Reunderstanding of the Classification of Syndromes in the Traditional Chinese Medicine Classic “Shang Han Lun” Based on Large Language Models

Objective: Traditional Chinese Medicine (TCM) has a long history of serving the Chinese people's heslth since its birth,as one of the crystallizations of Chinese wisdom, empazsizes the balance of Yin and Yang to keep the body healthy. The classic masterpiece “Shang Han Lun” (Treatise on Cold Damage Disorders) is one of the theoretical cornerstones of TCM, establishing a classification system of syndromes based on the Three Yang and Three Yin. This study aims to reclassify the data related to the Three Yang meridians in “Shang Han Lun” using mainstream large language models, in order to achieve a modern medical consensus-based reunderstanding of the syndrome differentiation in “Shang Han Lun.” Method: According to the “Traditional Chinese Medicine Classic Level Test Guide,” the articles on the Three Yang meridians in “Shang Han Lun” are graded. Ten articles are selected from the 1–2 level categories for data processing. The mainstream large language models ChatGLM4.0 (Chinese and English versions) and ChatGPT4.0 (Chinese and English versions) are used to classify cases based on modern medical consensus. The classification results are then statistically analyzed and compared with the original three Yin and three Yang Meridian syndrome differentiation in “Shang Han Lun.” Results: 1. Among the four sets of data, the ChatGLM4.0 Chinese version is the closest to the classification of the Three Yang meridians in “Shang Han Lun,” while the ChatGLM4.0 English version has the largest discrepancy. 2. The classification results of ChatGPT4.0 in both Chinese and English versions are moderately close to the classification of the Three Yang meridians in “Shang Han Lun.” 3. Both ChatGLM4.0 Chinese version and ChatGPT4.0 in Chinese and English versions selected the same categories as TCM, namely external infection (Taiyang meridian), digestive system diseases (Yangming meridian), and others (Shaoyang meridian). However, the ChatGLM4.0 English version classification results included the category of nervous system diseases (Yangming meridian). Conclusion: Among the existing mainstream large language models, traditional Chinese medicine demonstrates a certain degree of rationality in cross-era clinical applications. However, further research is still needed for improvement.