed>>
*/
private static function buildAnalysisPayload(array $context): array
{
$out = [];
foreach (['stats_7d', 'stats_30d'] as $key) {
$s = $context[$key] ?? null;
if (is_array($s)) {
$out[] = $s;
}
}
return $out;
}
/**
* 给前端展示的「运动降糖」建议（按血糖统计调整强度）
*
* @param array<string,mixed> $context
* @return array<string,mixed>
*/
private static function buildExercisePayload(array $context): array
{
return GiKnowledge::exercisePlan(
is_array($context['stats_7d'] ?? null) ? $context['stats_7d'] : [],
is_array($context['stats_30d'] ?? null) ? $context['stats_30d'] : []
);
}
/**
* @return array{0:string,1:string}
*/
@@ -320,6 +487,8 @@ class DailyDietAiLogic
$bloodLine = empty($context['blood_recent'])
? '近7日无血糖记录'
: implode('；', $context['blood_recent']);
$stat7Line = self::statsToLine($context['stats_7d'] ?? ['label' => '近7天', 'record_days' => 0]);
$stat30Line = self::statsToLine($context['stats_30d'] ?? ['label' => '近30天', 'record_days' => 0]);
$system = <<<SYS
你是村里懂糖尿病饮食的大夫助手，依据「霍大夫升糖指数（GI）」给农村老人推荐一日三餐。输出必须严格可执行。
@@ -335,12 +504,14 @@ class DailyDietAiLogic
SYS;
$user = sprintf(
"患者：%s，%s，%s岁。日期：%s。近7日血糖：%s。\n\nGI知识：\n%s\n\n农家饭参考：\n%s\n\n请输出严格符合硬性规则的三餐 JSON。",
"患者：%s，%s，%s岁。日期：%s。\n近7日逐日血糖：%s。\n血糖统计：%s；%s。\n（若近期偏高天数多或达标率低，请收紧主食与高GI食物，多安排蛋白与绿叶菜；若控制平稳可正常推荐。）\n\nGI知识：\n%s\n\n农家饭参考：\n%s\n\n请输出严格符合硬性规则的三餐 JSON。",
$context['patient_name'] ?: '大爷大妈',
$context['gender_text'] ?? '',
$context['age'] ?? 0,
$context['today'] ?? date('Y-m-d'),
$bloodLine,
$stat7Line,
$stat30Line,
GiKnowledge::summaryText(),
GiKnowledge::ruralMealHints()
);
@@ -362,6 +533,8 @@ SYS;
$bloodLine = empty($context['blood_recent'])
? '近7日无血糖记录'
: implode('；', $context['blood_recent']);
$stat7Line = self::statsToLine($context['stats_7d'] ?? ['label' => '近7天', 'record_days' => 0]);
$stat30Line = self::statsToLine($context['stats_30d'] ?? ['label' => '近30天', 'record_days' => 0]);
$system = <<<SYS
你是村里懂糖尿病饮食的大夫助手，依据「霍大夫升糖指数（GI）」给农村老人推荐一日三餐。
@@ -381,13 +554,15 @@ SYS;
SYS;
$user = sprintf(
"患者：%s，%s，%s岁。日期：%s。近7日血糖：%s。\n\nGI摘要：\n%s",
"患者：%s，%s，%s岁。日期：%s。\n近7日逐日血糖：%s。\n血糖统计：%s；%s。\n（偏高多或达标率低则收紧主食、多蛋白绿叶菜；平稳则正常推荐。）\n\nGI摘要：\n%s",
$context['patient_name'] ?: '大爷大妈',
$context['gender_text'] ?? '',
$context['age'] ?? 0,
$context['today'] ?? date('Y-m-d'),
$bloodLine,
mb_substr(GiKnowledge::summaryText(), 0, 380)
$stat7Line,
$stat30Line,
mb_substr(GiKnowledge::summaryText(), 0, 320)
);
if ($refresh) {
server/app/api/logic/tcm/GiKnowledge.php
+83
View File
@@ -192,6 +192,89 @@ class GiKnowledge
return $out;
}
/**
* 根据血糖统计给出「运动降糖」建议（规则化，按控制好坏调整强度）
*
* @param array<string,mixed> $stats7 近7天统计
* @param array<string,mixed> $stats30 近30天统计
* @return array{level:string,level_label:string,headline:string,items:list<string>,intensity:string,note:string}
*/
public static function exercisePlan(array $stats7 = [], array $stats30 = []): array
{
// 优先用记录更全的口径判断；都没记录则用近7天
$primary = ((int) ($stats30['record_days'] ?? 0) > 0) ? $stats30 : $stats7;
$recordDays = (int) ($primary['record_days'] ?? 0);
$compliance = (int) ($primary['compliance'] ?? 0);
$highDays = (int) ($primary['high_days'] ?? 0);
if ($recordDays <= 0) {
$level = 'unknown';
} elseif ($compliance < 50 || $highDays * 2 >= $recordDays) {
$level = 'high'; // 偏高多、达标率低 = 控制不佳
} elseif ($compliance < 80) {
$level = 'medium';
} else {
$level = 'good';
}
$note = '餐后 1 小时内开始动，别空腹剧烈运动；身上带几块糖，头晕、心慌、出虚汗就马上停下歇着。';
switch ($level) {
case 'high':
return [
'level' => 'high',
'level_label' => '血糖偏高 · 多动',
'headline' => '近期血糖偏高，三顿饭后都动一动，最能帮着把糖降下来。',
'items' => [
'早饭后快走 15 分钟，走到微微出汗',
'午饭后快走或原地踏步 20–30 分钟，降餐后血糖最管用',
'晚饭后慢走 30 分钟，吃完别马上坐下、躺下',
],
'intensity' => '中等强度 · 每天累计约 60 分钟',
'note' => $note,
];
case 'medium':
return [
'level' => 'medium',
'level_label' => '基本平稳 · 再稳稳',
'headline' => '血糖大体平稳，坚持餐后活动，把它稳住。',
'items' => [
'三餐后各散步 20 分钟，午饭后可以走快些',
'每天加一段八段锦或太极拳，10–15 分钟',
'能走楼梯少坐电梯，多干点家务、地里活',
],
'intensity' => '中低强度 · 每天累计 40–50 分钟',
'note' => $note,
];
case 'good':
return [
'level' => 'good',
'level_label' => '控制不错 · 保持',
'headline' => '血糖控制得不错，保持规律活动就行。',
'items' => [
'餐后散步 15–20 分钟，雷打不动',
'每天一段八段锦、太极或柔和拉伸',
'天好多到院里、地里走动，别久坐',
],
'intensity' => '中低强度 · 每天累计 30–40 分钟',
'note' => $note,
];
default:
return [
'level' => 'unknown',
'level_label' => '先记血糖 · 再调运动',
'headline' => '血糖记录还少，先按基础来：饭后多走动。',
'items' => [
'三餐后都散步 15–20 分钟',
'每天一段八段锦或太极拳',
'少久坐，坐 1 小时就起来活动几分钟',
],
'intensity' => '中低强度 · 每天累计约 30 分钟',
'note' => $note,
];
}
}
/**
* @return array{food:string,level:string,level_label:string,advice:string,source:string}
*/