feat: 后端架构重构 — Endpoint→Service→Repository分层 + AI确认机制 + 异步任务持久化

- 核心业务拆分为 Endpoint → Application Service → Repository 三层
- AI写入操作必须用户确认后才写库(确认卡片机制)
- 报告/饮食/用药分析改为持久化任务队列(原子领取/重试/重启恢复)
- 运动计划修复: 连续真实日期替代周模板
- 用药提醒去重 + 通知Outbox预留
- 认证收拢到AuthService, 管理员收拢到AdminService
- AI会话加用户归属校验防串号
- 提示词调整为患者视角
- 开发假数据已关闭
- 21/21测试通过, 0警告0错误

backend/src/Health.Infrastructure/AI/AgentHandlers/common_agent_handler.cs

@@ -1,3 +1,6 @@
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
@@ -21,38 +24,33 @@ public static class CommonAgentHandler
 
     public static List<ToolDefinition> Tools => [QueryHealthRecordsTool, CheckArchiveTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        Guid userId,
+        IHealthRecordService healthRecords,
+        IHealthArchiveService archives,
+        CancellationToken ct = default)
     {
         return toolName switch
         {
-            "query_health_records" => await ExecuteQueryHealthRecords(db, userId, args),
-            "check_archive" => await ExecuteCheckArchive(db, userId),
+            "query_health_records" => await ExecuteQueryHealthRecords(healthRecords, userId, args, ct),
+            "check_archive" => await ExecuteCheckArchive(archives, userId, ct),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
-    private static async Task<object> ExecuteQueryHealthRecords(AppDbContext db, Guid userId, JsonElement args)
+    private static async Task<object> ExecuteQueryHealthRecords(IHealthRecordService healthRecords, Guid userId, JsonElement args, CancellationToken ct)
     {
         var type = args.TryGetProperty("type", out var t) ? t.GetString() : null;
         var days = args.TryGetProperty("days", out var d) ? d.GetInt32() : 7;
-
-        var query = db.HealthRecords.Where(r => r.UserId == userId);
-        if (!string.IsNullOrEmpty(type) && Enum.TryParse<HealthMetricType>(type, ignoreCase: true, out var mt))
-            query = query.Where(r => r.MetricType == mt);
-
-        query = query.Where(r => r.RecordedAt >= DateTime.UtcNow.AddDays(-days));
-
-        var records = await query.OrderByDescending(r => r.RecordedAt).Take(30).Select(r => new
-        {
-            r.Id, Type = r.MetricType.ToString(), r.Systolic, r.Diastolic, r.Value, r.Unit, r.IsAbnormal, r.RecordedAt,
-        }).ToListAsync();
-
+        var records = await healthRecords.GetRecordsAsync(userId, type, days, ct);
         return new { count = records.Count, records };
     }
 
-    private static async Task<object> ExecuteCheckArchive(AppDbContext db, Guid userId)
+    private static async Task<object> ExecuteCheckArchive(IHealthArchiveService archives, Guid userId, CancellationToken ct)
     {
-        var archive = await db.HealthArchives.FirstOrDefaultAsync(a => a.UserId == userId);
+        var archive = await archives.GetAsync(userId, ct);
         if (archive == null) return new { found = false };
         return new
         {
@@ -85,49 +83,26 @@ public static class CommonAgentHandler
         }
     };
 
-    public static async Task<object> ExecuteManageArchive(AppDbContext db, Guid userId, JsonElement args)
+    public static Task<object> ExecuteManageArchive(
+        IHealthArchiveService archives,
+        Guid userId,
+        JsonElement args,
+        CancellationToken ct = default)
     {
         var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
-        var archive = await db.HealthArchives.FirstOrDefaultAsync(x => x.UserId == userId);
-        if (archive == null)
-        {
-            archive = new HealthArchive { Id = Guid.NewGuid(), UserId = userId };
-            db.HealthArchives.Add(archive);
-        }
-
-        switch (action)
-        {
-            case "update_diagnosis":
-                archive.Diagnosis = args.TryGetProperty("diagnosis", out var d) ? d.GetString() : archive.Diagnosis;
-                break;
-            case "update_surgery":
-                archive.SurgeryType = args.TryGetProperty("surgery_type", out var st) ? st.GetString() : archive.SurgeryType;
-                if (args.TryGetProperty("surgery_date", out var sd))
-                    archive.SurgeryDate = DateOnly.TryParse(sd.GetString(), out var date) ? date : archive.SurgeryDate;
-                break;
-            case "update_allergies":
-                if (args.TryGetProperty("allergies", out var al) && al.ValueKind == JsonValueKind.Array)
-                    archive.Allergies = [.. al.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            case "update_chronic_diseases":
-                if (args.TryGetProperty("chronic_diseases", out var cd) && cd.ValueKind == JsonValueKind.Array)
-                    archive.ChronicDiseases = [.. cd.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            case "update_diet_restrictions":
-                if (args.TryGetProperty("diet_restrictions", out var dr) && dr.ValueKind == JsonValueKind.Array)
-                    archive.DietRestrictions = [.. dr.EnumerateArray().Select(x => x.GetString()!)];
-                break;
-            default: // query
-                return new
-                {
-                    found = true, archive.Diagnosis, archive.SurgeryType,
-                    SurgeryDate = archive.SurgeryDate?.ToString("yyyy-MM-dd"),
-                    archive.Allergies, archive.DietRestrictions, archive.ChronicDiseases, archive.FamilyHistory,
-                };
-        }
-
-        archive.UpdatedAt = DateTime.UtcNow;
-        await db.SaveChangesAsync();
-        return new { success = true };
+        var request = new HealthArchiveUpdateRequest(
+            args.TryGetProperty("diagnosis", out var diagnosis) ? diagnosis.GetString() : null,
+            args.TryGetProperty("surgery_type", out var surgeryType) ? surgeryType.GetString() : null,
+            args.TryGetProperty("surgery_date", out var surgeryDate) && DateOnly.TryParse(surgeryDate.GetString(), out var date) ? date : null,
+            ReadStringArray(args, "allergies"),
+            ReadStringArray(args, "diet_restrictions"),
+            ReadStringArray(args, "chronic_diseases"),
+            args.TryGetProperty("family_history", out var familyHistory) ? familyHistory.GetString() : null);
+        return archives.ExecuteAiActionAsync(userId, action, request, ct);
     }
+
+    private static IReadOnlyList<string>? ReadStringArray(JsonElement args, string propertyName) =>
+        args.TryGetProperty(propertyName, out var value) && value.ValueKind == JsonValueKind.Array
+            ? value.EnumerateArray().Select(x => x.GetString()).Where(x => !string.IsNullOrWhiteSpace(x)).Cast<string>().ToList()
+            : null;
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/consultation_agent_handler.cs

