feat(ai): AI 健康管家 V2 基础设施 — 功能开关 + 角色沙箱准备 + 体征页 AI 趋势分析

- 迁移 000153: 新增 ai_feature_flags / ai_usage_daily / ai_suggestion_feedback 三张表,
  ai_tenant_configs 增加 billing_enabled 列, seed 12 个功能开关 + 2 个管理权限码
- 新增 FeatureFlagService: 5 分钟缓存 + DB 回退 + 即时更新
- VitalSignsTab 添加 AI 趋势分析按钮 (SSE 流式)
- 新增 3 个 Entity (ai_feature_flags / ai_usage_daily / ai_suggestion_feedback)
- AiState 扩展 feature_flags 字段
- 设计规格 + 讨论记录文档

Co-Authored-By: Claude Opus 4.7 <noreply@anthropic.com>

apps/web/src/pages/health/components/VitalSignsTab.tsx

@@ -1,6 +1,6 @@
 import { useCallback, useState, useMemo } from 'react';
-import { Table, Button, Modal, Form, InputNumber, DatePicker, Input, message, Typography, Tooltip, Popconfirm, Space } from 'antd';
-import { PlusOutlined, InfoCircleOutlined, EditOutlined, DeleteOutlined } from '@ant-design/icons';
+import { Table, Button, Modal, Form, InputNumber, DatePicker, Input, message, Typography, Tooltip, Popconfirm, Space, Card } from 'antd';
+import { PlusOutlined, InfoCircleOutlined, EditOutlined, DeleteOutlined, ThunderboltOutlined } from '@ant-design/icons';
 import type { Dayjs } from 'dayjs';
 import { dayjs } from '../../../utils/dayjs';
 import { healthDataApi } from '../../../api/health/healthData';
@@ -9,6 +9,7 @@ import { VitalSignsChart } from './VitalSignsChart';
 import { usePaginatedData } from '../../../hooks/usePaginatedData';
 import { AuthButton } from '../../../components/AuthButton';
 import { handleApiError } from '../../../api/client';
+import { startAnalysis } from '../../../api/ai/analysisSse';
 
 const { Text } = Typography;
 
@@ -20,6 +21,8 @@ export function VitalSignsTab({ patientId }: Props) {
   const [modalOpen, setModalOpen] = useState(false);
   const [editingRecord, setEditingRecord] = useState<VitalSigns | null>(null);
   const [chartRefreshKey, setChartRefreshKey] = useState(0);
+  const [analyzingTrend, setAnalyzingTrend] = useState(false);
+  const [trendContent, setTrendContent] = useState('');
   const [form] = Form.useForm();
   const [submitting, setSubmitting] = useState(false);
 
@@ -32,6 +35,16 @@ export function VitalSignsTab({ patientId }: Props) {
 
   const { data, total, page, loading, refresh } = usePaginatedData<VitalSigns>(fetcher, 10);
 
+  const handleTrendAnalysis = async () => {
+    setAnalyzingTrend(true);
+    setTrendContent('');
+    await startAnalysis('trends', { patient_id: patientId }, {
+      onChunk: (content) => setTrendContent(prev => prev + content),
+      onError: (msg) => { message.error(msg); setAnalyzingTrend(false); },
+      onDone: () => { message.success('AI 趋势分析完成'); setAnalyzingTrend(false); },
+    });
+  };
+
   const handleOpenCreate = () => {
     setEditingRecord(null);
     form.resetFields();
@@ -211,9 +224,36 @@ export function VitalSignsTab({ patientId }: Props) {
     <div>
       {/* 趋势图 */}
       <div style={{ marginBottom: 12 }}>
+        <div style={{ display: 'flex', justifyContent: 'flex-end', marginBottom: 8 }}>
+          <AuthButton
+            code="ai.analysis.manage"
+            icon={<ThunderboltOutlined />}
+            loading={analyzingTrend}
+            onClick={handleTrendAnalysis}
+            size="small"
+          >
+            AI 趋势分析
+          </AuthButton>
+        </div>
         <VitalSignsChart patientId={patientId} refreshKey={chartRefreshKey} />
       </div>
 
+      {/* AI 趋势分析结果 */}
+      {trendContent && (
+        <Card
+          title={<><ThunderboltOutlined /> AI 趋势分析结果</>}
+          size="small"
+          style={{ marginBottom: 12 }}
+          extra={
+            <Button size="small" onClick={() => setTrendContent('')}>关闭</Button>
+          }
+        >
+          <div style={{ whiteSpace: 'pre-wrap', lineHeight: 1.8 }}>
+            {trendContent}
+          </div>
+        </Card>
+      )}
+
       {/* 最新记录摘要条 */}
       {latest && (
         <div style={{