diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
index e1697ed7b..b1c4cbb78 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
@@ -1,7 +1,7 @@
 <template>
   <el-dialog
-    v-model="props.openAddDiagnosisDialog"
-    title="添加中医诊断"
+    v-model="dialogVisible"
+    :title="isUpdateMode ? '修改中医诊断' : '添加中医诊断'"
     width="1500px"
     append-to-body
     destroy-on-close
@@ -51,7 +51,7 @@
         <div class="search-box">
           <el-input
             v-model="searchMiddleDisease"
-            placeholder="搜索疾病名称或编码"
+            placeholder="搜索证候名称或编码"
             clearable
           >
             <template #prefix>
@@ -131,8 +131,8 @@
 </template>
 
 <script setup>
-import {getTcmCondition, getTcmSyndrome, saveTcmDiagnosis,} from '@/views/doctorstation/components/api';
-import {computed} from 'vue';
+import { getTcmCondition, getTcmSyndrome, saveTcmDiagnosis, updateTcmDiagnosis, getTcmDiagnosis } from '@/views/doctorstation/components/api';
+import { computed } from 'vue';
 
 const props = defineProps({
   openAddDiagnosisDialog: {
@@ -143,13 +143,17 @@ const props = defineProps({
     type: Object,
     required: true,
   },
+  updateZy: {
+    type: Array,
+    default: () => [],
+  },
 });
 
 const conditionList = ref([]);
 const syndromeList = ref([]);
 const tcmDiagonsisList = ref([]);
 const tcmDiagonsisSaveList = ref([]);
-const syndromeSelected = ref(false); // 当前诊断是否选择对应证候
+const syndromeSelected = ref(false);
 const timestamp = ref('');
 const selectedDisease = ref(false);
 const searchDisease = ref('');
@@ -157,35 +161,70 @@ const searchMiddleDisease = ref('');
 const { proxy } = getCurrentInstance();
 const emit = defineEmits(['close']);
 
+const dialogVisible = computed({
+  get: () => props.openAddDiagnosisDialog,
+  set: (val) => {
+    if (!val) {
+      emit('close');
+    }
+  },
+});
+
+const isUpdateMode = computed(() => {
+  return props.updateZy && props.updateZy.length > 0;
+});
+
 function handleOpen() {
   getTcmCondition().then((res) => {
     conditionList.value = res.data.records;
   });
+
+  tcmDiagonsisSaveList.value = [];
+  tcmDiagonsisList.value = [];
+  syndromeSelected.value = true;
+
+  if (isUpdateMode.value) {
+    props.updateZy.forEach((item) => {
+      let updateIds = item.updateId ? item.updateId.split('-') : [];
+      let nameParts = item.name ? item.name.split('-') : [item.name || ''];
+      tcmDiagonsisSaveList.value.push({
+        conditionId: updateIds[0] || '',
+        definitionId: item.illnessDefinitionId || item.definitionId || '',
+        ybNo: item.ybNo,
+        syndromeGroupNo: item.syndromeGroupNo,
+        verificationStatusEnum: item.verificationStatusEnum || 4,
+        medTypeCode: item.medTypeCode,
+      });
+      tcmDiagonsisList.value.push({
+        conditionName: nameParts[0] || '',
+        syndromeName: nameParts[1] || '',
+        syndromeGroupNo: item.syndromeGroupNo,
+        illnessDefinitionId: item.illnessDefinitionId,
+      });
+    });
+  }
 }
 
-// 搜索诊断
 const conditionDatas = computed(() => {
+  if (!searchDisease.value) {
+    return conditionList.value;
+  }
   return conditionList.value.filter((item) => {
-    if (searchDisease.value) {
-      return searchDisease.value == item.name || searchDisease.value == item.ybNo;
-    }
-    return conditionList;
+    return item.name.includes(searchDisease.value) || item.ybNo.includes(searchDisease.value);
   });
 });
 
-// 后证
 const syndromeListDatas = computed(() => {
+  if (!searchMiddleDisease.value) {
+    return syndromeList.value;
+  }
   return syndromeList.value.filter((item) => {
-    if (searchMiddleDisease.value) {
-      return searchMiddleDisease.value == item.name || searchMiddleDisease.value == item.ybNo;
-    }
-    return syndromeList;
+    return item.name.includes(searchMiddleDisease.value) || item.ybNo.includes(searchMiddleDisease.value);
   });
 });
 
-// 点击诊断列表处理，点击以后才显示证候列表
 function handleClickRow(row) {
-  if (syndromeSelected.value || tcmDiagonsisList.value == 0) {
+  if (syndromeSelected.value || tcmDiagonsisList.value.length === 0) {
     selectedDisease.value = true;
     syndromeSelected.value = false;
     timestamp.value = Date.now();
@@ -197,7 +236,7 @@ function handleClickRow(row) {
       ybNo: row.ybNo,
       syndromeGroupNo: timestamp.value,
       verificationStatusEnum: 4,
-      medTypeCode: undefined,  // 不设默认值
+      medTypeCode: undefined,
     });
     tcmDiagonsisList.value.push({
       conditionName: row.name,
@@ -216,7 +255,6 @@ function clickSyndromeRow(row) {
   syndromeSelected.value = true;
 }
 