@@ -7,12 +7,4 @@ public static class ConsultationAgentHandler
 {
     public static List<ToolDefinition> Tools => [CommonAgentHandler.QueryHealthRecordsTool, CommonAgentHandler.CheckArchiveTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "query_health_records" or "check_archive" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/diet_agent_handler.cs

@@ -7,12 +7,4 @@ public static class DietAgentHandler
 {
     public static List<ToolDefinition> Tools => [CommonAgentHandler.CheckArchiveTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "check_archive" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/exercise_agent_handler.cs

@@ -1,85 +1,83 @@
+using Health.Application.Exercises;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
-/// <summary>
-/// 运动计划 Agent 工具处理器
-/// </summary>
 public static class ExerciseAgentHandler
 {
     public static readonly ToolDefinition ManageExerciseTool = new()
     {
         Function = new()
         {
-            Name = "manage_exercise", Description = "运动计划管理（创建/查询/打卡）",
-            Parameters = new { type = "object", properties = new {
-                action = new { type = "string", description = "create/query/checkin" },
-                week_start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
-                items = new { type = "array", description = "每天的运动项目", items = new { type = "object", properties = new {
-                    day_of_week = new { type = "integer", description = "0=周日 1=周一...6=周六" },
-                    exercise_type = new { type = "string", description = "运动类型，如散步/慢跑/游泳/太极" },
-                    duration_minutes = new { type = "integer", description = "时长（分钟）" },
-                    is_rest_day = new { type = "boolean", description = "是否休息日" }
-                }}}
-            }, required = new[] { "action" } }
-        }
+            Name = "manage_exercise",
+            Description = "运动计划管理（创建/查询/打卡）",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    action = new { type = "string", description = "create/query/checkin" },
+                    start_date = new { type = "string", description = "开始日期 yyyy-MM-dd，默认今天" },
+                    duration_days = new { type = "integer", description = "连续运动天数，如一周为7天" },
+                    exercise_type = new { type = "string", description = "运动类型，如散步、慢跑、游泳" },
+                    duration_minutes = new { type = "integer", description = "每天运动时长，单位分钟" },
+                    reminder_time = new { type = "string", description = "每天提醒时间 HH:mm，默认19:00" },
+                    item_id = new { type = "string", description = "打卡条目 ID" },
+                },
+                required = new[] { "action" },
+            },
+        },
     };
 
     public static List<ToolDefinition> Tools => [ManageExerciseTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        AppDbContext db,
+        Guid userId,
+        IExerciseService? exercises = null,
+        CancellationToken ct = default)
     {
-        return toolName switch
+        if (toolName != "manage_exercise" || exercises == null)
+            return new { success = false, message = $"未知工具: {toolName}" };
+
+        var action = args.TryGetProperty("action", out var actionValue) ? actionValue.GetString() : "query";
+        if (action == "create")
         {
-            "manage_exercise" => await ExecuteManageExercise(db, userId, args),
-            _ => new { success = false, message = $"未知工具: {toolName}" }
-        };
-    }
-
-    private static async Task<object> ExecuteManageExercise(AppDbContext db, Guid userId, JsonElement args)
-    {
-        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
-        switch (action)
-        {
-            case "create":
-                var weekStart = args.TryGetProperty("week_start_date", out var wsd) ? DateOnly.Parse(wsd.GetString()!) : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
-                var plan = new ExercisePlan { Id = Guid.NewGuid(), UserId = userId, WeekStartDate = weekStart };
-                if (args.TryGetProperty("items", out var items))
-                {
-                    foreach (var item in items.EnumerateArray())
-                    {
-                        plan.Items.Add(new ExercisePlanItem
-                        {
-                            Id = Guid.NewGuid(), DayOfWeek = item.GetProperty("day_of_week").GetInt32(),
-                            ExerciseType = item.GetProperty("exercise_type").GetString() ?? "散步",
-                            DurationMinutes = item.GetProperty("duration_minutes").GetInt32(),
-                            IsRestDay = item.TryGetProperty("is_rest_day", out var rd) && rd.GetBoolean(),
-                        });
-                    }
-                }
-                db.ExercisePlans.Add(plan);
-                await db.SaveChangesAsync();
-                var firstItem = plan.Items.FirstOrDefault();
-                return new {
-                    success = true, plan_id = plan.Id,
-                    exercise_type = firstItem?.ExerciseType ?? "运动",
-                    duration_minutes = firstItem?.DurationMinutes ?? 30,
-                    day_count = plan.Items.Count,
-                };
-
-            case "checkin":
-                var itemId = args.TryGetProperty("item_id", out var iid) ? iid.GetGuid() : Guid.Empty;
-                var exerciseItem = await db.ExercisePlanItems.FindAsync([itemId]);
-                if (exerciseItem == null) return new { success = false, message = "条目不存在" };
-                exerciseItem.IsCompleted = true;
-                exerciseItem.CompletedAt = DateTime.UtcNow;
-                await db.SaveChangesAsync();
-                return new { success = true };
-
-            default:
-                var existingPlan = await db.ExercisePlans.Where(p => p.UserId == userId)
-                    .OrderByDescending(p => p.WeekStartDate).FirstOrDefaultAsync();
-                if (existingPlan == null) return new { found = false };
-                var exerciseItems = await db.ExercisePlanItems.Where(i => i.PlanId == existingPlan.Id).OrderBy(i => i.DayOfWeek).ToListAsync();
-                return new { found = true, plan_id = existingPlan.Id, items = exerciseItems.Select(i => new { i.Id, i.DayOfWeek, i.ExerciseType, i.DurationMinutes, i.IsCompleted }) };
+            var startDate = args.TryGetProperty("start_date", out var startValue) && DateOnly.TryParse(startValue.GetString(), out var parsedStart)
+                ? parsedStart
+                : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+            var days = args.TryGetProperty("duration_days", out var daysValue) && daysValue.TryGetInt32(out var parsedDays)
+                ? Math.Clamp(parsedDays, 1, 366)
+                : 7;
+            var exerciseType = args.TryGetProperty("exercise_type", out var typeValue) ? typeValue.GetString() : "散步";
+            var minutes = args.TryGetProperty("duration_minutes", out var minutesValue) && minutesValue.TryGetInt32(out var parsedMinutes) ? parsedMinutes : 30;
+            var reminder = args.TryGetProperty("reminder_time", out var reminderValue) && TimeOnly.TryParse(reminderValue.GetString(), out var parsedReminder)
+                ? parsedReminder
+                : new TimeOnly(19, 0);
+            var planId = await exercises.CreateAsync(userId, new ExercisePlanCreateRequest(
+                startDate, startDate.AddDays(days - 1), exerciseType, minutes, reminder), ct);
+            return new { success = true, plan_id = planId, exercise_type = exerciseType, duration_minutes = minutes, day_count = days, start_date = startDate, end_date = startDate.AddDays(days - 1), reminder_time = reminder };
         }
+
+        if (action == "checkin")
+        {
+            var itemId = args.TryGetProperty("item_id", out var itemValue) && itemValue.TryGetGuid(out var parsedId) ? parsedId : Guid.Empty;
+            var success = await exercises.CheckInAsync(userId, itemId, ct);
+            return success ? new { success = true } : new { success = false, message = "条目不存在" };
+        }
+
+        var plan = await exercises.GetLatestAsync(userId, ct);
+        return plan == null
+            ? new { found = false }
+            : new
+            {
+                found = true,
+                plan_id = plan.Id,
+                plan.StartDate,
+                plan.EndDate,
+                plan.ReminderTime,
+                items = plan.Items.Select(i => new { i.Id, i.ScheduledDate, i.ExerciseType, i.DurationMinutes, i.IsCompleted }),
+            };
     }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/health_data_agent_handler.cs

