diff --git a/.cursor/rules/Code-Standards.mdc b/.cursor/rules/Code-Standards.mdc
index 4836f59c..cdd0c377 100644
--- a/.cursor/rules/Code-Standards.mdc
+++ b/.cursor/rules/Code-Standards.mdc
@@ -107,6 +107,37 @@ alwaysApply: true
 
 - 上一部分代码和下一部分代码中间空行不超过 2 行
 
+## VIP 功能判断（PC 管理端强制）
+
+- **判断方法**：统一用 `#/utils/vip` 的 `hasVipPermission` / `useVipPermission` / `VIP_FEATURE` 常量
+- **显隐组件**：模板包一层 `<VipGate code="medical_record" :vip="receptionVip">`（`#/components/vip/VipGate.vue`）
+- 接诊/复诊/开方：**必须传履约诊所 vip**（`get-current-store-type` 的 `vip`），禁止只靠登录态判断门店权益
+- 显式传 `null` 表示「尚无履约诊所权益」，**不会**回落登录态；不传第二参才用 `userInfo.vip`
+- 禁止在业务页再手写 `permissions.indexOf('medical_record')` 或复制一套 VIP 拉取逻辑
+
+## 暗色模式适配（PC 管理端强制）
+
+后台支持亮/暗主题切换，**新增或改样式时必须同时适配暗色**，禁止只按白底写死颜色。
+
+### 优先用法（推荐）
+
+- 颜色、边框、背景一律用主题 CSS 变量，例如：
+  - 文字：`hsl(var(--foreground))` / `hsl(var(--muted-foreground))`
+  - 背景：`hsl(var(--background))` / `hsl(var(--card, var(--background)))` / `hsl(var(--muted) / 0.25)`
+  - 边框：`hsl(var(--border))`
+  - 强调/选中：`hsl(var(--primary))`、`hsl(var(--primary) / 0.1)`
+  - 警告：`hsl(var(--warning))`、`hsl(var(--warning) / 0.12)`（参考 `AiDisclaimerBanner.vue`）
+- **禁止**业务样式写死 `#fff`、`#000`、`#0f172a`、`#f8fafc`、`#64748b` 等仅适合亮色的色值
+- **禁止**用 `:global(.dark)` 改全局变量以免污染整站配色
+- 优先「一套变量样式自动跟主题」，避免再写一套 `.dark .xxx { ... }`；仅当变量无法表达（如图片反色、特殊阴影）才用局部 `.dark .xxx`（且必须 `scoped`）
+
+### 自检清单
+
+- 弹窗 / 抽屉 / 卡片 / 预览对照区：在暗色下背景、文字、边框对比度可读
+- 选中态、成功/导入高亮：用 `--primary` 透明度，不要写死浅绿底 `#f0faf8`
+- 表格空态、分割线、次要文案：用 `--muted` / `--muted-foreground` / `--border`
+- 改完后切换暗色主题肉眼过一遍，不要只测亮色
+
 ## Vben 组件使用规范
 
 ### VbenModal（来自 @vben/common-ui）
diff --git a/apps/web-antd/src/components/vip/VipGate.vue b/apps/web-antd/src/components/vip/VipGate.vue
index e756500a..9bd26652 100644
--- a/apps/web-antd/src/components/vip/VipGate.vue
+++ b/apps/web-antd/src/components/vip/VipGate.vue
@@ -1,20 +1,30 @@
 <script lang="ts" setup>
 /**
- * VIP 权限显隐口子组件
- * 用法：<VipGate code="xxx" :min-level="'V5'">内容</VipGate>
- * 后续业务权益接入时直接包一层即可；当前从 userInfo.vip 判断
+ * VIP 权限显隐全局组件
+ * 用法：
+ *   <VipGate code="medical_record">有权限才渲染</VipGate>
+ *   <VipGate :code="VIP_FEATURE.AI_PRESCRIPTION" :vip="receptionVip">...</VipGate>
+ * 接诊/复诊务必传 :vip="履约诊所vip"，不要只靠登录态
  */
 import { computed } from 'vue';
 
-import { hasVipPermission, levelAtLeast } from '#/utils/vip';
+import {
+  hasVipPermission,
+  levelAtLeast,
+  type StoreVipInfo,
+} from '#/utils/vip';
 
 const props = withDefaults(
   defineProps<{
-    /** 权限码（与等级 permissions 对齐） */
+    /** 权限码（与 xk_vip_feature.code / 等级 permissions 对齐） */
     code?: string;
     /** 最低等级编码 */
     minLevel?: string;
-    /** 无权限时是否渲染占位（默认不渲染） */
+    /**
+     * 指定 VIP 来源（挂号履约诊所）；不传则用登录态 userInfo.vip
+     */
+    vip?: StoreVipInfo | string[] | null;
+    /** 无权限时是否渲染 fallback 插槽（默认不渲染） */
     fallback?: boolean;
   }>(),
   {
@@ -26,15 +36,20 @@ const props = withDefaults(
 
 const allowed = computed(() => {
   if (props.code) {
+    // 传了 :vip 则按履约诊所判；未传则回落登录态
+    if (props.vip !== undefined) {
+      return hasVipPermission(props.code, props.vip);
+    }
     return hasVipPermission(props.code);
   }
   if (props.minLevel) {
-    return levelAtLeast(props.minLevel);
+    const vipObj = Array.isArray(props.vip) ? null : (props.vip ?? null);
+    return levelAtLeast(props.minLevel, vipObj);
   }
-  // 未指定条件时默认展示，方便后续逐步接入
   return true;
 });
 </script>
+
 <template>
   <slot v-if="allowed" />
   <slot v-else-if="fallback" name="fallback" />
diff --git a/apps/web-antd/src/components/wx-user-patient/WxUserPatientDetailModal.vue b/apps/web-antd/src/components/wx-user-patient/WxUserPatientDetailModal.vue
index 6ad91007..2c137f97 100644
--- a/apps/web-antd/src/components/wx-user-patient/WxUserPatientDetailModal.vue
+++ b/apps/web-antd/src/components/wx-user-patient/WxUserPatientDetailModal.vue
@@ -336,6 +336,14 @@ const orderColumns = [
                 bordered
                 size="small"
               >
+                <Descriptions.Item label="现病史">
+                  {{
+                    historyText(
+                      profile.health_inquiry.present_status,
+                      profile.health_inquiry.present_history,
+                    )
+                  }}
+                </Descriptions.Item>
                 <Descriptions.Item label="既往史">
                   {{
                     historyText(
diff --git a/apps/web-antd/src/utils/vip.ts b/apps/web-antd/src/utils/vip.ts
index dec8ce35..a7002bed 100644
--- a/apps/web-antd/src/utils/vip.ts
+++ b/apps/web-antd/src/utils/vip.ts
@@ -1,9 +1,23 @@
 /**
- * VIP 权限判断工具（前端口子）
- * 默认从登录态 userInfo.vip 读取；在线复诊等场景可传入挂号履约诊所的 vip
+ * VIP 权限判断（全局方法）
+ * - 默认读登录态 userInfo.vip
+ * - 接诊/复诊等场景务必传入「履约诊所」vip，避免用错门店权益
+ * - 模板显隐优先用 <VipGate code="xxx" :vip="storeVip" />
  */
+import { computed, type ComputedRef, type Ref } from 'vue';
+
 import { useUserStore } from '@vben/stores';
 
+/** 与 xk_vip_feature.code / 等级 permissions 对齐的常用功能码 */
+export const VIP_FEATURE = {
+  MEDICAL_RECORD: 'medical_record',
+  AI_MEDICAL_RECORD: 'ai_medical_record',
+  AI_PRESCRIPTION: 'ai_prescription',
+  GOLDEN_FORMULA: 'golden_formula',
+} as const;
+
+export type VipFeatureCode = (typeof VIP_FEATURE)[keyof typeof VIP_FEATURE] | string;
+
 export interface StoreVipInfo {
   level_code?: string;
   level_name?: string;
@@ -24,29 +38,56 @@ export function getCurrentVip(): StoreVipInfo | null {
 }
 
