# TCM-DiffRAG: Personalized Syndrome Differentiation Reasoning Method for Traditional Chinese Medicine based on Knowledge Graph and Chain of Thought

arXiv: https://arxiv.org/abs/2602.22828 · HTML: https://mlsanity.com/paper/2602.22828/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 45 of its 89 references that are in the map.
- First posted on arXiv 26 Feb 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 30 of 45)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [REALM: Retrieval-Augmented Language Model Pre-Training](https://mlsanity.com/paper/2002.08909/) (2020)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Measuring and Narrowing the Compositionality Gap in Language Models](https://mlsanity.com/paper/2210.03350/) (2022)
- [Interleaving Retrieval with Chain-of-Thought Reasoning for Knowledge-Intensive Multi-Step Questions](https://mlsanity.com/paper/2212.10509/) (2022)
- [Precise Zero-Shot Dense Retrieval without Relevance Labels](https://mlsanity.com/paper/2212.10496/) (2022)
- [Ragas: Automated Evaluation of Retrieval Augmented Generation](https://mlsanity.com/paper/2309.15217/) (2023)
- [Enhancing Retrieval-Augmented Large Language Models with Iterative Retrieval-Generation Synergy](https://mlsanity.com/paper/2305.15294/) (2023)
- [R1-Searcher: Incentivizing the Search Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2503.05592/) (2025)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [ChatDoctor: A Medical Chat Model Fine-Tuned on a Large Language Model Meta-AI (LLaMA) Using Medical Domain Knowledge](https://mlsanity.com/paper/2303.14070/) (2023)
- [MinerU: An Open-Source Solution for Precise Document Content Extraction](https://mlsanity.com/paper/2409.18839/) (2024)
- [Agentic Retrieval-Augmented Generation: A Survey on Agentic RAG](https://mlsanity.com/paper/2501.09136/) (2025)
- [Nougat: Neural Optical Understanding for Academic Documents](https://mlsanity.com/paper/2308.13418/) (2023)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [ReSearch: Learning to Reason with Search for LLMs via Reinforcement Learning](https://mlsanity.com/paper/2503.19470/) (2025)
- [Zhongjing: Enhancing the Chinese Medical Capabilities of Large Language Model through Expert Feedback and Real-world Multi-turn Dialogue](https://mlsanity.com/paper/2308.03549/) (2023)
- [MedReason: Eliciting Factual Medical Reasoning Steps in LLMs via Knowledge Graphs](https://mlsanity.com/paper/2504.00993/) (2025)
- [LayoutLLM: Layout Instruction Tuning with Large Language Models for Document Understanding](https://mlsanity.com/paper/2404.05225/) (2024)
- [Buffer of Thoughts: Thought-Augmented Reasoning with Large Language Models](https://mlsanity.com/paper/2406.04271/) (2024)
- [MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilot](https://mlsanity.com/paper/2502.04413/) (2025)
- [Simple Is Effective: The Roles of Graphs and Large Language Models in Knowledge-Graph-Based Retrieval-Augmented Generation](https://mlsanity.com/paper/2410.20724/) (2024)
- [Retrieval Augmented Generation (RAG) and Beyond: A Comprehensive Survey on How to Make your LLMs use External Data More Wisely](https://mlsanity.com/paper/2409.14924/) (2024)
- [BianQue: Balancing the Questioning and Suggestion Ability of Health LLMs with Multi-turn Health Conversations Polished by ChatGPT](https://mlsanity.com/paper/2310.15896/) (2023)
- [LayoutParser: A Unified Toolkit for Deep Learning Based Document Image Analysis](https://mlsanity.com/paper/2103.15348/) (2021)
- [Improving Retrieval-Augmented Generation in Medicine with Iterative Follow-up Questions](https://mlsanity.com/paper/2408.00727/) (2024)
- [In-Context Principle Learning from Mistakes](https://mlsanity.com/paper/2402.05403/) (2024)
- [DeepRAG: Thinking to Retrieve Step by Step for Large Language Models](https://mlsanity.com/paper/2502.01142/) (2025)

## Abstract (arXiv)

Background: Retrieval augmented generation (RAG) technology can empower large language models (LLMs) to generate more accurate, professional, and timely responses without fine tuning. However, due to the complex reasoning processes and substantial individual differences involved in traditional Chinese medicine (TCM) clinical diagnosis and treatment, traditional RAG methods often exhibit poor performance in this domain. Objective: To address the limitations of conventional RAG approaches in TCM applications, this study aims to develop an improved RAG framework tailored to the characteristics of TCM reasoning. Methods: We developed TCM-DiffRAG, an innovative RAG framework that integrates knowledge graphs (KG) with chains of thought (CoT). TCM-DiffRAG was evaluated on three distinctive TCM test datasets. Results: The experimental results demonstrated that TCM-DiffRAG achieved significant performance improvements over native LLMs. For example, the qwen-plus model achieved scores of 0.927, 0.361, and 0.038, which were significantly enhanced to 0.952, 0.788, and 0.356 with TCM-DiffRAG. The improvements were even more pronounced for non-Chinese LLMs. Additionally, TCM-DiffRAG outperformed directly supervised fine-tuned (SFT) LLMs and other benchmark RAG methods. Conclusions: TCM-DiffRAG shows that integrating structured TCM knowledge graphs with Chain of Thought based reasoning substantially improves performance in individualized diagnostic tasks. The joint use of universal and personalized knowledge graphs enables effective alignment between general knowledge and clinical reasoning. These results highlight the potential of reasoning-aware RAG frameworks for advancing LLM applications in traditional Chinese medicine.