@@ -1,3 +1,5 @@
+using Health.Application.HealthRecords;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
@@ -16,16 +18,50 @@ public static class HealthDataAgentHandler
 
     public static List<ToolDefinition> Tools => [RecordHealthDataTool, CommonAgentHandler.QueryHealthRecordsTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId, IHealthRecordService? healthRecords = null)
     {
         return toolName switch
         {
-            "record_health_data" => await ExecuteRecordHealthData(db, userId, args),
-            "query_health_records" => await CommonAgentHandler.Execute(toolName, args, db, userId),
+            "record_health_data" => healthRecords == null
+                ? await ExecuteRecordHealthData(db, userId, args)
+                : await ExecuteRecordHealthData(healthRecords, userId, args),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
+    private static async Task<object> ExecuteRecordHealthData(IHealthRecordService healthRecords, Guid userId, JsonElement args)
+    {
+        var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
+        var (metricType, value, unit, systolic, diastolic) = ParseMetric(type, args);
+        if (metricType == null)
+            return new { success = false, message = $"未知指标类型: {type}" };
+
+        var recordedAt = args.TryGetProperty("recorded_at", out var ra) && ra.TryGetDateTime(out var dt)
+            ? dt
+            : DateTime.UtcNow;
+
+        var request = new HealthRecordUpsertRequest(
+            metricType.Value,
+            systolic,
+            diastolic,
+            value,
+            unit,
+            HealthRecordSource.AiEntry,
+            recordedAt);
+
+        var id = await healthRecords.CreateAsync(userId, request, CancellationToken.None);
+        var valStr = metricType == HealthMetricType.BloodPressure ? $"{systolic}/{diastolic}" : value?.ToString() ?? "";
+        return new
+        {
+            success = true,
+            record_id = id,
+            type = metricType.Value.ToString(),
+            value = valStr,
+            unit,
+            isAbnormal = HealthRecordRules.CheckAbnormal(request)
+        };
+    }
+
     private static async Task<object> ExecuteRecordHealthData(AppDbContext db, Guid userId, JsonElement args)
     {
         var type = args.TryGetProperty("type", out var t) ? t.GetString()! : "";
@@ -82,4 +118,42 @@ public static class HealthDataAgentHandler
         };
         return new { success = true, record_id = record.Id, type = record.MetricType.ToString(), value = valStr, unit = record.Unit, isAbnormal = record.IsAbnormal };
     }
+
+    private static (HealthMetricType? Type, decimal? Value, string Unit, int? Systolic, int? Diastolic) ParseMetric(string type, JsonElement args)
+    {
+        return type switch
+        {
+            "blood_pressure" => (
+                HealthMetricType.BloodPressure,
+                null,
+                "mmHg",
+                args.TryGetProperty("systolic", out var s) ? s.GetInt32() : null,
+                args.TryGetProperty("diastolic", out var d) ? d.GetInt32() : null),
+            "heart_rate" => (
+                HealthMetricType.HeartRate,
+                args.TryGetProperty("heart_rate", out var hr) ? hr.GetDecimal() : null,
+                "次/分",
+                null,
+                null),
+            "glucose" => (
+                HealthMetricType.Glucose,
+                args.TryGetProperty("glucose", out var g) ? g.GetDecimal() : null,
+                "mmol/L",
+                null,
+                null),
+            "spo2" => (
+                HealthMetricType.SpO2,
+                args.TryGetProperty("spo2", out var o) ? o.GetDecimal() : null,
+                "%",
+                null,
+                null),
+            "weight" => (
+                HealthMetricType.Weight,
+                args.TryGetProperty("weight", out var w) ? w.GetDecimal() : null,
+                "kg",
+                null,
+                null),
+            _ => (null, null, "", null, null)
+        };
+    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/medication_agent_handler.cs

