Guanghui An

Jiacheng Xie, Ziyang Zhang, Biplab Poudel et al.

Tongue imaging serves as a valuable diagnostic tool, particularly in Traditional Chinese Medicine (TCM). The quality of tongue surface segmentation significantly affects the accuracy of tongue image classification and subsequent diagnosis in intelligent tongue diagnosis systems. However, existing research on tongue image segmentation faces notable limitations, and there is a lack of robust and user-friendly segmentation tools. This paper proposes a tongue image segmentation model (TOM) based on multi-teacher knowledge distillation. By incorporating a novel diffusion-based data augmentation method, we enhanced the generalization ability of the segmentation model while reducing its parameter size. Notably, after reducing the parameter count by 96.6% compared to the teacher models, the student model still achieves an impressive segmentation performance of 95.22% mIoU. Furthermore, we packaged and deployed the trained model as both an online and offline segmentation tool (available at https://itongue.cn/), allowing TCM practitioners and researchers to use it without any programming experience. We also present a case study on TCM constitution classification using segmented tongue patches. Experimental results demonstrate that training with tongue patches yields higher classification performance and better interpretability than original tongue images. To our knowledge, this is the first open-source and freely available tongue image segmentation tool.

Jiacheng Xie, Shuai Zeng, Yang Yu et al.

Traditional Chinese Medicine (TCM) presents a rich and structurally unique knowledge system that challenges conventional applications of large language models (LLMs). Although previous TCM-specific LLMs have shown progress through supervised fine-tuning, they often face limitations in alignment, data quality, and evaluation consistency. In this study, we introduce Ladder-base, the first TCM-focused LLM trained with Group Relative Policy Optimization (GRPO), a reinforcement learning method that improves reasoning and factual consistency by optimizing response selection based on intra-group comparisons. Ladder-base is built upon the Qwen2.5-7B-Instruct foundation model and trained exclusively on the textual subset of the TCM-Ladder benchmark, using 80 percent of the data for training and the remaining 20 percent split evenly between validation and test sets. Through standardized evaluation, Ladder-base demonstrates superior performance across multiple reasoning metrics when compared to both state-of-the-art general-purpose LLMs such as GPT-4, Gemini 2.5, Claude 3, and Qwen3 and domain-specific TCM models including BenTsao, HuatuoGPT2, and Zhongjing. These findings suggest that GRPO provides an effective and efficient strategy for aligning LLMs with expert-level reasoning in traditional medical domains and supports the development of trustworthy and clinically grounded TCM artificial intelligence systems.