 /**
- * 是否拥有指定权限码
- * @param code 权限码
- * @param vipOrPermissions 可选：挂号侧 vip 对象，或 permissions 字符串数组；不传则用登录态
+ * 从 get-current-store-type / 同类接口响应中取出 vip 对象
+ * 兼容 result / data / 已解包
+ */
+export function pickVipFromApiPayload(payload: unknown): StoreVipInfo | null {
+  if (!payload || typeof payload !== 'object') return null;
+  const raw = payload as Record<string, any>;
+  const data = raw.result ?? raw.data ?? raw;
+  if (!data || typeof data !== 'object') return null;
+  const vip = (data as any).vip;
+  return vip && typeof vip === 'object' ? (vip as StoreVipInfo) : null;
+}
+
+/** 规范化 permissions 列表 */
+export function normalizeVipPermissions(
+  vipOrPermissions?: StoreVipInfo | string[] | null,
+): string[] {
+  if (Array.isArray(vipOrPermissions)) {
+    return vipOrPermissions.filter((x) => typeof x === 'string' && x);
+  }
+  if (vipOrPermissions && typeof vipOrPermissions === 'object') {
+    const list = vipOrPermissions.permissions;
+    return Array.isArray(list) ? list.filter((x) => typeof x === 'string' && x) : [];
+  }
+  const cur = getCurrentVip()?.permissions;
+  return Array.isArray(cur) ? cur.filter((x) => typeof x === 'string' && x) : [];
+}
+
+/**
+ * 是否拥有指定权限码（全局判断方法）
+ * @param code 权限码，如 VIP_FEATURE.MEDICAL_RECORD
+ * @param vipOrPermissions 挂号侧 vip / permissions；
+ *   - 不传：用登录态 userInfo.vip
+ *   - 显式传 null：视为无履约诊所权益（不回落登录态，避免接诊未就绪时误放行）
  */
 export function hasVipPermission(
   code: string,
   vipOrPermissions?: StoreVipInfo | string[] | null,
 ): boolean {
   if (!code) return false;
-  let list: string[] | undefined;
-  if (Array.isArray(vipOrPermissions)) {
-    list = vipOrPermissions;
-  } else if (vipOrPermissions && typeof vipOrPermissions === 'object') {
-    list = vipOrPermissions.permissions;
-  } else {
-    list = getCurrentVip()?.permissions;
+  if (arguments.length < 2) {
+    return normalizeVipPermissions().includes(code);
   }
-  return Array.isArray(list) && list.includes(code);
+  if (vipOrPermissions == null) {
+    return false;
+  }
+  return normalizeVipPermissions(vipOrPermissions).includes(code);
 }
 
 /**
  * 等级是否不低于目标（按 level_weight；若无 weight 则仅精确匹配编码时返回 true）
- * 简化：仅当当前 level_code 与 minCode 相同，或 weight 足够时通过
  */
 export function levelAtLeast(minCode: string, vip?: StoreVipInfo | null): boolean {
   const current = vip ?? getCurrentVip();
@@ -70,11 +111,36 @@ function parseLevelWeight(code: string): number {
   return -1;
 }
 
-/** 组合式：供组件调用 */
-export function useVipGate() {
+/**
+ * 组合式：基于可选的门店 vip ref 做权限判断（接诊台推荐）
+ * @example
+ * const { has, canUseMedicalRecord } = useVipPermission(receptionVip)
+ * const ok = has(VIP_FEATURE.MEDICAL_RECORD)
+ */
+export function useVipPermission(
+  vipSource?: Ref<StoreVipInfo | null | undefined> | ComputedRef<StoreVipInfo | null | undefined>,
+) {
+  /** 传入了 vipSource 时始终走履约诊所分支（含 null=无权益） */
+  const has = (code: string) => {
+    if (vipSource) {
+      return hasVipPermission(code, vipSource.value ?? null);
+    }
+    return hasVipPermission(code);
+  };
   return {
-    vip: getCurrentVip(),
-    hasVipPermission,
-    levelAtLeast,
+    vip: computed(() => (vipSource ? vipSource.value : getCurrentVip())),
+    has,
+    hasVipPermission: has,
+    levelAtLeast: (minCode: string) =>
+      levelAtLeast(minCode, vipSource ? vipSource.value ?? null : getCurrentVip()),
+    canUseMedicalRecord: computed(() => has(VIP_FEATURE.MEDICAL_RECORD)),
+    canUseAiMedicalRecord: computed(() => has(VIP_FEATURE.AI_MEDICAL_RECORD)),
+    canUseAiPrescription: computed(() => has(VIP_FEATURE.AI_PRESCRIPTION)),
+    canUseGoldenFormula: computed(() => has(VIP_FEATURE.GOLDEN_FORMULA)),
   };
 }
+
+/** @deprecated 请用 useVipPermission；保留兼容旧调用 */
+export function useVipGate() {
+  return useVipPermission();
+}
diff --git a/apps/web-antd/src/views/business/chat/components/PrescriptionModal.vue b/apps/web-antd/src/views/business/chat/components/PrescriptionModal.vue
index 3670369e..e3ef444f 100644
--- a/apps/web-antd/src/views/business/chat/components/PrescriptionModal.vue
+++ b/apps/web-antd/src/views/business/chat/components/PrescriptionModal.vue
@@ -44,7 +44,11 @@ import {
   saveWestCommonPrescriptionApi,
 } from '#/views/business/chat/api';
 import { usePrescriptionStore } from '#/store/prescription';
-import { hasVipPermission } from '#/utils/vip';
+import {
+  hasVipPermission,
+  useVipPermission,
+  VIP_FEATURE,
+} from '#/utils/vip';
 import MedicalRecordPanel from '#/views/doctor/medical-record/MedicalRecordPanel.vue';
 import EntryKeywordBubble from '#/views/doctor/medical-record/components/EntryKeywordBubble.vue';
 import CommonDxOrderChips from '#/views/doctor/medical-record/components/CommonDxOrderChips.vue';
@@ -98,11 +102,20 @@ const registerSideVip = computed(
   () => prescriptionStore.registerStoreInfo?.vip ?? null,
 );
 
+/** 履约诊所 VIP 能力（金方 / AI 等） */
+const {
+  canUseAiMedicalRecord,
+  canUseAiPrescription,
+  canUseGoldenFormula,
+} = useVipPermission(registerSideVip);
+
 /**
- * 仅 chat-shop（非诊所前缀）且门店 VIP 含 medical_record 时显示病历 Tab
+ * 病历 Tab：履约诊所 medical_record + 弹窗场景开关（诊所前缀默认关）
  */
 const canUseMedicalRecord = computed(() => {
-  if (!hasVipPermission('medical_record', registerSideVip.value)) return false;
+  if (!hasVipPermission(VIP_FEATURE.MEDICAL_RECORD, registerSideVip.value)) {
+    return false;
+  }
   if (modalData.value?.enableMedicalRecord === false) return false;
   if (modalData.value?.enableMedicalRecord === true) return true;
   const prefix = modalData.value?.storagePrefix || 'onlineConsultation-';
@@ -186,19 +199,6 @@ const allowInsuranceCategory = computed(
 const canUseCommonPrescription = computed(() =>
   [1, 2].includes(prescriptionStore.activeCategory),
 );
-/** 金方导入 VIP（优先挂号履约诊所 vip） */
-const canUseGoldenFormula = computed(() =>
-  hasVipPermission('golden_formula', registerSideVip.value),
-);
-/** AI 辅助出方 VIP */
-const canUseAiPrescription = computed(() =>
-  hasVipPermission('ai_prescription', registerSideVip.value),
-);
-/** AI 写病历 VIP */
-const canUseAiMedicalRecord = computed(() =>
-  hasVipPermission('ai_medical_record', registerSideVip.value),
-);
-
 const aiPrescriptionDrawerRef = ref<InstanceType<typeof AiPrescriptionDrawer> | null>(null);
 
 /** 按字典 id 取展示名（提交仍存旧字段 id） */
@@ -929,12 +929,24 @@ const [PatientRxHistoryDrawerComp, patientRxHistoryDrawerApi] = useVbenDrawer({
   connectedComponent: PatientPrescriptionHistoryDrawer,
 });
 