@@ -1,7 +1,9 @@
+using Health.Application.Medications;
+
 namespace Health.Infrastructure.AI.AgentHandlers;
 
 /// <summary>
-/// 药管家 Agent 工具处理器——用药管理
+/// 药管家 Agent 工具处理器。
 /// </summary>
 public static class MedicationAgentHandler
 {
@@ -9,31 +11,105 @@ public static class MedicationAgentHandler
     {
         Function = new()
         {
-            Name = "manage_medication", Description = "用药管理（创建/查询/确认服药）",
-            Parameters = new { type = "object", properties = new {
-                action = new { type = "string", description = "create/query/confirm" },
-                name = new { type = "string", description = "药品名称" },
-                dosage = new { type = "string", description = "剂量，如 100mg" },
-                frequency = new { type = "string", description = "频率，如 Daily/EveryOtherDay/Weekly" },
-                time_of_day = new { type = "array", items = new { type = "string" }, description = "服药时间，如 [\"08:00\",\"20:00\"]" },
-                duration_days = new { type = "integer", description = "服用天数" },
-                start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
-            }, required = new[] { "action" } }
+            Name = "manage_medication",
+            Description = "用药管理（创建/查询/确认服药）",
+            Parameters = new
+            {
+                type = "object",
+                properties = new
+                {
+                    action = new { type = "string", description = "create/query/confirm" },
+                    medication_id = new { type = "string", description = "药品 ID，确认服药时使用" },
+                    name = new { type = "string", description = "药品名称" },
+                    dosage = new { type = "string", description = "剂量，如 100mg" },
+                    frequency = new { type = "string", description = "频率，如 Daily/EveryOtherDay/Weekly" },
+                    time_of_day = new { type = "array", items = new { type = "string" }, description = "服药时间，如 [\"08:00\",\"20:00\"]" },
+                    duration_days = new { type = "integer", description = "服用天数" },
+                    start_date = new { type = "string", description = "开始日期 yyyy-MM-dd" },
+                },
+                required = new[] { "action" }
+            }
         }
     };
 
     public static List<ToolDefinition> Tools => [ManageMedicationTool, CommonAgentHandler.CheckArchiveTool];
 
-    public static async Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
+    public static async Task<object> Execute(
+        string toolName,
+        JsonElement args,
+        AppDbContext db,
+        Guid userId,
+        IMedicationService? medications = null,
+        CancellationToken ct = default)
     {
         return toolName switch
         {
-            "manage_medication" => await ExecuteManageMedication(db, userId, args),
-            "check_archive" => await CommonAgentHandler.Execute(toolName, args, db, userId),
+            "manage_medication" => medications != null
+                ? await ExecuteManageMedication(medications, userId, args, ct)
+                : await ExecuteManageMedication(db, userId, args),
             _ => new { success = false, message = $"未知工具: {toolName}" }
         };
     }
 
+    private static async Task<object> ExecuteManageMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
+        return action switch
+        {
+            "create" => await CreateMedication(medications, userId, args, ct),
+            "query" => await QueryMedications(medications, userId, ct),
+            "confirm" => await ConfirmMedication(medications, userId, args, ct),
+            _ => new { success = false, message = $"未知操作: {action}" }
+        };
+    }
+
+    private static async Task<object> CreateMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var name = args.TryGetProperty("name", out var n) ? n.GetString()! : "";
+        var dosage = args.TryGetProperty("dosage", out var dg) ? dg.GetString() : null;
+        var frequency = ReadFrequency(args);
+        var times = ReadTimes(args);
+        var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
+        var startDate = ReadStartDate(args);
+        var endDate = durationDays > 0 ? startDate.AddDays(durationDays) : (DateOnly?)null;
+
+        var medicationId = await medications.CreateAsync(userId, new MedicationUpsertRequest(
+            name,
+            dosage,
+            frequency,
+            times.Count > 0 ? times : [new TimeOnly(8, 0)],
+            startDate,
+            endDate,
+            MedicationSource.AiEntry,
+            null), ct);
+
+        var timeLabels = times.Count > 0 ? string.Join(", ", times.Select(t => t.ToString("HH:mm"))) : "08:00";
+        return new
+        {
+            success = true,
+            medication_id = medicationId,
+            name,
+            dosage,
+            frequency = frequency.ToString(),
+            time = timeLabels,
+            start_date = startDate.ToString("yyyy-MM-dd"),
+            duration_days = durationDays,
+        };
+    }
+
+    private static async Task<object> QueryMedications(IMedicationService medications, Guid userId, CancellationToken ct)
+    {
+        var meds = await medications.ListActiveAsync(userId, ct);
+        return new { count = meds.Count, medications = meds.Select(m => new { m.Id, m.Name, m.Dosage, m.TimeOfDay }) };
+    }
+
+    private static async Task<object> ConfirmMedication(IMedicationService medications, Guid userId, JsonElement args, CancellationToken ct)
+    {
+        var medId = args.TryGetProperty("medication_id", out var mid) ? mid.GetGuid() : Guid.Empty;
+        var success = await medications.ConfirmNowAsync(userId, medId, ct);
+        return success ? new { success = true } : new { success = false, message = "药品不存在或今天已经打卡" };
+    }
+
     private static async Task<object> ExecuteManageMedication(AppDbContext db, Guid userId, JsonElement args)
     {
         var action = args.TryGetProperty("action", out var a) ? a.GetString()! : "query";
@@ -50,38 +126,36 @@ public static class MedicationAgentHandler
     {
         var name = args.TryGetProperty("name", out var n) ? n.GetString()! : "";
         var dosage = args.TryGetProperty("dosage", out var dg) ? dg.GetString() : null;
-        var frequencyStr = args.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily";
-        var frequency = Enum.TryParse<MedicationFrequency>(frequencyStr, out var fr) ? fr : MedicationFrequency.Daily;
-
-        List<TimeOnly> times = [];
-        if (args.TryGetProperty("time_of_day", out var tod) && tod.ValueKind == JsonValueKind.Array)
-        {
-            foreach (var t in tod.EnumerateArray())
-            {
-                if (TimeOnly.TryParse(t.GetString(), out var parsed)) times.Add(parsed);
-            }
-        }
-
+        var frequency = ReadFrequency(args);
+        var times = ReadTimes(args);
         var durationDays = args.TryGetProperty("duration_days", out var dd) ? dd.GetInt32() : 0;
-        var startDateStr = args.TryGetProperty("start_date", out var sd) && sd.GetString() is string sds ? sds : null;
+        var startDate = ReadStartDate(args);
 
