diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
index 9d97ac0e6..338fecea0 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
@@ -142,6 +142,34 @@
                 </el-form-item>
               </template>
             </el-table-column>
+            <el-table-column
+              label="诊断体系"
+              align="center"
+              prop="diagnosisSystem"
+              width="120"
+            >
+              <template #default="scope">
+                <el-form-item
+                  :prop="`diagnosisList.${scope.$index}.diagnosisSystem`"
+                >
+                  <el-select
+                    v-model="scope.row.diagnosisSystem"
+                    placeholder=" "
+                    style="width: 100%"
+                    @change="handleDiagnosisSystemChange(scope.row)"
+                  >
+                    <el-option
+                      label="西医"
+                      value="西医"
+                    />
+                    <el-option
+                      label="中医"
+                      value="中医"
+                    />
+                  </el-select>
+                </el-form-item>
+              </template>
+            </el-table-column>
             <el-table-column
               label="诊断类别"
               align="center"
@@ -187,6 +215,7 @@
                   >
                     <diagnosislist
                       :diagnosis-searchkey="diagnosisSearchkey"
+                      :diagnosis-system="scope.row.diagnosisSystem || '西医'"
                       @select-diagnosis="handleSelsectDiagnosis"
                     />
                     <template #reference>
@@ -208,19 +237,74 @@
               align="center"
               prop="diagnosisDoctor"
               width="120"
-            />
+            >
+              <template #default="scope">
+                <el-form-item>
+                  <span style="display: block; text-align: center; width: 100%;">{{ scope.row.diagnosisDoctor || '—' }}</span>
+                </el-form-item>
+              </template>
+            </el-table-column>
+            <el-table-column
+              align="center"
+              prop="tcmSyndromeName"
+              width="180"
+            >
+              <template #header>
+                <span>中医证候 <span style="color: #f56c6c;">*</span></span>
+              </template>
+              <template #default="scope">
+                <template v-if="scope.row.diagnosisSystem === '中医'">
+                  <el-form-item
+                    :prop="`diagnosisList.${scope.$index}.tcmSyndromeCode`"
+                    :rules="scope.row.diagnosisSystem === '中医' ? [{ required: true, message: '请选择中医证候', trigger: 'change' }] : []"
+                  >
+                    <el-select
+                      v-model="scope.row.tcmSyndromeCode"
+                      placeholder="请选择中医证候"
+                      filterable
+                      clearable
+                      style="width: 100%"
+                      @focus="loadSyndromeOptions(scope.row.ybNo)"
+                      @change="(val) => handleSyndromeSelect(val, scope.row)"
+                    >
+                      <el-option
+                        v-for="item in syndromeOptions"
+                        :key="item.value"
+                        :label="item.label"
+                        :value="item.value"
+                      />
+                    </el-select>
+                  </el-form-item>
+                </template>
+                <el-form-item v-else>
+                  <span>—</span>
+                </el-form-item>
+              </template>
+            </el-table-column>
             <el-table-column
               label="诊断时间"
               align="center"
               prop="diagnosisTime"
               width="150"
-            />
+            >
+              <template #default="scope">
+                <el-form-item>
+                  <span style="display: block; text-align: center; width: 100%;">{{ scope.row.diagnosisTime || '—' }}</span>
+                </el-form-item>
+              </template>
+            </el-table-column>
             <el-table-column
               label="诊断代码"
               align="center"
               prop="ybNo"
               width="180"
-            />
+            >
+              <template #default="scope">
+                <el-form-item>
+                  <span style="display: block; text-align: center; width: 100%;">{{ scope.row.ybNo || '—' }}</span>
+                </el-form-item>
+              </template>
+            </el-table-column>
             <el-table-column
               label="诊断类型"
               align="center"
@@ -228,30 +312,32 @@
               width="120"
             >
               <template #default="scope">
-                <div style="display:flex;flex-direction:column;align-items:center;gap:5px;">
-                  <el-checkbox
-                    v-model="scope.row.maindiseFlag"
-                    label="主诊断"
-                    :true-label="1"
-                    :false-label="0"
-                    border
-                    size="small"
-                    @change="(value) => handleMaindise(value, scope.$index)"
-                  />
-                  <el-select
-                    v-model="scope.row.verificationStatusEnum"
-                    placeholder=" "
-                    style="width: 100%; padding-bottom: 5px; padding-left: 10px"
-                    size="small"
-                  >
-                    <el-option
-                      v-for="item in diagnosisOptions"
-                      :key="item.value"
-                      :label="item.label"
-                      :value="item.value"
+                <el-form-item>
+                  <div style="display:flex;flex-direction:column;align-items:center;gap:5px;">
+                    <el-checkbox
+                      v-model="scope.row.maindiseFlag"
+                      label="主诊断"
+                      :true-label="1"
+                      :false-label="0"
+                      border
+                      size="small"
+                      @change="(value) => handleMaindise(value, scope.$index)"
                     />
-                  </el-select>
-                </div>
+                    <el-select
+                      v-model="scope.row.verificationStatusEnum"
+                      placeholder=" "
+                      style="width: 100%; padding-bottom: 5px; padding-left: 10px"
+                      size="small"
+                    >
+                      <el-option
+                        v-for="item in diagnosisOptions"
+                        :key="item.value"
+                        :label="item.label"
+                        :value="item.value"
+                      />
+                    </el-select>
+                  </div>
+                </el-form-item>
               </template>
             </el-table-column>
             <el-table-column
@@ -260,13 +346,15 @@
               width="130"
             >
               <template #default="scope">
-                <el-button
-                  link
-                  type="primary"
-                  @click="handleDeleteDiagnosis(scope.row, scope.$index)"
-                >
-                  删除
-                </el-button>
+                <el-form-item>
+                  <el-button
+                    link
+                    type="primary"
+                    @click="handleDeleteDiagnosis(scope.row, scope.$index)"
+                  >
+                    删除
+                  </el-button>
+                </el-form-item>
               </template>
             </el-table-column>
           </el-table>
@@ -288,7 +376,7 @@
 </template>
 