+/** 健康档案史写入病历草稿并切到病历 Tab */
+function importHealthHistoryToMedicalRecord(fields: Record<string, string>) {
+  if (!canUseMedicalRecord.value) {
+    message.warning('未开通病历功能');
+    return;
+  }
+  rxMrTab.value = 'mr';
+  medicalRecordPanelRef.value?.patchFields?.(fields || {});
+}
+
 function openPatientInfoDrawer() {
   patientInfoDrawerApi.setData({
     patient: prescriptionStore.activePatient,
     register: prescriptionStore.patientInfo,
     healthInquiry: prescriptionStore.userPatientHealthInquiry,
     patientName: prescriptionStore.activePatient?.name,
+    canImportMedicalRecord: canUseMedicalRecord.value,
+    onImportHistory: importHealthHistoryToMedicalRecord,
   });
   patientInfoDrawerApi.open();
 }
@@ -2212,6 +2224,7 @@ const cancelSaveCommonPrescription = () => {
             :patient-sex="Number(prescriptionStore.activePatient?.sex || 0)"
             :patient-age="Number(prescriptionStore.activePatient?.age || 0)"
             :storage-prefix="medicalRecordStoragePrefix"
+            :store-vip="registerSideVip"
             :show-toolbar="false"
             @sync-to-prescription="onMrSyncToPrescription"
             @apply-tcm-ids="onApplyAiTcmIds"
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/components/PatientInfoDrawer.vue b/apps/web-antd/src/views/doctor/doctor-reception/components/PatientInfoDrawer.vue
index 9008ddc4..3da0c7d8 100644
--- a/apps/web-antd/src/views/doctor/doctor-reception/components/PatientInfoDrawer.vue
+++ b/apps/web-antd/src/views/doctor/doctor-reception/components/PatientInfoDrawer.vue
@@ -6,9 +6,10 @@
 import { computed, ref } from 'vue';
 
 import { useVbenDrawer } from '@vben/common-ui';
-import { Descriptions, Empty, Tag } from 'ant-design-vue';
+import { Button, Descriptions, Empty, Modal, Tag, message } from 'ant-design-vue';
 
 import SensitiveText from '#/components/sensitive-text/SensitiveText.vue';
+import { mapHealthInquiryToMrHistory } from '#/views/doctor/medical-record/utils/mapHealthInquiryToMrHistory';
 
 defineOptions({ name: 'PatientInfoDrawer' });
 
@@ -17,6 +18,10 @@ type DrawerData = {
   register?: Record<string, any> | null;
   healthInquiry?: Record<string, any> | null;
   patientName?: string;
+  /** 门店开通病历 VIP 时展示「导入到病历」 */
+  canImportMedicalRecord?: boolean;
+  /** 父级回写病历草稿（不落库） */
+  onImportHistory?: (fields: Record<string, string>) => void;
 };
 
 const meta = ref<DrawerData>({});
@@ -28,12 +33,55 @@ const sexText = computed(() => {
   return '未填写';
 });
 
+const patientSex = computed(() => Number(meta.value.patient?.sex || 0));
+const patientAge = computed(() => Number(meta.value.patient?.age || 0));
+
+/** 月经史仅女；婚育史男>22 或 女>20（与病历显隐一致） */
+const showMenstrual = computed(() => patientSex.value === 2);
+const showMarital = computed(
+  () =>
+    (patientSex.value === 1 && patientAge.value > 22) ||
+    (patientSex.value === 2 && patientAge.value > 20),
+);
+
 /** 逗号分隔标签拆分（与接诊页 splitString 一致） */
 function splitString(str: unknown): string[] {
   if (!str || typeof str !== 'string') return [];
   return str.split(/[,，]/).map((s) => s.trim()).filter(Boolean);
 }
 
+/** 史字段：status=0 无；=1 有并展示内容 */
+function historyStatusText(status: unknown): string {
+  return Number(status) === 1 ? '有' : '无';
+}
+
+const canImportMedicalRecord = computed(
+  () => !!meta.value.canImportMedicalRecord && !!meta.value.healthInquiry,
+);
+
+/**
+ * 确认后把档案史写入病历草稿，由父级 patchFields + 切病历 Tab
+ */
+function handleImportToMedicalRecord() {
+  if (!canImportMedicalRecord.value) return;
+  Modal.confirm({
+    title: '导入到病历',
+    content:
+      '将用当前健康档案中的病史覆盖病历对应字段（既往/过敏/家族/流行病学/个人/月经/婚育等），导入后请检查并保存病历。',
+    okText: '确认导入',
+    cancelText: '取消',
+    onOk() {
+      const fields = mapHealthInquiryToMrHistory(meta.value.healthInquiry, {
+        sex: patientSex.value,
+        age: patientAge.value,
+      });
+      meta.value.onImportHistory?.(fields);
+      message.success('已导入到病历草稿');
+      drawerApi.close();
+    },
+  });
+}
+
 const [Drawer, drawerApi] = useVbenDrawer({
   class: 'w-[720px]',
   title: '患者信息',
@@ -91,12 +139,25 @@ defineExpose({ drawerApi });
     </Descriptions>
     <Empty v-else description="暂无患者信息" class="py-6" />
 
+    <div
+      v-if="meta.healthInquiry"
+      class="mb-2 flex items-center justify-between"
+    >
+      <span class="text-sm font-medium">健康信息</span>
+      <Button
+        v-if="canImportMedicalRecord"
+        type="primary"
+        size="small"
+        @click="handleImportToMedicalRecord"
+      >
+        导入到病历
+      </Button>
+    </div>
     <Descriptions
       v-if="meta.healthInquiry"
       :column="2"
       bordered
       size="small"
-      title="健康信息"
       class="mb-4"
     >
       <Descriptions.Item label="肝功能">
@@ -127,19 +188,21 @@ defineExpose({ drawerApi });
           </Tag>
         </div>
       </Descriptions.Item>
+      <Descriptions.Item label="现病史" :span="2">
+        <span>{{ historyStatusText(meta.healthInquiry.present_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.present_status) === 1" class="mt-2 mb-0">
+          {{ meta.healthInquiry.present_history || '—' }}
+        </p>
+      </Descriptions.Item>
       <Descriptions.Item label="既往史" :span="2">
-        <span>{{
-          meta.healthInquiry.person_status === 0 ? '无' : '有'
-        }}</span>
-        <p v-if="meta.healthInquiry.person_status === 1" class="mt-2 mb-0">
+        <span>{{ historyStatusText(meta.healthInquiry.person_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.person_status) === 1" class="mt-2 mb-0">
           {{ meta.healthInquiry.person_history || '—' }}
         </p>
       </Descriptions.Item>
       <Descriptions.Item label="过敏史" :span="2">
-        <span>{{
-          meta.healthInquiry.allergic_status === 0 ? '无' : '有'
-        }}</span>
-        <div v-if="meta.healthInquiry.allergic_status === 1" class="mt-2">
+        <span>{{ historyStatusText(meta.healthInquiry.allergic_status) }}</span>
+        <div v-if="Number(meta.healthInquiry.allergic_status) === 1" class="mt-2">
           <Tag
             v-for="(item, idx) in splitString(
               meta.healthInquiry.allergic_history,
@@ -152,13 +215,35 @@ defineExpose({ drawerApi });
         </div>
       </Descriptions.Item>
       <Descriptions.Item label="家庭遗传史" :span="2">
-        <span>{{
-          meta.healthInquiry.family_status === 0 ? '无' : '有'
-        }}</span>
-        <p v-if="meta.healthInquiry.family_status === 1" class="mt-2 mb-0">
+        <span>{{ historyStatusText(meta.healthInquiry.family_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.family_status) === 1" class="mt-2 mb-0">
           {{ meta.healthInquiry.family_history || '—' }}
         </p>
       </Descriptions.Item>
+      <Descriptions.Item label="流行病学史" :span="2">
+        <span>{{ historyStatusText(meta.healthInquiry.epidemic_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.epidemic_status) === 1" class="mt-2 mb-0">
+          {{ meta.healthInquiry.epidemic_history || '—' }}
+        </p>
+      </Descriptions.Item>
+      <Descriptions.Item label="个人史" :span="2">
+        <span>{{ historyStatusText(meta.healthInquiry.personal_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.personal_status) === 1" class="mt-2 mb-0">
+          {{ meta.healthInquiry.personal_history || '—' }}
+        </p>
+      </Descriptions.Item>
+      <Descriptions.Item v-if="showMenstrual" label="月经史" :span="2">
+        <span>{{ historyStatusText(meta.healthInquiry.menstrual_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.menstrual_status) === 1" class="mt-2 mb-0">
+          {{ meta.healthInquiry.menstrual_history || '—' }}
+        </p>
+      </Descriptions.Item>
+      <Descriptions.Item v-if="showMarital" label="婚育史" :span="2">
+        <span>{{ historyStatusText(meta.healthInquiry.marital_status) }}</span>
+        <p v-if="Number(meta.healthInquiry.marital_status) === 1" class="mt-2 mb-0">
+          {{ meta.healthInquiry.marital_history || '—' }}
+        </p>
+      </Descriptions.Item>
     </Descriptions>
     <Empty
       v-else
diff --git a/apps/web-antd/src/views/doctor/doctor-reception/index.vue b/apps/web-antd/src/views/doctor/doctor-reception/index.vue
index 8b0871f6..4bfa1bc0 100644
--- a/apps/web-antd/src/views/doctor/doctor-reception/index.vue
+++ b/apps/web-antd/src/views/doctor/doctor-reception/index.vue
@@ -46,7 +46,10 @@ import {
 import {debounce} from 'lodash-es'; // 或者使用自定义防抖函数
 