         var med = new Medication
         {
-            Id = Guid.NewGuid(), UserId = userId,
-            Name = name, Dosage = dosage, Frequency = frequency,
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            Name = name,
+            Dosage = dosage,
+            Frequency = frequency,
             TimeOfDay = times.Count > 0 ? times : [new TimeOnly(8, 0)],
-            Source = MedicationSource.AiEntry, IsActive = true,
-            StartDate = DateOnly.TryParse(startDateStr, out var parsedDate) ? parsedDate : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
-            EndDate = durationDays > 0 ? DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8)).AddDays(durationDays) : null,
+            Source = MedicationSource.AiEntry,
+            IsActive = true,
+            StartDate = startDate,
+            EndDate = durationDays > 0 ? startDate.AddDays(durationDays) : null,
         };
         db.Medications.Add(med);
         await db.SaveChangesAsync();
 
         var timeLabels = times.Count > 0 ? string.Join(", ", times.Select(t => t.ToString("HH:mm"))) : "08:00";
-        return new {
-            success = true, medication_id = med.Id,
-            name = med.Name, dosage = med.Dosage,
-            frequency = med.Frequency.ToString(), time = timeLabels,
+        return new
+        {
+            success = true,
+            medication_id = med.Id,
+            name = med.Name,
+            dosage = med.Dosage,
+            frequency = med.Frequency.ToString(),
+            time = timeLabels,
             start_date = med.StartDate?.ToString("yyyy-MM-dd"),
             duration_days = durationDays,
         };
@@ -97,12 +171,47 @@ public static class MedicationAgentHandler
     private static async Task<object> ConfirmMedication(AppDbContext db, Guid userId, JsonElement args)
     {
         var medId = args.TryGetProperty("medication_id", out var mid) ? mid.GetGuid() : Guid.Empty;
+        var med = await db.Medications.FirstOrDefaultAsync(m => m.Id == medId && m.UserId == userId);
+        if (med == null) return new { success = false, message = "药品不存在" };
+
         db.MedicationLogs.Add(new MedicationLog
         {
-            Id = Guid.NewGuid(), MedicationId = medId, UserId = userId,
-            Status = MedicationLogStatus.Taken, ScheduledTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)), ConfirmedAt = DateTime.UtcNow,
+            Id = Guid.NewGuid(),
+            MedicationId = medId,
+            UserId = userId,
+            Status = MedicationLogStatus.Taken,
+            ScheduledTime = TimeOnly.FromDateTime(DateTime.UtcNow.AddHours(8)),
+            ConfirmedAt = DateTime.UtcNow,
         });
         await db.SaveChangesAsync();
         return new { success = true };
     }
+
+    private static MedicationFrequency ReadFrequency(JsonElement args)
+    {
+        var frequencyStr = args.TryGetProperty("frequency", out var f) ? f.GetString() : "Daily";
+        return Enum.TryParse<MedicationFrequency>(frequencyStr, out var frequency) ? frequency : MedicationFrequency.Daily;
+    }
+
+    private static DateOnly ReadStartDate(JsonElement args)
+    {
+        var startDateStr = args.TryGetProperty("start_date", out var sd) && sd.GetString() is string sds ? sds : null;
+        return DateOnly.TryParse(startDateStr, out var parsedDate)
+            ? parsedDate
+            : DateOnly.FromDateTime(DateTime.UtcNow.AddHours(8));
+    }
+
+    private static List<TimeOnly> ReadTimes(JsonElement args)
+    {
+        List<TimeOnly> times = [];
+        if (!args.TryGetProperty("time_of_day", out var tod) || tod.ValueKind != JsonValueKind.Array)
+            return times;
+
+        foreach (var t in tod.EnumerateArray())
+        {
+            if (TimeOnly.TryParse(t.GetString(), out var parsed)) times.Add(parsed);
+        }
+
+        return times;
+    }
 }

backend/src/Health.Infrastructure/AI/AgentHandlers/report_agent_handler.cs

@@ -12,15 +12,6 @@ public static class ReportAgentHandler
 
     public static List<ToolDefinition> Tools => [AnalyzeReportTool, CommonAgentHandler.QueryHealthRecordsTool];
 
-    public static Task<object> Execute(string toolName, JsonElement args, AppDbContext db, Guid userId)
-    {
-        return toolName switch
-        {
-            "query_health_records" => CommonAgentHandler.Execute(toolName, args, db, userId),
-            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" })
-        };
-    }
-
     public static async Task<object> AnalyzeReport(AppDbContext db, Guid userId, JsonElement args, VisionClient visionClient)
     {
         var imageUrl = args.TryGetProperty("image_url", out var u) ? u.GetString()! : "";
@@ -28,13 +19,13 @@ public static class ReportAgentHandler
             return new { success = false, message = "缺少报告图片" };
 
         var prompt = """
-            你是一个医学报告解读专家。请分析以下检查报告图片，以JSON格式返回：
+            你是患者端医学报告预解读助手。请分析以下检查报告图片，以JSON格式返回：
             {
               "reportType": "报告类型（血常规/生化全项/心电图/彩超/出院小结/其他）",
               "indicators": [
                 {"name":"指标名","value":"数值","unit":"单位","range":"参考范围","status":"normal/high/low"}
               ],
-              "summary": "初步分析摘要",
+              "summary": "面向患者的初步预解读，说明异常指标的可能方向，不作确定诊断，不给出处方、停药、换药或调药建议；必要时建议咨询医生",
               "needsDoctorReview": true/false
             }
             只返回JSON，不要其他内容。

