diff --git a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
index 4d060e259..c4f7b204f 100755
--- a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
+++ b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
@@ -1,6 +1,6 @@
 <template>
   <el-dialog
-    v-model="props.openAddDiagnosisDialog"
+    v-model="openDialog"
     title="添加中医诊断"
     width="1300px"
     teleported
@@ -153,6 +153,11 @@ const props = defineProps({
   },
 });
 
+const openDialog = ref(false);
+watch(() => props.openAddDiagnosisDialog, (val) => {
+  openDialog.value = val;
+}, { immediate: true });
+
 const conditionList = ref([]);
 const syndromeList = ref([]);
 const tcmDiagonsisList = ref([]);
@@ -260,7 +265,8 @@ function handleOpen() {
 }
 
 // 点击诊断列表处理，点击以后才显示证候列表
-function handleClickRow(row) {
+// vxe-table v4 cell-click 事件参数为 { row, column, rowIndex, ... }，需解构获取实际行数据
+function handleClickRow({ row }) {
   if (syndromeSelected.value || tcmDiagonsisList.value.length == 0) {
     syndromeSelected.value = false;
     selectedDisease.value = true;
@@ -286,7 +292,8 @@ function handleClickRow(row) {
   }
 }
 
-function clickSyndromeRow(row) {
+// vxe-table v4 cell-click 事件参数为 { row, column, rowIndex, ... }，需解构获取实际行数据
+function clickSyndromeRow({ row }) {
   // 检查是否已存在完全相同的诊断和证候
   let flag = true;
   const currentConditionName = tcmDiagonsisList.value[tcmDiagonsisList.value.length - 1].conditionName;
diff --git a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosis.vue b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosis.vue
index fb45a8617..45a32037c 100755
--- a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosis.vue
+++ b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosis.vue
@@ -219,6 +219,7 @@
                         <div class="diagnosis-popover-body">
                           <diagnosislist
                             :diagnosis-searchkey="diagnosisSearchkey"
+                            :med-type-code="scope.row.medTypeCode"
                             @select-diagnosis="(row) => handleSelectDiagnosis(row, scope.row, scope.rowIndex)"
                           />
                         </div>
@@ -810,8 +811,18 @@ async function handleSaveDiagnosis() {
     // 开始加载状态，防止重复提交
     saveLoading.value = true;
 
-    // 保存前按排序号排序，并转换日期格式为后端期望的格式 yyyy/M/d HH:mm:ss
-    const diagnosisChildList = form.value.diagnosisList.map(item => ({
+    // 保存前按排序号排序，排除中医诊断（已通过中医对话框独立保存），并转换日期格式
+    const westernOnlyList = form.value.diagnosisList
+      .filter(item => item.typeName !== '中医诊断');
+
+    // 如果仅有中医诊断无西医诊断，直接刷新列表即可（中医已通过对话框独立保存）
+    if (westernOnlyList.length === 0) {
+      saveLoading.value = false;
+      proxy.$modal.msgWarning('没有需要保存的西医诊断');
+      return;
+    }
+
+    const diagnosisChildList = westernOnlyList.map(item => ({
       ...item,
       onsetDate: item.onsetDate ? formatDateStr(item.onsetDate, 'YYYY/M/D HH:mm:ss') : null,
       diagnosisTime: item.diagnosisTime ? formatDateStr(item.diagnosisTime, 'YYYY/M/D HH:mm:ss') : null
diff --git a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosislist.vue b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosislist.vue
index 2e329c73e..3e71032f2 100755
--- a/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosislist.vue
+++ b/healthlink-his-ui/src/views/doctorstation/components/diagnosis/diagnosislist.vue
@@ -70,6 +70,11 @@ const props = defineProps({
     type: String,
     default: '',
   },
+  /** 当前行的诊断类型编码，用于按分类过滤诊断列表 */
+  medTypeCode: {
+    type: String,
+    default: '',
+  },
 });
 
 const emit = defineEmits(['selectDiagnosis']);
@@ -82,6 +87,18 @@ const queryParams = ref({
 });
 const diagnosisDefinitionList = ref([]);
 
+/**
+ * 将 medTypeCode 映射为后端 typeCode 参数
+ *   '1' (西医诊断) → typeCode='1'
+ *   '2','3' (中医主病/主证) → typeCode='2'
+ *   其他 → 不过滤
+ */
+function mapMedTypeToTypeCode(medTypeCode) {
+  if (medTypeCode === '1') return '1';
+  if (medTypeCode === '2' || medTypeCode === '3') return '2';
+  return undefined;
+}
+
 // 监听外部传入的搜索关键字
 watch(
   () => props.diagnosisSearchkey,
@@ -94,9 +111,22 @@ watch(
   { immediate: true }
 );
 
+// 监听诊断类型变化（切换不同分类的行时重新加载）
+watch(
+  () => props.medTypeCode,
+  () => {
+    queryParams.value.pageNo = 1;
+    getList();
+  }
+);
+
 // 获取诊断列表
 function getList() {
-  getDiagnosisDefinitionList(queryParams.value).then((res) => {
+  const params = {
+    ...queryParams.value,
+    typeCode: mapMedTypeToTypeCode(props.medTypeCode),
+  };
+  getDiagnosisDefinitionList(params).then((res) => {
     diagnosisDefinitionList.value = res.data.records || [];
     total.value = res.data.total || 0;
   });