 import {getRegisterStatus} from '#/util/tool';
-import { hasVipPermission, type StoreVipInfo } from '#/utils/vip';
+import {
+  useVipPermission,
+  type StoreVipInfo,
+} from '#/utils/vip';
 import MedicalRecordPanel from '#/views/doctor/medical-record/MedicalRecordPanel.vue';
 import EntryKeywordBubble from '#/views/doctor/medical-record/components/EntryKeywordBubble.vue';
 import CommonDxOrderChips from '#/views/doctor/medical-record/components/CommonDxOrderChips.vue';
@@ -167,12 +170,22 @@ interface UserPatientHealthInquiry {
   renal_function: number;
   liver_index: string;
   renal_index: string;
+  present_status?: number;
+  present_history?: string;
   person_history: string;
   allergic_history: string;
   person_status: number;
   allergic_status: number;
   family_status: number;
-  family_history: number;
+  family_history: string;
+  epidemic_status?: number;
+  epidemic_history?: string;
+  personal_status?: number;
+  personal_history?: string;
+  menstrual_status?: number;
+  menstrual_history?: string;
+  marital_status?: number;
+  marital_history?: string;
   is_delete: number;
 }
 
@@ -182,21 +195,13 @@ const rxMrTab = ref<'rx' | 'mr'>('rx');
 const medicalRecordPanelRef = ref<InstanceType<typeof MedicalRecordPanel> | null>(null);
 /** 当前接诊挂号对应履约诊所 VIP（来自 getCurrentStoreType） */
 const receptionVip = ref<StoreVipInfo | null>(null);
-const canUseMedicalRecord = computed(() =>
-  hasVipPermission('medical_record', receptionVip.value),
-);
-/** AI 辅助出方 VIP */
-const canUseAiPrescription = computed(() =>
-  hasVipPermission('ai_prescription', receptionVip.value),
-);
-/** AI 写病历 VIP */
-const canUseAiMedicalRecord = computed(() =>
-  hasVipPermission('ai_medical_record', receptionVip.value),
-);
-/** 金方导入 VIP */
-const canUseGoldenFormula = computed(() =>
-  hasVipPermission('golden_formula', receptionVip.value),
-);
+/** 统一用全局 useVipPermission，避免各处手写 hasVipPermission 字符串 */
+const {
+  canUseMedicalRecord,
+  canUseAiMedicalRecord,
+  canUseAiPrescription,
+  canUseGoldenFormula,
+} = useVipPermission(receptionVip);
 
 watch(rxMrTab, (tab) => {
   const rid = getRegisterId();
@@ -2303,6 +2308,18 @@ const [PatientRxHistoryDrawerComp, patientRxHistoryDrawerApi] = useVbenDrawer({
   connectedComponent: PatientPrescriptionHistoryDrawer,
 });
 
+/**
+ * 患者信息抽屉：健康档案导入病历（有 medical_record VIP 时）
+ */
+function importHealthHistoryToMedicalRecord(fields: Record<string, string>) {
+  if (!canUseMedicalRecord.value) {
+    message.warning('未开通病历功能');
+    return;
+  }
+  rxMrTab.value = 'mr';
+  medicalRecordPanelRef.value?.patchFields?.(fields || {});
+}
+
 /** 打开患者信息抽屉 */
 function openPatientInfoDrawer() {
   patientInfoDrawerApi.setData({
@@ -2310,6 +2327,8 @@ function openPatientInfoDrawer() {
     register: patientInfo.value,
     healthInquiry: userPatientHealthInquiry.value,
     patientName: activePatient.value?.name,
+    canImportMedicalRecord: canUseMedicalRecord.value,
+    onImportHistory: importHealthHistoryToMedicalRecord,
   });
   patientInfoDrawerApi.open();
 }
@@ -4115,6 +4134,7 @@ function onStoreSelectOpenChange(open: boolean) {
           :patient-sex="Number(activePatient?.sex || 0)"
           :patient-age="Number(activePatient?.age || 0)"
           :patient-name="String(activePatient?.name || '')"
+          :store-vip="receptionVip"
           :show-toolbar="false"
         />
       </div>
diff --git a/apps/web-antd/src/views/doctor/medical-record/MedicalRecordPanel.vue b/apps/web-antd/src/views/doctor/medical-record/MedicalRecordPanel.vue
index f43787ce..2d8d8b72 100644
--- a/apps/web-antd/src/views/doctor/medical-record/MedicalRecordPanel.vue
+++ b/apps/web-antd/src/views/doctor/medical-record/MedicalRecordPanel.vue
@@ -24,7 +24,11 @@ import {
 } from '@ant-design/icons-vue';
 
 import { getSystemConfigByKeys } from '#/views/system/system-config/api';
-import { hasVipPermission } from '#/utils/vip';
+import {
+  hasVipPermission,
+  VIP_FEATURE,
+  type StoreVipInfo,
+} from '#/utils/vip';
 
 import {
   clearMedicalRecord,
@@ -38,6 +42,9 @@ import CommonDxOrderChips from './components/CommonDxOrderChips.vue';
 import PatientMedicalRecordDrawer from './components/PatientMedicalRecordDrawer.vue';
 import TextareaExpandModal from './components/TextareaExpandModal.vue';
 import AiMedicalRecordModal from './components/AiMedicalRecordModal.vue';
+import HistoryImportModal, {
+  type HistoryImportDiffItem,
+} from './components/HistoryImportModal.vue';
 import { emptyMedicalRecord, isHistoryFieldVisible } from './config/constants';
 import {
   clearMedicalRecordDraft,
@@ -67,6 +74,10 @@ const props = withDefaults(
     patientAge?: number;
     /** 就诊人姓名（AI 写病历确认用） */
     patientName?: string;
+    /**
+     * 履约诊所 VIP（接诊/复诊传入）；不传则回落登录态
+     */
+    storeVip?: StoreVipInfo | null;
     /**
      * 是否在面板内展示操作工具栏
      * 接诊台/弹窗已把按钮提到一级 Tab 下吸顶工具栏时传 false
@@ -81,10 +92,19 @@ const props = withDefaults(
     patientSex: 0,
     patientAge: 0,
     patientName: '',
+    storeVip: undefined,
     showToolbar: true,
   },
 );
 
+/** 按履约诊所或登录态判断 VIP */
+function checkVip(code: string) {
+  if (props.storeVip !== undefined) {
+    return hasVipPermission(code, props.storeVip);
+  }
+  return hasVipPermission(code);
+}
+
 const emit = defineEmits<{
   'update:diagnosis': [string];
   'update:medicalAdvice': [string];
@@ -134,7 +154,7 @@ const showCommonInBubble = computed(
 );
 /** AI写病历入口：门店 VIP 需开通 ai_medical_record */
 const canUseAiMedicalRecord = computed(() =>
-  hasVipPermission('ai_medical_record'),
+  checkVip(VIP_FEATURE.AI_MEDICAL_RECORD),
 );
 /** 标签区刷新（气泡内新增/加常用后） */
 const commonChipsTick = ref(0);
@@ -288,6 +308,78 @@ const [CiteHistoryDrawer, citeHistoryDrawerApi] = useVbenDrawer({
   connectedComponent: PatientMedicalRecordDrawer,
 });
 
