diff --git a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/doctorstation/appservice/impl/DoctorStationChineseMedicalAppServiceImpl.java b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/doctorstation/appservice/impl/DoctorStationChineseMedicalAppServiceImpl.java
index 2f93fc86d..3ea899b35 100755
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/doctorstation/appservice/impl/DoctorStationChineseMedicalAppServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/doctorstation/appservice/impl/DoctorStationChineseMedicalAppServiceImpl.java
@@ -459,22 +459,38 @@ public class DoctorStationChineseMedicalAppServiceImpl implements IDoctorStation
         }
 
         if (is_sign) {
-            // 按groupId分组
-            Map<Long, List<AdviceSaveDto>> groupMap
-                    = insertOrUpdateList.stream().collect(Collectors.groupingBy(AdviceSaveDto::getGroupId));
-            // 为每个分组生成唯一的处方号
-            groupMap.forEach((groupId, groupList) -> {
-                // 先查询当前groupId是否已经被签发生成过处方号
-                List<MedicationRequest> list = iMedicationRequestService
-                        .list(new LambdaQueryWrapper<MedicationRequest>().eq(MedicationRequest::getGroupId, groupId));
-                if (!list.isEmpty() && StringUtils.isNotEmpty(list.get(0).getPrescriptionNo())) {
-                    groupList.forEach(dto -> dto.setPrescriptionNo(list.get(0).getPrescriptionNo()));
-                } else {
-                    String prescriptionNo
-                            = assignSeqUtil.getSeq(AssignSeqEnum.PRESCRIPTION_CHINESE_HERBAL_MEDICINE.getPrefix(), 8);
-                    groupList.forEach(dto -> dto.setPrescriptionNo(prescriptionNo));
+            // 有 groupId 的按组生成处方号（groupingBy 不接受 null key，先过滤）
+            insertOrUpdateList.stream()
+                    .filter(e -> e.getGroupId() != null)
+                    .collect(Collectors.groupingBy(AdviceSaveDto::getGroupId))
+                    .forEach((groupId, groupList) -> {
+                        List<MedicationRequest> list = iMedicationRequestService
+                                .list(new LambdaQueryWrapper<MedicationRequest>()
+                                        .eq(MedicationRequest::getGroupId, groupId));
+                        if (!list.isEmpty() && StringUtils.isNotEmpty(list.get(0).getPrescriptionNo())) {
+                            groupList.forEach(dto -> dto.setPrescriptionNo(list.get(0).getPrescriptionNo()));
+                        } else {
+                            String prescriptionNo = assignSeqUtil.getSeq(
+                                    AssignSeqEnum.PRESCRIPTION_CHINESE_HERBAL_MEDICINE.getPrefix(), 8);
+                            groupList.forEach(dto -> dto.setPrescriptionNo(prescriptionNo));
+                        }
+                    });
+
+            // 无 groupId 的各自生成处方号
+            for (AdviceSaveDto dto : insertOrUpdateList) {
+                if (dto.getGroupId() != null) {
+                    continue;
                 }
-            });
+                if (dto.getRequestId() != null) {
+                    MedicationRequest existing = iMedicationRequestService.getById(dto.getRequestId());
+                    if (existing != null && StringUtils.isNotEmpty(existing.getPrescriptionNo())) {
+                        dto.setPrescriptionNo(existing.getPrescriptionNo());
+                        continue;
+                    }
+                }
+                dto.setPrescriptionNo(assignSeqUtil.getSeq(
+                        AssignSeqEnum.PRESCRIPTION_CHINESE_HERBAL_MEDICINE.getPrefix(), 8));
+            }
         }
 
         // 医嘱签发编码