Driven jointly by digital communication and the strategy of building a culturally strong nation, the inheritance of Traditional Chinese Medicine (TCM) culture is shifting from the traditional one-way model of dissemination and instruction toward a new stage characterized by multi-actor participation and multi-dimensional value symbiosis. Value co-creation theory offers a new theoretical perspective for addressing the current practical dilemmas of TCM cultural inheritance, including insufficient excavation of cultural connotations, monotonous communication forms, inadequate coordination among stakeholders, and weak public participation. Based on the core values of TCM culture and contemporary inheritance practices, and drawing on relevant studies on value co-creation, cultural communication, and digital-intelligent empowerment, this paper elucidates the connotations and core features of value co-creation in TCM culture, analyzes its theoretical logic, deconstructs its generative mechanism from the dimensions of actors, content, media, and fields, and constructs a systematic model of inheritance and innovation centered on “multi-actor collaboration—co-creation of content symbols—digital-intelligent media empowerment—institutional and procedural support.” The aim is to provide theoretical reference and practical pathways for promoting the creative transformation and innovative development of TCM culture.