Based on the punctuated equilibrium theory （PET） in paleontology， an analytical framework is constructed to systematically elucidate the intrinsic evolution patterns and underlying dynamic mechanisms of traditional Chinese medicine （TCM） knowledge system. It further develops a dual-wheel driven model of inheritance and innovation， consisting of three parts， the wheel of inheritance， the axis of innovation， and the environmental field. As a typical complex adaptive system （CAS）， TCM's equilibrium phase is jointly sustained by multiple stabilizing mechanisms， including scholarly annotation， state authority， cultural orthodoxy， and the apprenticeship system， which ensures the resilient inheritance of core knowledge. Its brief disruptive phase is triggered by critical internal and external junctures such as technological revolutions， ideological liberations， and policy transformations， propelling adaptive innovation within the TCM knowledge system. Inheritance and innovation form a dual-wheel drive dialectical unity， jointly advancing the spiral evolution of TCM knowledge system through cycles of "equilibrium-punctuated disruption-re-equilibrium"， and offering insights for the contemporary inheritance and innovative development of TCM knowledge system.

Based on the punctuated equilibrium theory （PET） in paleontology， an analytical framework is constructed to systematically elucidate the intrinsic evolution patterns and underlying dynamic mechanisms of traditional Chinese medicine （TCM） knowledge system. It further develops a dual-wheel driven model of inheritance and innovation， consisting of three parts， the wheel of inheritance， the axis of innovation， and the environmental field. As a typical complex adaptive system （CAS）， TCM's equilibrium phase is jointly sustained by multiple stabilizing mechanisms， including scholarly annotation， state authority， cultural orthodoxy， and the apprenticeship system， which ensures the resilient inheritance of core knowledge. Its brief disruptive phase is triggered by critical internal and external junctures such as technological revolutions， ideological liberations， and policy transformations， propelling adaptive innovation within the TCM knowledge system. Inheritance and innovation form a dual-wheel drive dialectical unity， jointly advancing the spiral evolution of TCM knowledge system through cycles of "equilibrium-punctuated disruption-re-equilibrium"， and offering insights for the contemporary inheritance and innovative development of TCM knowledge system.