diff --git a/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java b/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
index b04d7b1fa..45add69da 100755
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
@@ -198,8 +198,14 @@ public class ServiceRequestServiceImpl extends ServiceImpl<ServiceRequestMapper,
      */
     @Override
     public void updateDraftStatus(List<Long> serviceRequestIdList, Long practitionerId, Date checkDate, String backReason) {
-        baseMapper.update(new ServiceRequest().setStatusEnum(RequestStatus.DRAFT.getValue())
-                .setPerformerCheckId(SecurityUtils.getLoginUser().getPractitionerId()).setCheckTime(DateUtils.getNowDate()),
+        ServiceRequest updateEntity = new ServiceRequest()
+                .setStatusEnum(RequestStatus.DRAFT.getValue())
+                .setPerformerCheckId(SecurityUtils.getLoginUser().getPractitionerId())
+                .setCheckTime(DateUtils.getNowDate());
+        if (backReason != null && !backReason.isEmpty()) {
+            updateEntity.setReasonText(backReason);
+        }
+        baseMapper.update(updateEntity,
                 new LambdaUpdateWrapper<ServiceRequest>().in(ServiceRequest::getId, serviceRequestIdList)
                         .eq(ServiceRequest::getDeleteFlag, DelFlag.NO.getCode()));
     }
diff --git a/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
new file mode 100644
index 000000000..08f941cd5
--- /dev/null
+++ b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
@@ -0,0 +1,13 @@
+-- Bug #613: 医嘱退回流程 — med_medication_request 表缺少退回原因字段
+-- 执行前检查：如果列已存在则跳过
+DO $$
+BEGIN
+    IF NOT EXISTS (
+        SELECT 1 FROM information_schema.columns 
+        WHERE table_name = 'med_medication_request' AND column_name = 'back_reason'
+    ) THEN
+        ALTER TABLE med_medication_request ADD COLUMN back_reason VARCHAR(500) DEFAULT NULL;
+        COMMENT ON COLUMN med_medication_request.back_reason IS '退回原因';
+    END IF;
+END
+$$;