 <script setup>
-import {getCurrentInstance} from 'vue'; // 添加 nextTick 导入
+import {getCurrentInstance, ref, watch} from 'vue'; // 添加 nextTick 导入
 import useUserStore from '@/store/modules/user';
 import {
   delEncounterDiagnosis,
@@ -299,8 +387,10 @@ import {
   getEmrDetail,
   getEncounterDiagnosis,
   getTcmDiagnosis,
+  getTcmSyndrome,
   isFoodDiseasesNew,
   saveDiagnosis,
+  saveTcmDiagnosis,
 } from '../api';
 import {deleteTcmDiagnosis} from '@/views/doctorstation/components/api.js';
 import diagnosisdialog from '../diagnosis/diagnosisdialog.vue';
@@ -319,6 +409,7 @@ const diagnosisOptions = ref([]);
 const rowIndex = ref();
 const diagnosis = ref();
 const orgOrUser = ref();
+const syndromeOptions = ref([]);
 const form = ref({
   diagnosisList: [],
 });
@@ -397,46 +488,68 @@ function getList() {
     return;
   }
 
-  // 初始化中医诊断列表
-  const newList = [];
-
+  // 先加载西医诊断，再加载中医诊断（避免竞态覆盖）
   getEncounterDiagnosis(props.patientInfo.encounterId).then((res) => {
     if (res.code == 200) {
-      const datas = (res.data || []).map((item) => {
-        let obj = {
-          ...item,
-        };
-        if (obj.diagSrtNo == null) {
-          obj.diagSrtNo = 1;
-        }
-        return obj;
-      });
+      // 过滤掉中医诊断（typeName: '中医诊断'），中医数据由 getTcmDiagnosis 统一管理
+      const datas = (res.data || [])
+        .filter((item) => item.typeName !== '中医诊断')
+        .map((item) => {
+          let obj = {
+            ...item,
+            diagnosisSystem: '西医',
+            tcmSyndromeCode: '',
+            tcmSyndromeName: '',
+            syndromeDefinitionId: '',
+            syndromeGroupNo: '',
+            showPopover: false,
+          };
+          if (obj.diagSrtNo == null) {
+            obj.diagSrtNo = 1;
+          }
+          return obj;
+        });
       form.value.diagnosisList = datas;
-      // form.value.diagnosisList = res.data;
       emits('diagnosisSave', false);
     }
-  });
-  getTcmDiagnosis({ encounterId: props.patientInfo.encounterId }).then((res) => {
-    console.log('getTcmDiagnosis=======>', JSON.stringify(res.data.illness));
 
