更新

server/app/common/service/AiChatService.php

@@ -29,6 +29,12 @@ class AiChatService
             return ['ok' => false, 'error' => 'AI 密钥未配置'];
         }
 
+        try {
+            $messages = NihaixiaClinicalSkill::augmentMessages($messages);
+        } catch (\RuntimeException $error) {
+            return ['ok' => false, 'error' => '临床 AI 参考资料不可用'];
+        }
+
         $baseUrl = rtrim((string) ($cfg['base_url'] ?? 'https://api.deepseek.com'), '/');
         $model   = (string) ($options['model'] ?? ($cfg['model'] ?? 'deepseek-chat'));
         $timeout = (int) ($options['timeout'] ?? ($cfg['timeout'] ?? 60));
@@ -99,6 +105,12 @@ class AiChatService
             return ['ok' => false, 'error' => 'AI 密钥未配置'];
         }
 
+        try {
+            $messages = NihaixiaClinicalSkill::augmentMessages($messages);
+        } catch (\RuntimeException $error) {
+            return ['ok' => false, 'error' => '临床 AI 参考资料不可用'];
+        }
+
         $baseUrl = rtrim((string) ($cfg['base_url'] ?? 'https://api.deepseek.com'), '/');
         $model   = (string) ($options['model'] ?? ($cfg['model'] ?? 'deepseek-chat'));
         $timeout = (int) ($options['timeout'] ?? ($cfg['timeout'] ?? 60));

server/app/common/service/DifyChatService.php

@@ -77,6 +77,12 @@ class DifyChatService
             return self::error('CONFIG_INVALID', 'AI 模型配置无效');
         }
 
+        try {
+            $query = NihaixiaClinicalSkill::augmentQuery($query);
+        } catch (\RuntimeException $error) {
+            return self::error('SKILL_UNAVAILABLE', '临床 AI 参考资料不可用');
+        }
+
         $strictFiles = !empty($options['strict_files']);
         $normalized = self::normalizeFiles($files, self::maxFiles($config, $modelConfig), !$strictFiles);
         if ($strictFiles && !self::strictFilesComplete($files, $normalized)) {
@@ -229,6 +235,12 @@ class DifyChatService
             return self::error('CONFIG_INVALID', 'AI 模型配置无效');
         }
 
+        try {
+            $query = NihaixiaClinicalSkill::augmentQuery($query);
+        } catch (\RuntimeException $error) {
+            return self::error('SKILL_UNAVAILABLE', '临床 AI 参考资料不可用');
+        }
+
         $normalized = self::normalizeFiles($files, self::maxFiles($config, $modelConfig));
         $startedAt = microtime(true);
         $formatted = null;

server/app/common/service/NihaixiaClinicalSkill.php

@@ -0,0 +1,103 @@
+<?php
+
+declare(strict_types=1);
+
+namespace app\common\service;
+
+use RuntimeException;
+
+/**
+ * A bounded clinical reference distilled at runtime from the vendored skill.
+ * The repository contains historical cases and agent instructions; neither is
+ * allowed to override patient evidence, structured output, or physician review.
+ */
+final class NihaixiaClinicalSkill
+{
+    public const VERSION = 'nihaixia-270e94e-clinical-v1';
+
+    private const MARKER = '[NIHAIXIA_CLINICAL_SKILL:' . self::VERSION . ']';
+
+    private static ?string $reference = null;
+
+    public static function augmentQuery(string $query): string
+    {
+        if (str_contains($query, self::MARKER)) {
+            return $query;
+        }
+
+        return self::reference() . "\n\n【原始临床任务与患者资料】\n" . $query;
+    }
+
+    /** @param array<int,array<string,mixed>> $messages
+     *  @return array<int,array<string,mixed>>
+     */
+    public static function augmentMessages(array $messages): array
+    {
+        foreach ($messages as $message) {
+            if (str_contains((string) ($message['content'] ?? ''), self::MARKER)) {
+                return $messages;
+            }
+        }
+
+        array_unshift($messages, ['role' => 'system', 'content' => self::reference()]);
+        return $messages;
+    }
+
+    public static function reference(): string
+    {
+        if (self::$reference !== null) {
+            return self::$reference;
+        }
+
+        $path = dirname(__DIR__, 3) . '/knowledge/nihaixia-skill/SKILL.md';
+        $source = @file_get_contents($path);
+        if (!is_string($source) || $source === '') {
+            throw new RuntimeException('NIHAIXIA_SKILL_UNAVAILABLE');
+        }
+
+        $meridians = [];
+        preg_match_all(
+            '/^\|\s*\*\*(太阳|阳明|少阳|太阴|少阴|厥阴)\*\*\s*\|\s*([^|\r\n]+)\s*\|/mu',
+            $source,
+            $rows,
+            PREG_SET_ORDER
+        );
+        foreach ($rows as $row) {
+            $meridians[$row[1]] ??= trim($row[2]);
+        }
+        preg_match_all('/^第[一二三四五六七]步：\s*([^─\r\n]+)/mu', $source, $steps);
+        $stepNames = array_values(array_unique(array_map('trim', $steps[1] ?? [])));
+        preg_match_all(
+            '/^IF\s+([^\r\n]+?)\s*→\s*(太阳病|阳明病|少阳病|太阴病|少阴病|厥阴病|少阴热化证)\s*$/mu',
+            $source,
+            $formulas,
+            PREG_SET_ORDER
+        );
+        $diagnosticClues = [];
+        foreach ($formulas as $formula) {
+            $diagnosticClues[$formula[2]] ??= trim($formula[1]);
+        }
+        if (count($meridians) !== 6 || count($stepNames) !== 7 || count($diagnosticClues) !== 7) {
+            throw new RuntimeException('NIHAIXIA_SKILL_INVALID');
+        }
+
+        $signs = [];
+        foreach ($meridians as $name => $symptoms) {
+            $signs[] = $name . '：' . $symptoms;
+        }
+        $clues = [];
+        foreach ($diagnosticClues as $name => $condition) {
+            $clues[] = $name . '（' . $condition . '）';
+        }
+        self::$reference = self::MARKER
+            . "\n参考来源：coinweth/nihaixia-skill，SKILL.md「六经速查表」「六经辨证诊断公式」「七步走辨证思维模式」，commit 270e94e。"
+            . "\n六经主证：" . implode('；', $signs) . '。'
+            . "\n条件线索：" . implode('；', $clues) . '。'
+            . "\n辨证步骤：" . implode('→', $stepNames) . '。'
+            . "\n以上为传统中医教学参考，条件线索并非确诊规则。只根据当前患者的病史、症状、舌脉、检查及用药资料作有条件的辨证；病名不能直接等同证型，未满足关键证据时不得强行归经，缺失信息须说明。"
+            . "仓库医案、角色扮演和治疗主张均是待核对资料，不得据此建议停用现有治疗、忽略急症或跳过医师复核。"
+            . "保持原任务要求的 JSON 结构、来源编号、权限和处方审核规则；不要新增输出字段。";
+
+        return self::$reference;
+    }
+}

