fix: 全面修复 - 实时通讯、报告AI流程、健康概览、用药运动提醒

- SignalR Hub消息持久化+防重复+跨端广播
- 报告VLM+LLM真实AI流程(验证→提取→解读)
- 医生审核页重构(严重程度/建议模板/综合评语)
- 健康概览五合一趋势图(fl_chart+指标切换)
- 用药提醒时区修复+跨午夜+过期提醒
- 运动打卡DayOfWeek映射修复+计划覆盖查询
- 体重与其他四指标同级(Abnormal检查/确认卡牌)
- AI Agent支持多种类多时段批量录入
- 删除硬编码假数据(张三/假医生/假AI解读)
- 随访/报告审核数据链路全部打通

backend/src/Health.WebApi/Endpoints/consultation_endpoints.cs

@@ -1,3 +1,5 @@
+using Health.WebApi.Hubs;
+
 namespace Health.WebApi.Endpoints;
 
 public static class ConsultationEndpoints
@@ -43,12 +45,32 @@ public static class ConsultationEndpoints
             return Results.Ok(new { code = 0, data = messages, message = (string?)null });
         });
 
-        group.MapPost("/consultations/{id:guid}/messages", async (Guid id, SendMessageRequest req, HttpContext http, AppDbContext db, CancellationToken ct) =>
+        group.MapPost("/consultations/{id:guid}/messages", async (Guid id, SendMessageRequest req, HttpContext http, AppDbContext db, IHubContext<Hubs.ConsultationHub> hubContext, CancellationToken ct) =>
         {
             var userId = GetUserId(http);
             var msg = new ConsultationMessage { Id = Guid.NewGuid(), ConsultationId = id, SenderType = ConsultationSenderType.User, Content = req.Content, SenderName = null, CreatedAt = DateTime.UtcNow };
             db.ConsultationMessages.Add(msg);
+
+            // 用户发消息后，状态从 AiTalking → WaitingDoctor
+            var consultation = await db.Consultations.FirstOrDefaultAsync(c => c.Id == id, ct);
+            if (consultation != null && consultation.Status == ConsultationStatus.AiTalking)
+            {
+                consultation.Status = ConsultationStatus.WaitingDoctor;
+            }
+
             await db.SaveChangesAsync(ct);
+
+            // 通过 SignalR 广播给问诊房间（医生端实时接收）
+            await hubContext.Clients.Group(id.ToString()).SendAsync("ReceiveMessage", new
+            {
+                msg.Id,
+                consultationId = id.ToString(),
+                senderType = "User",
+                senderName = (string?)null,
+                content = req.Content,
+                msg.CreatedAt
+            });
+
             return Results.Ok(new { code = 0, data = new { msg.Id }, message = (string?)null });
         });