Background: Mechanistic elucidation of traditional Chinese medicine (TCM) compound formulas remains a central challenge in the modernization of TCM. Conventional approaches, including data mining and network pharmacology, are insufficient for achieving deep integration between classical TCM theory and modern scientific research. In addition, direct question-answering using general-purpose artificial intelligence large language models is limited by inadequate adaptation to TCM theoretical frameworks and susceptibility to reasoning hallucinations. Consequently, there is an urgent need to develop intelligent analytical methods aligned with the holistic principles of TCM. Objective: To establish a multi-expert intelligent agent framework integrating classical TCM theory with modern life sciences, thereby enabling systematic and interpretable mechanistic analysis of TCM compound formulas, with Guizhi Decoction serving as a representative validation case. Methods: The DeepTCM1.0 framework was constructed based on the general-purpose large language model DeepSeek V3.2. It adopts a three-tier collaborative architecture and a three-round iterative quality-control workflow, simulating the collaborative analytical process of 11 interdisciplinary intelligent agents. The framework was applied to the mechanistic interpretation of Guizhi Decoction from the dual perspectives of classical traditional Chinese medicine theory and modern scientific research. Framework performance was comprehensively evaluated through double-blind five-dimensional scoring, intraclass correlation coefficient (ICC) reliability testing, Mann-Whitney U tests, and effect size analysis. The evaluation employed four independent large language models as evaluators, each conducting five rounds of repeated scoring on five anonymized reports, resulting in a total of 100 independent scoring assessments.
Aim: Existing AI-assisted traditional Chinese medicine diagnostic tools suffer from opaque reasoning processes, passive interaction, and limited treatment plan presentation. This study proposes a knowledge-enhanced visual diagnostic system to improve the transparency and interpretability of syndrome differentiation and treatment. Methods: The system is built upon a Neo4j knowledge graph comprising 241 syndromes, 1,263 symptoms, and 2,485 relations. It incorporates a four-stage symptom matching pipeline (exact, semantic, fuzzy, and large language model verification), an information gain-driven proactive questioning strategy optimized with genetic algorithms, and a multimodal treatment presentation integrating artificial intelligence-generated illustrations, three-dimensional meridian-acupoint models, and evidence-based literature. Results: Knowledge graph constraints reduced non-standard outputs by 32%. Case studies validated the effectiveness of the interactive workflow across patient self-assessment, clinician-assisted diagnosis, and traditional Chinese medicine education. Automated paired-comparison evaluation across 30 cases further demonstrated significant improvements in diagnostic trust (Cohen's d = 1.82, p < 0.001), reduced cognitive load (improvements in four of five dimensions), and higher credibility of evidence-based references (4.21 vs. 2.95). Conclusions: The proposed system enhances the transparency of traditional Chinese medicine diagnostic reasoning and the interpretability of treatment plans through knowledge graph-driven visualization and multimodal interaction, offering a practical solution for trustworthy artificial intelligence-assisted traditional Chinese medicine applications.