backend/src/Health.Infrastructure/AI/AiToolExecutionService.cs

@@ -0,0 +1,78 @@
+using System.Text.Json;
+using Health.Application.AI;
+using Health.Application.Exercises;
+using Health.Application.HealthArchives;
+using Health.Application.HealthRecords;
+using Health.Application.Medications;
+using Health.Infrastructure.AI.AgentHandlers;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class AiToolExecutionService(
+    AppDbContext db,
+    VisionClient visionClient,
+    IHealthArchiveService healthArchives,
+    IHealthRecordService healthRecords,
+    IExerciseService exercises,
+    IMedicationService medications,
+    IAiWriteConfirmationStore confirmations) : IAiToolExecutionService
+{
+    private readonly AppDbContext _db = db;
+    private readonly VisionClient _visionClient = visionClient;
+    private readonly IHealthArchiveService _healthArchives = healthArchives;
+    private readonly IHealthRecordService _healthRecords = healthRecords;
+    private readonly IExerciseService _exercises = exercises;
+    private readonly IMedicationService _medications = medications;
+    private readonly IAiWriteConfirmationStore _confirmations = confirmations;
+
+    public async Task<object> ExecuteAsync(string toolName, string arguments, Guid userId, CancellationToken ct)
+    {
+        using var json = JsonDocument.Parse(arguments);
+        var root = json.RootElement;
+        return await (toolName switch
+        {
+            "record_health_data" => HealthDataAgentHandler.Execute(toolName, root, _db, userId, _healthRecords),
+            "query_health_records" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
+            "check_archive" => CommonAgentHandler.Execute(toolName, root, userId, _healthRecords, _healthArchives, ct),
+            "manage_medication" => MedicationAgentHandler.Execute(toolName, root, _db, userId, _medications, ct),
+            "analyze_report" => ReportAgentHandler.AnalyzeReport(_db, userId, root, _visionClient),
+            "manage_exercise" => ExerciseAgentHandler.Execute(toolName, root, _db, userId, _exercises, ct),
+            "manage_archive" => CommonAgentHandler.ExecuteManageArchive(_healthArchives, userId, root, ct),
+            _ => Task.FromResult<object>(new { success = false, message = $"未知工具: {toolName}" }),
+        });
+    }
+
+    public async Task<AiConfirmedWriteResult> ConfirmAsync(Guid commandId, Guid userId, CancellationToken ct)
+    {
+        await using var transaction = await _db.Database.BeginTransactionAsync(ct);
+        var command = await _confirmations.TakeAsync(commandId, userId, ct);
+        if (command == null)
+            return new AiConfirmedWriteResult(40004, null, "确认请求不存在、已执行或已过期");
+
+        try
+        {
+            var result = await ExecuteAsync(command.ToolName, command.Arguments, userId, ct);
+            if (!Succeeded(result, out var error))
+            {
+                await transaction.RollbackAsync(ct);
+                return new AiConfirmedWriteResult(40001, result, error ?? "写入失败，请检查内容后重试");
+            }
+            await _confirmations.CompleteAsync(command, ct);
+            await transaction.CommitAsync(ct);
+            return new AiConfirmedWriteResult(0, result, null);
+        }
+        catch (Exception ex)
+        {
+            await transaction.RollbackAsync(ct);
+            return new AiConfirmedWriteResult(50001, null, $"写入失败: {ex.Message}");
+        }
+    }
+
+    private static bool Succeeded(object result, out string? error)
+    {
+        using var json = JsonDocument.Parse(JsonSerializer.Serialize(result));
+        var root = json.RootElement;
+        error = root.TryGetProperty("message", out var message) ? message.GetString() : null;
+        return !root.TryGetProperty("success", out var success) || success.ValueKind != JsonValueKind.False;
+    }
+}

backend/src/Health.Infrastructure/AI/EfAiConversationRepository.cs

@@ -0,0 +1,45 @@
+using Health.Application.AI;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class EfAiConversationRepository(AppDbContext db) : IAiConversationRepository
+{
+    private readonly AppDbContext _db = db;
+
+    public Task<Conversation?> GetOwnedAsync(Guid userId, Guid conversationId, CancellationToken ct) =>
+        _db.Conversations.FirstOrDefaultAsync(c => c.Id == conversationId && c.UserId == userId, ct);
+
+    public Task<Conversation?> GetAsync(Guid conversationId, CancellationToken ct) =>
+        _db.Conversations.FirstOrDefaultAsync(c => c.Id == conversationId, ct);
+
+    public async Task<IReadOnlyList<Conversation>> ListAsync(Guid userId, CancellationToken ct) =>
+        await _db.Conversations
+            .Where(c => c.UserId == userId)
+            .OrderByDescending(c => c.UpdatedAt)
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<ConversationMessage>> GetMessagesAsync(Guid conversationId, CancellationToken ct) =>
+        await _db.ConversationMessages
+            .Where(m => m.ConversationId == conversationId)
+            .OrderBy(m => m.CreatedAt)
+            .ToListAsync(ct);
+
+    public async Task<IReadOnlyList<ConversationMessage>> GetRecentMessagesAsync(Guid conversationId, int limit, CancellationToken ct) =>
+        await _db.ConversationMessages
+            .Where(m => m.ConversationId == conversationId)
+            .OrderByDescending(m => m.CreatedAt)
+            .Take(limit)
+            .ToListAsync(ct);
+
+    public async Task AddConversationAsync(Conversation conversation, CancellationToken ct) =>
+        await _db.Conversations.AddAsync(conversation, ct);
+
+    public async Task AddMessageAsync(ConversationMessage message, CancellationToken ct) =>
+        await _db.ConversationMessages.AddAsync(message, ct);
+
+    public void Delete(Conversation conversation) =>
+        _db.Conversations.Remove(conversation);
+
+    public Task SaveChangesAsync(CancellationToken ct) =>
+        _db.SaveChangesAsync(ct);
+}

