大模型视角下中医四诊合参的认知机制与多模态研究方法  

Cognitive mechanisms and multimodal research methodologies of traditional Chinese medicine diagnostics under the large language model perspective

作　　者：林树元[1,2] 黄慧雯 刘畅 刘婉婷 李健民 瞿溢谦 曹灵勇[1,2] LIN Shuyuan;HUANG Huiwen;LIU Chang;LIU Wanting;LI Jianmin;QU Yiqian;CAO Lingyong(Zhejiang Chinese Medical University,Hangzhou 310053,China;Zhejiang Chinese Medical University-Gancao Doctor Chinese Medicine Artificial Intelligence Joint Engineering Center,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江中医药大学-甘草医生中医药人工智能联合工程中心,杭州310053

出　　处：《中华中医药杂志》2025年第1期97-102,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局科技局-浙江省中医药管理局共建重大项目(No.GZY-ZJ-KJ-23018);浙江省中医药重点研究项目(No.2022ZZ010);2023年度高校国内访问学者“教师专业发展项目”(No.FX2023024)。

摘　　要：文章以认知神经科学的全局工作空间理论为指导,剖析中医四诊合参的认知机制,提出了“选择性注意形成的意识事件在全局工作空间中的传递”是中医四诊合参的关键过程及中医四诊多模态研究的认知神经科学基础。从表征与融合层面,总结了中医四诊多模态研究的技术现状,提出了“统一表征与模型内融合”的技术发展方向,认为基于自注意力机制的变换器构架的多模态大模型可以较好地拟合中医四诊合参的认知过程,并实现统一表征与模型内融合的技术路径。同时,类比中医教育三阶梯培养路径,梳理了中医药多模态大模型研究“预训练-指令微调-人类对齐”三阶段的研究目标与技术方法,为中医四诊多模态研究奠定新的理论与方法学基础。Guided by the Global Workspace Theory within cognitive neuroscience,this paper dissects the cognitive mechanisms underlying the synthesis of the four diagnostic methods in traditional Chinese medicine(TCM).It suggests that the key process in synthesis of the four diagnostic methods in TCM,crucially,involves ‘the transference of consciousness events formed by selective attention within the global workspace'.It is also the cognitive neuroscientific basis of multi-modal study of the f diagnostic methods in TCM.From the perspective of representation and integration,this study summarizes the current state of multimodal research in TCM diagnostics and presents an evolutionary direction towards ‘unified representation and intramodel integration'.It posits that the multimodal large language models with Transformer architecture,employing self-attention mechanisms,could approximate the cognitive processes of synthesis of the four diagnostic methods in TCM,while achieving technical pathways for unified representation and intra-model integration.Concurrently,this study delineates a tri-phase research protocol,‘pre-training,fine-tuning,and human alignment',aligned with the three-tier educational system in TCM training,thereby laying a novel theoretical and methodological foundation for future studies in TCM multimodal diagnostics.

关 键 词：中医四诊 多模态 大模型 人工智能 认知神经科学 全局工作工间理论 

分 类 号：R241[医药卫生—中医诊断学]