diff --git a/crates/erp-ai/src/agent/orchestrator.rs b/crates/erp-ai/src/agent/orchestrator.rs
index 4ff88ba..7f2ca55 100644
--- a/crates/erp-ai/src/agent/orchestrator.rs
+++ b/crates/erp-ai/src/agent/orchestrator.rs
@@ -12,6 +12,8 @@ pub struct AgentRunParams {
     pub temperature: f32,
     pub max_tokens: u32,
     pub max_iterations: usize,
+    /// 可选：累计 Token 预算（input + output），超出后强制结束
+    pub token_budget: Option<u32>,
 }
 
 impl Default for AgentRunParams {
@@ -21,6 +23,7 @@ impl Default for AgentRunParams {
             temperature: 0.7,
             max_tokens: 2048,
             max_iterations: 5,
+            token_budget: None,
         }
     }
 }
@@ -109,6 +112,27 @@ impl AgentOrchestrator {
                 continue;
             }
 
+            // Token 预算检查：超出后强制结束
+            if let Some(budget) = params.token_budget {
+                let total = total_input_tokens + total_output_tokens;
+                if total >= budget {
+                    tracing::warn!(
+                        total_tokens = total,
+                        budget = budget,
+                        iterations = iterations,
+                        "Token budget exhausted, forcing final reply"
+                    );
+                    messages.push(ChatMessage {
+                        role: ChatMessageRole::User,
+                        content: "（系统提示：Token 预算已用尽，请立即基于已有信息总结回复用户，不要再调用工具）"
+                            .to_string(),
+                        tool_calls: None,
+                        tool_call_id: None,
+                    });
+                    continue;
+                }
+            }
+
             // 将 assistant 的 tool_calls 加入消息历史
             messages.push(ChatMessage {
                 role: ChatMessageRole::Assistant,
diff --git a/crates/erp-ai/src/agent/sandbox.rs b/crates/erp-ai/src/agent/sandbox.rs
index 6c604de..8ed8e9c 100644
--- a/crates/erp-ai/src/agent/sandbox.rs
+++ b/crates/erp-ai/src/agent/sandbox.rs
@@ -46,6 +46,7 @@ pub fn get_sandbox_config(role: &UserRole) -> SandboxConfig {
                 "query_patient_medications".into(),
                 "search_medical_knowledge".into(),
                 "query_patient_profile".into(),
+                "get_health_insights".into(),
             ]),
             system_prompt_suffix: PATIENT_PROMPT_SUFFIX,
             output_filter: OutputFilter {
@@ -65,6 +66,7 @@ pub fn get_sandbox_config(role: &UserRole) -> SandboxConfig {
                 "query_patient_profile".into(),
                 "analyze_lab_report".into(),
                 "analyze_health_trends".into(),
+                "get_health_insights".into(),
             ]),
             system_prompt_suffix: MEDICAL_STAFF_PROMPT_SUFFIX,
             output_filter: OutputFilter {
diff --git a/crates/erp-ai/src/agent/tools/get_health_insights.rs b/crates/erp-ai/src/agent/tools/get_health_insights.rs
new file mode 100644
index 0000000..344ab0d
--- /dev/null
+++ b/crates/erp-ai/src/agent/tools/get_health_insights.rs
@@ -0,0 +1,211 @@
+use async_trait::async_trait;
+use erp_core::health_provider::TimeRange;
+
+use crate::agent::tool::{AgentTool, DisplayHint, ToolContext, ToolResult};
+
+/// 聚合多源数据生成健康洞察摘要
+pub struct GetHealthInsightsTool;
+
+#[async_trait]
+impl AgentTool for GetHealthInsightsTool {
+    fn name(&self) -> &str {
+        "get_health_insights"
+    }
+
+    fn description(&self) -> &str {
+        "获取患者综合健康洞察，聚合档案摘要、近期化验报告异常、体征异常值等多源数据，生成结构化洞察概览。"
+    }
+
+    fn parameters_schema(&self) -> serde_json::Value {
+        serde_json::json!({
+            "type": "object",
+            "properties": {}
+        })
+    }
+
+    async fn execute(&self, ctx: &ToolContext, _params: serde_json::Value) -> ToolResult {
+        let patient_id = match ctx.patient_id {
+            Some(id) => id,
+            None => {
+                return ToolResult {
+                    output: "未关联患者档案，无法获取健康洞察".to_string(),
+                    display_hint: None,
+                };
+            }
+        };
+
+        let mut output = String::from("患者综合健康洞察：\n\n");
+        let mut insight_items: Vec<String> = Vec::new();
+
+        // 1. 患者档案摘要
+        match ctx
+            .health_provider
+            .get_patient_summary(ctx.tenant_id, patient_id)
+            .await
+        {
+            Ok(summary) => {
+                output.push_str("【档案摘要】\n");
+                output.push_str(&format!("- 年龄组: {}\n", summary.age_group));
+                if !summary.chronic_conditions.is_empty() {
+                    output.push_str(&format!(
+                        "- 慢性疾病: {}\n",
+                        summary.chronic_conditions.join("、")
+                    ));
+                    insight_items
+                        .push(format!("慢性病: {}", summary.chronic_conditions.join("、")));
+                }
+                if !summary.medications.is_empty() {
+                    output.push_str(&format!(
+                        "- 当前用药（{} 种）: {}\n",
+                        summary.medications.len(),
+                        summary.medications.join("、")
+                    ));
+                }
+                output.push('\n');