+/** 档案史与病历史不一致时确认导入 */
+const [HistoryImportModalHost, historyImportModalApi] = useVbenModal({
+  connectedComponent: HistoryImportModal,
+});
+
+/** 空串与「无」视为同一默认态（与后端 normalizeHistoryCompare 对齐） */
+function normalizeHistoryCompare(value: unknown): string {
+  const t = String(value ?? '').trim();
+  return t === '' || t === '无' ? '无' : t;
+}
+
+/** 本会话已对某挂号提示过导入，避免切 Tab 反复弹 */
+function historyImportSkipKey(registerId: number) {
+  return `xk_mr_hist_import_skip_${props.storagePrefix || ''}${registerId}`;
+}
+
+/**
+ * 草稿合并后按「当前表单 vs 档案」再滤一遍差异，有差异才弹预览确认
+ */
+function maybeAskHistoryImport(rawDiff: HistoryImportDiffItem[]) {
+  const rid = Number(props.registerId || 0);
+  if (!rid || !Array.isArray(rawDiff) || !rawDiff.length) return;
+  try {
+    if (sessionStorage.getItem(historyImportSkipKey(rid)) === '1') return;
+  } catch {
+    /* ignore */
+  }
+  const rows: HistoryImportDiffItem[] = [];
+  for (const item of rawDiff) {
+    if (!item?.field) continue;
+    const current = normalizeHistoryCompare((form as any)[item.field]);
+    const importVal = normalizeHistoryCompare(item.import);
+    if (current === importVal) continue;
+    rows.push({
+      field: item.field,
+      label: item.label || item.field,
+      current,
+      import: importVal,
+    });
+  }
+  if (!rows.length) return;
+  historyImportModalApi.setData({
+    rows,
+    onConfirm: (list: HistoryImportDiffItem[]) => {
+      const patch: Record<string, string> = {};
+      for (const row of list || []) {
+        if (row?.field) patch[row.field] = row.import || '无';
+      }
+      Object.keys(patch).forEach((k) => {
+        if (Object.prototype.hasOwnProperty.call(form, k)) {
+          (form as any)[k] = patch[k];
+        }
+      });
+      persistLocalDraft();
+      try {
+        sessionStorage.setItem(historyImportSkipKey(rid), '1');
+      } catch {
+        /* ignore */
+      }
+      message.success('已导入档案病史，请检查后保存');
+    },
+    onCancel: () => {
+      try {
+        sessionStorage.setItem(historyImportSkipKey(rid), '1');
+      } catch {
+        /* ignore */
+      }
+    },
+  });
+  historyImportModalApi.open();
+}
+
 /** 组装当前可落盘的病历草稿（含诊断/医嘱） */
 function buildDraftPayload() {
   return {
@@ -315,15 +407,22 @@ const debouncedPersistLocal = useDebounceFn(persistLocalDraft, 300);
 async function loadRecord() {
   if (!props.registerId) return;
   // 无病历 VIP 不请求，避免弹出「未开通病历VIP」；普通诊所只看病历 Tab 隐藏即可
-  if (!hasVipPermission('medical_record')) return;
+  if (!checkVip(VIP_FEATURE.MEDICAL_RECORD)) return;
   loading.value = true;
   hydrating.value = true;
+  let historyDiff: HistoryImportDiffItem[] = [];
   try {
     const data = await getMedicalRecord({
       register_id: props.registerId,
       store_id: props.storeId || undefined,
     });
+    historyDiff = Array.isArray(data?.history_import_diff)
+      ? data.history_import_diff
+      : [];
     Object.assign(form, emptyMedicalRecord(props.registerId, props.storeId), data || {});
+    // 提示字段不进表单/草稿
+    delete (form as any).history_import_diff;
+    delete (form as any).patient_history_defaults;
     const draftKey = `${props.storagePrefix || ''}${props.registerId}`;
     const draft = loadMedicalRecordDraft(draftKey);
     if (draft) {
@@ -364,6 +463,8 @@ async function loadRecord() {
   } finally {
     loading.value = false;
     hydrating.value = false;
+    // 草稿合并完成后再判断是否弹导入确认
+    nextTick(() => maybeAskHistoryImport(historyDiff));
   }
 }
 
