feat(ai): Phase 2B 洞察→推送→反馈闭环 — 风险评分+通知+建议反馈

- 风险评分引擎 load_patient_data 实装（体征+化验异常）
- refresh_all_patients 高风险自动创建洞察+事件推送
- erp-message 订阅 copilot.insight.created 推送医护通知
- 每日 cron 增加洞察过期清理+建议过期清理
- POST /ai/suggestions/{id}/feedback 建议反馈端点
- SuggestionFeedbackService 反馈服务层
- 小程序健康页建议卡片增加采纳/忽略/咨询医生按钮

apps/miniprogram/src/pages/health/index.scss

@@ -289,10 +289,22 @@
 }
 
 .ai-suggestion-item {
+  padding: var(--tk-gap-xs) 0;
+  border-bottom: 1px solid rgba($acc, 0.15);
+
+  &:last-child {
+    border-bottom: none;
+  }
+}
+
+.ai-suggestion-main {
   display: flex;
   align-items: center;
   gap: var(--tk-gap-xs);
-  padding: var(--tk-gap-2xs) 0;
+
+  &:active {
+    opacity: var(--tk-touch-feedback-opacity);
+  }
 }
 
 .ai-risk-dot {
@@ -319,3 +331,48 @@
   color: $tx2;
   line-height: 1.6;
 }
+
+/* ─── AI 建议反馈按钮 ─── */
+.ai-feedback-row {
+  display: flex;
+  gap: var(--tk-gap-xs);
+  margin-top: var(--tk-gap-2xs);
+  padding-left: 20px;
+}
+
+.ai-feedback-btn {
+  height: 32px;
+  border-radius: $r-xs;
+  @include flex-center;
+  padding: 0 var(--tk-gap-sm);
+
+  &:active {
+    opacity: var(--tk-touch-feedback-opacity);
+  }
+
+  &.ai-feedback-adopt {
+    background: rgba($acc, 0.15);
+  }
+
+  &.ai-feedback-ignore {
+    background: $surface-alt;
+  }
+
+  &.ai-feedback-consult {
+    background: var(--tk-pri-l);
+  }
+}
+
+.ai-feedback-btn-text {
+  font-size: var(--tk-font-micro);
+  font-weight: 500;
+  color: $tx2;
+}
+
+.ai-feedback-adopt .ai-feedback-btn-text {
+  color: $acc;
+}
+
+.ai-feedback-consult .ai-feedback-btn-text {
+  color: var(--tk-pri);
+}

apps/miniprogram/src/pages/health/index.tsx

@@ -12,6 +12,7 @@ import SegmentTabs from '../../components/SegmentTabs';
 import PageShell from '@/components/ui/PageShell';
 import ContentCard from '@/components/ui/ContentCard';
 import { useHealthData, VITAL_TABS, type VitalType } from './useHealthData';
+import { submitSuggestionFeedback } from '../../services/ai-analysis';
 import './index.scss';
 
 function buildRefRange(t: HealthThreshold[]): Record<VitalType, string> {
@@ -171,16 +172,7 @@ export default function Health() {
       </View>
 
       {aiSuggestions.length > 0 && (
-        <View className='ai-suggestion-card' onClick={() => {
-          const first = aiSuggestions[0];
-          if (first?.suggestion_type === 'appointment') {
-            safeNavigateTo(`/pages/appointment/create/index`);
-          } else if (first?.suggestion_type === 'followup') {
-            safeNavigateTo('/pages/pkg-profile/followups/index');
-          } else {
-            Taro.switchTab({ url: '/pages/health/index' });
-          }
-        }}>
+        <View className='ai-suggestion-card'>
           <View className='ai-card-header'>
             <Text className='ai-card-title'>AI 健康建议</Text>
             <Text className='ai-card-count'>{aiSuggestions.length} 条待查看</Text>
@@ -192,8 +184,44 @@ export default function Health() {
             const reason = (params?.reason as string) || (params?.message as string) || typeLabel;
             return (
               <View key={s.id} className='ai-suggestion-item'>
-                <View className={`ai-risk-dot ${riskCls}`} />
-                <Text className='ai-suggestion-text'>{reason.slice(0, 40)}</Text>
+                <View className='ai-suggestion-main' onClick={() => {
+                  if (s.suggestion_type === 'appointment') {
+                    safeNavigateTo(`/pages/appointment/create/index`);
+                  } else if (s.suggestion_type === 'followup') {
+                    safeNavigateTo('/pages/pkg-profile/followups/index');
+                  }
+                }}>
+                  <View className={`ai-risk-dot ${riskCls}`} />
+                  <Text className='ai-suggestion-text'>{reason.slice(0, 40)}</Text>
+                </View>
+                <View className='ai-feedback-row'>
+                  <View className='ai-feedback-btn ai-feedback-adopt' onClick={async () => {
+                    try {
+                      await submitSuggestionFeedback(s.id, 'adopt');
+                      Taro.showToast({ title: '已采纳', icon: 'success' });
+                      fetchData();
+                    } catch { Taro.showToast({ title: '操作失败', icon: 'none' }); }
+                  }}>
+                    <Text className='ai-feedback-btn-text'>采纳</Text>
+                  </View>
+                  <View className='ai-feedback-btn ai-feedback-ignore' onClick={async () => {
+                    try {
+                      await submitSuggestionFeedback(s.id, 'ignore');
+                      Taro.showToast({ title: '已忽略', icon: 'success' });
+                      fetchData();
+                    } catch { Taro.showToast({ title: '操作失败', icon: 'none' }); }
+                  }}>
+                    <Text className='ai-feedback-btn-text'>忽略</Text>
+                  </View>
+                  <View className='ai-feedback-btn ai-feedback-consult' onClick={async () => {
+                    try {
+                      await submitSuggestionFeedback(s.id, 'consult');
+                      safeNavigateTo('/pages/consultation/index');
+                    } catch { Taro.showToast({ title: '操作失败', icon: 'none' }); }
+                  }}>
+                    <Text className='ai-feedback-btn-text'>咨询医生</Text>
+                  </View>
+                </View>
               </View>
             );
           })}

apps/miniprogram/src/services/ai-analysis.ts

@@ -41,6 +41,17 @@ export async function listPendingSuggestions() {
   return resp.data || [];
 }
 
+export async function submitSuggestionFeedback(
+  suggestionId: string,
+  action: 'adopt' | 'ignore' | 'consult',
+  feedbackText?: string,
+) {
+  return api.post(`/ai/suggestions/${suggestionId}/feedback`, {
+    action,
+    feedback_text: feedbackText || null,
+  });
+}
+
 // === 健康摘要 ===
 
 export interface SummaryItem {