+            }
+            Err(e) => {
+                output.push_str(&format!("【档案摘要】加载失败: {}\n\n", e));
+            }
+        }
+
+        // 2. 近期化验报告异常
+        match ctx
+            .health_provider
+            .get_patient_lab_reports(ctx.tenant_id, patient_id, 3)
+            .await
+        {
+            Ok(reports) => {
+                let abnormal_reports: Vec<_> =
+                    reports.iter().filter(|r| r.abnormal_count > 0).collect();
+                if !abnormal_reports.is_empty() {
+                    output.push_str(&format!(
+                        "【近期化验异常】（{} 份报告有异常）\n",
+                        abnormal_reports.len()
+                    ));
+                    for r in &abnormal_reports {
+                        output.push_str(&format!(
+                            "- {}（{}，{} 项异常，ID: {}）\n",
+                            r.report_type, r.report_date, r.abnormal_count, r.id
+                        ));
+                        insight_items.push(format!(
+                            "化验异常: {} {}项",
+                            r.report_type, r.abnormal_count
+                        ));
+                    }
+                    output.push('\n');
+                } else {
+                    output.push_str("【近期化验】无异常报告\n\n");
+                }
+            }
+            Err(e) => {
+                output.push_str(&format!("【近期化验】加载失败: {}\n\n", e));
+            }
+        }
+
+        // 3. 最近 7 天体征异常
+        let now = chrono::Utc::now();
+        let start = now - chrono::Duration::days(7);
+        let range = TimeRange { start, end: now };
+        let metrics = vec![
+            "systolic_bp_morning".into(),
+            "diastolic_bp_morning".into(),
+            "heart_rate".into(),
+            "blood_sugar".into(),
+        ];
+
+        match ctx
+            .health_provider
+            .get_vital_signs(ctx.tenant_id, patient_id, &metrics, &range)
+            .await
+        {
+            Ok(vitals) => {
+                let high_bp: Vec<_> = vitals
+                    .iter()
+                    .filter(|v| {
+                        v.metric.contains("systolic")
+                            && v.values.iter().any(|(_, val)| *val > 140.0)
+                    })
+                    .collect();
+
+                let high_sugar: Vec<_> = vitals
+                    .iter()
+                    .filter(|v| {
+                        v.metric.contains("blood_sugar")
+                            && v.values.iter().any(|(_, val)| *val > 11.1)
+                    })
+                    .collect();
+
+                if !high_bp.is_empty() || !high_sugar.is_empty() {
+                    output.push_str("【近期体征异常】\n");
+                    for v in &high_bp {
+                        let max_val = v.values.iter().map(|(_, val)| *val).fold(0.0f64, f64::max);
+                        output
+                            .push_str(&format!("- 收缩压最高 {} {}（近 7 天）\n", max_val, v.unit));
+                        insight_items.push(format!("血压偏高: 最高{}", max_val as i32));
+                    }
+                    for v in &high_sugar {
+                        let max_val = v.values.iter().map(|(_, val)| *val).fold(0.0f64, f64::max);
+                        output.push_str(&format!("- 血糖最高 {} {}（近 7 天）\n", max_val, v.unit));
+                        insight_items.push(format!("血糖偏高: 最高{}", max_val as i32));
+                    }
+                    output.push('\n');
+                } else {
+                    output.push_str("【近期体征】无显著异常\n\n");
+                }
+            }
+            Err(e) => {
+                output.push_str(&format!("【近期体征】加载失败: {}\n\n", e));
+            }
+        }
+
+        let severity = if insight_items.len() >= 3 {
+            "high"
+        } else if !insight_items.is_empty() {
+            "medium"
+        } else {
+            "low"
+        };
+
+        let display_hint = DisplayHint::InsightCard {
+            title: "健康洞察概览".into(),
+            severity: severity.into(),
+            items: insight_items,
+        };
+
+        ToolResult {
+            output,
+            display_hint: Some(display_hint),
+        }
+    }
+}
+
+#[cfg(test)]
+mod tests {
+    use super::*;
+
+    #[test]
+    fn tool_name() {
+        let tool = GetHealthInsightsTool;
+        assert_eq!(tool.name(), "get_health_insights");
+    }
+
+    #[test]
+    fn severity_high() {
+        let items: Vec<String> = vec!["a".into(), "b".into(), "c".into()];
+        let severity = if items.len() >= 3 { "high" } else { "medium" };
+        assert_eq!(severity, "high");
+    }
+
+    #[test]
+    fn severity_medium() {
+        let items: Vec<String> = vec!["a".into()];
+        let severity = if items.len() >= 3 {
+            "high"
+        } else if !items.is_empty() {
+            "medium"
+        } else {
+            "low"
+        };
+        assert_eq!(severity, "medium");
+    }
+}
diff --git a/crates/erp-ai/src/agent/tools/mod.rs b/crates/erp-ai/src/agent/tools/mod.rs
index 3a6248a..2251fde 100644
--- a/crates/erp-ai/src/agent/tools/mod.rs
+++ b/crates/erp-ai/src/agent/tools/mod.rs
@@ -2,6 +2,7 @@
 