@@ -1286,6 +1387,7 @@ const visibleNormalFields = computed(() =>
 
     <ExpandModal />
     <CiteHistoryDrawer />
+    <HistoryImportModalHost />
     <AiMedicalRecordModal
       ref="aiMedicalRecordModalRef"
       @import="handleImportAiMedicalRecord"
diff --git a/apps/web-antd/src/views/doctor/medical-record/components/HistoryImportModal.vue b/apps/web-antd/src/views/doctor/medical-record/components/HistoryImportModal.vue
new file mode 100644
index 00000000..4c27b6f1
--- /dev/null
+++ b/apps/web-antd/src/views/doctor/medical-record/components/HistoryImportModal.vue
@@ -0,0 +1,138 @@
+<script lang="ts" setup>
+/**
+ * 接诊进病历：患者档案史与当前病历史不一致时，预览并确认是否导入
+ * 用 VbenModal 展示差异对照，确认后把档案侧内容写回病历草稿
+ */
+import { ref } from 'vue';
+
+import { useVbenModal } from '@vben/common-ui';
+
+export type HistoryImportDiffItem = {
+  field: string;
+  label: string;
+  current: string;
+  import: string;
+};
+
+const rows = ref<HistoryImportDiffItem[]>([]);
+const onConfirmCb = ref<((list: HistoryImportDiffItem[]) => void) | null>(
+  null,
+);
+const onCancelCb = ref<(() => void) | null>(null);
+
+const [Modal, modalApi] = useVbenModal({
+  title: '导入患者档案病史？',
+  class: 'w-[640px]',
+  draggable: true,
+  confirmText: '确认导入',
+  cancelText: '暂不导入',
+  closeOnClickModal: false,
+  onConfirm() {
+    const list = rows.value.slice();
+    const cb = onConfirmCb.value;
+    modalApi.close();
+    cb?.(list);
+  },
+  onCancel() {
+    onCancelCb.value?.();
+  },
+  onOpenChange(isOpen: boolean) {
+    if (!isOpen) {
+      rows.value = [];
+      onConfirmCb.value = null;
+      onCancelCb.value = null;
+      return;
+    }
+    const data = modalApi.getData<{
+      rows?: HistoryImportDiffItem[];
+      onConfirm?: (list: HistoryImportDiffItem[]) => void;
+      onCancel?: () => void;
+    }>();
+    rows.value = Array.isArray(data?.rows) ? data!.rows! : [];
+    onConfirmCb.value = data?.onConfirm || null;
+    onCancelCb.value = data?.onCancel || null;
+  },
+});
+</script>
+
+<template>
+  <Modal>
+    <div class="hist-import">
+      <p class="hist-import__tip">
+        就诊人档案中的病史与当前病历不一致，请确认是否用档案内容覆盖对应字段（导入后仍需保存病历）。
+      </p>
+      <div
+        v-for="row in rows"
+        :key="row.field"
+        class="hist-import__card"
+      >
+        <div class="hist-import__label">{{ row.label }}</div>
+        <div class="hist-import__cols">
+          <div class="hist-import__col">
+            <span class="hist-import__tag">当前病历</span>
+            <div class="hist-import__val">{{ row.current || '无' }}</div>
+          </div>
+          <div class="hist-import__col hist-import__col--import">
+            <span class="hist-import__tag hist-import__tag--import">将导入</span>
+            <div class="hist-import__val">{{ row.import || '无' }}</div>
+          </div>
+        </div>
+      </div>
+    </div>
+  </Modal>
+</template>
+
+<style scoped>
+/* 颜色一律主题变量，亮/暗色自动适配，禁止写死 #fff / #0f172a */
+.hist-import__tip {
+  margin: 0 0 12px;
+  font-size: 13px;
+  color: hsl(var(--muted-foreground));
+  line-height: 1.5;
+}
+.hist-import__card {
+  border: 1px solid hsl(var(--border));
+  border-radius: 8px;
+  padding: 10px 12px;
+  margin-bottom: 10px;
+  background: hsl(var(--muted) / 0.25);
+}
+.hist-import__label {
+  font-size: 13px;
+  font-weight: 600;
+  margin-bottom: 8px;
+  color: hsl(var(--foreground));
+}
+.hist-import__cols {
+  display: grid;
+  grid-template-columns: 1fr 1fr;
+  gap: 10px;
+}
+.hist-import__col {
+  background: hsl(var(--card, var(--background)));
+  border-radius: 6px;
+  padding: 8px 10px;
+  border: 1px solid hsl(var(--border));
+}
+.hist-import__col--import {
+  border-color: hsl(var(--primary));
+  background: hsl(var(--primary) / 0.1);
+}
+.hist-import__tag {
+  display: inline-block;
+  font-size: 11px;
+  color: hsl(var(--muted-foreground));
+  margin-bottom: 4px;
+}
+.hist-import__tag--import {
+  color: hsl(var(--primary));
+  font-weight: 600;
+}
+.hist-import__val {
+  font-size: 13px;
+  color: hsl(var(--foreground));
+  white-space: pre-wrap;
+  word-break: break-all;
+  line-height: 1.45;
+}
+</style>
diff --git a/apps/web-antd/src/views/doctor/medical-record/utils/mapHealthInquiryToMrHistory.ts b/apps/web-antd/src/views/doctor/medical-record/utils/mapHealthInquiryToMrHistory.ts
new file mode 100644
index 00000000..ff68d358
--- /dev/null
+++ b/apps/web-antd/src/views/doctor/medical-record/utils/mapHealthInquiryToMrHistory.ts
@@ -0,0 +1,116 @@
+/**
+ * 就诊人健康问诊 → 病历「史」字段
+ * 映射与后端 MedicalRecordService::resolveHistoryDefaultsFromPatient 一致：
+ * present→现病史，person→既往史，allergic→过敏史，family→家族史，其余同名
+ */
+
+type HealthInquiryLike = Record<string, any> | null | undefined;
+
+const HISTORY_MAP: Array<{
+  statusKey: string;
+  historyKey: string;
+  mrKey: string;
+  /** menstrual | marital | always */
+  visibility: 'always' | 'menstrual' | 'marital';
+}> = [
+  {
+    statusKey: 'present_status',
+    historyKey: 'present_history',
+    mrKey: 'present_illness',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'person_status',
+    historyKey: 'person_history',
+    mrKey: 'past_history',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'allergic_status',
+    historyKey: 'allergic_history',
+    mrKey: 'allergy_history',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'family_status',
+    historyKey: 'family_history',
+    mrKey: 'family_history',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'epidemic_status',
+    historyKey: 'epidemic_history',
+    mrKey: 'epidemic_history',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'personal_status',
+    historyKey: 'personal_history',
+    mrKey: 'personal_history',
+    visibility: 'always',
+  },
+  {
+    statusKey: 'menstrual_status',
+    historyKey: 'menstrual_history',
+    mrKey: 'menstrual_history',
+    visibility: 'menstrual',
+  },
+  {
+    statusKey: 'marital_status',
+    historyKey: 'marital_history',
+    mrKey: 'marital_history',
+    visibility: 'marital',
+  },
+];
+
+function isFieldVisible(
+  visibility: 'always' | 'menstrual' | 'marital',
+  sex: number,
+  age: number,
+): boolean {
+  if (visibility === 'menstrual') return sex === 2;
+  if (visibility === 'marital') {
+    return (sex === 1 && age > 22) || (sex === 2 && age > 20);
+  }
+  return true;
+}
+
+/** status≠1 或内容空 →「无」；有内容用顿号拼接 */
+function resolveHistoryText(status: unknown, raw: unknown): string {
+  if (Number(status) !== 1) return '无';
+  if (Array.isArray(raw)) {
+    const parts = raw.map((v) => String(v ?? '').trim()).filter(Boolean);
+    return parts.length ? parts.join('、') : '无';
+  }
+  const str = String(raw ?? '').trim();
+  if (!str || str === '[]' || str === 'null') return '无';
+  try {
+    const decoded = JSON.parse(str);
+    if (Array.isArray(decoded)) {
+      const parts = decoded.map((v) => String(v ?? '').trim()).filter(Boolean);
+      return parts.length ? parts.join('、') : '无';
+    }
+  } catch {
+    /* 非 JSON，按分隔符拆 */
+  }
+  const parts = str.split(/[,，、]+/).map((s) => s.trim()).filter(Boolean);
+  return parts.length ? parts.join('、') : '无';
+}
+
+/**
+ * 将健康问诊转为可 patch 到病历的史字段对象
+ */
+export function mapHealthInquiryToMrHistory(
+  health: HealthInquiryLike,
+  opts?: { sex?: number; age?: number },
+): Record<string, string> {
+  const hi = health || {};
+  const sex = Number(opts?.sex || 0);
+  const age = Number(opts?.age || 0);
+  const out: Record<string, string> = {};
+  for (const row of HISTORY_MAP) {
+    if (!isFieldVisible(row.visibility, sex, age)) continue;
+    out[row.mrKey] = resolveHistoryText(hi[row.statusKey], hi[row.historyKey]);
+  }
+  return out;
+}
diff --git a/apps/web-antd/src/views/doctor/patient-management/api/index.ts b/apps/web-antd/src/views/doctor/patient-management/api/index.ts
index 786116d1..e9f3ae6e 100644
--- a/apps/web-antd/src/views/doctor/patient-management/api/index.ts
+++ b/apps/web-antd/src/views/doctor/patient-management/api/index.ts
@@ -121,6 +121,8 @@ export interface PrescriptionItem {
   type: number;
   /** 状态 */
   status: number;
+  /** 是否支付 1已支付 0未支付 */
+  is_pay: number;
   /** 临床诊断 */
   clinical_diagnose: string;
   /** 患者信息 */
diff --git a/apps/web-antd/src/views/doctor/patient-management/components/PatientDetailModal.vue b/apps/web-antd/src/views/doctor/patient-management/components/PatientDetailModal.vue
index 4a53276f..2a4223c9 100644
--- a/apps/web-antd/src/views/doctor/patient-management/components/PatientDetailModal.vue
+++ b/apps/web-antd/src/views/doctor/patient-management/components/PatientDetailModal.vue
@@ -58,12 +58,22 @@ interface UserPatientHealthInquiry {
   renal_function: number;
   liver_index: string;
   renal_index: string;
+  present_status?: number;
+  present_history?: string;
   person_history: string;
   allergic_history: string;
   person_status: number;
   allergic_status: number;
   family_status: number;
   family_history: string;
+  epidemic_status?: number;
+  epidemic_history?: string;
+  personal_status?: number;
+  personal_history?: string;
+  menstrual_status?: number;
+  menstrual_history?: string;
+  marital_status?: number;
+  marital_history?: string;
   is_delete: number;
 }
 