backend/src/Health.Infrastructure/AI/EfAiWriteConfirmationStore.cs

@@ -0,0 +1,98 @@
+using Health.Application.AI;
+using Health.Infrastructure.Data.Records;
+
+namespace Health.Infrastructure.AI;
+
+public sealed class EfAiWriteConfirmationStore(AppDbContext db) : IAiWriteConfirmationStore
+{
+    private readonly AppDbContext _db = db;
+
+    public async Task<PendingAiWriteCommand> CreateAsync(
+        Guid userId,
+        string toolName,
+        string arguments,
+        TimeSpan lifetime,
+        CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        if (IsInMemory())
+        {
+            var expired = await _db.AiWriteCommands.Where(x => x.Status == "Pending" && x.ExpiresAt <= now).ToListAsync(ct);
+            foreach (var item in expired) { item.Status = "Expired"; item.UpdatedAt = now; }
+        }
+        else
+        {
+            await _db.AiWriteCommands
+                .Where(x => x.Status == "Pending" && x.ExpiresAt <= now)
+                .ExecuteUpdateAsync(setters => setters
+                    .SetProperty(x => x.Status, "Expired")
+                    .SetProperty(x => x.UpdatedAt, now), ct);
+        }
+
+        var command = new AiWriteCommandRecord
+        {
+            Id = Guid.NewGuid(),
+            UserId = userId,
+            ToolName = toolName,
+            Arguments = arguments,
+            Status = "Pending",
+            ExpiresAt = now.Add(lifetime),
+            CreatedAt = now,
+            UpdatedAt = now,
+        };
+        await _db.AiWriteCommands.AddAsync(command, ct);
+        await _db.SaveChangesAsync(ct);
+        return ToCommand(command);
+    }
+
+    public async Task<PendingAiWriteCommand?> TakeAsync(Guid commandId, Guid userId, CancellationToken ct)
+    {
+        var now = DateTime.UtcNow;
+        if (IsInMemory())
+        {
+            var tracked = await _db.AiWriteCommands.FirstOrDefaultAsync(
+                x => x.Id == commandId && x.UserId == userId && x.Status == "Pending" && x.ExpiresAt > now, ct);
+            if (tracked == null) return null;
+            tracked.Status = "Processing";
+            tracked.UpdatedAt = now;
+            await _db.SaveChangesAsync(ct);
+        }
+        else
+        {
+            var updated = await _db.AiWriteCommands
+                .Where(x => x.Id == commandId && x.UserId == userId && x.Status == "Pending" && x.ExpiresAt > now)
+                .ExecuteUpdateAsync(setters => setters
+                    .SetProperty(x => x.Status, "Processing")
+                    .SetProperty(x => x.UpdatedAt, now), ct);
+            if (updated == 0) return null;
+        }
+
+        var record = await _db.AiWriteCommands.AsNoTracking().FirstAsync(x => x.Id == commandId, ct);
+        return ToCommand(record);
+    }
+
+    public async Task CompleteAsync(PendingAiWriteCommand command, CancellationToken ct)
+    {
+        if (IsInMemory())
+        {
+            var tracked = await _db.AiWriteCommands.FirstOrDefaultAsync(
+                x => x.Id == command.Id && x.UserId == command.UserId && x.Status == "Processing", ct);
+            if (tracked != null) { tracked.Status = "Completed"; tracked.UpdatedAt = DateTime.UtcNow; await _db.SaveChangesAsync(ct); }
+            return;
+        }
+        await _db.AiWriteCommands
+            .Where(x => x.Id == command.Id && x.UserId == command.UserId && x.Status == "Processing")
+            .ExecuteUpdateAsync(setters => setters
+                .SetProperty(x => x.Status, "Completed")
+                .SetProperty(x => x.UpdatedAt, DateTime.UtcNow), ct);
+    }
+
+    private bool IsInMemory() => _db.Database.ProviderName == "Microsoft.EntityFrameworkCore.InMemory";
+
+    private static PendingAiWriteCommand ToCommand(AiWriteCommandRecord record) => new(
+        record.Id,
+        record.UserId,
+        record.ToolName,
+        record.Arguments,
+        record.ExpiresAt);
+}

backend/src/Health.Infrastructure/AI/prompt_manager.cs

@@ -8,18 +8,33 @@ public sealed class PromptManager
     /// <summary>
     /// 获取指定 Agent 的 System Prompt
     /// </summary>
-    public string GetSystemPrompt(AgentType agentType) => agentType switch
+    public string GetSystemPrompt(AgentType agentType)
     {
-        AgentType.Default => DefaultPrompt,
-        AgentType.Consultation => ConsultationPrompt,
-        AgentType.Health => HealthDataPrompt,
-        AgentType.Diet => DietPrompt,
-        AgentType.Medication => MedicationPrompt,
-        AgentType.Report => ReportPrompt,
-        AgentType.Exercise => ExercisePrompt,
-        AgentType.Unified => UnifiedPrompt,
-        _ => DefaultPrompt
-    };
+        var prompt = agentType switch
+        {
+            AgentType.Default => DefaultPrompt,
+            AgentType.Consultation => ConsultationPrompt,
+            AgentType.Health => HealthDataPrompt,
+            AgentType.Diet => DietPrompt,
+            AgentType.Medication => MedicationPrompt,
+            AgentType.Report => ReportPrompt,
+            AgentType.Exercise => ExercisePrompt,
+            AgentType.Unified => UnifiedPrompt,
+            _ => DefaultPrompt
+        };
+
+        return $"{prompt}\n\n{MedicalBoundaryRules}";
+    }
+
+    private const string MedicalBoundaryRules = """
+        医疗边界（必须遵守）：
+        - 你的定位是患者端 AI 健康解释与预问诊助手，不是医生，不能替代医生诊断、处方或治疗决策。
+        - 可以解释健康数据、报告指标和症状可能方向，但不要给出确定诊断，不要说“你就是/一定是/已经确诊”。
+        - 不要要求用户自行新增、停用、更换药物或调整剂量；涉及用药变化时，必须建议咨询医生或药师。
+        - 对胸痛、胸闷憋气、呼吸困难、意识异常、晕厥、说话不清、一侧肢体无力、血氧明显偏低、血压或血糖严重异常等情况，优先建议及时就医或急诊评估。
+        - 回答用语使用“可能、建议、需要结合医生判断”等表达，避免绝对化结论。
+        - 医疗相关分析末尾用一句自然的话提醒：以上为 AI 预分析，不能替代医生诊断和治疗建议。
+        """;
 
     private const string DefaultPrompt = """
         你是一位专业的AI健康管家，专注于为心脏术后康复患者提供贴心的健康管理服务。
@@ -38,15 +53,15 @@ public sealed class PromptManager
         """;
 
     private const string ConsultationPrompt = """
-        你是一个心血管内科医生助手，负责对心脏术后患者进行多轮问诊。
+        你是一个患者端 AI 预问诊助手，负责帮助心脏术后患者梳理症状和就医前信息。
 