 pub mod analyze_health_trends;
 pub mod analyze_lab_report;
+pub mod get_health_insights;
 pub mod query_appointments;
 pub mod query_lab_reports;
 pub mod query_medications;
@@ -11,6 +12,7 @@ pub mod search_medical_knowledge;
 
 pub use analyze_health_trends::AnalyzeHealthTrendsTool;
 pub use analyze_lab_report::AnalyzeLabReportTool;
+pub use get_health_insights::GetHealthInsightsTool;
 pub use query_appointments::QueryAppointmentsTool;
 pub use query_lab_reports::QueryLabReportsTool;
 pub use query_medications::QueryMedicationsTool;
diff --git a/crates/erp-ai/src/handler/chat_handler.rs b/crates/erp-ai/src/handler/chat_handler.rs
index 59d1824..0c38f19 100644
--- a/crates/erp-ai/src/handler/chat_handler.rs
+++ b/crates/erp-ai/src/handler/chat_handler.rs
@@ -9,6 +9,7 @@ use crate::agent::sandbox::{get_sandbox_config, resolve_role};
 use crate::agent::tool::ToolContext;
 use crate::agent::tools::AnalyzeHealthTrendsTool;
 use crate::agent::tools::AnalyzeLabReportTool;
+use crate::agent::tools::GetHealthInsightsTool;
 use crate::agent::tools::QueryPatientProfileTool;
 use crate::agent::tools::QueryPatientVitalsTool;
 use crate::agent::tools::SearchMedicalKnowledgeTool;
@@ -75,6 +76,23 @@ where
     // 从 settings 表加载 AI 配置（替代硬编码）
     let config = config_resolver::load_ai_config(ctx.tenant_id, &ai_state.db).await;
 
+    // 配额前置检查
+    if let Err(e) = ai_state
+        .quota
+        .check_quota(ctx.tenant_id, body.patient_id)
+        .await
+    {
+        tracing::warn!(
+            tenant_id = %ctx.tenant_id,
+            patient_id = ?body.patient_id,
+            error = %e,
+            "Quota check failed"
+        );
+        return Err(erp_core::error::AppError::Validation(
+            "AI 使用配额已用尽，请稍后再试或联系管理员".into(),
+        ));
+    }
+
     // 构建 Agent 消息历史
     let mut messages = vec![];
 
@@ -129,6 +147,7 @@ where
     registry.register(std::sync::Arc::new(QueryPatientProfileTool));
     registry.register(std::sync::Arc::new(AnalyzeLabReportTool));
     registry.register(std::sync::Arc::new(AnalyzeHealthTrendsTool));
+    registry.register(std::sync::Arc::new(GetHealthInsightsTool));
 
     // 根据用户角色获取沙箱配置
     let user_role = resolve_role(&ctx.roles);
@@ -161,6 +180,7 @@ where
         temperature: config.agent.temperature,
         max_tokens: config.agent.max_tokens,
         max_iterations: config.agent.max_iterations,
+        token_budget: None,
     };
 
     tracing::info!(