@@ -236,6 +246,17 @@ const prescriptionColumns = [
     },
   },
   { title: '诊断', dataIndex: 'clinical_diagnose', key: 'clinical_diagnose' },
+  {
+    title: '支付状态',
+    dataIndex: 'is_pay',
+    key: 'is_pay',
+    customRender: ({ text }: { text: number }) =>
+      h(
+        Tag,
+        { color: Number(text) === 1 ? 'green' : 'orange' },
+        () => (Number(text) === 1 ? '已支付' : '未支付'),
+      ),
+  },
   {
     title: '状态',
     dataIndex: 'status',
@@ -561,6 +582,20 @@ function getSexText(sex: number): string {
                           </Tag>
                         </p>
                       </Descriptions.Item>
+                      <Descriptions.Item label="现病史">
+                        <span>{{
+                          Number(healthInfo.present_status) === 1 ? '有' : '无'
+                        }}</span>
+                        <p v-if="Number(healthInfo.present_status) === 1" class="mt-3">
+                          <Tag
+                            v-for="item in splitString(String(healthInfo.present_history || ''))"
+                            :key="item"
+                            color="#455cda"
+                          >
+                            {{ item }}
+                          </Tag>
+                        </p>
+                      </Descriptions.Item>
                       <Descriptions.Item label="既往史">
                         <span>{{
                           healthInfo.person_status === 0 ? '无' : '有'
@@ -606,6 +641,71 @@ function getSexText(sex: number): string {
                           </Tag>
                         </p>
                       </Descriptions.Item>
+                      <Descriptions.Item label="流行病学史">
+                        <span>{{
+                          Number(healthInfo.epidemic_status) === 1 ? '有' : '无'
+                        }}</span>
+                        <p v-if="Number(healthInfo.epidemic_status) === 1" class="mt-3">
+                          <Tag
+                            v-for="item in splitString(String(healthInfo.epidemic_history || ''))"
+                            :key="item"
+                            color="#455cda"
+                          >
+                            {{ item }}
+                          </Tag>
+                        </p>
+                      </Descriptions.Item>
+                      <Descriptions.Item label="个人史">
+                        <span>{{
+                          Number(healthInfo.personal_status) === 1 ? '有' : '无'
+                        }}</span>
+                        <p v-if="Number(healthInfo.personal_status) === 1" class="mt-3">
+                          <Tag
+                            v-for="item in splitString(String(healthInfo.personal_history || ''))"
+                            :key="item"
+                            color="#455cda"
+                          >
+                            {{ item }}
+                          </Tag>
+                        </p>
+                      </Descriptions.Item>
+                      <Descriptions.Item
+                        v-if="Number(patientDetail?.patient?.sex) === 2"
+                        label="月经史"
+                      >
+                        <span>{{
+                          Number(healthInfo.menstrual_status) === 1 ? '有' : '无'
+                        }}</span>
+                        <p v-if="Number(healthInfo.menstrual_status) === 1" class="mt-3">
+                          <Tag
+                            v-for="item in splitString(String(healthInfo.menstrual_history || ''))"
+                            :key="item"
+                            color="#455cda"
+                          >
+                            {{ item }}
+                          </Tag>
+                        </p>
+                      </Descriptions.Item>
+                      <Descriptions.Item
+                        v-if="
+                          (Number(patientDetail?.patient?.sex) === 1 && Number(patientDetail?.age) > 22) ||
+                          (Number(patientDetail?.patient?.sex) === 2 && Number(patientDetail?.age) > 20)
+                        "
+                        label="婚育史"
+                      >
+                        <span>{{
+                          Number(healthInfo.marital_status) === 1 ? '有' : '无'
+                        }}</span>
+                        <p v-if="Number(healthInfo.marital_status) === 1" class="mt-3">
+                          <Tag
+                            v-for="item in splitString(String(healthInfo.marital_history || ''))"
+                            :key="item"
+                            color="#455cda"
+                          >
+                            {{ item }}
+                          </Tag>
+                        </p>
+                      </Descriptions.Item>
                     </Descriptions>
                     <Empty v-else description="暂无健康信息" />
                   </Card>
diff --git a/apps/web-antd/src/views/system/vip/feature/api/index.ts b/apps/web-antd/src/views/system/vip/feature/api/index.ts
index cff34b15..9ea9582b 100644
--- a/apps/web-antd/src/views/system/vip/feature/api/index.ts
+++ b/apps/web-antd/src/views/system/vip/feature/api/index.ts
@@ -22,3 +22,17 @@ export async function updateVipFeature(data: Record<string, any>) {
 export async function deleteVipFeature(data: Record<string, any>) {
   return requestClient.post<any>(`${prefix}delete`, data);
 }
+
+/**
+ * 功能反绑会员等级
+ * @param data.id 功能 id
+ * @param data.code 功能编码（可选，有 id 即可）
+ * @param data.level_ids 勾选的等级 id 列表
+ */
+export async function bindVipFeatureLevels(data: {
+  id: number;
+  code?: string;
+  level_ids: number[];
+}) {
+  return requestClient.post<any>(`${prefix}bind-levels`, data);
+}
diff --git a/apps/web-antd/src/views/system/vip/feature/components/bind-levels-modal.vue b/apps/web-antd/src/views/system/vip/feature/components/bind-levels-modal.vue
new file mode 100644
index 00000000..1ae0efd5
--- /dev/null
+++ b/apps/web-antd/src/views/system/vip/feature/components/bind-levels-modal.vue
@@ -0,0 +1,281 @@
+<script lang="ts" setup>
+/**
+ * VIP 功能反绑会员等级：卡片勾选 + 徽章图 + 全选/取消全选/反选
+ * 真相源仍是 xk_vip_level.permissions
+ */
+import { computed, ref } from 'vue';
+
+import { useVbenModal } from '@vben/common-ui';
+import { Button, Empty, message } from 'ant-design-vue';
+
+import { getVipLevelOption } from '../../level/api';
+import { bindVipFeatureLevels } from '../api';
+
+type LevelCard = {
+  id: number;
+  name: string;
+  code: string;
+  badge_url: string;
+  weight: number;
+  price: number;
+};
+
+const feature = ref<Record<string, any>>({});
+const levelOptions = ref<LevelCard[]>([]);
+const selectedIds = ref<number[]>([]);
+const loadingOptions = ref(false);
+const onSaved = ref<null | (() => void)>(null);
+
+const selectedSet = computed(() => new Set(selectedIds.value));
+const selectedCount = computed(() => selectedIds.value.length);
+
+/** 是否已选中某等级 */
+function isSelected(id: number) {
+  return selectedSet.value.has(id);
+}
+
+/**
+ * 点击卡片切换选中（不用 CheckboxGroup，避免嵌套点击问题）
+ */
+function toggleLevel(id: number) {
+  const set = new Set(selectedIds.value);
+  if (set.has(id)) {
+    set.delete(id);
+  } else {
+    set.add(id);
+  }
+  selectedIds.value = Array.from(set);
+}
+
+/** 全选当前列表中的等级 */
+function selectAll() {
+  selectedIds.value = levelOptions.value.map((row) => row.id);
+}
+
+/** 取消全选 */
+function clearAll() {
+  selectedIds.value = [];
+}
+
+/** 反选 */
+function invertAll() {
+  const set = new Set(selectedIds.value);
+  selectedIds.value = levelOptions.value
+    .map((row) => row.id)
+    .filter((id) => !set.has(id));
+}
+
+/**
+ * 拉取启用中的等级选项（含徽章）
+ */
+async function loadLevelOptions() {
+  loadingOptions.value = true;
+  try {
+    const rows = await getVipLevelOption();
+    const list = Array.isArray(rows) ? rows : [];
+    levelOptions.value = list
+      .map((row: any) => ({
+        id: Number(row.id),
+        name: String(row.name || row.code || ''),
+        code: String(row.code || ''),
+        badge_url: String(row.badge_url || ''),
+        weight: Number(row.level_weight || 0),
+        price: Number(row.price || 0),
+      }))
+      .filter((row) => row.id > 0)
+      .sort((a, b) => a.weight - b.weight || a.id - b.id);
+  } finally {
+    loadingOptions.value = false;
+  }
+}
+
+const [Modal, modalApi] = useVbenModal({
+  title: '绑定会员等级',
+  class: 'w-[780px]',
+  draggable: true,
+  confirmText: '保存绑定',
+  async onConfirm() {
+    const id = Number(feature.value.id || 0);
+    if (!id) {
+      message.warning('功能无效');
+      return;
+    }
+    modalApi.setState({ confirmLoading: true });
+    try {
+      await bindVipFeatureLevels({
+        id,
+        code: feature.value.code,
+        level_ids: selectedIds.value.slice(),
+      });
+      message.success('绑定已更新（低档勾选会自动补齐更高档）');
+      onSaved.value?.();
+      modalApi.close();
+    } finally {
+      modalApi.setState({ confirmLoading: false });
+    }
+  },
+  async onOpenChange(isOpen: boolean) {
+    if (!isOpen) {
+      feature.value = {};
+      selectedIds.value = [];
+      onSaved.value = null;
+      return;
+    }
+    const data = modalApi.getData<{
+      feature?: Record<string, any>;
+      onSaved?: () => void;
+    }>();
+    feature.value = data?.feature || {};
+    onSaved.value = data?.onSaved || null;
+    await loadLevelOptions();
+    const ids = Array.isArray(feature.value.bound_level_ids)
+      ? feature.value.bound_level_ids.map((x: any) => Number(x)).filter(Boolean)
+      : (feature.value.bound_levels || []).map((x: any) => Number(x.id));
+    selectedIds.value = ids;
+    modalApi.setState({
+      title: feature.value.name
+        ? `绑定会员等级 - ${feature.value.name}`
+        : '绑定会员等级',
+    });
+  },
+});
+</script>
+
+<template>
+  <Modal>
+    <div class="mb-3 text-sm text-[hsl(var(--muted-foreground))]">
+      功能编码：
+      <span class="font-medium text-[hsl(var(--foreground))]">{{
+        feature.code || '—'
+      }}</span>
+      。点击卡片勾选/取消；勾选较低档时，更高档会自动补齐。
+    </div>
+    <div class="mb-3 flex flex-wrap items-center gap-2">
+      <Button size="small" @click="selectAll">全选</Button>
+      <Button size="small" @click="clearAll">取消全选</Button>
+      <Button size="small" @click="invertAll">反选</Button>
+      <span class="ml-auto text-xs text-[hsl(var(--muted-foreground))]">
+        已选 {{ selectedCount }} / {{ levelOptions.length }}
+      </span>
+    </div>
+    <Empty
+      v-if="!loadingOptions && !levelOptions.length"
+      description="暂无启用中的会员等级"
+    />
+    <div
+      v-else
+      class="grid max-h-[420px] grid-cols-2 gap-3 overflow-y-auto pr-1 md:grid-cols-3"
+    >
+      <div
+        v-for="opt in levelOptions"
+        :key="opt.id"
+        class="vip-level-card"
+        :class="{ 'vip-level-card--on': isSelected(opt.id) }"
+        @click="toggleLevel(opt.id)"
+      >
+        <div class="vip-level-card__check">
+          {{ isSelected(opt.id) ? '✓' : '' }}
+        </div>
+        <div class="vip-level-card__badge">
+          <img
+            v-if="opt.badge_url"
+            :src="opt.badge_url"
+            :alt="opt.name"
+            class="vip-level-card__img"
+          />
+          <div v-else class="vip-level-card__placeholder">
+            {{ (opt.name || opt.code || '?').slice(0, 1) }}
+          </div>
+        </div>
+        <div class="vip-level-card__name">{{ opt.name }}</div>
+        <div class="vip-level-card__meta">
+          {{ opt.code }} · 权重 {{ opt.weight }}
+        </div>
+      </div>
+    </div>
+  </Modal>
+</template>
+
+<style scoped>
+.vip-level-card {
+  position: relative;
+  display: flex;
+  flex-direction: column;
+  align-items: center;
+  padding: 14px 10px 12px;
+  border: 1px solid hsl(var(--border));
+  border-radius: 10px;
+  background: hsl(var(--card, var(--background)));
+  cursor: pointer;
+  transition:
+    border-color 0.15s,
+    background 0.15s,
+    box-shadow 0.15s;
+  user-select: none;
+}
+.vip-level-card:hover {
+  border-color: hsl(var(--primary) / 0.45);
+}
+.vip-level-card--on {
+  border-color: hsl(var(--primary));
+  background: hsl(var(--primary) / 0.08);
+  box-shadow: 0 0 0 1px hsl(var(--primary) / 0.25);
+}
+.vip-level-card__check {
+  position: absolute;
+  top: 8px;
+  right: 8px;
+  width: 20px;
+  height: 20px;
+  border-radius: 50%;
+  border: 1px solid hsl(var(--border));
+  background: hsl(var(--background));
+  color: hsl(var(--primary));
+  font-size: 12px;
+  line-height: 18px;
+  text-align: center;
+  font-weight: 700;
+}
+.vip-level-card--on .vip-level-card__check {
+  border-color: hsl(var(--primary));
+  background: hsl(var(--primary));
+  color: #fff;
+}
+.vip-level-card__badge {
+  width: 72px;
+  height: 72px;
+  display: flex;
+  align-items: center;
+  justify-content: center;
+  margin-bottom: 8px;
+}
+.vip-level-card__img {
+  max-width: 72px;
+  max-height: 72px;
+  object-fit: contain;
+}
+.vip-level-card__placeholder {
+  width: 56px;
+  height: 56px;
+  border-radius: 50%;
+  background: hsl(var(--muted) / 0.5);
+  color: hsl(var(--muted-foreground));
+  display: flex;
+  align-items: center;
+  justify-content: center;
+  font-size: 20px;
+  font-weight: 600;
+}
+.vip-level-card__name {
+  font-size: 14px;
+  font-weight: 600;
+  color: hsl(var(--foreground));
+  text-align: center;
+}
+.vip-level-card__meta {
+  margin-top: 4px;
+  font-size: 11px;
+  color: hsl(var(--muted-foreground));
+  text-align: center;
+}
+</style>
diff --git a/apps/web-antd/src/views/system/vip/feature/index.vue b/apps/web-antd/src/views/system/vip/feature/index.vue
index b2e66ca8..85af2c67 100644
--- a/apps/web-antd/src/views/system/vip/feature/index.vue
+++ b/apps/web-antd/src/views/system/vip/feature/index.vue
@@ -1,6 +1,6 @@
 <script lang="ts" setup>
 /**
- * VIP 功能字典列表：供等级 permissions 勾选的功能码维护
+ * VIP 功能字典列表：维护功能码，并支持反绑「开放给哪些会员等级」
  */
 import { onMounted, reactive, ref } from 'vue';
 
