diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/InpatientDrugMapper.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/InpatientDrugMapper.java
index 6c9301102..397ce97bc 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/InpatientDrugMapper.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/mapper/InpatientDrugMapper.java
@@ -52,37 +52,30 @@ public interface InpatientDrugMapper {
                                @Param("operator") String operator);
 
     /**
-     * 汇总单 UPSERT：若不存在则 INSERT；若已存在则 UPDATE 累计数量。
-     * 这里使用 MySQL 的 INSERT ... ON DUPLICATE KEY UPDATE 语法。
+     * 汇总发药/退药数量（正负累计）。如果汇总记录不存在则插入；存在则累计 quantity。
      *
      * 表结构示例（仅供参考）：
-     *   CREATE TABLE inpatient_drug_dispense_summary (
-     *       order_id BIGINT NOT NULL,
-     *       drug_id  BIGINT NOT NULL,
-     *       total_quantity INT NOT NULL DEFAULT 0,
-     *       last_operator VARCHAR(50),
-     *       last_update_time DATETIME,
-     *       PRIMARY KEY (order_id, drug_id)
-     *   );
+     *   inpatient_drug_dispense_summary
+     *   -------------------------------
+     *   id          BIGINT PK AUTO_INCREMENT
+     *   order_id    BIGINT NOT NULL
+     *   drug_id     BIGINT NOT NULL
+     *   total_qty   INT NOT NULL DEFAULT 0   -- 正负累计数量
+     *   last_update DATETIME NOT NULL
+     *
+     * 唯一键 (order_id, drug_id) 用于 ON DUPLICATE KEY UPDATE。
      *
      * @param orderId   医嘱ID
      * @param drugId    药品ID
-     * @param deltaQty  本次操作的数量增量（正数发药，负数退药）
-     * @param operator  操作人
+     * @param quantity  本次操作的数量（正发药、负退药）
      */
-    @Insert({
-        "<script>",
-        "INSERT INTO inpatient_drug_dispense_summary ",
-        "(order_id, drug_id, total_quantity, last_operator, last_update_time) ",
-        "VALUES (#{orderId}, #{drugId}, #{deltaQty}, #{operator}, NOW()) ",
-        "ON DUPLICATE KEY UPDATE ",
-        "total_quantity = total_quantity + #{deltaQty}, ",
-        "last_operator = #{operator}, ",
-        "last_update_time = NOW()",
-        "</script>"
-    })
+    @Insert("INSERT INTO inpatient_drug_dispense_summary " +
+            "(order_id, drug_id, total_qty, last_update) " +
+            "VALUES (#{orderId}, #{drugId}, #{quantity}, NOW()) " +
+            "ON DUPLICATE KEY UPDATE " +
+            "total_qty = total_qty + #{quantity}, " +
+            "last_update = NOW()")
     int upsertDrugDispenseSummary(@Param("orderId") Long orderId,
                                   @Param("drugId") Long drugId,
-                                  @Param("deltaQty") Integer deltaQty,
-                                  @Param("operator") String operator);
+                                  @Param("quantity") Integer quantity);
 }
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/impl/InpatientDrugServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/impl/InpatientDrugServiceImpl.java
index f0eb8a92d..4bdb77028 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/impl/InpatientDrugServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inpatient/service/impl/InpatientDrugServiceImpl.java
@@ -50,49 +50,43 @@ public class InpatientDrugServiceImpl implements InpatientDrugService {
             Integer quantity = (Integer) drug.get("quantity");
             String operator = (String) drug.get("operator");
 
-            // 明细表：inpatient_drug_dispense_detail
+            // 正向发药，数量必须为正
+            if (quantity == null || quantity <= 0) {
+                throw new IllegalArgumentException("发药数量必须为正数");
+            }
+
+            // 2. 插入明细
             drugMapper.insertDrugDispenseDetail(orderId, drugId, quantity, operator);
-        }
 
-        // 2. 汇总单（inpatient_drug_dispense_summary）使用 UPSERT（INSERT ... ON DUPLICATE KEY UPDATE）
-        //    通过同一批次的明细累计数量，确保汇总单始终是明细的聚合结果。
-        for (Map<String, Object> drug : drugList) {
-            Long drugId = (Long) drug.get("drugId");
-            Integer quantity = (Integer) drug.get("quantity");
-            String operator = (String) drug.get("operator");
-
-            // 汇总表：若不存在则 INSERT；若已存在则 UPDATE 累计数量
-            drugMapper.upsertDrugDispenseSummary(orderId, drugId, quantity, operator);
+            // 3. 更新/插入汇总（正向累计）
+            drugMapper.upsertDrugDispenseSummary(orderId, drugId, quantity);
         }
     }
 
     /**
-     * 退药（仅限已发药状态下的退药）
+     * 退药（数量使用负数保存，汇总同样累计负数）
      *
      * @param orderId   医嘱主键
-     * @param drugList  退药信息，键包括 drugId、quantity（退药数量，正数）、operator 等
+     * @param drugList  每种药品的退药信息，键包括 drugId、quantity（正数表示退药量）、operator 等
      */
     @Override
     @Transactional(rollbackFor = Exception.class)
     public void returnDrugs(Long orderId, List<Map<String, Object>> drugList) {
-        // 1. 先写退药明细（负数量表示退药）
         for (Map<String, Object> drug : drugList) {
             Long drugId = (Long) drug.get("drugId");
-            Integer quantity = (Integer) drug.get("quantity"); // 正数，表示退药数量
+            Integer quantity = (Integer) drug.get("quantity"); // 正数表示退药量
             String operator = (String) drug.get("operator");
 
-            // 退药明细使用负数保存，便于后续统计
-            drugMapper.insertDrugReturnDetail(orderId, drugId, -quantity, operator);
-        }
+            if (quantity == null || quantity <= 0) {
+                throw new IllegalArgumentException("退药数量必须为正数");
+            }
 
-        // 2. 更新汇总单，使用负数冲减已发药数量
-        for (Map<String, Object> drug : drugList) {
-            Long drugId = (Long) drug.get("drugId");
-            Integer quantity = (Integer) drug.get("quantity");
-            String operator = (String) drug.get("operator");
+            // 负数保存到明细表，标记为退药
+            int negativeQty = -quantity;
+            drugMapper.insertDrugReturnDetail(orderId, drugId, negativeQty, operator);
 
-            // 汇总表同样使用 UPSERT，数量为 -quantity
-            drugMapper.upsertDrugDispenseSummary(orderId, drugId, -quantity, operator);
+            // 汇总同样使用负数累计
+            drugMapper.upsertDrugDispenseSummary(orderId, drugId, negativeQty);
         }
     }
 }