Prediction of Five Elements Imbalance and Acupuncture Point Recommendations Using Health-LLM Agent Method for Symptom Diagnosis Based on Traditional Chinese Medicine (TCM) Theory at Acumastery Clinic
DOI:
https://doi.org/10.35870/ijsecs.v5i3.5775Keywords:
Acupuncture, Artificial Intelligence, Five Element, Symptom Diagnosis, Traditional Chinese MedicineAbstract
Traditional Chinese Medicine (TCM) is a medical system that has been historically proven effective in diagnosing and managing various symptoms through the concepts of the Five Element imbalance, Yin-Yang, and acupuncture points. In the era of artificial intelligence, the utilization of Large Language Models (LLMs) specifically designed for the healthcare domain, referred to as Health-LLM Agents (AI-based health agents powered by LLMs), holds great potential in supporting TCM practices with greater efficiency and precision. This study aims to design and evaluate the performance of a Health-LLM Agent in predicting imbalances among the Five Elements (Wood, Fire, Earth, Metal, Water) based on patient symptoms, while also recommending appropriate acupuncture points for therapy. The methodology involves fine-tuning an LLM model with prompt engineering tailored to TCM terminology and principles, along with integrating symptom data in semi-structured text format. Evaluation is conducted using expert validation and classification metrics such as diagnostic accuracy, relevance of acupuncture point recommendations, and result interpretability. The findings indicate that the Health-LLM Agent achieves an 81% accuracy in predicting Five Element imbalances and receives 92% positive validation from TCM practitioners regarding acupuncture point recommendations. These results demonstrate that the Health-LLM Agent can serve as a promising tool to support the digitalization and personalization of TCM diagnosis through AI-based systems
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References
Yang, Y., Ma, T., Li, R., Zheng, X., Shan, G., & Li, C. (2025). JingFang: An expert-level large language model for traditional Chinese medicine clinical consultation and syndrome differentiation-based treatment. ArXiv preprint.
Wei, S., et al. (2024). BianCang: A traditional Chinese medicine large language model. ArXiv preprint.
Li, Y., et al. (2024). Relation extraction using large language models: A case study on acupuncture point locations. Journal of the American Medical Informatics Association, 31(11), 2622–2631. https://doi.org/10.1093/jamia/ocae233
Chen, Z., et al. (2024). Traditional Chinese medicine diagnostic prediction model for holistic syndrome differentiation based on deep learning. Integrative Medicine Research, 13(1), 101019. https://doi.org/10.1016/j.imr.2023.101019
Pahlawan, M. R. (2024). Penggunaan explainable machine learning untuk prediksi pasien diabetes. Sisfo, 11(1). https://doi.org/10.24089/j.sisfo.2024.05.002
Al Nazi, Z., & Peng, W. (2024). Large language models in healthcare and medical domain: A review. Informatics, 11(3), 57. https://doi.org/10.3390/informatics11030057
Belyaeva, A., et al. (2024). Multimodal LLMs for health grounded in individual-specific data. In Proceedings of the Conference (pp. 86–102). https://doi.org/10.1007/978-3-031-47679-2_7
Lu, Z., Peng, Y., Cohen, T., Ghassemi, M., Weng, C., & Tian, S. (2024). Large language models in biomedicine and health: Current research landscape and future directions. Journal of the American Medical Informatics Association, 31(9), 1801–1811. https://doi.org/10.1093/jamia/ocae202
Yu, H., et al. (2024). Large language models in biomedical and health informatics: A review with bibliometric analysis. Journal of Healthcare Informatics Research, 8(4), 658–711. https://doi.org/10.1007/s41666-024-00171-8
Goh, E., et al. (2024). Large language model influence on diagnostic reasoning. JAMA Network Open, 7(10), e2440969. https://doi.org/10.1001/jamanetworkopen.2024.40969
Khatim, N. A., Irfan, A. A., & Arief, M. M. (2024). Using LLM for real-time transcription and summarization of doctor-patient interactions into ePuskesmas in Indonesia. ArXiv preprint.
Harahap, N. C., Handayani, P. W., & Hidayanto, A. N. (2023). Integrated personal health record in Indonesia: Design science research study. JMIR Medical Informatics, 11, e44784. https://doi.org/10.2196/44784
Herlawati, H., & Handayanto, R. T. (2025). Fine-tuning large language model (LLM) for chatbot with additional data sources. PIKSEL: Penelitian Ilmu Komputer Sistem Embedded and Logic, 13(1), 125–132. https://doi.org/10.33558/piksel.v13i1.10832
De Vito, G., Filomena, F., & Angelakis, A. (2025). LLMs for drug-drug interaction prediction: A comprehensive comparison. ArXiv preprint.
Tang, H., et al. (2024). TCMLLM-PR: Evaluation of large language models for prescription recommendation in traditional Chinese medicine. Digital Chinese Medicine, 7(4), 343–355. https://doi.org/10.1016/j.dcmed.2025.01.007
Yang, G., Liu, X., Shi, J., Wang, Z., & Wang, G. (2024). TCM-GPT: Efficient pre-training of large language models for domain adaptation in traditional Chinese medicine. Computer Methods and Programs in Biomedicine Update, 6, 100158. https://doi.org/10.1016/j.cmpbup.2024.100158
Jia, Y., et al. (2025). Qibo: A large language model for traditional Chinese medicine. Expert Systems with Applications, 284, 127672. https://doi.org/10.1016/j.eswa.2025.127672
Dai, Y., et al. (2024). TCMChat: A generative large language model for traditional Chinese medicine. Pharmacological Research, 210, 107530. https://doi.org/10.1016/j.phrs.2024.107530
Wang, Y., Shi, X., Efferth, T., & Shang, D. (2022). Artificial intelligence-directed acupuncture: A review. Chinese Medicine, 17(1), 80. https://doi.org/10.1186/s13020-022-00636-1
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Copyright (c) 2025 Iwan Muttaqin, Arya Adhyaksa Waskita, Choirul Basir

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