@@ -20,6 +20,7 @@ import {
 import { TableAction } from '#/components/table-action';
 
 import { deleteVipFeature, getVipFeatureList } from './api';
+import BindLevelsModal from './components/bind-levels-modal.vue';
 import FormModal from './components/modal.vue';
 import { STATUS_OPTIONS } from './config/constants';
 
@@ -38,6 +39,9 @@ const filters = reactive({
 const [FormModalComp, formModalApi] = useVbenModal({
   connectedComponent: FormModal,
 });
+const [BindLevelsModalComp, bindLevelsModalApi] = useVbenModal({
+  connectedComponent: BindLevelsModal,
+});
 
 async function loadList() {
   loading.value = true;
@@ -77,6 +81,15 @@ const showModal = (data: any = {}, isUpdate = false) => {
   formModalApi.open();
 };
 
+/** 打开反绑等级弹窗 */
+function openBindLevels(item: Record<string, any>) {
+  bindLevelsModalApi.setData({
+    feature: item,
+    onSaved: loadList,
+  });
+  bindLevelsModalApi.open();
+}
+
 const handleDelete = (id: number) => {
   deleteVipFeature({ ids: [id] }).then(() => {
     message.success('删除成功');
@@ -89,6 +102,7 @@ onMounted(loadList);
 <template>
   <Page auto-content-height title="VIP功能字典">
     <FormModalComp />
+    <BindLevelsModalComp />
     <div class="p-4">
       <div class="mb-4 flex flex-wrap items-center gap-3">
         <Input
@@ -135,6 +149,7 @@ onMounted(loadList);
           <template #extra>
             <TableAction
               :actions="[
+                { label: '绑定等级', onClick: () => openBindLevels(item) },
                 { label: '编辑', onClick: () => showModal(item, true) },
                 {
                   label: '删除',
@@ -147,10 +162,38 @@ onMounted(loadList);
               ]"
             />
           </template>
-          <div class="text-sm text-gray-600">
+          <div class="text-sm text-[hsl(var(--muted-foreground))]">
             <div>编码：{{ item.code }}</div>
             <div class="mt-1">说明：{{ item.description || '-' }}</div>
             <div class="mt-1">排序：{{ item.sort }}</div>
+            <div class="mt-2">
+              <div class="mb-1">已绑等级：</div>
+              <div
+                v-if="item.bound_levels && item.bound_levels.length"
+                class="flex flex-wrap gap-2"
+              >
+                <div
+                  v-for="lv in item.bound_levels"
+                  :key="lv.id"
+                  class="bound-vip-chip"
+                  :title="lv.name || lv.code"
+                >
+                  <img
+                    v-if="lv.badge_url"
+                    :src="lv.badge_url"
+                    :alt="lv.name || lv.code"
+                    class="bound-vip-chip__img"
+                  />
+                  <span v-else class="bound-vip-chip__fallback">{{
+                    (lv.name || lv.code || '?').slice(0, 1)
+                  }}</span>
+                  <span class="bound-vip-chip__name">{{
+                    lv.name || lv.code
+                  }}</span>
+                </div>
+              </div>
+              <span v-else class="text-xs">未绑定任何会员等级</span>
+            </div>
           </div>
         </Card>
       </div>
@@ -167,3 +210,40 @@ onMounted(loadList);
     </div>
   </Page>
 </template>
+
+<style scoped>
+.bound-vip-chip {
+  display: inline-flex;
+  align-items: center;
+  gap: 6px;
+  padding: 4px 8px 4px 4px;
+  border-radius: 8px;
+  border: 1px solid hsl(var(--border));
+  background: hsl(var(--muted) / 0.25);
+}
+.bound-vip-chip__img {
+  width: 28px;
+  height: 28px;
+  object-fit: contain;
+}
+.bound-vip-chip__fallback {
+  width: 28px;
+  height: 28px;
+  border-radius: 50%;
+  display: inline-flex;
+  align-items: center;
+  justify-content: center;
+  font-size: 12px;
+  font-weight: 600;
+  background: hsl(var(--muted) / 0.5);
+  color: hsl(var(--muted-foreground));
+}
+.bound-vip-chip__name {
+  font-size: 12px;
+  color: hsl(var(--foreground));
+  max-width: 88px;
+  overflow: hidden;
+  text-overflow: ellipsis;
+  white-space: nowrap;
+}
+</style>