-// 删除诊断
 function removeDiagnosis(row, index) {
   tcmDiagonsisList.value.splice(index, 1);
   tcmDiagonsisSaveList.value = tcmDiagonsisSaveList.value.filter((item) => {
@@ -225,77 +263,67 @@ function removeDiagnosis(row, index) {
 }
 
 function save() {
-  saveTcmDiagnosis({
-    patientId: props.patientInfo.patientId,
-    encounterId: props.patientInfo.encounterId,
-    diagnosisChildList: tcmDiagonsisSaveList.value,
-  }).then((res) => {
-    if (res.code == 200) {
-      emit('close');
-      proxy.$modal.msgSuccess('诊断已保存');
-    }
-  });
+  const newDiagnosisList = tcmDiagonsisSaveList.value.filter((item) => !item.conditionId);
+
+  if (isUpdateMode.value) {
+    updateTcmDiagnosis({
+      patientId: props.patientInfo.patientId,
+      encounterId: props.patientInfo.encounterId,
+      diagnosisChildList: tcmDiagonsisSaveList.value,
+    }).then((res) => {
+      if (res.code == 200) {
+        if (newDiagnosisList.length > 0) {
+          saveTcmDiagnosis({
+            patientId: props.patientInfo.patientId,
+            encounterId: props.patientInfo.encounterId,
+            diagnosisChildList: newDiagnosisList,
+          }).then((res2) => {
+            if (res2.code == 200) {
+              emit('close');
+              proxy.$modal.msgSuccess('诊断已保存');
+            }
+          });
+        } else {
+          emit('close');
+          proxy.$modal.msgSuccess('诊断已保存');
+        }
+      }
+    });
+  } else {
+    saveTcmDiagnosis({
+      patientId: props.patientInfo.patientId,
+      encounterId: props.patientInfo.encounterId,
+      diagnosisChildList: tcmDiagonsisSaveList.value,
+    }).then((res) => {
+      if (res.code == 200) {
+        emit('close');
+        proxy.$modal.msgSuccess('诊断已保存');
+      }
+    });
+  }
 }
 
 function submit() {
-  if (tcmDiagonsisSaveList.value.length > 0 && syndromeSelected.value) {
+  const hasNewDiagnosis = tcmDiagonsisSaveList.value.some((item) => !item.conditionId);
+
+  if (!hasNewDiagnosis && isUpdateMode.value) {
+    emit('close');
+    return;
+  }
+
+  if (syndromeSelected.value || tcmDiagonsisSaveList.value.length % 2 === 0) {
     save();
   } else {
     proxy.$modal.msgWarning('请选择证候');
   }
 }
+
 function close() {
   emit('close');
 }
 </script>
 
 <style scoped>
-:deep(.pagination-container .el-pagination) {
-  right: 20px !important;
-}
-
-.app-container {
-  max-width: 1400px;
-  margin: 20px auto;
-  padding: 20px;
-  background: white;
-  border-radius: 12px;
-  box-shadow: 0 2px 20px rgba(0, 0, 0, 0.08);
-}
-
-.header {
-  display: flex;
-  justify-content: space-between;
-  align-items: center;
-  padding-bottom: 15px;
-  border-bottom: 1px solid var(--el-border-color);
-  margin-bottom: 20px;
-}
-
-.header h1 {
-  color: var(--el-color-primary);
-  font-size: 24px;
-  font-weight: 600;
-}
-
-.patient-info {
-  background: var(--el-color-primary-light-9);
-  padding: 15px;
-  border-radius: 8px;
-  margin-bottom: 20px;
-}
-
-.patient-info .info-row {
-  display: flex;
-  margin-bottom: 8px;
-}
-
-.patient-info .info-label {
-  width: 100px;
-  color: var(--el-text-color-secondary);
-  font-weight: 500;
-}
-
 .main-content {
   display: grid;
   grid-template-columns: 1fr 1fr 1.2fr;
@@ -322,125 +350,13 @@ function close() {
   border-bottom: 1px solid var(--el-border-color);
 }
 
-.disease-list {
-  max-height: 400px;
-  overflow-y: auto;
-}
-
-.disease-item {
-  padding: 12px 15px;
-  border-bottom: 1px solid var(--el-border-color-lighter);
-  cursor: pointer;
-  transition: all 0.3s;
-  border-radius: 4px;
-}
-
-.disease-item:hover {
-  background-color: var(--el-color-primary-light-9);
-}
-
-.disease-item.active {
-  background-color: var(--el-color-primary-light-8);
-  border-left: 3px solid var(--el-color-primary);
-}
-
-.disease-name {
-  font-weight: 500;
-  margin-bottom: 5px;
-}
-
-.disease-code {
-  font-size: 12px;
-  color: var(--el-text-color-secondary);
-}
-
 .search-box {
   margin-bottom: 15px;
 }
 
