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

crates/erp-ai/src/handler/suggestion_handler.rs

@@ -193,6 +193,69 @@ where
     }
 }
 
+#[derive(Debug, Deserialize, utoipa::ToSchema)]
+pub struct SubmitFeedbackBody {
+    pub action: String, // "adopt" | "ignore" | "consult"
+    pub feedback_text: Option<String>,
+}
+
+/// 患者端提交建议反馈（采纳/忽略/咨询医生）
+#[utoipa::path(
+    post,
+    path = "/ai/suggestions/{id}/feedback",
+    responses((status = 200, description = "提交建议反馈")),
+    tag = "AI 建议",
+    security(("bearer_auth" = [])),
+)]
+pub async fn submit_feedback<S>(
+    State(state): State<AiState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(id): Path<uuid::Uuid>,
+    Json(body): Json<SubmitFeedbackBody>,
+) -> Result<Json<ApiResponse<serde_json::Value>>, erp_core::error::AppError>
+where
+    AiState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "ai.suggestion.manage")?;
+
+    if !matches!(body.action.as_str(), "adopt" | "ignore" | "consult") {
+        return Err(erp_core::error::AppError::Validation(
+            "action 必须为 adopt、ignore 或 consult".into(),
+        ));
+    }
+
+    let feedback_id =
+        crate::service::suggestion_feedback::SuggestionFeedbackService::submit_feedback(
+            &state.db,
+            ctx.tenant_id,
+            id,
+            ctx.user_id,
+            body.action.clone(),
+            body.feedback_text.clone(),
+        )
+        .await?;
+
+    // 发布反馈事件
+    let event = erp_core::events::DomainEvent::new(
+        "ai.suggestion.feedback",
+        ctx.tenant_id,
+        erp_core::events::build_event_payload(serde_json::json!({
+            "suggestion_id": id,
+            "action": body.action,
+            "feedback_text": body.feedback_text,
+            "user_id": ctx.user_id,
+        })),
+    );
+    state.event_bus.publish(event, &state.db).await;
+
+    Ok(Json(ApiResponse::ok(serde_json::json!({
+        "id": feedback_id,
+        "suggestion_id": id,
+        "action": body.action,
+    }))))
+}
+
 /// 发布建议状态变更事件
 async fn publish_status_event(state: &AiState, suggestion: &crate::entity::ai_suggestion::Model) {
     let event = erp_core::events::DomainEvent::new(