diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingDetailMapper.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingDetailMapper.java
new file mode 100644
index 000000000..047c3a5d3
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingDetailMapper.java
@@ -0,0 +1,37 @@
+package com.openhis.web.inpatient.mapper;
+
+import org.apache.ibatis.annotations.*;
+
+import java.util.Map;
+
+/**
+ * 住院发药明细 Mapper
+ *
+ * 新增：
+ * 1. insertDetail – 插入单条发药明细
+ * 2. countByOrderIdForUpdate – 统计指定医嘱的明细数量并加行级锁，确保后续汇总在同一事务内读取到最新数据
+ */
+@Mapper
+public interface DispensingDetailMapper {
+
+    /**
+     * 插入发药明细记录
+     *
+     * @param detail 包含 orderId、drug_id、quantity、price 等字段的 map
+     * @return 受影响行数
+     */
+    @Insert("<script>" +
+            "INSERT INTO dispensing_detail (order_id, drug_id, quantity, price, created_at) " +
+            "VALUES (#{orderId}, #{drugId}, #{quantity}, #{price}, NOW())" +
+            "</script>")
+    int insertDetail(@Param("detail") Map<String, Object> detail);
+
+    /**
+     * 统计指定医嘱的明细数量并加行级锁（FOR UPDATE），用于在同一事务中安全生成汇总单。
+     *
+     * @param orderId 医嘱主键
+     * @return 明细行数
+     */
+    @Select("SELECT COUNT(*) FROM dispensing_detail WHERE order_id = #{orderId} FOR UPDATE")
+    int countByOrderIdForUpdate(@Param("orderId") Long orderId);
+}
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingSummaryMapper.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingSummaryMapper.java
new file mode 100644
index 000000000..5d16043f7
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/DispensingSummaryMapper.java
@@ -0,0 +1,39 @@
+package com.openhis.web.inpatient.mapper;
+
+import org.apache.ibatis.annotations.*;
+
+import java.util.Map;
+
+/**
+ * 住院发药汇总单 Mapper
+ *
+ * 新增：
+ * 1. insertSummaryByOrderId – 基于已写入的明细数据聚合生成汇总单，所有聚合在数据库完成，避免业务层时序问题。
+ */
+@Mapper
+public interface DispensingSummaryMapper {
+
+    /**
+     * 根据医嘱 ID 聚合已写入的发药明细，生成对应的汇总单记录。
+     *
+     * 汇总字段示例（实际字段请依据业务表结构）：
+     * - order_id
+     * - total_quantity (SUM(quantity))
+     * - total_amount   (SUM(quantity * price))
+     * - created_at
+     *
+     * @param orderId 医嘱主键
+     * @return 受影响行数
+     */
+    @Insert("<script>" +
+            "INSERT INTO dispensing_summary (order_id, total_quantity, total_amount, created_at) " +
+            "SELECT " +
+            "   #{orderId} AS order_id, " +
+            "   SUM(quantity) AS total_quantity, " +
+            "   SUM(quantity * price) AS total_amount, " +
+            "   NOW() AS created_at " +
+            "FROM dispensing_detail " +
+            "WHERE order_id = #{orderId}" +
+            "</script>")
+    int insertSummaryByOrderId(@Param("orderId") Long orderId);
+}
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/DispensingServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/DispensingServiceImpl.java
index e902d21ac..b89305044 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/DispensingServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/DispensingServiceImpl.java
@@ -44,25 +44,21 @@ public class DispensingServiceImpl implements DispensingService {
             throw new IllegalArgumentException("发药参数缺失或明细为空");
         }
 
-        // 1. 写入发药明细
+        // 1. 写入发药明细（每条明细都在同一事务中）
         for (Map<String, Object> drug : drugList) {
             drug.put("orderId", orderId);
             dispensingDetailMapper.insertDetail(drug);
         }
 
-        // 2. 确认明细已写入（行锁防并发）
-        List<Map<String, Object>> writtenDetails = dispensingDetailMapper.selectDetailsForOrderForUpdate(orderId);
-        if (writtenDetails == null || writtenDetails.isEmpty()) {
+        // 2. 立即统计已写入的明细行数（使用 FOR UPDATE 锁定相关记录，防止并发导致统计不一致）
+        int detailCount = dispensingDetailMapper.countByOrderIdForUpdate(orderId);
+        if (detailCount <= 0) {
+            // 若明细写入异常，主动抛异常回滚事务
             throw new IllegalStateException("发药明细写入失败，无法生成汇总单");
         }
 
-        // 3. 基于已写入的明细聚合生成汇总单
-        Map<String, Object> summary = dispensingSummaryMapper.calculateSummaryFromDetails(orderId);
-        if (summary == null || summary.isEmpty()) {
-            throw new IllegalStateException("汇总单计算失败");
-        }
-
-        // 4. 写入汇总单
-        dispensingSummaryMapper.insertSummary(summary);
+        // 3. 基于已写入的明细聚合生成发药汇总单
+        // 汇总单的业务字段（如总数量、总金额）全部由数据库聚合计算，避免业务层自行计算导致时序不一致
+        dispensingSummaryMapper.insertSummaryByOrderId(orderId);
     }
 }