-.disease-categories {
-  display: flex;
-  flex-wrap: wrap;
-  gap: 10px;
-  margin-bottom: 15px;
-}
-
-.category-tag {
-  cursor: pointer;
-  padding: 5px 12px;
-  border-radius: 15px;
-  background: var(--el-fill-color-light);
-  font-size: 13px;
-  transition: all 0.3s;
-}
-
-.category-tag.active {
-  background: var(--el-color-primary);
-  color: white;
-}
-
-.relation-container {
-  text-align: center;
-  padding: 30px 0;
-  border: 2px dashed var(--el-border-color);
-  border-radius: 8px;
-  margin: 20px 0;
-  background: var(--el-fill-color-lighter);
-}
-
-.relation-icon {
-  margin-bottom: 15px;
-  color: var(--el-color-primary);
-}
-
-.relation-text {
-  font-size: 18px;
-  font-weight: 500;
-  color: var(--el-text-color-primary);
-}
-
-.syndrome-details {
-  padding: 15px;
-  background: var(--el-color-primary-light-9);
-  border-radius: 8px;
-  border: 1px solid var(--el-color-primary-light-5);
-}
-
-.detail-item {
-  margin-bottom: 12px;
-}
-
-.detail-label {
-  font-weight: 500;
-  color: var(--el-text-color-secondary);
-  margin-bottom: 3px;
-}
-
-.actions {
-  display: flex;
-  justify-content: flex-end;
-  gap: 15px;
-  padding-top: 20px;
-  border-top: 1px solid var(--el-border-color);
-}
-
-.empty-state {
-  text-align: center;
-  padding: 40px 0;
-  color: var(--el-text-color-secondary);
-}
-
-.diagnosis-history {
-  margin-top: 20px;
-  border-top: 1px solid var(--el-border-color);
-  padding-top: 20px;
-}
-
-.history-title {
-  font-size: 16px;
-  font-weight: 500;
-  margin-bottom: 12px;
-  color: var(--el-text-color-primary);
+.diagnosis-list {
+  max-height: 520px;
+  overflow-y: auto;
 }
 
 .history-item {
@@ -451,17 +367,6 @@ function close() {
   border-radius: 0 4px 4px 0;
 }
 
-.diagnosis-list {
-  max-height: 520px;
-  overflow-y: auto;
-}
-
-.history-date {
-  font-size: 12px;
-  color: var(--el-text-color-secondary);
-  margin-bottom: 5px;
-}
-
 .history-diagnosis {
   display: flex;
   justify-content: space-between;
@@ -469,16 +374,9 @@ function close() {
   margin-bottom: 5px;
 }
 
-.history-note {
-  font-size: 13px;
-  color: var(--el-text-color-secondary);
-  padding-top: 5px;
-  border-top: 1px dashed var(--el-border-color);
-  margin-top: 5px;
-}
-
-.empty-list {
-  padding: 20px 0;
+.empty-state {
   text-align: center;
+  padding: 40px 0;
+  color: var(--el-text-color-secondary);
 }
 </style>
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 501aa0ce3..8f8de977a 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
@@ -281,6 +281,7 @@
     <AddDiagnosisDialog
       :open-add-diagnosis-dialog="openAddDiagnosisDialog"
       :patient-info="props.patientInfo"
+      :update-zy="tcmDiagnosisListForEdit"
       @close="closeDiagnosisDialog"
     />
   </div>
@@ -338,6 +339,7 @@ const rules = ref({
   diagSrtNo: [{ required: true, message: '请输入诊断序号', trigger: 'change' }],
 });
 const diagnosisNetDatas = ref([]);
+const tcmDiagnosisListForEdit = ref([]);
 
 watch(
   () => form.value.diagnosisList,
@@ -448,6 +450,7 @@ function getList() {
 
 init();
 function init() {
+  loadTcmSyndromeOptions();
   diagnosisInit().then((res) => {
     if (res.code == 200) {
       diagnosisOptions.value = res.data.verificationStatusOptions;
@@ -612,6 +615,13 @@ function addDiagnosisItem() {
 
 // 添加中医诊断
 function handleAddTcmDiagonsis() {
+  tcmDiagnosisListForEdit.value = form.value.diagnosisList.filter(
+    (item) => item.diagnosisSystem === '中医'
+  ).map((item) => ({
+    ...item,
+    updateId: item.conditionId ? `${item.conditionId}-${item.syndromeGroupNo || ''}` : '' ,
+    illnessDefinitionId: item.definitionId || '' ,
+  }));
   openAddDiagnosisDialog.value = true;
 }