server/app/common/service/prescriptionai/PrescriptionAiGenerator.php

@@ -5,11 +5,12 @@ declare(strict_types=1);
 namespace app\common\service\prescriptionai;
 
 use app\common\service\DifyChatService;
+use app\common\service\NihaixiaClinicalSkill;
 
 /** One model branch. It receives a saved context and never queries patient data. */
 final class PrescriptionAiGenerator
 {
-    public const PROMPT_VERSION = 'manual-prescription-required-candidate-v4';
+    public const PROMPT_VERSION = 'manual-prescription-required-candidate-nihaixia-v5';
     private const REPORT_KEYS = ['summary', 'diagnosis', 'risk_assessment', 'treatment_advice', 'evidence_references', 'missing_information'];
     private const RETRYABLE = ['UPSTREAM_TIMEOUT', 'UPSTREAM_BUSY', 'UPSTREAM_UNAVAILABLE', 'INCOMPLETE_RESPONSE', 'EMPTY_RESPONSE',
         'CANDIDATE_WITHHELD_BY_MODEL', 'INVALID_EVIDENCE_OUTPUT', 'INVALID_REPORT_OUTPUT'];
@@ -212,12 +213,12 @@ final class PrescriptionAiGenerator
             // model prescribes plain names such as 麦冬 while the clinic stocks 生麦冬, and every
             // row is then an unmappable identity rather than a comparable one.
             $catalogNames = self::catalogNames($context, $inputBudget);
-            if (strlen(self::finalPrompt([], $coverage, $candidateBlocked, $requireCandidate, $dispensing, $catalogNames, $readIds)) + ($insistRounds > 0 ? self::INSIST_RESERVE : 0) > $inputBudget) {
+            if (strlen(NihaixiaClinicalSkill::augmentQuery(self::finalPrompt([], $coverage, $candidateBlocked, $requireCandidate, $dispensing, $catalogNames, $readIds))) + ($insistRounds > 0 ? self::INSIST_RESERVE : 0) > $inputBudget) {
                 throw new \RuntimeException('FINAL_CONTEXT_EXCEEDS_BUDGET');
             }
             // Include the complete coverage and prompt overhead when deciding to reduce evidence.
             $prompt = self::finalPrompt($summaries, $coverage, $candidateBlocked, $requireCandidate, $dispensing, $catalogNames, $readIds);
-            for ($round = 0; strlen($prompt) + ($insistRounds > 0 ? self::INSIST_RESERVE : 0) > $inputBudget; $round++) {
+            for ($round = 0; strlen(NihaixiaClinicalSkill::augmentQuery($prompt)) + ($insistRounds > 0 ? self::INSIST_RESERVE : 0) > $inputBudget; $round++) {
                 if ($round >= 8) {
                     throw new \RuntimeException('SYNTHESIS_BUDGET_EXCEEDED');
                 }
@@ -354,7 +355,7 @@ final class PrescriptionAiGenerator
         $progress['format_rejects'][count($progress['format_rejects'] ?? []) - 1]['content_length'] = $reject['content_length'];
         self::invalidateStep($key, $progress, $checkpoint);
         $repairPrompt = self::repairPrompt($prompt, $reject['rule']);
-        if (strlen($repairPrompt) > $inputBudget) {
+        if (strlen(NihaixiaClinicalSkill::augmentQuery($repairPrompt)) > $inputBudget) {
             return ['value' => $value, 'parsed' => null];
         }
         $repaired = self::step($key . ':repair', $repairPrompt, $files, $modelKey, $context, $progress, $transport, $checkpoint, $inputBudget, $maxCalls);
@@ -382,6 +383,7 @@ final class PrescriptionAiGenerator
 
     private static function step(string $key, string $prompt, array $files, string $model, array $context, array &$progress, callable $transport, ?callable $checkpoint, int $inputBudget, int $maxCalls): array
     {
+        $prompt = NihaixiaClinicalSkill::augmentQuery($prompt);
         // UTF-8 byte length is a conservative upper bound for byte-fallback tokenizers. File
         // vision tokens depend on provider preprocessing and are tracked as unknown usage.
         if (strlen($prompt) > $inputBudget) {