         规则：
         1. 每次只问一个问题，不要一次问多个
         2. 给出 2-3 个快捷选项让患者点击
         3. 问诊步骤：先问感受 → 持续时间 → 伴随症状 → 近期用药 → 给出初步分析
         4. 遇到以下情况建议立即就医：剧烈胸痛、呼吸困难、心悸
-        5. 遇到以下情况建议转医生：血压持续>160/100、心率>120或<50
-        6. 所有分析末尾标注"以上为AI分析，具体请咨询医生"
+        5. 遇到以下情况建议咨询医生：血压持续>160/100、心率>120或<50
+        6. 只给出初步分析和下一步建议，不作诊断结论
         7. 问诊结束给出结构化小结
         """;
 
@@ -55,13 +70,13 @@ public sealed class PromptManager
 
         规则：
         1. 解析用户消息中的指标和数值（血压/心率/血糖/血氧/体重）
-        2. 指标明确+数值明确→直接调用 record_health_data 录入
+        2. 指标明确+数值明确→调用 record_health_data 生成待确认写入命令，不要直接声称已经录入
         3. 用户可以一次性说多个指标（如"血压120/80，血糖6.2，血氧97"）→多次调用 record_health_data
-        4. 用户可以分时段说（如"早上血压120，下午血压130"）→分别录入，recorded_at 参数用不同时间
+        4. 用户可以分时段说（如"早上血压120，下午血压130"）→分别生成待确认命令，recorded_at 参数用不同时间
         5. 数值明确但指标模糊（如只说"120"）→追问是"收缩压还是血糖？"
         6. 时间模糊→取当前时间
         7. 数值超出正常范围→附带异常提醒
-        8. 每次调用 record_health_data 后，继续调用下一个，全部录入完成后生成确认卡片格式的回复
+        8. 每次调用 record_health_data 后继续处理下一个；工具返回仅表示等待确认，必须提示用户点击确认卡片，不能说“录入成功”
 
         正常值参考范围：
         - 收缩压 90-139 mmHg，舒张压 60-89 mmHg
@@ -86,24 +101,24 @@ public sealed class PromptManager
         """;
 
     private const string MedicationPrompt = """
-        你是一个用药管理专家。
+        你是一个用药记录与提醒助手。
 
         规则：
         1. 用户询问当前用药时，必须先调用 manage_medication(action="query") 查询已有用药记录
         2. 解析用户口中的药品信息（药名/剂量/频次/时间）
         3. "早饭后"等模糊时间→追问具体几点
-        4. 解析完成后展示确认卡片
+        4. 解析完成后调用 manage_medication(action="create") 生成待确认命令并展示确认卡片；用户点击确认前不得声称已保存
         5. 处方拍照→提取药品信息→生成用药计划→让用户确认
-        6. 回答用药相关疑问
+        6. 可以解释常见用药注意事项，但不要建议用户自行新增、停用、更换药物或调整剂量
         """;
 
     private const string ReportPrompt = """
-        你是一个医学报告解读专家。
+        你是一个患者端医学报告预解读助手。
 
         规则：
         1. 收到报告图片后，提取所有指标及其数值
         2. 标注异常指标（偏高/偏低/正常）
-        3. 给出初步分析
+        3. 给出初步分析和可能方向，不作诊断结论
         4. 所有内容标注"AI预解读，待医生确认"
         5. 图像类报告（彩超/CT）注明"需医生人工审阅"
         """;
@@ -120,7 +135,7 @@ public sealed class PromptManager
         """;
 
     private const string UnifiedPrompt = """
-        你是一个全能的AI健康管家，为心脏术后康复患者提供全方位服务。
+        你是一个患者端 AI 健康管家，为心脏术后康复患者提供健康解释、记录和预问诊辅助服务。
 
         核心规则：首先理解用户意图属于哪个领域，然后调用对应的工具。
 
@@ -133,20 +148,21 @@ public sealed class PromptManager
         6. 历史数据查询 → 调用 query_health_records
 
         运动计划参数格式（manage_exercise）：
-        - action="create", week_start_date="今天日期(YYYY-MM-DD)"
-        - items: [{"day_of_week":0-6(周日=0),"exercise_type":"散步","duration_minutes":30,"is_rest_day":false}, ...]
+        - action="create", start_date="开始日期(YYYY-MM-DD，默认今天)"
+        - duration_days=连续天数，exercise_type="散步"，duration_minutes=30，reminder_time="19:00"
         - 时长必须识别中文数字：半小时=30 一小时=60 三十分钟=30 一个半小时=90 一小时二十分钟=80，中文数字必须转为阿拉伯数字
         - 天数："一个月"=30天 "一周"=7天 "10天"=10天，必须识别中文，默认7天
         - 用户说"坚持X天/月/周"则创建对应天数
-        - items 数量必须等于持续天数
+        - 结束日期由 start_date + duration_days - 1 自动计算，不要按星期几生成条目
 
         用药管理参数格式（manage_medication）：
         - action="create", name="药名", dosage="剂量", frequency="Daily", time_of_day=["08:00","20:00"], duration_days=7
 
         规则：
         - 用户可能一句话涉及多个领域，全部处理
-        - 数值明确+指标明确→直接录入，不要追问
-        - 录入完成后生成确认卡片
+        - 数值明确+指标明确→直接生成待确认命令，不要追问
+        - 所有写入工具调用只生成待确认命令；用户点击卡片确认后才真正写入数据库
+        - 工具返回 pendingConfirmation=true 时，不得回复“已录入”或“保存成功”，应提示用户核对并点击确认
         - 遇到紧急症状（剧烈胸痛、呼吸困难）立即建议就医
         - 回复语气温暖、专业
         """;