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

health_app/lib/providers/consultation_provider.dart

@@ -164,9 +164,13 @@ class ConsultationChatNotifier extends Notifier<ConsultationChatState> {
               : DateTime.now(),
         );
 
-        // 去重
-        final existingIds = state.messages.map((m) => m.id).toSet();
-        if (!existingIds.contains(msg.id)) {
+        // 去重：按 ID + 内容+时间窗口（防止本地消息和服务器消息重复）
+        final isDuplicate = state.messages.any((m) =>
+            m.id == msg.id ||
+            (m.senderType == msg.senderType &&
+             m.content == msg.content &&
+             msg.createdAt.difference(m.createdAt).inSeconds.abs() < 3));
+        if (!isDuplicate) {
           state = state.copyWith(messages: [...state.messages, msg]);
         }
       });
@@ -220,8 +224,9 @@ class ConsultationChatNotifier extends Notifier<ConsultationChatState> {
   Future<void> sendMessage(String text) async {
     if (text.trim().isEmpty || state.isSending || state.consultationId == null) return;
 
+    final localId = '${DateTime.now().millisecondsSinceEpoch}';
     final userMsg = ConsultationMsg(
-      id: '${DateTime.now().millisecondsSinceEpoch}',
+      id: localId,
       senderType: 'User',
       content: text,
       createdAt: DateTime.now(),
@@ -234,13 +239,50 @@ class ConsultationChatNotifier extends Notifier<ConsultationChatState> {
     try {
       // 优先通过 SignalR 发送
       if (_hub != null && _hub!.state == HubConnectionState.Connected) {
-        await _hub!.invoke('SendMessage',
+        final result = await _hub!.invoke('SendMessage',
             args: <Object>[state.consultationId!, 'User', '', text]);
+        // 用服务器返回的真实 ID 更新本地消息，防止后续轮询重复
+        if (result != null) {
+          final serverId = (result as Map<String, dynamic>)['id']?.toString();
+          if (serverId != null && serverId != localId) {
+            final updated = state.messages.map((m) {
+              if (m.id == localId) {
+                return ConsultationMsg(
+                  id: serverId,
+                  senderType: m.senderType,
+                  senderName: m.senderName,
+                  content: m.content,
+                  createdAt: m.createdAt,
+                );
+              }
+              return m;
+            }).toList();
+            state = state.copyWith(messages: updated);
+          }
+        }
       } else {
         // 回退到 HTTP
         final api = ref.read(apiClientProvider);
-        await api.post('/api/consultations/${state.consultationId}/messages',
+        final res = await api.post('/api/consultations/${state.consultationId}/messages',
             data: {'content': text});
+        // 用服务器返回的真实 ID 更新本地消息
+        final dataMap = res.data['data'] as Map<String, dynamic>?;
+        final serverId = dataMap?['id']?.toString();
+        if (serverId != null && serverId != localId) {
+          final updated = state.messages.map((m) {
+            if (m.id == localId) {
+              return ConsultationMsg(
+                id: serverId,
+                senderType: m.senderType,
+                senderName: m.senderName,
+                content: m.content,
+                createdAt: m.createdAt,
+              );
+            }
+            return m;
+          }).toList();
+          state = state.copyWith(messages: updated);
+        }
       }
     } catch (_) {
       // 静默失败，消息已显示在本地

health_app/lib/providers/data_providers.dart

@@ -23,6 +23,10 @@ final dietServiceProvider = Provider<DietService>((ref) {
   return DietService(ref.watch(apiClientProvider));
 });
 
+final followUpServiceProvider = Provider<FollowUpService>((ref) {
+  return FollowUpService(ref.watch(apiClientProvider));
+});
+
 final consultationServiceProvider = Provider<ConsultationService>((ref) {
   return ConsultationService(ref.watch(apiClientProvider));
 });
@@ -62,24 +66,24 @@ final doctorListProvider = FutureProvider<List<Map<String, dynamic>>>((ref) asyn
 
 const _fallbackDoctors = [
   {
-    'id': 'doc_1',
-    'name': '张医生',
+    'id': '468b82e2-d95a-4436-bff6-a50eecf99a66',
+    'name': '张明',
     'title': '主任医师',
-    'department': '心内科',
+    'department': '心脏康复科',
     'introduction': '擅长冠心病、高血压术后管理，20年临床经验',
   },
   {
-    'id': 'doc_2',
-    'name': '李医生',
+    'id': 'd4148733-b538-4398-af17-0c7592fc0c2d',
+    'name': '李芳',
     'title': '副主任医师',
-    'department': '内分泌科',
+    'department': '营养科',
     'introduction': '擅长糖尿病、甲状腺疾病管理，15年临床经验',
   },
   {
-    'id': 'doc_3',
-    'name': '王医生',
-    'title': '主治医师',
-    'department': '营养科',
+    'id': 'ef0953c9-eb63-4d03-b6d7-050a1897d4a3',
+    'name': '王建国',
+    'title': '主任医师',
+    'department': '心血管内科',
     'introduction': '擅长术后营养指导、饮食方案制定，10年临床经验',
   },
 ];
@@ -102,10 +106,10 @@ final currentExercisePlanProvider = FutureProvider<Map<String, dynamic>?>((ref)
       'weekStartDate': '${monday.year}-${monday.month.toString().padLeft(2, '0')}-${monday.day.toString().padLeft(2, '0')}',
       'items': List.generate(7, (i) => {
         'id': 'local_$i',
-        'dayOfWeek': i,
-        'exerciseType': i == 2 || i == 5 ? '休息' : '散步',
-        'durationMinutes': i == 2 || i == 5 ? 0 : 30,
-        'isRestDay': i == 2 || i == 5,
+        'dayOfWeek': i, // matches C# DayOfWeek: 0=Sun, 1=Mon, ..., 6=Sat
+        'exerciseType': i == 1 || i == 6 ? '休息' : '散步',
+        'durationMinutes': i == 1 || i == 6 ? 0 : 30,
+        'isRestDay': i == 1 || i == 6,
         'isCompleted': false,
       }),
     };