-    if (res.code == 200) {
-      if (res.data.illness.length > 0) {
-        diagnosisNetDatas.value = res.data.illness;
-        res.data.illness.forEach((item, index) => {
-          newList.push({
-            name: item.name + '-' + (res.data.symptom[index]?.name || ''),
-            ybNo: item.ybNo,
-            medTypeCode: item.medTypeCode,
-            diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-            diagnosisTime: new Date().toLocaleString('zh-CN')
+    // 西医数据就绪后再加载中医诊断并追加
+    getTcmDiagnosis({ encounterId: props.patientInfo.encounterId }).then((res) => {
+      console.log('getTcmDiagnosis=======>', JSON.stringify(res.data.illness));
+
+      if (res.code == 200) {
+        if (res.data.illness.length > 0) {
+          diagnosisNetDatas.value = res.data.illness;
+          const newList = [];
+          res.data.illness.forEach((item, index) => {
+            newList.push({
+              conditionId: item.conditionId || '',
+              encounterDiagnosisId: item.encounterDiagnosisId || '',
+              syndromeGroupNo: item.syndromeGroupNo || res.data.symptom[index]?.syndromeGroupNo || '',
+              name: item.name + '-' + (res.data.symptom[index]?.name || ''),
+              ybNo: item.ybNo,
+              definitionId: item.definitionId || '',
+              diagnosisSystem: '中医',
+              tcmSyndromeCode: res.data.symptom[index]?.ybNo || '',
+              tcmSyndromeName: res.data.symptom[index]?.name || '',
+              syndromeDefinitionId: res.data.symptom[index]?.definitionId || '',
+              diagSrtNo: item.diagSrtNo,
+              medTypeCode: item.medTypeCode,
+              maindiseFlag: item.maindiseFlag,
+              verificationStatusEnum: item.verificationStatusEnum,
+              diagnosisDesc: item.diagnosisDesc || '',
+              iptDiseTypeCode: item.iptDiseTypeCode,
+              showPopover: false,
+              diagnosisDoctor: item.diagnosisDoctor || props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
+              diagnosisTime: item.diagnosisTime || new Date().toLocaleString('zh-CN')
+            });
           });
-        });
-        
-        // 将新数据添加到现有列表中
-        form.value.diagnosisList.push(...newList);
-        
-        // 重新排序整个列表
-        form.value.diagnosisList.sort((a, b) => {
+
+          // 将新数据添加到现有列表现有列表
+          form.value.diagnosisList.push(...newList);
+
+          // 重新排序整个列表
+          form.value.diagnosisList.sort((a, b) => {
           const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
           const bNo = typeof b.diagSrtNo === 'number' ? b.diagSrtNo : 9999;
           return aNo - bNo;
@@ -445,7 +558,9 @@ function getList() {
       emits('diagnosisSave', false);
     }
   });
-  
+
+  });
+
   getTree();
 }
 
@@ -596,6 +711,11 @@ function addDiagnosisItem() {
   form.value.diagnosisList.push({
     showPopover: false,
     name: undefined,
+    diagnosisSystem: '西医',
+    tcmSyndromeCode: '',
+    tcmSyndromeName: '',
+    syndromeDefinitionId: '',
+    syndromeGroupNo: '',
     verificationStatusEnum: 4,
     medTypeCode: undefined,
     diagSrtNo: form.value.diagnosisList.length + 1,
@@ -613,6 +733,48 @@ function addDiagnosisItem() {
   }
 }
 
+// 诊断体系切换
+function handleDiagnosisSystemChange(row) {
+  if (row.diagnosisSystem === '西医') {
+    row.tcmSyndromeCode = '';
+    row.tcmSyndromeName = '';
+    row.syndromeDefinitionId = '';
+    row.syndromeGroupNo = '';
+  }
+  row.name = '';
+  row.ybNo = '';
+  row.definitionId = '';
+  row.showPopover = false;
+}
+
+// 加载中医证候选项（按诊断名称关联过滤）
+function loadSyndromeOptions(conditionCode) {
+  const params = conditionCode ? { conditionCode } : {};
+  getTcmSyndrome(params).then((res) => {
+    if (res.data && res.data.records) {
+      syndromeOptions.value = res.data.records.map((item) => ({
+        value: item.ybNo,
+        label: item.name,
+        id: item.id,
+      }));
+    } else {
+      syndromeOptions.value = [];
+    }
+  });
+}
+
+// 中医证候选中赋值
+function handleSyndromeSelect(val, row) {
+  if (val) {
+    const selected = syndromeOptions.value.find((item) => item.value === val);
+    row.tcmSyndromeName = selected ? selected.label : '';
+    row.syndromeDefinitionId = selected ? selected.id : '';
+  } else {
+    row.tcmSyndromeName = '';
+    row.syndromeDefinitionId = '';
+  }
+}
+
 // 添加中医诊断
 function handleAddTcmDiagonsis() {
   tcmDiagnosisListForEdit.value = form.value.diagnosisList.filter(
@@ -632,40 +794,27 @@ function handleAddTcmDiagonsis() {
  * 删除诊断
  */
 function handleDeleteDiagnosis(row, index) {
-  //中医诊断用-拼接 例如：疳气-表里俱实证
-  const nameArr = row.name?.split('-') || [];
+  // 新行（未保存）：直接从列表中移除
+  if (!row.conditionId && !row.encounterDiagnosisId) {
+    form.value.diagnosisList.splice(index, 1);
+    return;
+  }
+
+  // 已保存的中医诊断（name含'-'且syndromeGroupNo有值）
+  if (row.syndromeGroupNo) {
+    deleteTcmDiagnosis(row.syndromeGroupNo).then(() => {
+      getList();
+      getTree();
+    });
+    return;
+  }
+
+  // 已保存的西医诊断
   if (row.conditionId) {
-    if (nameArr.length > 1) {
-      deleteTcmDiagnosis(row.syndromeGroupNo).then(() => {
-        getList();
-        getTree();
-      });
-    } else {
-      delEncounterDiagnosis(row.conditionId).then(() => {
-        getList();
-        getTree();
-      });
-    }
-  } else {
-    console.log('row============>', JSON.stringify(row));
-    console.log('item============>', index);
-    if (nameArr.length > 1) {
-      let obj = null;
-      for (let index = 0; index < diagnosisNetDatas.value.length; index++) {
-        const item = diagnosisNetDatas.value[index];
-        console.log('item.name============>', item.name);
-        console.log('row.name============>', row.name);
-        if (item.ybNo == row.ybNo) {
-          obj = item;
-        }
-      }
-      deleteTcmDiagnosis(obj.syndromeGroupNo).then(() => {
-        getList();
-        getTree();
-      });
-    } else {
-      form.value.diagnosisList.splice(index, 1);
-    }
+    delEncounterDiagnosis(row.conditionId).then(() => {
+      getList();
+      getTree();
+    });
   }
 }
 
@@ -723,6 +872,19 @@ function handleSaveDiagnosis() {
         return;
       }
 
+      // 校验中医诊断证候完整性
+      for (let i = 0; i < form.value.diagnosisList.length; i++) {
+        const item = form.value.diagnosisList[i];
+        if (!item.name) {
+          ElMessage.warning(`第${i + 1}行诊断名称不能为空`);
+          return;
+        }
+        if (item.diagnosisSystem === '中医' && !item.tcmSyndromeCode) {
+          ElMessage.error('中医诊断不完整，请录入对应的证候！');
+          return;
+        }
+      }
+
       // 设置保存标志，避免触发watch监听器
       isSaving.value = true;
 
@@ -735,29 +897,78 @@ function handleSaveDiagnosis() {
 
       // 步骤2：重新分配连续的序号（从1开始）
       sortedList.forEach((item, index) => {
-        item.diagSrtNo = index + 1; // 这里是关键！把”诊断排序”改成新顺序
+        item.diagSrtNo = index + 1;
       });
 
-      // 步骤3：提交排序后的数据
-      saveDiagnosis({
-        patientId: props.patientInfo.patientId,
-        encounterId: props.patientInfo.encounterId,
-        diagnosisChildList: sortedList,
-      }).then((res) => {
-        if (res.code === 200) {
-          emits('diagnosisSave', false);
-          proxy.$modal.msgSuccess('诊断已保存');
+      // 步骤3：拆分为西医诊断和中医诊断
+      const westernList = sortedList.filter((item) => item.diagnosisSystem !== '中医');
+      const tcmList = sortedList.filter((item) => item.diagnosisSystem === '中医');
 
-          // 保存成功后从服务器重新加载数据，确保前后端数据一致
-          getList();
+      const savePromises = [];
 
-          // 食源性疾病逻辑
-          isFoodDiseasesNew({ encounterId: props.patientInfo.encounterId }).then((res2) => {
+      // 保存西医诊断
+      if (westernList.length > 0) {
+        savePromises.push(
+          saveDiagnosis({
+            patientId: props.patientInfo.patientId,
+            encounterId: props.patientInfo.encounterId,
+            diagnosisChildList: westernList,
+          })
+        );
+      }
+
+      // 保存中医诊断
+      tcmList.forEach((item) => {
+        const syndromeGroupNo = item.conditionId
+          ? `${item.conditionId}-${item.tcmSyndromeCode || Date.now()}`
+          : `${Date.now()}-${item.tcmSyndromeCode || '0'}`;
+        savePromises.push(
+          saveTcmDiagnosis({
+            patientId: props.patientInfo.patientId,
+            encounterId: props.patientInfo.encounterId,
+            diagnosisChildList: [
+              // 病（illness）
+              {
+                conditionId: item.conditionId || null,
+                name: item.name,
+                ybNo: item.ybNo,
+                definitionId: item.definitionId || null,
+                diagSrtNo: item.diagSrtNo,
+                medTypeCode: item.medTypeCode,
+                maindiseFlag: item.maindiseFlag,
+                verificationStatusEnum: item.verificationStatusEnum,
+                diagnosisDesc: item.diagnosisDesc || '',
+                diagnosisDoctor: item.diagnosisDoctor || '',
+                diagnosisTime: item.diagnosisTime || '',
+                iptDiseTypeCode: item.iptDiseTypeCode,
+                syndromeGroupNo: syndromeGroupNo,
+              },
+              // 证（syndrome）
+              {
+                name: item.tcmSyndromeName,
+                ybNo: item.tcmSyndromeCode,
+                definitionId: item.syndromeDefinitionId || null,
+                diagSrtNo: null,
+                syndromeGroupNo: syndromeGroupNo,
+              },
+            ],
+          })
+        );
+      });
+
+      Promise.all(savePromises).then(() => {
+        emits('diagnosisSave', false);
+        proxy.$modal.msgSuccess('诊断已保存');
+
+        // 保存成功后从服务器重新加载数据，确保前后端数据一致
+        getList();
+
+        // 食源性疾病逻辑
+        isFoodDiseasesNew({ encounterId: props.patientInfo.encounterId }).then((res2) => {
             if (res2.code === 20 && res2.data) {
               window.open(res2.data, '_blank');
             }
           });
-        }
       }).finally(() => {
         setTimeout(() => {
           isSaving.value = false;
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosislist.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosislist.vue
index 83f157d18..dc92a19f3 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosislist.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosislist.vue
@@ -28,38 +28,55 @@
 </template>
     
 <script setup>
-import {getDiagnosisDefinitionList} from '../api';
+import {getDiagnosisDefinitionList, getTcmCondition} from '../api';
 
 const props = defineProps({
   diagnosisSearchkey: {
     type: String,
     default: '',
   },
+  diagnosisSystem: {
+    type: String,
+    default: '西医',
+  },
 });
 const emit = defineEmits(['selectDiagnosis']);
 const total = ref(0);
 const queryParams = ref({
   pageSize: 1000,
   pageNo: 1,
-  // typeCode: 1,
 });
 const diagnosisDefinitionList = ref([]);
 
 watch(
-  () => props.diagnosisSearchkey,
-  (newValue) => {
-    queryParams.value.searchKey = newValue;
+  () => [props.diagnosisSearchkey, props.diagnosisSystem],
+  () => {
     getList();
   },
-  { immdiate: true }
+  { immediate: true }
 );
 
 getList();
 function getList() {
-  getDiagnosisDefinitionList(queryParams.value).then((res) => {
-    diagnosisDefinitionList.value = res.data.records;
-    total.value = res.data.total;
-  });
+  if (props.diagnosisSystem === '中医') {
+    getTcmCondition({ searchKey: props.diagnosisSearchkey || undefined }).then((res) => {
+      if (res.data && res.data.records) {
+        diagnosisDefinitionList.value = res.data.records.map((item) => ({
+          name: item.name,
+          ybNo: item.ybNo,
+          typeName: '中医诊断',
+          id: item.id,
+        }));
+      }
+      total.value = res.data?.total || 0;
+    });
+  } else {
+    queryParams.value.searchKey = props.diagnosisSearchkey || undefined;
+    getDiagnosisDefinitionList(queryParams.value).then((res) => {
+      diagnosisDefinitionList.value = res.data.records;
+      total.value = res.data.total;
+    });
+  }
 }
 
 function clickRow(row) {